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Dr Felicity Thomas

Dr Felicity Thomas

Senior Research Fellow

4249 / 2820

South Cloisters 2.06

I am a Senior Research Fellow in the Medical School and a Research Fellow on the Cultural Contexts of Health in the College of Humanities.

After working for several years in the international development sector, I pursued doctoral research on the impacts of HIV and AIDS on rural livelihoods and social support networks in southern Africa. More recently, my work has focused on understanding and addressing the social and cultural factors that perpetuate health inequalities.

Drawing primarily on narrative, ethnographic and participatory approaches, my research examines the ways that people experience health and illness and make decisions over treatment use. I am particularly interested in understanding how certain health 'conditions' become medicalised, and the ways that this inter-relates with poverty, disadvantage and health-related inequalities. My current ESRC-funded project (DE-STRESS) is concerned with understanding how moral narratives relating to responsibility and welfare reform influence the medicalisation of distress and the uptake of antidepressants in low-income communities in the UK.

My work has focused on the health and well-being of low-income communities, migrants and families with complex needs; sexual health and HIV; environment-related health inequities; and the promotion of healthy schools.

I am co-director (with Professor Mark Jackson) of the WHO Collaborating Centre on Culture and Health and work closely with the WHO Regional Office for Europe project on the Cultural Contexts of Health (http://euro.who.int/en/data-and-evidence/cultural-contexs-of-health).

I have undertaken a number of consultancies including work for UNAIDS, WHO, the Ministerio da Educacao in Brazil, and the Departments of Health and Education and Communities, NSW, Australia. I was also on the external evaluation team of the Ford Foundation's Global Dialogues on Sexual Health and Well-being programme. 

Research

Research interests

Poverty, pathology and pills: moral narratives and the medicalisation of distress (ESRC ref: ES/N018281/1)

The provision of effective treatment and support for mental distress is a stated aim of the British Government and many civil society organisations. Within low-income communities, use of antidepressant medications is relatively high. However, current strategies frame mental distress as a psychological problem that lies within the individual concerned. This not only suggests that such distress can be 'corrected' through medical treatment, but also masks the factors that often underlie the root causes of suffering e.g. poor living conditions, unemployment. At the same time, policies in place to restrict welfare support, and popular media e.g. Benefits Street, draw on moralising narratives that promote the idea that people should take responsibility for their actions and circumstances. This research is exploring how people in low-income communities perceive and respond to mental distress caused by material deprivation and social disadvantage. Addressing key knowledge gaps, attention will be given to understanding: i) the role of moral narratives in influencing decisions to seek medical support for mental distress; ii) how these narratives manifest within GP consultations and influence treatment decisions and patient wellbeing.

Research team: Felicity Thomas (PI), Katrina Wyatt (Exeter), Rose McCabe (Exeter) and Richard Byng (Plymouth).

 

Cultural contexts of health (collaboration with WHO Regional Office for Europe)

Our experiences of health, and our interactions with those who care for us, are strongly influenced by the cultural contexts we inhabit. Yet whilst there has been a recent drive to understand the social determinants of health, the ways in which societal norms, value systems, traditions and beliefs impact on health pathways and outcomes are often ignored, as is the frequently positive, protective impact that culture can have in the face of certain health challenges. We are working with WHO to systematically investigate the cultural contexts of health and well-being across the European Region, and to embed humanities and social sciences research and methodological approaches into the public health sector.

