The work coordinators do. An organisational reflection on the coordination function as enactive of change in complex policy fields.

In this paper, we reflect on the work of coordinators in the fields of mental healthcare and internment. We examine the contribution of this new type of workers to the implementing of policy plans targeting complex social problems, such as the issue of mental health care fragmentation. We outline a theoretical and methodological framework appropriate to the study of coordination in action, before describing the coordinators’ working environment, concrete coordination practices and the occasions in which they are visible. Based on this empirical description, we argue that the coordinator work begin more with ignorance than with knowledge and that coordinators do not know precisely who they are, as coordinators, both individually and collectively. Neither do they know exactly what to do. The coordinators’ world is nevertheless full of knowledge: there are plenty of experts claiming diverging interpretations of the complex problems addressed by the coordinators. Therefore, we ask how the coordinators deal with their ignorance in such an ambiguous world, that is, a world characterised by both an abundance of knowledge and a scarcity of resources. We show that postulating the coordinators ignorance helps to see what is the core of their function and how they perform their work, that is, by attending and scheduling meetings where previously separated and incommensurable events are linked together

Virtual Meetings during the Pandemic: Boon or Bane for Gender Inequality

Prior research has revealed gender inequalities in (pre-pandemic) face-to-face meetings in terms of the inclusivity of meeting participant composition and the difficulty of participants to speak up during meetings. Since the start of the Covid-19 pandemic, the majority of meetings have been held virtually. The virtual nature of meetings offers flexibility in terms of including participants and it neutralizes some physical cues related to power dynamics. However, gender inequalities have also been identified related to the lockdown and work-from-home measures. Therefore, we set out to explore how the sudden switch to virtual meetings impacted gender inequalities in workplace meetings, in terms of the number of meetings participated in and difficulty to speak up, while controlling for hierarchical rank. Based on survey responses of 542 academic researchers, our exploratory findings indicate that virtual meetings mirror organizational gender inequalities and that these inequalities have exacerbated since the pandemic

Meeting Boundaries: Exploring the Faces of Social Inclusion beyond Mental Health Systems

This article examines social inclusion in the context of the deinstitutionalisation of mental health care. It draws on a scientific evaluation of the Belgian reform of mental health care (2010), designed to assess the influence of organisational mechanisms on the social and care trajectories of service users. The findings highlight the ongoing challenge for mental health systems to support the inclusion of service users within the community, and the increasingly difficult access to mental health care for people with complex and chronic mental health problems. Drawing from Systems Theory (Luhmann, 2013) and the analysis of subjective experiences, this article delves into the complex processes of social inclusion using the empirically-grounded concepts of the patient role and the impatient role. By acknowledging the relational dimensions of social inclusion, this article argues that complementarities between two faces of the mental health system are key to achieving inclusion beyond the walls of institutions and within society at large

La réunion comme parenthèse

In this presentation, I suggest studying "the meetings" for themselves, by considering them as a topic for research and not as tool for doing researches on other topics as problem-solving and policy-making. By drawing on a sociological research on a Belgian reform of mental healthcare delivery, I argue that the concept of bracketing might be used to identify the forms and to analyse the various roles played by meetings, or what the meetings do to the organisational and policy work

Perlindungan Konsumen Undang-Undang No.8 tahun 1999 terhadap Pelecehan oleh Mitra Grab Jasa Transportaasi Online

Hasil penelitian ini menunjukkan bahwa masyarakat dapat memahami terkait dengan perlindungan konsumen atas pelecehan seksual yang terjadi pada konsumen pengguna jasa transportasi online. Dan terhadap pelaku pelecehan seksual teersebut dapat dihukum dengan ketentuan hukum yang berlaku serta dapat diberikan sanksi oleh pihak perusahaan berupa pembekuan akun mitra bahkan bisa saja sampai pada putus mitra sesuai dengan kode etik perusahaan jasa transportasi online

The Belgian Reform of Mental Health: Changing the Face of Psychiatric Hospitals

This paper focuses on the ongoing reform of psychiatric and mental health care delivery in Belgium. It starts by mentioning particularities of the system’s development, then it defines the reform’s objectives and policy instruments used to reach these objectives and, finally, it indicates specific issues and outcomes resulting from the implementing

