Methodology

Critical ethnographies are a way to provide an informed reflection based on real-world contact with mental health service users and providers in highly marginalized and simultaneously gentrified urban areas for a sustained period. A key strength of ethnographic case studies is the ability to tease out the underlying value systems of the specific organizational cultures and their contexts, which can then provide key lessons to understand other situations (22). Its questioning of the relationship of social order and social structures and its methods of “reconstructing social reality by privileging multiple voices” (23) are techniques indispensable to describing and explaining relationships between people and systems within the larger political, economic, social contexts (24). At the same time, critical ethnography is considered to be a methodology that refuses to separate theory from methods (25), thereby offering a way for professionals to become “more consciously aware of how they take up their professional authority in managed mental health care contexts” (26, p. 173). Moreover, ethnographic inquiry results in not only a “thick description” (27, p. 10) of the culture being studied but also an inductive analytical strategy that requires the researcher to uncover relationships in the context of the observational and interview data. I adopted a cross-paradigm framework, including Healy’s (28) conceptual model of critical practice that speaks to the importance of context and power relations in intervention construction and on Garfinkel’s (29) ethnomethodological focus on the interactional and in situ nature of interventions. The use of multiple frameworks is coherent with qualitative research and enhanced the research to “to see in new and different ways what seems to be ordinary and familiar” (30).

The ethical considerations specific to ethnography were considered, and they were attended to through a consistent reflexive stance and structured journaling. Although Husserl’s notion of “bracketing” and putting aside historical and cultural assumptions to attain objectivity is vigorously contested (31), the reflexive ethnographic researcher can acknowledge these assumptions to be more thoughtful, critical, responsible, and informed of potential biases, expectations, and judgments.