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Personligt ombud och förändringsprocesser på det socialpsykiatriska fältet
Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Social Work.
2010 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In a new reform in 2001, Swedish authorities emphasized the need for support for persons with psychiatric disabilities living in the community. This reform included the establishment of a new occupation: the Swedish case manager, personligt ombud (PO). In examining this new occupation, the overall aim of this thesis is to analyze how the Swedish case manager, PO, as an evolving occupation, affects and is affected by the organisational and professional field in which it enters. More specifically, the aim is to describe and analyse, using organisational and professional theories, the changing processes that the PO con-tributes to in the welfare system and the practice of social policy, the field of social psychiatry focusing on the discretion for professionals and in the under-standing of the professional role to help as described by clients.

Three studies have been carried out. The first study, for the licentiate´s degree, focused on the PO occupational role and functions for the welfare system as well as for mental health service users. In the second study, the results from the first study were analyzed together with the results of another reform, namely, the Swedish care manager reform, in order to investigate their joint implications for social policy and its practice. The third study focused on what meaning the PO has for the clients and particularly what features of the service the clients find to be helpful.

In summary, the results indicate that the PO contributes to the development of a negotiated rights model, by taking on the assignment of advocacy as a client representative, and then defining the social worker as a representative for the organisation with the assignment of needs assessment. In the field of social psychiatry, the PO fills a vacancy by supporting the legitimacy of the professionals as well as their organisations. Furthermore, the PO has a function of providing organised transparency through restricting the discretion of other professionals. The discretion of the PO itself has weak boundaries allowing for great liberty of action. Finally, the PO service has led to a new understanding of the professional role, as built on reciprocity with the client, using knowledge evolving from the interaction between the professional PO and the client. These findings suggest that the PO could be understood as a new occupation evolving from weak professional traits to, as suggested, a new model for professionalism, called user-mandated professionalism. This emphasizes the reciprocative foundation of knowledge between the service user and the professional.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press , 2010. , p. 77
Series
Linnaeus University Dissertations ; 7/2010
Keywords [en]
case management, reform, service users, mental health, recovery, professional
National Category
Social Work
Research subject
Social Sciences, Social Work
Identifiers
URN: urn:nbn:se:lnu:diva-146ISBN: 978-91-86491-09-3 (print)OAI: oai:DiVA.org:lnu-146DiVA, id: diva2:304923
Public defence
2010-04-16, Myrdal, Hus K, Växjö, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-09 Created: 2010-03-22 Last updated: 2010-12-30Bibliographically approved
List of papers
1. Personligt ombud: Social praktik i medicinsk diskurs
Open this publication in new window or tab >>Personligt ombud: Social praktik i medicinsk diskurs
2006 (Swedish)Licentiate thesis, monograph (Other academic)
Abstract [en]

The objective of this licentiate’s dissertation is the developing occupational role of ‘personligt ombud’ (PO), a case manager for persons with severe psychiatric disabilities. The purpose of PO, put forward by a government’s commission (Psykiatriutredningen) 1992, was to implement a new way of providing support and to coordinate interventions with an aim to improve the life conditions of persons with severe psychiatric disabilities.

The aim of this licentiate’s dissertation is to characterize PO as a phenomenon within disability politics.

The empirical data were collected in three counties, viz the counties of Blekinge, Kalmar and Kronoberg. All POs within these counties were inter-viewed as well as influential managers. Clients of the POs were also interviewed.

The results imply that POs construct their understanding of their clients’ problems within a medical discourse, individualizing the problems as a result of illness. However, in their actions to solve problems they take social measures relating to a citizen discourse, focusing on citizen rights and living conditions. The occupational role of the PO develops within these discourses in conflict.

The POs’ courses of action were analyzed as four stylized patterns that can be identified with methods and theory in Social Work: rehabilitation, paternalism, empowerment and advocacy. Empowerment and advocacy can be seen as new courses of action used by POs as professionals within the public sector for sup-porting this target group.

Conclusions indicate that while formulating medical explanations to their cli-ents’ problems, the lack of language to formulate and analyze the structural and social problems is creating a risk of POs strengthening the exclusionary proc-esses. Nevertheless, the occupational role of the PO has developed a new ex-pected function as society integrated support, built on empowerment, advocacy and user control.

Place, publisher, year, edition, pages
Växjö: Institutionen för vårdvetenskap och socialt arbete, 2006. p. 173
Series
Rapportserie i socialt arbete: Växjö universitet, Institutionen för vårdvetenskap och socialt arbete, ISSN 1652-8573 ; 2 : 2006
Keywords
case management, personligt ombud, socialt arbete, psykiskt funktionshinder, systemfel
National Category
Social Work
Research subject
Social Sciences, Social Work
Identifiers
urn:nbn:se:vxu:diva-795 (URN)
Presentation
2006-03-29, K2083, Växjö Universitet, 10:15 (English)
Opponent
Supervisors
Available from: 2006-08-22 Created: 2006-08-22 Last updated: 2016-07-21Bibliographically approved
2. Traits of a representative welfare state: the Swedish example
Open this publication in new window or tab >>Traits of a representative welfare state: the Swedish example
2010 (English)In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 19, no 4, p. 402-411Article in journal (Refereed) Published
Abstract [en]

The care manager reform and the case manager reform are new reforms in the social care services in Sweden, which are evolving during the 2000s. Together they shape the social care services introducing a new way of decision-making where representatives for the organisation (care manager) and the users (case manager) negotiate. The reforms have been analysed in two studies with results presented in this article. Using the concepts of role, orientation, function and assignments, it is argued that the managers come to the negotiations on rights from different positions that are both conflicting and complementary. They further mediate the development towards a welfare mix, where the market, social networks and users interact to obtain the public welfare provision. Through this negotiated rights model, it is argued that traits of a representative welfare state emerge, with the distinction of moving the focus to the administrative practices and their differences away from political ideologies.

Place, publisher, year, edition, pages
Oxford, UK: Blackwell Publishing Ltd, 2010
Keywords
representative welfare, negotiated rights model, case management, care management, social work division
National Category
Social Work
Research subject
Social Sciences, Social Work
Identifiers
urn:nbn:se:lnu:diva-132 (URN)10.1111/j.1468-2397.2009.00700.x (DOI)
Available from: 2010-03-21 Created: 2010-03-21 Last updated: 2018-02-26Bibliographically approved
3. User-oriented mental health reform in Sweden: featuring "professional friendship"
Open this publication in new window or tab >>User-oriented mental health reform in Sweden: featuring "professional friendship"
2010 (English)In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 25, no 5, p. 565-577Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2010
Keywords
case management, professional, friendship, mental health service, recovery, reform
National Category
Social Work
Research subject
Social Sciences, Social Work
Identifiers
urn:nbn:se:lnu:diva-133 (URN)10.1080/09687599.2010.489303 (DOI)
Available from: 2010-03-21 Created: 2010-03-21 Last updated: 2017-12-12Bibliographically approved

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