Enjeux, obstacles et atouts d'un modèle de soins aux contours indéterminés

Cette contribution porte sur les enjeux que soulève la réforme des soins de santé mentale en Belgique, au carrefour de l’évolution socio-historique du secteur, et d’un modèle des soins inscrit au sein de tendances internationales. Précisément, l’objectif est de mettre en tension l’indétermination du modèle, au sens où il renvoie à un ensemble d’expériences étrangères plus qu’un un corpus de savoirs; et la configuration d’une offre de soins encore déterminée par ses frontières institutionnelles

Changements institutionnels dans le champs de la santé mentale en Belgique: dynamiques écologiques et sociales

Ce texte examine les changements passés et actuels dans les politiques publiques de santé mentale belge, en s’appuyant sur une approche constructiviste des systèmes professionnels. Dans un premier temps, cette approche permet de comprendre les dynamiques sociales propres aux réformes passées, et de montrer comment ces dynamiques expliquent les caractéristiques actuelles du système belge des soins de santé mentale ; en particulier sa spécialisation, sa segmentation et sa complexité. Dans un second temps, cette approche est appliquée à l’analyse la réforme actuelle de la santé mentale « Vers de meilleurs soins de santé mentale par la réalisation des réseaux et circuits de soins ». En ce qui concerne la réforme, l’approche constructiviste permet de d’identifier et de faire sens des continuités et des discontinuités entre cette réforme et les réformes précédentes. Ensuite, elle permet de saisir la possibilité qu’ont des connaissances locales, développées et portées par les acteurs de terrain, d’impacter sur des changements globaux dans le système. Les chemins particuliers qu’empruntent les connaissances locales pour circuler vers le changement global sont mis en évidence en recourant à la phénoménologie des connaissances en politique, ou Embodied, Inscribed, Enacted Knowlegde in Policy. Celle-ci offre effectivement la possibilité de faire des allers-retours entre le global et le local, pour montrer comment différentes idées relatives à la réforme circulent, et comment ces idées sont assemblées et réassemblées aux niveaux global et local

How does policy learning occur? The case of Belgian mental health care reforms

This article asks how policy learning is achieved and whether and how it impacts on policy change. By drawing on the empirical case of Belgian mental health reforms, it shows that policy learning occurs through the very practice of policy-making. In-depth analyses of the process of preparing and devising, a current reform of mental health care delivery, called Reform 107, evidence that the transformation of policy learning – through verbal expression, inscription in documents or enactment in social situations such as meetings – is crucial to its impact on policy change. A phenomenological approach to knowledge in policy helps to perceive and describe the transformation of policy learning through practical actions and interactions involved in devising policy change. Analytically, looking at this transformation entails shifting the focus from big and visible changes in policy objectives and instruments to micro policy practices such as meeting and writing documents. Placing the focus on micro policy practices should not lead, however, to a disregard for the social context in which they develop. The interactionist concept of linked ecologies provides the means to consider social regulations influencing policy learning without underestimating their very ephemeral and contingent natur

Le champ de la santé mentale en Belgique à l’épreuve de la concertation : entre participation politique et politique de la participation

Dès le début des années 2000, l'Organisation Mondiale de la Santé invite les gouvernements à promouvoir la santé mentale de leurs citoyens, et en propose une conception spécifique ainsi que des solutions thérapeutiques et politiques, parmi lesquelles la participation des usagers. Progressivement, les recommandations de l'OMS intègrent le discours politique belge. Il faut pourtant attendre 2005 pour qu'elles trouvent une expression tangible, au sein d'un dispositif d'action publique. Celui-ci comprend deux niveaux. D'une part, des projets locaux au sein desquels professionnels et usagers expérimentent les conditions de travail en réseaux de soins. D'autre part, un volet transversal où les représentants des projets partagent les enseignements issus de pratiques novatrices, afin de les inscrire au sein de recommandations destinées aux décideurs politiques. Au travers d'une étude de cas portant sur le volet transversal, nous nous proposons de confronter cette conception de la santé mentale, ainsi que le discours sur la participation qui l'accompagne, aux pratiques qui se déploient dans leur sillon. Combinant analyse documentaire, entretiens semi-directifs et observations, cette étude de cas nous autorise effectivement à décortiquer les ressorts d'un processus de participation, et à interroger le recours aux savoirs d'expérience, son utilité, et son utilisation