Praxeological Analysis (PA/CPA) for Stigma, Health Inequalities, and Coercion in Women's Services A Methods/Protocol Paper

Phil Hutchinson^1*Loreen Chikwira²

• ¹Manchester Metropolitan University, Manchester, United Kingdom
• ²The King's Fund, London, United Kingdom

This paper sets out a practical, interview-free protocol for studying how stigma, inequalities, and restrictive practices are done in women's mental health, learning-disability, and autism services, with a particular focus on women detained in inpatient and other institutional settings. Building on Praxeological Analysis (PA) and Critical Praxeological Analysis (CPA), we specify data pathways for naturally occurring materials (clinical letters, triage logs, ward round notes, safeguarding records, complaint correspondence, public hearings/transcripts, and, where ethically approved, audio/video recordings of clinical interactions between people who use services and healthcare professionals), and a replicable analytic procedure keyed to linguistic/praxeological Gestalts. Rather than treating "stigma" as an attitude, attribute or variable, we investigate stigma in its sites of production, the situations in which discrimination, discreditation, degradation etc are done, experienced and witnessable. The protocol operationalises what we call a praxeological respecification: a shift from traits to scenes and from beliefs and attitudes to practices, enabling research and quality improvement that directly addresses the levers through which inequalities are produced and maintained and which supports least-restrictive, trauma-informed, autism-informed and culturally competent inpatient care in line with current NHS culture-of-care standards.