Barriers to collaboration between health care, social services and schools

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Background: </span></strong><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">It is essential for professionals from different organizations to collaborate when handling matters concerning children, adolescents, and their families in order to enable society to provide holistic health care and social services. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 11pt; font-family: " lang="EN-US"> </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Objective: </span></strong><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">This paper reports perceptions of obstacles to collaboration among professionals in health care (county council), social services (municipality), and schools in an administrative district of the city of Stockholm, Sweden. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 11pt; font-family: " lang="EN-US"> </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; font-family: " lang="EN-US">Methods: </span></strong><span style="font-size: 11pt; font-family: " lang="EN-US">Data were collected in focus group interviews with unit managers and employees. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 11pt; font-family: " lang="EN-US"> </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Results and discussion: </span></strong><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Our results show that the responsibility for collaboration fell largely on the professionals. Also, there was a <em style="mso-bidi-font-style: normal;">lack of clarity</em> regarding differences in mission and regulations, allocation of responsibilities, competence, explanatory models, and working approach. We conclude that a <em style="mso-bidi-font-style: normal;">holding environment</em> and a <em style="mso-bidi-font-style: normal;">committed management</em> would support these professionals in their efforts to collaborate.</span></p

Normalitetens gränser : En studie om 1900-talets mentalhygieniska diskurser

The comprehensive aim of the dissertation is to examine how ideas about mental hygiene have been elaborated and debated within the context of Swedish welfare. The dissertation is a compilation of four articles where issues of mental hygiene are examined in detail through an analysis of texts. In addition, a theoretical and methodological framework and a discussion of the concepts of mental health and normality are asserted to the dissertation. The subjects of research are (1) the launching of the movement in USA in the early twentieth, and the autobiographical narrative "A Mind That Found Itself" (Beers 1908), (2) the conception and the evolution of the movement in Sweden, (3) the psychosocial training within the education of social workers between the years 1939 –1989, and (4) the debate about the Mental health Campaign in 1969. The issues of mental hygiene and mental health discussed in the articles are elaborated in relation to the academic disciplines of Sociology of Health and Illness and the History of Public Health. The theoretical approach of these disciplines proceeds from a post-structural and social constructivist perspective of knowledge and language, a perspective also used in the interpretation of the textual materials. The section where the research methods are presented, consists of a description of how the textual materials have been selected and treated in relation to the theoretical and methodological standpoints. The outcome of the investigation of the autobiographical book "A Mind That Found Itself" (Beers 1908) in relation to the launching of the movement in the USA, is that the monomyth-character of the story supported an image of victory and hope, important for the movements aims to improve the reputation of psychiatry. Concerning the launching of the mental hygiene movement in Sweden two important conditions stands out as the course behind the rather hesitant start: the dominant position of custodial care and the antagonistic attitude towards psychoanalytical theories. The study of the psychosocial training of social workers showed how the skills of the clinical gaze were taught to the students by the technique of case-writing. The study of the Mental Health campaign in 1969 showed important divergences concerning the opinions of normality. Since the individual anatomy in the welfare system in Sweden is organised through the individuals position within the labour market, the issues of mental health and allied opinions of normality also contained the risks of exclusion. In conclusion, a comprehensive reflection concerning the results of the studies, is that the concept of mental hygiene, due to the mix of psychiatric and social knowledge, mediated shifting ideas about normality.At the time of the doctoral defence the following papers were unpublished and had s status as follows: Papar nr. 1: Manuscript; Paper nr. 3 Accepted Manuscript; Paper nr. 4: Manuscript.</p

Social Work and the Practice of Mental hygiene : The dispensary, the clinical gaze and the making of a case

The subject of this article is derives from my thesis Borders of Normality – discoursive practices of mental hygiene in the twentieth century. This comprehensive aim in this present text is to develop the ideas of the rise of modern knowledge and human science that Michel Foucault introduced in The Birth of the Clinic into the field of professional Social Work. During the midst of the twentieth century social workers created the concept of psychosocial work in close cooperation with the psychiatric profession. Mental hygiene was a public health- project which aimed to reach the “ordinary citizen” through practices of outward psychiatric care and social counselling. The issue addressed in the article is: -How did the medical professions influence the practice of psychosocial and mental hygiene social work? The analytical tools used in understanding the practices of mental hygiene are “the dispensary model”, “the clinical gaze” and “the construction of a case”. The “gaze” is an elaboration of the Foucaultian concept of the construction of medical knowledge and the dispensary practice relates to the new social perspectives of medicine in the twentieth century. The way of “seeing things” and the ways of organizing the clinical work, through “cases” construe a certain knowledge about the human kind. This technique was teached to social workers through The Mental hygiene Course and the course Training in Social Treatment between the years 1939 and 1989. The empirical materials consists of preserved materials of the course and the texts that are studied for the purpose of the article consists of pedagogic materials such as course books, papers, drafts and preparations for courses. A conclusion of the study is that the psychosocial training within the education of social workers was built on medical and psychological concepts and methods. The skills of the clinical gaze were trained through education in psychosocial theories. Theories, developed within medical and psychiatric practices, were applied to social work through the presentation of cases. The client, the ”owner” of the psychosocial problem, represented the case that confirmed the existence of psychosocial problems

The Meaning of Normality : The controversy about the mental health campaign in Sweden 1969

At the height of the Swedish welfare society, a campaign with the aim of promoting mental health issues within the Swedish labour market was launched. The title and purpose of the campaign, 'Mental health - an action of increased understanding and solidarity at work', was to illuminate mental health issues at work. Surprisingly to the organizers, the mental health campaign stirred up major opposition, especially from the political left. The idea of mental hygiene in an industrial and workplace setting, a cross-breed between the values of the Human Relations School and psychiatric science, was received with deep mistrust. The campaign caused an agitated debate in the media about power relations between employers and employees. The political disagreements were exposed in a number of articles in the daily newspapers and in the evening papers during the summer of that year. This article undertakes an investigation of the campaign literature and the media debate. The interpretation of the debate highlights different opinions about the meaning of normal mental health. Four different views of normality and mental health which demonstrate the complexity of the issue are presented. Mental health could mean adjustment and harmony, it could be a medical weapon to suppress the working class, it could even mean a neutral state of absence of mental problems, or lastly it could be a claim for the right to live a normal life

The Case of Psychosocial Work : The Pedagogic Discourse of Psychosocial Work in Sweden 1938-1989

This article examines the pedagogic discourse of The Mental Hygiene Course (1939–1970) and the subsequent Training in Social Treatment (1971–1989), in Stockholm.The aim is to investigate the development of the psychosocial concept in Sweden; how it was expressed when adapted to the changing discourses of psychiatry and psychoanalysis and to the regulative discourses of social policy during the time. The interpretation is undertaken through the guidelines of critical discourse analysis and Bernstein’s structural model of the discourse of education. The outcome of the textual analysis showed that the psychiatric and regulative discourses were transmitted into the local context of social work by a technique of case writing, and the social worker/client relationship of the cases was, throughout the period, congruent with current scientific assumptions and predominant social policy. In conclusion, the concept of psychosocial work from the 1980s, which is still in use, is a mixture of psychiatric and psychoanalytic assumptions and political demands, certifying both the function of social work and the status of the client. Finally, the problems of psychosocial work attached to the dependency of social policy and psychiatric knowledge are discussed in relation to the outcome of the investigation