Historicising involvement: the visibility of user groups in the modernisation of the Chilean Mental Health System

Montenegro, Cristián; Cornish, Flora

doi:10.1080/09581596.2017.1400659

Cited by 12 publications

(18 citation statements)

References 36 publications

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“…But who was going to be invited? The mental health system already had a recurrent “public” (Newman 2009) assembled around the perennial call for financial resources (Montenegro and Cornish 2017), a call linking global and national agents from the PAHO, INGOs, local NGOs, Family Organisations, and many others. The group rejected this call, considering itself outside of the instrumental version of the public sphere created by the mental health system.…”

Section: Resultsmentioning

confidence: 99%

“…This reduces the complexity of their potentially immense number of interlocutors and also defines the scope and characteristics of that interlocution (Montenegro and Cornish 2017). A user is a user because it needs something from the system, and the system approaches users on this basis.…”

Section: Discussionmentioning

confidence: 99%

“…ANUSSAM, the oldest user organisation in the country, was born in 2000 out of a confluence of interests between the Mental Health Department of the national Ministry of Health and a group of users participating in CORFAUSAM, a coalition of family organisations (Montenegro and Cornish 2017). In the typology of the mental health system, ANUSSAM is the only organisation representing the interest of users at a national level.…”

Section: Methodsmentioning

confidence: 99%

“…While the call for users’ involvement is common in mental health plans and in declarations from authorities, user groups are generally placed within an undifferentiated “civil society” (Montenegro and Cornish 2017), whose role is to support specific reforms in the region (Ceriani, Obiols, and Stolkiner 2010; Montalbán 2013; Zaldúa et al 2012). …”

Section: Introductionmentioning

confidence: 99%

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Beyond Participation: Politics, Incommensurability and the Emergence of Mental Health Service Users’ Activism in Chile

Montenegro

2018

Cult Med Psychiatry

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Although the organisation of mental health service users and ex-users in Latin America is a recent and under-researched phenomenon, global calls for their involvement in policy have penetrated national agendas, shaping definitions and expectations about their role in mental health systems. In this context, how such groups react to these expectations and define their own goals, strategies and partnerships can reveal the specificity of the “user movement” in Chile and Latin America. This study draws on Jacques Rancière’s theorisation of “police order” and “politics” to understand the emergence of users’ collective identity and activism, highlighting the role of practices of disengagement and rejection. It is based on interviews and participant observation with a collective of users, ex-users and professionals in Chile. The findings show how the group’s aims and self-understandings evolved through hesitations and reflexive engagements with the legal system, the mental health system, and wider society. The notion of a “politics of incommensurability” is proposed to thread together a reflexive rejection of external expectations and definitions and the development of a sense of being “outside” of the intelligibility of the mental health system and its frameworks of observation and proximity. This incommensurability problematises a technical definition of users’ presence and influence and the generalisation of abstract parameters of engagement, calling for approaches that address how these groups constitute themselves meaningfully in specific situations.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beyond Participation: Politics, Incommensurability and the Emergence of Mental Health Service Users’ Activism in Chile

Montenegro

2018

Cult Med Psychiatry

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“…In another paper, the first author has linked the ‘low presence’ of service‐user groups to policy shifts within and beyond the mental health field. Here, we pay closer attention to how, without guidelines, and facing precarious financial and administrative conditions, local bureaucracies engage with local groups and communities, and how this engagement is sustained over time.…”

Section: Introductionmentioning

confidence: 99%

Communities, health‐care organizations and the contingencies and contradictions of engagement: A case study from Chile

Montenegro

Mercado²

2019

Health Expectations

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Context Despite a growing interest in service‐user involvement in mental health services, the interaction between health institutions and local groups is only beginning to receive attention, particularly in global south settings. Objective Looking at a participatory initiative in Chile, this study explores how, under unfavourable administrative conditions, health organizations approach and work with communities. Methods We interviewed policy‐makers (5), local professionals (10), service users and community representatives (6) linked to a concrete participatory initiative. Participant observation in relevant meetings helped to enrich the interpretations. Thematic analysis was applied to interview transcripts and field notes. Findings The findings present a sequence of actions starting with the creation of a network of community‐based groups. A set of problems ensued, related to the group's diversity, internal representation, decision‐making and funding processes. In response, processionals implemented simultaneously bureaucratic and democratic adjustments, developing a vision of community that ignored the particularities—including the motivations—of local groups. Discussion and conclusion Based on these findings, we argue that participatory initiatives should be studied as on‐going achievements shaped by broad policy orientations and local configurations of interest. In the process, they produce ad hoc forms of knowledge and visions of community that provide orientation to the agents involved.

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Collective Deliberations and Hearts on Fire: Experiential Knowledge Among Entrepreneurs and Organisations in the Mental Health Service User Movement

Näslund

2020

Voluntas

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Previous research has shown that experiential knowledge plays an important role for service user movements and has also discussed ambiguities in the definition of this type of knowledge. This study contributes to clarifying how experiential knowledge is understood within the service user movement. Through semi-structured interviews, it explores how Swedish mental health service user organisations (MHSUOs) and service user entrepreneurs (SUEs) regard the role of experiential knowledge for their endeavours. The study shows that SUEs and MHSUOs view experiential knowledge as complementary to established medical and expert knowledge. Both groups further reflect on the functions of individual and collective dimensions of experiential knowledge. Emotions are important in conveying experiential knowledge, although emotional commitment can be short-lived. The study discusses challenges for SUEs and MHSUOs in developing strategies to manage risks tied to strategic essentialism, and also in maintaining a critical standpoint towards established service providers.

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Historicising involvement: the visibility of user groups in the modernisation of the Chilean Mental Health System

Cited by 12 publications

References 36 publications

Beyond Participation: Politics, Incommensurability and the Emergence of Mental Health Service Users’ Activism in Chile

Beyond Participation: Politics, Incommensurability and the Emergence of Mental Health Service Users’ Activism in Chile

Communities, health‐care organizations and the contingencies and contradictions of engagement: A case study from Chile

Collective Deliberations and Hearts on Fire: Experiential Knowledge Among Entrepreneurs and Organisations in the Mental Health Service User Movement

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