Unraveling reactionary care: the experience of mother-caregivers of adults with severe mental disorders in Catalonia

Abstract

In most Mediterranean countries, people diagnosed with severe mental disorders (SMDs) are typically cared for by the mother, causing a significant burden on people in this family role. Based on a broader mental health participatory action and qualitative research carried out in Catalonia (Spain) of 12 in-depth interviews and 3 focus groups, this article analyses the mother-caregivers' experience in the domestic space. The results show that patients and caregivers are engaged in a relationship of 'nested dependencies', which create social isolation. This produces the conditions of 'reactionary care', practices that limit the autonomy of those affected and that reproduce forms of disciplinary psychiatric institutions. We conclude that both institutional violence derived from economic rationality and that which stems from the gender mandate feed off each other into the domestic sphere. This research argues for placing care at the center of clinical practice and shows the need to consider the structural forces shaping it.