Research team: Dr Felicity Thomas, Professor Mark Jackson

Research grants

  • 2016 Economic and Social Research Council
    The provision of effective treatment and support for mental distress is a stated aim of the British Government and many civil society organisations. Within low-income communities, use of antidepressant medications is relatively high. However, current strategies frame mental distress as a psychological problem that lies within the individual concerned. This not only suggests that such distress can be 'corrected' through medical treatment, but also masks the factors that often underlie the root causes of suffering e.g. poor living conditions, unemployment. At the same time, policies in place to restrict welfare support, and popular media e.g. Benefits Street, draw on moralising narratives that promote the idea that people should take responsibility for their actions and circumstances. This research aims to explore how people in low-income communities perceive and respond to mental distress caused by material deprivation and social disadvantage. Addressing key knowledge gaps, attention will be given to understanding: i) the role of moral narratives in influencing decisions to seek medical support for mental distress; ii) how these narratives manifest within GP consultations and influence treatment decisions and patient wellbeing. The objectives are to: 1) Use focus groups and ethnography to explore how moral narratives are used/resisted in the lives of people in low-income communities in relation to mental distress. 2) Use semi-structured interviews and video recordings to explore how moral narratives manifest within GP consultations. 3) Conduct repeat interviews and use audio-diaries to explore how individuals experience, talk about and embody mental distress following medical consultation. 4) Advance theoretical understandings within the fields of medical sociology, anthropology and public health by analysing how the medicalisation of socially and structurally induced distress affects wellbeing. 5) Identify responses to mental distress that effectively support people and inform ethical debates on the medicalisation of distress in a way that benefits patients, and assists practitioners and policy makers. This 30 month programme of research consists of two stages: 1) 96 people from 2 low-income areas will participate in focus groups to explore how moral narratives are used/resisted in people's daily lives. Groups will be divided by gender and age to identify differences between social groups. 2) Analysis of 60 video-recorded consultations between GPs and people from low-income backgrounds presenting with mental distress. In-depth analysis of 30 consultations will identify how GPs and patients interact (verbally and physically) and the ways this interaction influences decision-making to prescribe/accept or withhold/reject treatment. Further insights will be gained through interviews with 10 GPs in the study sites and repeat interviews with 40 people who have attended a GP consultation for mental distress. The first interview will focus on the person’s experiences of distress and the role of moral narratives in i) their decisions to seek medical consultation, and ii) in their responses to the treatment or intervention prescribed/accepted or withheld/rejected. The second interview will enable participants to reflect on their experiences of mental distress within the wider context of daily pressures e.g. poor living conditions, to reflect on their decision to seek medical support, and to reflect on the outcome of the GP consultation. The research programme is intended to have strong and distinctive impacts in academic, policy and user communities. This will be achieved by advancing understanding of i) people’s use/resistance of moral narratives of responsibility (why? when? how? where? with who?); ii) the relationship between moral narratives and the medicalisation of distress; iii) the ethical implications of prescribing antidepressants for distress induced by poverty/deprivation; iv) identification of GP-patient interactions that enable positive wellbeing.

Key publications | Publications by category | Publications by year

Key publications


Thomas F, Depledge M (2015). Medicine ‘misuse’: Implications for health and environmental sustainability. Social Science & Medicine, 143, 81-87. Full text.
Thomas F, Aggleton P (2015). School-based sex and relationships education: current knowledge and emerging themes. In Sundaram V, Saunston H (Eds.) Global Perspectives and Key Debates in SRE: Addressing Issues of Gender, Sexuality, Plurality and Power, Palgrave. Full text.
Thomas F (2015). The role of natural environments within women's everyday health and wellbeing in Copenhagen, Denmark. Health Place, 35, 187-195. Abstract.  Author URL.  Full text.
Thomas F, Sabel CE, Morton K, Hiscock R, Depledge MH (2014). Extended impacts of climate change on health and wellbeing. ENVIRONMENTAL SCIENCE & POLICY, 44, 271-278. Author URL.  Full text.
Thomas F, Gideon J (eds)(2013). Migration, Health and Inequality. London, Zed Books. Abstract.

Publications by category


Books

Thomas F (2016). Handbook of Migration and Health., Edward Elgar Publishing. Abstract.
Aggleton P, Parker R, Thomas F (eds)(2015). Culture, health and sexuality: an introduction. Abingdon, Routledge.
Thomas F, Gideon J (eds)(2013). Migration, Health and Inequality. London, Zed Books. Abstract.
Thomas F, Haour-Knipe M, Aggleton P (eds)(2010). Mobility, Sexuality and AIDS. Abingdon, Routledge. Abstract.  Author URL.

