呻吟之王

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Professor Brian Brown

Job: Professor of Health Communication

Faculty: Health and Life Sciences

School/department: School of Applied Social Sciences

Address: De Montfort, University, The Gateway, Leicester, LE1 9BH.

T: +44 (0)116 207 8755

E: brown@dmu.ac.uk

W: /hls

 

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Personal profile

The core of Prof Brown's work has focused on the interpretation of human experience across a variety of different disciplines including health care, philosophy, education and spirituality studies, exploring how this may be understood with a view to improving practice and with regard to theoretical development in the social sciences. Particularly, this concerns notions of governmentality and habitus from Foucauldian and Bourdieusian sociology and how the analysis of everyday experience can afford novel theoretical developments.

Prof Brown has completed twelve books and around seventy refereed journal articles. Most notably, his books have included Evidence based health communication (with P. Crawford and R. Carter, Open University Press, 2006) and Evidence based Research: Dilemmas and debates in health care (with P. Crawford and C. Hicks, Open University Press, 2003). As well as health care, his papers have ranged across fields such as linguistics, education and sociology.

Notably this has included The habitus of hygiene (with P. Crawford, B. Nerlich and N. Koteyko, Social Science and Medicine, Post antibiotic apocalypse’: Discourses of mutation in narratives of MRSA, (with Paul Crawford, Sociology of Health and Illness 31 (4): 508-524, Soft authority: Ecologies of infection management in the working lives of modern matrons and infection control staff, (with Paul Crawford, Sociology of Health and Illness, 30, (5): 756-771), The clinical governance of the soul (with Crawford, Social Science and Medicine 55: 67-81) and Clinical governmentality (with P. Crawford and L. Mullany, Journal of Applied Linguistics 2: 273-298).

Research group affiliations

  • Applied Social Sciences Research Group
  • Health Policy Research Unit

Publications and outputs


  • dc.title: How do Muslim service users, caregivers, and community members in Malappuram, Kerala, use their faith to address the challenges associated with mental ill health? dc.contributor.author: Raghavan, Raghu; Brown, Brian J.; Hussain, Saliah; Kumar, Sanjana; Wilson, Amanda; Svirydzenka, N.; Kumar, Manoj; Ali, Ameer; Chandrasekharan, Anagha; Soletti, Asha Banu; Lakhanpaul, Monica; Iyer, Meena; Venkateswaran, Chitra; Dasan, Chandra; Sivakami, Muthusamy; Manickam, Sam; Barrett, Andy; Wilson, Mike dc.description.abstract: Our aim was to explore the role religion and spiritual beliefs play in dealing with the challenges associated with mental ill health among the Muslim community in Malappuram, Kerala. Twenty-four interviews were conducted with patients of Islamic faith diagnosed with a mental health condition (n鈥�=鈥�10) in urban (Ponnani) and rural (Vailathur) area of Malappuram, a Muslim majority district in Kerala, their family carers (n鈥�=鈥�8) and community members (n鈥�=鈥�6). Four key themes were derived, namely (1) Attribution to supernatural factors, (2) Relying on 鈥淕od鈥檚 will鈥�, (3) Prayer, and (4) Traditional healing. Faith was seen to be a prerequisite for any treatment, including modern medicine, to work. Even within a single faith group there can be considerable variation in belief and practice, with more pious participants disapproving of the reliance on local traditional healers and belief systems, highlighting the value of paying attention to the detail of local beliefs and practices. dc.description: open access article

  • dc.title: Using participatory action research methods to address epistemic injustice within mental health research and the mental health system dc.contributor.author: Mooney, Roisin; Dempsey, Clair; Brown, Brian J.; Keating, Frank; Joseph, Doreen; Bhui, Kam dc.description.abstract: In this paper, we describe a model of research practise that addresses epistemic injustice as a central objective, by valuing lived experience and addressing structural disadvantages. We set out here the processes we undertook, and the experiences of those involved in an attempt to transform research practise within a study known as Co-pact. We do not discuss the findings of the research. Rather, we wish to build expertise on how to address epistemic injustice and offer examples of participatory research processes, central values, and practical procedures that we implemented. dc.description: open access article

