Samarbeid uten fellesskap : Om individuelle planer i kommunalt psykisk helsearbeid

This thesis is about the implementation of individual plans in the municipal mental health sector. Persons with need for long-term and coordinated services are entitled to have an individual plan. The objectives of an individual plan are to see that the service provides user participation, individual adaptation, comprehension and coordination. The purpose of this thesis is to see if an individual plan really contributes to reaching these objectives. It is possible to see individual plans as a tool based on the ideology of New Public Management (NPM). As such, their basis is rational-instrumental logic. Mental health is, however, a sector recognized for different knowledge bases, indefinite relations between cause and result, and users with vague and complex needs. The reason for choosing this field of investigation is to see what happens when a sector recognized for ambiguity meets products designed upon a rational-instrumental logic. The study shows that it is difficult to achieve user participation and individual adaptations. The reason for this is first of all insignificant resources in the municipal sector. The service providers are mostly positive to user participation and user involvement. This is, however, difficult to achieve as long as the users do not understand the reason for an individual plan and they lack concrete goals for their lives. The prospect of making a comprehensive and coordinated service is only to a small extent dependent on individual plans. Instead it seems as if factors like how the municipality is organized, professional boundaries and insight into rehabilitation ideology and cooperation, account for how comprehensive and coordinated the service becomes. The individual plan should be administered by a service provider with overall responsibility to follow up the work (a coordinator). My results show that this coordinator usually has a very important role in assisting the users in getting the service they need. Often the plan is followed by a team meeting where the different service providers together meet the user. For some of the users, these meetings are an arena where they can influence decisions about the service