An "ideal-type" of trust? Using Schutz to relate trust in systems to trust in individual professionals in the context of mental health services
School of Social Policy, Sociology and Social Research University of Kent Canterbury, United Kingdom
School of Social Policy, Sociology and Social Research University of Kent Canterbury, UK
Trust in healthcare systems, and indeed individual professionals, has received much recent attention and a significant literature now exists. Research suggests that perceptions of individuals and the systems within which they work are related, but neither necessary nor sufficient in explaining one another. Though clearly defined and differentiated, there is a lack of theory which reconciles trust in systems with trust in individual experts in explaining why some may trust the individual but not the system, or vice versa. Giddens, for example, suggests confidence in systems is extended into specific inter-personal scenarios but this does not aid in explaining such conflicting trust perspectives. Moreover whilst facework at the "access points" is described as being decisive, there is little explanation as to why this is the case. This paper uses the phenomenology of Alfred Schutz to analyse this relationship and in particular applies his concept of "ideal-types" as a means of understanding the building blocks of inferential knowledge through which trust functions.
Trust - either in healthcare systems or individual professionals - involves the application of "ideal-typical" assumptions. Such assumptions are made as to the motives and capabilities of institutions - inferred from limited knowledge and experience. Similarly, beliefs are constructed regarding the competency and care of practitioners based on ideal-typical notions of how such characteristics appear as embodied by an individual. So whilst the extent to which trust is ether "assumed" or "conditional" may vary between when it is directed towards institutions or individuals, the inferential process is the same. Rather it is the nature of ideal-typical knowledge being applied which varies and Schutz clarifies why some such knowledge may be more "concrete" and therefore compelling than others.
The context of mental healthcare is used as an illustration, especially as it is a domain where issues of mistrust in healthcare institutions may be especially salient for service-users.