Listening well to psychiatric service users: What does it mean to give uptake?

Abstract

Communication is central to good healthcare, with clinician, patient, and family members all playing a key role in identifying the needs and treatment options for the patient. Because good healthcare is person-centered, communication needs also to be person-centered - with the patient as the primary focal point - even though there may be several other parties who have interests and concerns for the patient. But in what does good communication consist? This article delves more deeply into the question of what is entailed in listening well, expanding on the concept of uptake as introduced by J.L. Austin. I apply uptake to psychiatric service users; because of persistent stigma, implicit bias, and stereotyping, this population faces some unique challenges when it comes to being listened to and taken seriously, This is especially true for members of Black, minority and ethnic groups. While the focus of this article is on uptake, I also discuss some kinds of silencing that may be at play in clinical encounters and in co-production. However, many questions are left unanswered as to when and how uptake is properly given, and when, if ever, it should not be given. The final section of this paper speaks to the need for others to engage in research and practical engagements so that this vitally important practice can be taught and employed. Here, I raise a number of questions that need to be addressed in order for a deeper understanding can develop about what it means to give uptake well.