Spontant planerad komplexitet i hjälpande relationer

I och med avinstitutionaliseringen av mentalsjukhusen har den dagliga hjälpen flyttat ut till hemmen och samhället, ofta med stöd av socialarbetare. Men vad vet vi då om hur hur praktiken på det här område har utvecklats, och vilka har konsekvenserna blivit?

Detta är något som studerats av Alain Topor och David Matscheck, genom intervjuer med både brukare och professionella. Du kan ta del av deras studie genom artikeln "Diversity, Complexity and Ordinality: Mental Health Services Outside the Institutions—Service Users’ and Professionals’ Experience-Based Practices and Knowledges, and New Public Management." 

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Topor, A. & Matscheck, D. (2021). Diversity, Complexity and Ordinality: Mental Health Services Outside the Institutions—Service Users’ and Professionals’ Experience-Based Practices and Knowledges, and New Public Management. International Journal of Environmental Research and Public Health, 18, 7075. https://doi.org/10.3390/
ijerph18137075

Abstract

In conjunction with the dismantling of psychiatric hospitals, social workers have been commissioned to help service users in their daily living in their homes and in the community. The consequences of these changes for experience-based knowledge and practices in their contexts remain relatively unknown. In this study, eighteen service users and the social workers they described as helpful for them were interviewed. The interviews were recorded, transcribed, and analyzed using Thematic Analysis. The following themes emerged: “Here, there and everywhere”, “Doing, being, becoming”, “Talking” and “Order, planning and improvisation” concerning the contradictions service users and professionals mentioned about their practices and the conditions imposed by managerial methods connected to New Public Management. Finally, “Spontaneous planned complexity” was chosen as our overarching theme to characterize the new knowledge and practices which have been developed. The displacement of the place for the encounter and the introduction of non-medicalized professions have allowed community-based practices and thus the co-creation and emergence of new knowledge about the service users as persons and the professionals as qualified professionals. The challenge remains for managers to have trust in their colleagues and not impose rigid rules, schematized methods, and repeated controls.