Journal articles

Thomas F, Aggleton P (In Press). A confluence of evidence: What lies behind a whole-school approach to health education in schools?. Health Education, 116(2). Full text.
Thomas F (In Press). Young people's use of medicines: Pharmaceuticalised governance and illness management within household and school settings. Social science & medicine Full text.
Thomas F (2017). Pharmaceutical waste in the environment: a cultural perspective. Public Health Panorama Full text.
Thomas F (2016). Climate change and health. Reference Module in Earth Systems and Environmental Science Full text.
Thomas F, Depledge M (2015). Medicine ‘misuse’: Implications for health and environmental sustainability. Social Science & Medicine, 143, 81-87. Full text.
Thomas F (2015). The role of natural environments within women's everyday health and wellbeing in Copenhagen, Denmark. Health Place, 35, 187-195. Abstract.  Author URL.  Full text.
Thomas F, Sabel CE, Morton K, Hiscock R, Depledge MH (2014). Extended impacts of climate change on health and wellbeing. ENVIRONMENTAL SCIENCE & POLICY, 44, 271-278. Author URL.  Full text.
Bennett C, Thomas F (2013). Seeking asylum in the UK: lesbian perspectives. Forced Migration Review, 42, 25-28.
Drew R, Aggleton P, Boyce P, Chalmers H, Maxwell C, Pachauri S, Thomas F, Warwick I, Wood K (2011). Social Network Analysis to evaluate organisational networks on sexual health and rights. Development in Practice, 21(8), 1062-1079. Abstract.
Thomas F, Aggleton P, Anderson J (2010). 'Experts', 'partners' and 'fools': exploring agency in HIV treatment seeking among African migrants in London. Social Science and Medicine, 70, 736-743. Abstract.  Author URL.
Thomas F, Aggleton P, Anderson J (2010). If I cannot access services then there is no need for me to test." the impacts of health service charges on HIV testing and treatment amongst migrants in England. , 22(4), 526-531. Abstract.  Author URL.
Chase E, Chalmers H, Thomas F, Hollingworth K, Aggleton P (2010). Shifting Policies and Enduring Themes in. School Nursing. British Journal of School Nursing, 5, 492-500.
Thomas F (2010). Transnational health and treatment networks: meaning, value and place in health seeking amongst southern African migrants in London. Health and Place, 16(3), 606-612. Abstract.  Author URL.
Evans R, Thomas F (2009). Emotional interactions and an ethic of care: caring relations in families affected by HIV and AIDS'. Emotions, Space and Society, 2(2), 111-119. Abstract.  Author URL.
Thomas F (2008). Indigenous narratives of HIV/AIDS: morality and blame in a time of change. Medical Anthropology, 27(3), 227-256. Abstract.
Thomas F (2008). Remarriage after spousal death: options facing widows and implications for livelihood security. Gender and Development, 16(1), 75-85. Abstract.
Thomas F (2007). Eliciting emotions: using solicited text and photo diary methods in HIV/AIDS research. Area, 39(1), 74-82. Abstract.  Author URL.
Thomas F (2007). Global rights, local realities: negotiating gender equality and sexual rights in the Caprivi Region, Namibia. Culture, Health and Sexuality, 9(6), 599-614. Abstract.  Author URL.
Thomas F (2007). Our families are killing us": witchcraft narratives and social tensions in the Caprivi Region, Namibia. Anthropology and Medicine, 14(3), 279-291. Abstract.  Author URL.
Thomas F (2006). Stigma, fatigue and social breakdown: exploring the impacts of HIV/AIDS on patient and carer well-being in the Caprivi Region, Namibia. Social Science and Medicine, 63, 3174-3187. Abstract.  Author URL.

