Agency in Youth Mental Health (2): Matthew Broome

Matthew Broome

This post is the second in a series of posts on a project on agency and youth mental health funded by the Medical Research Council and led by Rose McCabe at City University. The research team members were asked the same four questions and today it is Matthew Broome's turn to answer.

Matthew is an academic psychiatrist and Director of the Institute for Mental Health at the University of Birmingham. His main research interests lie in the field early psychosis and in the philosophy and ethics of mental health. 

What interests you about clinical encounters with young people in the mental health context?

There were two main drivers to my interest. One is very practical: as a psychiatrist I often see young people with mental health problems and am aware of the difficulties they can face in getting the help and understanding they would like. 

The second driver is more theoretical, but with potential clinical relevance. I became interested in how young people may change their conceptualisation of themselves, of their competence, agency, and responsibility, through the experience of clinical encounters and how the interactions with professionals could themselves shape that self-understanding, positively or negatively. Through studying these encounters, I hope we can improve the positive consequences for young people and lessen the negative impacts.

Why is the focus of agency important in this context?

Agency is important for us in the project as we want to examine how the young person is able to be an agent in the clinical encounter, that is, have their own views, opinions, and choices recognised and valued, and how we can improve these clinical meetings to further support agency. 

We’re aware that too much freedom and choice can itself be overwhelming, particularly when young people may be experiencing mental distress, but conversely, it’s important for young people not to be treated passively and not to have their views ignored. The agency of young people, both in terms of being a conveyor of knowledge and of being responsible for clinical and moral choices, is a key theme for us in the project and one that we see as being dynamic, and being in part connected with the interpersonal experience of the clinical encounter.

What do your experience and disciplinary background bring to the project?

I hope I have been able to bring my experience and background is as a medical doctor and clinical psychiatrist where I have worked with many young people with predominantly psychotic illnesses. In parallel, I have supported a close family member, who has had times of poor mental health, in their clinical consultations with professionals. In addition, I hope I have been able to bring a wider experience of how NHS services and professionals work, and how we train clinicians. 

In addition to clinical experience, I hope I have also brought an interest in philosophy and ethics of mental health care. Specifically, the ideas of the philosopher Miranda Fricker on epistemic injustice and how that can be experienced by young people with mental health problems, and themes from German Idealist philosophy, that run into twentieth century phenomenological-existentialism, namely, how the self is in some sense constituted by its relation with the Other.

What do you hope to see as an outcome of this project?

The main outcome I hope for is to take what we can learn from the clinical encounters and use it to help professionals in various settings (for examples, primary and secondary care, education) improve how clinical consultations are conducted, such that the mental health of young people is improved, and they are given support to enhance their agency in relation to their care and the choices they can make.