  • dc.title: Multiple Mental Health Literacies in a Traditional Temple Site in Kerala: The Intersection between Beliefs, Spiritual and Healing Regimes dc.contributor.author: Raghavan, Raghu; Horne, Francesca; Ram Kamal, Sreedevi; Parameswaran, Uma; Raghu, Ardra; Wilson, Amanda; Venkateswaran, Chitra; Svirydzenka, N.; Lakhanpaul, Monica; Dasan, Chandra; Brown, Brian J. dc.description.abstract: The notion of 鈥榤ental health literacy鈥� has been proposed as a way of improving mental health problem recognition, service utilisation and reducing stigma. Yet the idea embodies a number of medical-model assumptions which are often at odds with diverse communities鈥� spiritual traditions and local belief systems. Twenty participants were recruited to this study consisting of mental health service users (N = 7), family carers (N = 8) and community members (N = 5) in a temple town in Kerala, South India participated in semi structured interviews exploring the variety of beliefs and practices relating to mental health. Our findings indicate that the issue may be better understood in terms of multiple mental health literacies which people deploy in different circumstances. Even those sceptical of traditional and spiritual approaches are knowledgeable about them, and the traditional practices themselves often involve detailed regimes of activities aimed at effecting an improvement in the person鈥檚 mood or condition. Therefore, we argue it is appropriate to consider mental health literacy not as a unitary universal phenomenon but instead as a mosaic of different literacies which may be deployed in different settings and in line with different experiences and which may operate in synergy with each other to enable treatment but also facilitate a sense of meaning and purpose in life. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

  • dc.title: Stigma and mental health problems in an Indian context. Perceptions of people with mental disorders in urban, rural, and tribal areas of Kerala dc.contributor.author: Raghavan, Raghu; Brown, Brian J.; Horne, Francesca; Kumar, Sanjana; Parameswaran, Uma; Bin Ali, Ameer; Raghu, Ardra; Wilson, Amanda; Venkateswaran, Chitra; Svirydzenka, N.; Kumar, Manoj; Ram Kamal, Sreedevi; Barrett, Andy; Dasan, Chandra; Varma, Aarcha; Banu, Asha dc.description.abstract: Background The concept of stigma has been widely used to understand patterns of discrimination and negative ideas surrounding people with mental health problems, yet we know little of the specific nuances of how this might operate beyond the 鈥楪lobal North鈥�. Aim This paper aims to explore the notion of stigma in an Indian context by considering the lived experience of patients, carers and community members. Methods A sample of 204 participants, representing mental health patients, informal carers and community members was recruited from urban and rural areas in Kerala, India. Participants took part in interviews where they were encouraged to talk about their experiences of mental ill health, attitudes towards these problems, barriers encountered and sources of support. Results Experiences akin to the experience of stigma in Europe and the United States were elicited but there were important local dimensions specific to the Indian context. The difficulties faced by people with diagnoses of mental disorders in finding marriage partners was seen as an important problem, leading to marriage proposals being refused in some cases, and secrecy on the part of those with mental health problems. Rather than the 鈥榮elf-stigma鈥� identified in the US, participants were more likely to see this as a collective problem in that it could reflect badly on the family group as a whole rather than just the sufferer. Conclusions In the Indian context, the idioms of stigma emphasised impairments in marriage eligibility and the implications for the family group rather than just the self. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

  • dc.title: Imaginaries of patienthood: Constructions of HIV patients by HIV specialist health professionals dc.contributor.author: Brown, Brian J.; Jaspal, Rusi dc.description.abstract: This paper explores the ways in which HIV specialists based in the United Kingdom (UK) construct, conceptualise and imagine their patient group via the concept of the 鈥榠maginary鈥�, a notion encompassing the symbols, concepts and values through which people make sense of their social environment. In discussing their work with men who have sex with men (MSM), practitioners described patients as knowledgeable and highly adherent to treatment, yet apt to pursue hedonistic lives involving sex and recreational drugs. Recent innovations in treatment were formulated in terms of optimism and progress and the ascent of biomedical approaches was cast as an advance over former emphases on psychosocial interventions and attempts to facilitate behaviour change. In contrast to the imaginary of patients who were well-informed and highly compliant with treatment, participants also sought to explain those who were not easily enfolded within modern treatment regimens or who were seen to be overly emotional. These patients, it was said, had some pre-existing psychological problem or perhaps were especially vulnerable to societal pressures. Overall, the imaginary of the public was pervaded by therapeutic optimism, a sense of progress and an invigoration of biomedical themes in overcoming the challenges of delivering services to MSM. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