Chapters

Thomas F (2016). Climate change and health. In  (Ed) Encyclopedia of the Anthropocene, UK: Elsevier. Full text.
Thomas F (2016). Cultural competence in migrant healthcare. In Thomas F (Ed) Handbook of Migration and Health, Edward Elgar, 459-476.  Full text.
Thomas F (2016). Migration and health: an introduction. In Thomas F (Ed) Handbook of Migration and Health, Edward Elgar Publishing, 3-18.  Abstract.  Full text.
Thomas F, Aggleton P (2016). School-Based Sex and Relationships Education: Current Knowledge and Emerging Themes. In  (Ed) Global Perspectives and Key Debates in Sex and Relationships Education: Addressing Issues of Gender, Sexuality, Plurality and Power, 13-29.
Thomas F, Hoyez A (2016). Socio-spatial dimensions of healthcare for newly arrived migrants. In Thomas F (Ed) Handbook of Migration and Health, Edward Elgar, 158-172.  Full text.
Aggleton P, Parker R, Thomas F (2015). From Sex to Sexuality: Sexual Cultures and Sexual Selves. In Aggleton P, Parker R, Thomas F (Eds.) Culture, Health and Sexuality: an introduction, Abingdon: Routledge. Full text.
Thomas F, Aggleton P (2015). School-based sex and relationships education: current knowledge and emerging themes. In Sundaram V, Saunston H (Eds.) Global Perspectives and Key Debates in SRE: Addressing Issues of Gender, Sexuality, Plurality and Power, Palgrave. Full text.
Thomas F, Gideon J (2013). Introduction. In Thomas F, Gideon J (Eds.) , London: Zed Books, 1-10.
Thomas F (2013). Multiple medicaments: looking beyond structural inequalities in migrant healthcare. In Thomas F, Gideon J (Eds.) Migration, Health and Inequality, London: Zed Books, 137-149.
Schifter J, Thomas F (2010). Fantasies, dependency and denial: HIV and the sex industry in Costa Rica. In Thomas F, Haour-Knipe M, Aggleton P (Eds.) Mobility, Sexuality and AIDS, London: Routledge.

Reports

Aggleton P, Thomas F (2012). Diversity in School. Brazil, Latin American Center in Sexuality and Human Rights.
Wood K, Aggleton P, Thomas F (2010). Developing sexual health programmes: a framework for action. World Health Organisation,  Geneva, WHO. Author URL.

Publications by year


In Press

Thomas F, Aggleton P (In Press). A confluence of evidence: What lies behind a whole-school approach to health education in schools?. Health Education, 116(2). Full text.
Thomas F (In Press). Young people's use of medicines: Pharmaceuticalised governance and illness management within household and school settings. Social science & medicine Full text.

2017

Thomas F (2017). Pharmaceutical waste in the environment: a cultural perspective. Public Health Panorama Full text.

2016

Thomas F (2016). Climate change and health. In  (Ed) Encyclopedia of the Anthropocene, UK: Elsevier. Full text.
Thomas F (2016). Climate change and health. Reference Module in Earth Systems and Environmental Science Full text.
Thomas F (2016). Cultural competence in migrant healthcare. In Thomas F (Ed) Handbook of Migration and Health, Edward Elgar, 459-476.  Full text.
Thomas F (2016). Handbook of Migration and Health., Edward Elgar Publishing. Abstract.
Thomas F (2016). Migration and health: an introduction. In Thomas F (Ed) Handbook of Migration and Health, Edward Elgar Publishing, 3-18.  Abstract.  Full text.
Thomas F, Aggleton P (2016). School-Based Sex and Relationships Education: Current Knowledge and Emerging Themes. In  (Ed) Global Perspectives and Key Debates in Sex and Relationships Education: Addressing Issues of Gender, Sexuality, Plurality and Power, 13-29.
Thomas F, Hoyez A (2016). Socio-spatial dimensions of healthcare for newly arrived migrants. In Thomas F (Ed) Handbook of Migration and Health, Edward Elgar, 158-172.  Full text.

2015

Aggleton P, Parker R, Thomas F (eds)(2015). Culture, health and sexuality: an introduction. Abingdon, Routledge.
Aggleton P, Parker R, Thomas F (2015). From Sex to Sexuality: Sexual Cultures and Sexual Selves. In Aggleton P, Parker R, Thomas F (Eds.) Culture, Health and Sexuality: an introduction, Abingdon: Routledge. Full text.
Thomas F, Depledge M (2015). Medicine ‘misuse’: Implications for health and environmental sustainability. Social Science & Medicine, 143, 81-87. Full text.
Thomas F, Aggleton P (2015). School-based sex and relationships education: current knowledge and emerging themes. In Sundaram V, Saunston H (Eds.) Global Perspectives and Key Debates in SRE: Addressing Issues of Gender, Sexuality, Plurality and Power, Palgrave. Full text.
Thomas F (2015). The role of natural environments within women's everyday health and wellbeing in Copenhagen, Denmark. Health Place, 35, 187-195. Abstract.  Author URL.  Full text.

