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By applying the concept of participatory spaces, this article maps and analyzes current research on mental health service user organizations (MHSUOs). We have analyzed research literature from 2006 to 2016 to examine how the role of and challenges facing MHSUOs are formulated in the post-deinstitutional era. The current situation is marked by MHSUOs parallel presence in invited, claimed and popular spaces for participation. The post-deinstitutional era is characterized by a shift in focus from gaining access to such participatory spaces, to critically examining the political opportunities available in these. We further argue that the dominance of psychiatry-specific spaces could prevent MHSUOs from fully exploring their potential for participation in broader social issues. 

This article aims to investigate to what extent social service organisations (SSOs) conceive news management as a means to promote organisational self-interest as opposed to achieving democratic openness. The study is based on a nationally representative telephone survey with persons responsible for communication or public relations in Swedish SSOs (n = 91). Against the background of descriptive statistics, the aim is pursued by qualitative analysis of four open-ended questions. The literature on the relations between social work and media has largely painted a negative picture. This study suggests a different image. The statistical analysis of survey data revealed that respondents were largely satisfied with their relations to journalists. It is concluded that increasingly professionalised news management in SSOs has largely served the function of protecting organisational self-interest, at the expense of democratic openness. This is expressed in how respondents talked in terms of promoting the positive aspects of organisational performance, how they applied a marketing perspective and how the goal of addressing criticism was to deflect it rather than embrace the potential it had for improving performance. This approach is problematic and scholars and practitioners alike need to be more detached from the interests of the social work profession and its organisations.

Independent experts serve a vital role in how the human rights of patients are protected in mental health law. This article investigates the contribution of court-appointed psychiatrists (APs) in civil commitment court hearings. Analysis is based on 12 court hearings that were audiotaped. Supplementary informal interviews with participants were also conducted. Data were analysed through a combination of rhetoric analysis and discourse analysis. Analysis of the hearings reveals that APs do not fulfil their function to critically investigate treating psychiatrists’ (CPs) recommendations that patients meet commitment criteria. They typically do not ask any questions from CPs, and the few questions that are asked do not cast light on the legal issues at stake. To further understand the role of APs, their communication has been analyzed in terms of four interpretative repertoires: collegial, disclosing, therapeutic and mediating. In conclusion, the human rights of patients subjected to involuntary commitment might be at risk when therapeutic concerns are built into the process. The specific Swedish model where APs deliver their own assessment about whether commitment criteria are met may be counterproductive. This argument possibly extends to the role of medical members in mental health tribunals in the United Kingdom, Australia and New Zealand.

This article aims to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last twenty-five years. The introduction of CCC in Sweden is used as a case in point, which is then contrasted against events in Norway, England/Wales and New York State.

Cet article s’attache à comprendre une évolution remarquable des politiques de santé mentale au cours des vingt-cinq dernières années : comment expliquer que les soins psychiatriques sans consentement en ambulatoire (compulsory community care ou CCC) soient apparus comme une solution dans tant de contextes sociaux et juridiques différents ? Nous partirons du cas de l’introduction des CCC en Suède, pour le comparer ensuite à celui de la Norvège, de l’Angleterre/du Pays de Galles et de l’État de New York.

School social workers can be seen as a professional group operating on the margin of an educational logic that dominates schools as institutions. This conditions what tasks they are assigned and what aspects of social work knowledge they will find relevant. On the other hand, the role as a sole professional and relative outsider in the organization provides a potential for school social workers to transcend established theories of social work practice. This article aims to investigate how social work theory is applied in school social work. Twelve semi-structured interviews with school social workers were analysed in terms of how they relate to four knowledge approaches derived from the literature: task-centred, systems theory, strengths and anti-oppressive. Contrary to claims within the sociology of professions that social work practice is formed largely by organizational context rather than a discipline-specific knowledge base, the interviewees seemed to lean on a robust professional foundation within social work theory. Interviewees strongly emphasised their role as working for the individual pupil and positioned themselves as somewhat in opposition to a somewhat oppressive school environment.

