Organizing normality : Essays on organizing day activities for people with severe mental disturbances

Sammanfattning: This thesis focuses on the organizing of day activities, outside hospital care, for people with severe mental disturbances in Sweden. The purpose of the study is threefold: to describe the material and structural conditions of day activity settings on a national scale; to analyse some of the ideological claims made in the field; and to discuss problems and possibilities arising when more than one organizational sector is involved in the work.The thesis is divided into two parts. Part A presents the empirical material, derived from a national survey, as well as some historical and theoretical points of departure and concludes with a summarizing analysis of results. Part B contains four empirically based papers.The results show a considerable growth in the 1980s of day activity units specifically arranged for this group of people with severe mental disturbances. The average economic resource-input is considerably larger in psychiatry-run units than in units run by the social services. The collaborative efforts between the social services and psychiatry are discussed in the light of the fact that joint venture units develop distinctively different features, when it comes to, for example, recruitment routes of users and collaborative work with other organizations, as compared to units run by the social services or psychiatry alone. Thestructural and discursive power in this new field is largely in the hands of psychiatry. Ideological claims as to the definition of the work adhers to a "therapeutic paradigm".Results from an analysis of self-presentation documents reveals five distinct content categories: the dimension of ambition to change, the dimension of time-structuring, the dimension of profession/expertise, the dimension of intimacy of relation, and the dimension of autonomy. This is discussed in view of tendencies towards professionalization from different occupational groups as well as in view of issues of social control in modem society.Finally some prospects for the development in the future are discussed.