Remaking children's mental health: On children, community and care in reform.

By the mid-1990s, it was clear that the relationship between the U.S. government and the nation's children was being re-formed. Michigan was a national reform leader, reinventing the State's social service, health care and juvenile justice systems, while encouraging local communities to participate in special collaborative, seamless, locally-controlled, family friendly initiatives. This dissertation tells the story of efforts to demonstrate wraparound services, one collaborative model of mental health care for children in Michigan. Research on new collaborative designs such as wraparound has focused on achievement of specified outcome measures. Even though one of the aims of the wraparound project is to disseminate new ideas to human service workers and community leaders in local settings, little systematic attention has been paid to the particular constructions of children, communities and care embedded in new models. This ethnographic study examines how demonstrating wraparound services in one local context reshaped relationships among troubling children and the parents, professionals and community volunteers who tried to help them, creating new possibilities but constraining others. It explores how reform was made compelling to a network of participants across the state, as wraparound training sessions mobilized discontent with past welfare programs and harnessed that energy to an agenda for change. Contemporary collaborative models of service employ a language of risk, allowing professionals from different disciplines to assess children and evaluate services on a common metric. The author argues that as children are constructed as risks to be managed, efforts to identify the cause of children's problems are gradually supplanted by efforts to contain their behaviors. Local interests in making small improvements in the economic or social conditions of child life are displaced by a focus on child behavior within the new designs. The activities of community focus primarily on monitoring and controlling children, with recourse to juvenile justice accepted as a natural consequence if containment fails. As new strategies of governance are deployed in local contexts, there is a need for studies that probe what sort of relationships with children, ourselves and the world these strategies presuppose, make possible or exclude. This dissertation offers one model for such research.PhDCultural anthropologySocial SciencesSocial workUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/123251/2/3068937.pd