Mental health is everybody's business: The doxa and illusio of local public policy implementation.

Abstract

This paper provides a novel application of Bourdieu's theory to the implementation of public policy in the mental health field, by deploying two of his lesser-used concepts (doxa and illusio). Framing a local case study as a Bourdieusian game, we demonstrate how these concepts have explanatory power within the field and how national policy discourses at once influenced and constrained by neoliberalism have real and long-lasting effects when it comes to the implementation of public policy. We found three key themes in the case study: doxa as a narrative device ('mental health is everybody's business'); the linking of this doxa with the game's illusio in a shared view that the policy should address the problem of a high rate of 'inappropriate referrals' into specialist services; and the consequences of the dynamic between the game's doxa and illusio for the organisational hierarchy in the mental health services field. We do not evaluate the success of the policy, but instead apply and explore the potential of Bourdieu's concepts to provide explanatory power to the processes and interactions evident in the implementation programme. This paper highlights the potential of such a theoretically based analytical approach, which could be applied in other contexts and to other health fields and policy domains.