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.

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.