Embracing an Emerging Structure in Community Mental Health Services

Abstract

This article investigates evidence of mental health system change at two community mental health organizations. Using ethnographic methods, the study explored the relationships, culture and characteristics of organizations employing consumer-survivors in designated positions, examining the ways in which they reflect traditional medically-based services and/or more recovery, partnership-oriented services. The data suggest that two structures of mental health services are evident at the organizations: the dominant structure and the emerging structure. It is argued that relationships based on hope, respect and affection appear to encourage the presence of the emerging structure.

Rede de Atenção Psicossocial: qual o lugar da saúde mental?

“…Com a interconexão entre os serviços de saúde mental e os PSFs, evita-se a fragmentação dos atendimentos e facilita-se o planejamento das ações no território, tais como os atendimentos domiciliares e as intervenções clínicas na rede pessoal significativa dos sujeitos (VIEIRA FILHO;NÓBREGA, 2004). Por conseguinte, as novas formas organizacionais em saúde mental diferem das antigas estruturas dominantes quando operam com o foco na autonomia dos usuários, na estreita relação entre os usuários e trabalhadores e na integração dos serviços de saúde mental com a comunidade (GRANT, 2010).…”

The role of therapy in personal recovery – Trauma clients’ use of resources to continue positive processes following group therapy

“…Research indicates that some people experience therapy as hindering their processes of recovery, while others find that mental health services provide valuable support to their efforts to lead a full and meaningful life (Ljungberg et al., 2015). According to Grant (2010) mental health and social work services that are oriented toward a recovery-oriented perspective, may create relationships that to a stronger degree will be based on hope, respect, and affection. However, there is little knowledge on how people consolidate and continue the positive processes of change that they initiated during their mental healthcare.…”

Between a rock and a softer place—A discourse analysis of helping cultures in crisis resolution teams

“…Despite mental health guidelines advocating a holistic, normalizing, and contextually oriented approach to mental distress and service users reporting that such an approach is consistent with their needs in crisis, mental health services often continue to be characterized by practices belonging to the technological paradigm (Barker and Buchanan-Barker, 2011; Grant, 2010; Grant, 2015; Tickle et al., 2014). To further develop mental health services in line with what service users experience as helpful help, it is crucial to obtain better understanding of the discourses through which clinicians position their work and how these are negotiated and given meaning.…”