  • dc.title: 鈥榊ou鈥檇 think they鈥檇 know鈥�: social epistemology and informal carers of mental health service users dc.contributor.author: Brown, Brian J. dc.description.abstract: This paper considers the experience of informal carers for people with mental health problems from the point of view of social epistemology, where human knowledge is seen as a social achievement and people鈥檚 social position informs the kinds of knowledge they accumulate and deploy. Based on interviews with 31 carers for people with mental health problems, three areas of localised, specified epistemological activity were identified. First, the management of knowledge involved in shaping the situation to gain professionals鈥� recognition. Relatedly, the second theme concerned the participants鈥� construction of what it was that the professionals knew but which was felt to be withheld from carers. Finally, there were aspects of being a carer, such as dealing with the emotional friction in the caring relationship which either 鈥榥obody tells you about鈥� or which 鈥榶ou can鈥檛 tell anyone鈥�. Examining these experiences through the lens of social epistemology highlights the interactive and personal work that carer participants did to create, shape and manage both knowledge itself and their relationships with health professionals and the cared-for person. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

  • dc.title: Idioms of resilience: Mental health and migration in India dc.contributor.author: Raghavan, Raghu; Brown, Brian J.; Coope, Jonathan; Crossley, Mark; Sivakami, Muthusamy; Gawde, Nilesh; Pendse, Tejasi; Jamwal, Saba; Barrett, Andy; Dyalchand, Ashok; Chaturvedi, Santosh; Chowdary, Abijeet; Heblikar, Dhanashree dc.description.abstract: Background: Resilience has proved to be a versatile notion to explain why people are not defeated by hardship and adversity, yet so far, we know little of how it might apply to communities and cultures in low to middle income countries. Aim: This paper aims to explore the notion of resilience in cross-cultural context through considering the lived experience of internal migration. Methods: A sample of 30 participants with experience of migration was recruited from a low-income slum dwelling neighbourhood in the city of Pune, India. These individuals participated in biographical narrative interviews in which they were encouraged to talk about their experience of migration, their adaptation to life in their new environment and making new lives for themselves. Results: Participants referred to a variety of intra-individual and external factors that sustained their resilience, including acceptance of their circumstances, the importance of memory, hope for their children鈥檚 futures as well as kindness from family friends and community members and aspects of the physical environment which were conducive to an improvement in their lives. Conclusions: By analogy with the widely used term 鈥榠dioms of distress鈥�, we advocate attention to the locally nuanced and culturally inflected 鈥榠dioms of resilience鈥� or 鈥榚udaemonic idioms鈥� which are of crucial importance as migration and movement become ever more prominent in discussions of human problems. The nature and extent of people鈥檚 coping abilities, their aspirations and strategies for tackling adversity, their idioms of resilience and eudaemonic repertoires merit attention so that services can genuinely support their adjustment and progress in their new-found circumstances. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

  • dc.title: Conflicting experiences of health and habitus in a poor urban neighbourhood: A Bourdieusian ethnography dc.contributor.author: Scott-Arthur, Tom; Brown, Brian J.; Saukko, Paula dc.description.abstract: An ethnographic study of health and wellbeing was undertaken in a deprived urban neighbourhood in the UK Midlands. Drawing on Bourdieu's concepts of habitus, capital and field, we discerned three different, even conflicting, ways of understanding and acting on health: (i) older adults discussed their wellbeing in relation to the local context or field, walking the dog, helping at the community centre and visiting the off licence, (ii) young professionals and students who lived in the neighbourhood were oriented towards leisure facilities, career opportunities and supermarkets outside of the neighbourhood, disdaining local facilities and (iii) community activists and carers discussed health in terms of providing for others but not themselves. Bourdieu is frequently used in medical sociology to highlight how poor people's lifestyle is constrained by their habitus; we suggest paying more attention to its both enabling and differentiating contradictions as well as the constraints it entails. Empirically and in terms of health promotion findings suggest that supposedly healthy activities, such as going to the gym, may also be a means of rejecting the local community; similarly, older people's pottering about in the neighbourhood, which is not usually recognised as a healthy activity, may enhance wellbeing in this context. dc.description: open access article

  • dc.title: Intimate citizenship and mental ill health: Informal carers鈥� accounts of romantic relationship difficulties of people with mental health problems dc.contributor.author: Brown, Brian J. dc.description.abstract: In this paper I take a relational approach to understanding the experiences of carers in enabling the 鈥榠ntimate citizenship鈥� of people with long-term mental health problems. This aspect of informal care has received little attention, yet the relational context in which intimacy occurs is important as a background to the more frequently addressed questions of sex and sexuality themselves. Thirty-one carers were asked about their experience of caring. Of those who were partners or spouses of the person cared for, a sense of diminished erotic capital and romantic potential appeared common. For those caring for a relative, there was a sense that their romantic opportunities were restricted and rendered risky by their mental health problems. The interviews suggest substantial relational activity is undertaken to make intimate life possible, which is an important area of investigation if we are to appreciate the barriers to sexual participation of people with mental health problems. dc.description: The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

