The rights and responsibilities of citizenship for service users: some terms and conditions apply

Abstract

Service users have long been lobbying for equal participation as citizens, yet citizenship is an important and largely overlooked concept within nursing education and practice. The study explored service users' understandings of their rights and responsibilities of citizenship and the conditions placed on these. A total of 17 service users participated in semi-structured interviews. Isin's theory of the content of citizenship was used to analyze the data using a framework approach. Service users experience conditional citizenship that includes barriers to their participation and their rights and responsibilities that others in society enjoy. When the world of the service user is constructed through the language of the biomedical model, nurses may unwittingly reinforce psychiatric labels and thus perpetuate the stereotype that service users lack the competence to fully enact their rights and responsibilities. When providing care, nurses should incorporate the notion of therapeutic jurisprudence and the principles of reciprocity, procedural justice and the implementation of advanced directives to reduce conditions on service users' status as citizens.