«Det nye paradigmet» i rus- og psykiske helsetjenester – utfordringer og muligheter

Catharina Bjørkquist, Helge Ramsdal
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Abstract

The purpose of this book has been to show how the challenges associated with services for people with complex needs, exemplified here by addiction and mental health disorders, are handled at the local level. The starting point was three characteristics of trends in national policy and organization of services for people with complex needs: decentralization, user participation and coordination. We argue that these characteristics represent conditions within the services for such disorders and also provide a framework for development within them. The characteristics are understood as entangled processes that constitute elements in the emergence of a “new paradigm” in the services, what is described as a focus on “locally based services”. The processes for change at the local level which we have studied show that institutional characteristics, based on different histories and traditions in the work with addiction and mental health disorders, are important for understanding how these change processes are organized. The three municipalities we studied all recognize that addiction and mental health disorders and illness are important societal problems that must be addressed locally. We can also state, however, that local strategies for achieving the goal of better coordination and integrated services evolve in very different ways.
这本书的目的是展示如何在地方一级处理与为有复杂需求的人提供服务相关的挑战,在这里以成瘾和精神健康障碍为例。出发点是国家政策和为有复杂需要的人组织服务的趋势的三个特点:权力下放、用户参与和协调。我们认为,这些特征代表了这些疾病的服务条件,也为其中的发展提供了一个框架。这些特征被理解为相互纠缠的过程,这些过程构成了服务中出现的“新范式”的要素,被描述为对“基于本地的服务”的关注。我们所研究的地方一级的变革进程表明,基于成瘾和精神健康障碍工作的不同历史和传统的体制特征,对于理解如何组织这些变革进程非常重要。我们研究的三个城市都认识到,成瘾和精神健康障碍和疾病是重要的社会问题,必须在当地加以解决。然而,我们也可以说,实现更好的协调和综合服务目标的地方战略以非常不同的方式发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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