  • dc.title: Introduction: Trauma and textualities dc.contributor.author: Brown, Brian J.; Rodrigues, Ricardo; Baker, Charlotte; Crawford, Paul dc.description.abstract: This special issue of the Journal of Medical Humanities focuses on papers from an International Health Humanities Network conference held in Nottingham, UK. Informed by the centenary of World War I, the theme of 鈥榯rauma鈥� was chosen, and the presentations over the lively three-day meeting included a wide range of topics such as trauma in literature and text; managing trauma in clinical practice related to domestic violence and abuse; a theatrical performance involving trauma, personal history and theory; and using humanities in clinical education to offer new ways of making sense of and addressing trauma. dc.description: Editorial for a special issue based on a health humanities conference we hosted at Nottingham.

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Research interests/expertise

  • Health communication
  • Health policy
  • The historical sociology of Wales
  • Philosophy of Science
  • Epistemology
  • Social theory.

Areas of teaching

  • Theoretical and epistemological perspectives in the social sciences
  • Mental health issues,
  • Qualitative methodologies,
  • Sociology.

Current teaching includes:

  • Final year projects PSYC3000
  • Research designs in health HEST5001
  • Interpreting quantitative nd qualitative data HEST5016 
  • PhD, M.Res, MA and DHSci dissertations
  • University’s training programme for research students.

Qualifications

BSc PhD

Conference attendance

Brown, B.J. “Power and responsibility: Devolving risk to patients in an age of neoliberalism” Medical Humanities Conference, Swansea, April 2011.

Brown, B.J. ‘‘Talking about Health in English’ International Conference on English for Specific Purposes at Fooyin University November 2008.

Brown, B.J. ‘Hygiene as habitus: Putting Bourdieu to work in hospital infection control’ Emerging Diseases: Structure, controversy and change in the scientific constitution of disease patterns, University of Hamburg, February 2008.

Current research students

Prof Brown currently has 12 PhD students undertaking research on a variety of topics, including communication between health professionals and clients, the role of emotions in human service work, the role of ancient Cypriot art in contemporary creative practice and the life narratives of people in the health professions. He has examined PhD candidates on 28 occasions. 

Externally funded research grants information

AHRC programme Grant for 'Creative practice as mutual recovery: Connecting communities for mental health and wellbeing'. This is a multi-centre study involving the universities of Nottingham, Derby, Wolverhampton, Falmouth and the Royal College of Music. This programme of related projects will attempt to bring together service users, carers and practitioners in creative activities centred upon music, photography, sculpture and storytelling as well as adult education. £1.5m 2013-2018.      

CI in International Health Humanities Network Funded by the AHRC. With Paul Crawford to provide a website, a seminar series and a conference to promote the health humanities £38,000, August 2011 – July 2013.

CI in Experiences of surgical site infection Study funded by the Infection Prevention Society 2011-2012 with Judith Tanner and Wendy Padley. £4,985.

Madness in contemporary English literature. A study of the representation of madness in post 1945 English language fiction funded by the Leverhulme Trust (£91,830) with a team from Nottingham University including Paul Crawford (principal investigator) Ronald Carter, Maurice Lipsedge. March 2007-March 2010.

Cleanliness and infection control; A comparative study of discourses of cleanliness in health and agriculture examining discourses surrounding biosecurity concentrating on infections such as MRSA and zoonoses such as avian flu, funded by the ESRC (£151,000) with a team from Nottingham University, including Brigitte Nerlich (principal investigator) Paul Crawford, Ronald Carter. Rated ‘outstanding’. May 2006 to October 2008.

Mothers, Wives and Changing Lives; A project concerned with oral history and women’s working lives in mid-twentieth century Wales, funded by the British Academy (£6655) with a team from Bangor University including Howard Davies and Sally Baker. January 2007 - March 2007.

Internally funded research project information

Healthcare-Associated Infection Control in the Ambulance Service. Grant from 呻吟之王’s Revolving Investment Fund to conduct a study of healthcare associated infection risk and infection control in the ambulance service. October 2010 to July 2011.