2014

Thomas F, Sabel CE, Morton K, Hiscock R, Depledge MH (2014). Extended impacts of climate change on health and wellbeing. ENVIRONMENTAL SCIENCE & POLICY, 44, 271-278. Author URL.  Full text.

2013

Thomas F, Gideon J (2013). Introduction. In Thomas F, Gideon J (Eds.) , London: Zed Books, 1-10.
Thomas F, Gideon J (eds)(2013). Migration, Health and Inequality. London, Zed Books. Abstract.
Thomas F (2013). Multiple medicaments: looking beyond structural inequalities in migrant healthcare. In Thomas F, Gideon J (Eds.) Migration, Health and Inequality, London: Zed Books, 137-149.
Bennett C, Thomas F (2013). Seeking asylum in the UK: lesbian perspectives. Forced Migration Review, 42, 25-28.

2012

Aggleton P, Thomas F (2012). Diversity in School. Brazil, Latin American Center in Sexuality and Human Rights.

2011

Drew R, Aggleton P, Boyce P, Chalmers H, Maxwell C, Pachauri S, Thomas F, Warwick I, Wood K (2011). Social Network Analysis to evaluate organisational networks on sexual health and rights. Development in Practice, 21(8), 1062-1079. Abstract.

2010

Thomas F, Aggleton P, Anderson J (2010). 'Experts', 'partners' and 'fools': exploring agency in HIV treatment seeking among African migrants in London. Social Science and Medicine, 70, 736-743. Abstract.  Author URL.
Wood K, Aggleton P, Thomas F (2010). Developing sexual health programmes: a framework for action. World Health Organisation,  Geneva, WHO. Author URL.
Schifter J, Thomas F (2010). Fantasies, dependency and denial: HIV and the sex industry in Costa Rica. In Thomas F, Haour-Knipe M, Aggleton P (Eds.) Mobility, Sexuality and AIDS, London: Routledge.
Thomas F, Aggleton P, Anderson J (2010). If I cannot access services then there is no need for me to test." the impacts of health service charges on HIV testing and treatment amongst migrants in England. , 22(4), 526-531. Abstract.  Author URL.
Thomas F, Haour-Knipe M, Aggleton P (eds)(2010). Mobility, Sexuality and AIDS. Abingdon, Routledge. Abstract.  Author URL.
Chase E, Chalmers H, Thomas F, Hollingworth K, Aggleton P (2010). Shifting Policies and Enduring Themes in. School Nursing. British Journal of School Nursing, 5, 492-500.
Thomas F (2010). Transnational health and treatment networks: meaning, value and place in health seeking amongst southern African migrants in London. Health and Place, 16(3), 606-612. Abstract.  Author URL.

2009

Evans R, Thomas F (2009). Emotional interactions and an ethic of care: caring relations in families affected by HIV and AIDS'. Emotions, Space and Society, 2(2), 111-119. Abstract.  Author URL.

2008

Thomas F (2008). Indigenous narratives of HIV/AIDS: morality and blame in a time of change. Medical Anthropology, 27(3), 227-256. Abstract.
Thomas F (2008). Remarriage after spousal death: options facing widows and implications for livelihood security. Gender and Development, 16(1), 75-85. Abstract.

2007

Thomas F (2007). Eliciting emotions: using solicited text and photo diary methods in HIV/AIDS research. Area, 39(1), 74-82. Abstract.  Author URL.
Thomas F (2007). Global rights, local realities: negotiating gender equality and sexual rights in the Caprivi Region, Namibia. Culture, Health and Sexuality, 9(6), 599-614. Abstract.  Author URL.
Thomas F (2007). Our families are killing us": witchcraft narratives and social tensions in the Caprivi Region, Namibia. Anthropology and Medicine, 14(3), 279-291. Abstract.  Author URL.

2006

Thomas F (2006). Stigma, fatigue and social breakdown: exploring the impacts of HIV/AIDS on patient and carer well-being in the Caprivi Region, Namibia. Social Science and Medicine, 63, 3174-3187. Abstract.  Author URL.

I have a strong interest in interdisciplinary teaching at undergraduate and postgraduate levels and am keen to expand the medical curriculum to bring in the perspectives afforded by the humanities and social sciences. I am currently teaching on the following modules:

HISM017 Critical Approaches to Medical Humanities

HISM Medicine Across Borders

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