Mental Healthcare Reform in Belgium: a qualitative study with mobile teams

Alevanti, Eleni (2020) Mental Healthcare Reform in Belgium: a qualitative study with mobile teams. Doctoral thesis, Birmingham City University.

Eleni Alevanti Thesis eSubmission.pdf - Submitted Version

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The Belgian mental healthcare reform is located between the current mostly residential models of delivery, and the first line care as well as ‘ambulatory’ mental healthcare. The implementation of a novel function through new community mobile services and interventions aims to bridge the gap, while also offering care alternatives.

The presented research is a qualitative study of four such new mobile projects, each with one participating “2A”team and one “2B”team i.e. for acute and long-term care respectively. Their main goal is to maintain people in their home environment and within their social fabric, offering supportive, individual and flexible therapeutic interventions through multi-disciplinary networks.

After an initial observation of the teams, a set of intensive semi-structured interviews were carried out, followed by a second observation period. Drawing upon and developing critical social theories, the interviews and observations were analysed using a constructivist grounded theory method. This was underlined by a methodology using a Foucauldian and social justice lens, including experiential knowledge literature to examine mental healthcare constructs. Concepts of confluence and social navigation allowed this analysis to focus on the way different contested categories in mental health are shared; on how they are part of the same field and in effect are confluent through their differences.

The analysis presented reflects the process of inquiry. Firstly, a presentation of the data collected through the interviews uses three levels: (i) team working, (ii) working with other services and (iii) working within a wider context. Using those levels and taking into consideration the second observation with the teams four subcategories are explored: existing in ‘time’, making use(s) of ‘space’, carrying ‘memory’ and(up)holding (on to) ‘value(s)’. These in turn, set the basis for two central categories: forming ‘relationships’ as well as borrowing words and diffusing ‘language’.

The analysis reveals a series of emerging paradoxes through the subcategories and central categories, borne out of the disparities in the content between the interviews and the direct observations. In an original way these paradoxes reflect contested meanings present within the wider field of mental health and psychiatry. Located on social justice principles, a set of possibilities is examined at the end of this work, further exploring these paradoxes in practice, which may in fact prove to be important opportunities for navigating the future of mental healthcare.

Item Type: Thesis (Doctoral)
17 March 2020Completed
Uncontrolled Keywords: Mental health care reform, 107 reform, mobile teams, Belgium, constructivist grounded theory, Foucault, social justice in mental health, confluence, social navigation, deinstitutionalization, social fact
Subjects: CAH04 - psychology > CAH04-01 - psychology > CAH04-01-04 - psychology and health
CAH01 - medicine and dentistry > CAH01-01 - medicine and dentistry > CAH01-01-01 - medical sciences (non-specific)
Divisions: Faculty of Health, Education and Life Sciences > School of Health Sciences
Doctoral Research College > Doctoral Theses Collection
Depositing User: Kip Darling
Date Deposited: 04 Nov 2021 16:59
Last Modified: 12 Jan 2022 11:30

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