The experience of illness. Grant from 呻吟之王’s pump priming fund to conduct a study of peoples’ experience of long term, non–life-threatening illness. February 2005 – July 2005.

Role plays in the assessment of nurses undergoing training as nurse prescribers. Grant from 呻吟之王’s pump priming fund to cover equipment and transcription costs. February 2002 – July 2002.

Online learning for postgraduates in qualitative methodology Funded through the Roberts scheme, this project sought to develop an online learning module in qualitative methodology for 呻吟之王’s postgraduate students, with Simon Rogerson and Matthew Croft Wake. This led to the development of module no. REST7526. July 2009-July 2010.

Professional esteem indicators

Prof Brown has served as a reviewer for Social Science and Medicine, Journal of Social Work, Journal of Applied Linguistics, Human Relations, Journal of Advanced Nursing, Feminism and Psychology, Health Risk and Society, Biomed Central, Diversity in Health and Care, Sociologia Ruralis, Health and Social Care in the Community.

Guest editor of special issues Journal of Medical Humanities (2015 and 2012) and Mental Health Review (2011) on the humanities in health care.

Case studies

Brief communication in health care
A current focus of interest is that of brief encounters and brief communication in health care. Initial indications suggest that relatively fleeting encounters can make a huge difference to the emotional feel of the health care experience and can even accelerate recovery for patients. Despite guidance in documents such as Tomorrow’s Doctors (General Medical Council, 2009) which stresses the desirability of involving patients in decision making about their care and Good Medical Practice (2009) emphasising working in partnership with patients, a production line approach all too frequently prevails in practice. Even in formally scheduled consultations, the emphasis is often to elicit information and undertake standardized assessments as quickly as possible rather than form a supportive social relationship. Therefore there is an urgent need to explore how these time-limited encounters can be rendered as effective as possible. Our work on what we have called ‘Brief, Ordinary and Effective’ (BOE) communication in health care has already excited interest. It has informed the Chief Nursing Officer’s report on Mental Health Nursing (Department of Health, 2006), which required application in all mental health nurse training and practice in the UK. More recently, the commissioned report into the impact of Chief Nursing Officer’s review found that the BOE-driven communication competencies and capabilities achieved the highest implementation score for Higher Education Institutions (HEIs) (Callaghan et al, 2010). The BOE Model was originally presented in outline in Brown et al (2006) and further developed in Crawford et al (2006) and Brown and Crawford (2011). Possible future developments include further dissemination via Managed Innovation Networks and a book length monograph for which we have commenced negotiation with publishers.

Health Humanities
An unexpected area of success over the last few years has concerned the health humanities. This represents an attempt to explore interrelationships between the humanities and health care disciplines and the contribution of the humanities and arts to the full range of health care disciplines. It represents a broader and more inclusive approach than the existing medical humanities, which has often focussed on the ethics, history and philosophy of medicine itself. This new discipline also offers the possibilities of innovative and creative contributions to therapeutic activity. This ambition was prompted by our success in obtaining a Leverhulme grant to study representations of madness in English literature from 1945 to the present, and an AHRC grant to set up a ‘Madness and Literature Network’. This yielded a seminar series through 2008-2010 and culminated in an international conference in August 2010 attracting speakers from the US and over 30 other countries in the global scholarly community. Of particular note were contributions from internationally renowned scholars Elaine Showalter (The Female Malady) and Kay Redfield Jamison (Touched by Fire, An Unquiet Mind). Following on from this we have guest edited a special issue of Journal of Medical Humanities (for over thirty years the leading journal in the medical humanities field) composed of key papers from the conference. In addition we edited a special issue of Mental Health Review on the role of the humanities in mental health care.

The AHRC have also generously supported our International Health humanities Network http://www.healthhumanities.org/.

We have recently secured an AHRC Programme Grant to fund a multi centre study of arts and humanities in mental health care, involving scholars and practitioners from numerous institutions. The initiatives in this programme include projects concerned with photography, music, sculpture, and storytelling where service users, carers and practitioners are brought together to benefit from creative activities. 

This health humanities initiative offers the possibility of international leadership in a field poised to develop rapidly in the next few years. It offers also the opportunity to develop novel interdisciplinary collaborations and creative syntheses. From the point of view of the health and social sciences it provides innovative means of dissemination and impact, through exhibition, performance, drama and literature as well as formal academic publishing, to seek new syntheses, develop further humanities and arts based interventions in health and social care and enhance dissemination and impact.

Brown