Skolkuratorer är en professionell grupp som har en perifer position i förhållande till skolan, som domineras av en pedagogisk logik. Detta påverkar vilka specifika arbetsuppgifter och aspekter av socialt arbete som blir relevanta för den skolkurativa praktiken. Samtidigt erbjuds denna grupp av socialarbetare genom sin perifera roll möjligheter att överskrida och utveckla etablerade former och teorier för vad som utgör det sociala arbetets praktik. Syftet med artikeln är att undersöka hur teorier i socialt arbete tillämpas i den skolkurativa praktiken. Tolv semistrukturerade intervjuer med skolkuratorer analyserades med utgångspunkt i fyra centrala perspektiv inom socialt arbete: uppgiftscentrerat, systemteoretiskt, empowerment och antiförtryckande. I motsats till vad som framförts i professionssociologiska studier, där det hävdas att det sociala arbetets praktik formas av den organisatoriska kontexten snarare än av en disciplinspecifik kunskapsbas, föreföll intervjupersonerna i sin praktik primärt förhålla sig till en robust kunskapsbas hämtad från teoribildning i socialt arbete. Intervjupersonerna framhöll vidare hur deras arbete präglades av ett barnperspektiv, vilket gjorde att de i viss utsträckning positionerade sig i opposition till en skola som delvis uppfattades som förtryckande. Dock var de inte benägna att kritiskt reflektera över sin egen potentiella roll i denna förtryckande kontext.

Until the last 50 years or so, psychiatric patients mostly interacted with clinical staff within closed institutions permeated with a paternalistic culture. The transition from hospital-based to community care marked a radical shift in treatment ideologies and the general approach to service users with mental illness. In the community we expect services to have values of participation and respect for autonomy. Staff whom patients meet in the community often have different knowledge and value systems from those primarily trained to function within institutions. Community staff may find the idea of coercing service users into complying with a treatment regime quite troubling. Accordingly, when community treatment orders (CTOs) were to be introduced in Sweden in 2008, representatives of municipal social services expressed concern that their staff would have to start using coercion. Relatively little is known about the everyday enactment of coercion in community settings. Emerging research suggests that problematic features observed in inpatient settings occur here as well: patients are not always aware of their formal status and may be subject to various kinds of informal coercion (Lambert et al. 2009; Newton-Howes and Mullen 2011; Sjöström 2012; Canvin et al. 2013). A particularly salient phenomenon is how different kinds of ‘leverages’ (Monahan et al. 2005) or ‘influencing behaviors’ (Rugkåsa et al. 2014) are brought into play to make patients under a CTO comply with things they would not otherwise have chosen (Szmukler and Appelbaum 2008). This chapter will draw upon my experience gained from a number of studies regarding coercion within Swedish mental health care over the past 20 years, both in hospital and community settings (Sjöström 1997, 2000, 2012; Zetterberg et al. 2014). The Swedish arrangements for community compulsion are similar to those in the USA, Australia, New Zealand, England and Wales, as well as other European countries such as Norway and Finland. For the purpose of discussing the practice of coercion in community settings, they are thus likely to be transferable. This chapter proposes a theoretical understanding of the micro-level interaction by which community coercion is enacted. A crucial element in analysing human interaction is the context in which it takes place. I will argue that it is meaningful to think about how staff exercise coercion in terms of how they invoke a certain kind of coercion context when interacting with people under compulsion in the community.

The alcohol consumption of female rape victims is often discussed during rape trials. This has been regarded as an emblematic example of victim blaming and the failures of the legal system in relation to rape. From a feminist perspective it can be seen as an expression of the structural subordination of women in society in general.

This article investigates the meanings attached to alcohol in written court decisions in Swedish rape trials (2008-2012). Rape trials are contrasted with assault trials, where the complainants are men. Thirty court decisions from each type of trial are compared, with the same number of guilty and not-guilty verdicts.

Quantitative analysis reveals that alcohol consumption is mentioned more often in rape trials, where it also appears more relevant to decision-making. The complainants' consumption is mentioned four times more often than the defendants' consumption. In assault decisions, the mentioning of alcohol consumption is distributed roughly equally between the parties.  

The analysis shows how a large proportion of the alcohol references in both rape trials and assault trials can be regarded as largely irrelevant noise. The remaining alcohol references are understood in terms of five interpretative repertoires: 1) the accuracy of memory on part of witnesses; 2) explanations of seemingly irrational behaviors; 3) vulnerability, 4) getting the victim drunk, and 5) moral character. The latter three interpretive repertoires are more common in rape decisions. As a conclusion, part of the preoccupation with rape victims’ alcohol consumption can be attributed to protectionary strategies, and should thus not be regarded as victim-blaming. However, some assessments appear to build on assumptions that information about alcohol consumption is indicative to moral character that is relevant to court decisions. 

Hur våldtäktsmål och våldtäktsoffer hanteras är en ständigt aktuell fråga, som nyligen föranledde ytterligare en statlig offentlig utredning (SOU 2016:60). I denna artikel har Maritha Jacobsson och Stefan Sjöström undersökt hur alkohol relateras till i våldtäktsdomar, och jämfört detta med misshandelsdomar. De konstaterar att alkoholkonsumtion ibland kan hjälpa till att få en fällande dom, medan det i andra fall blir till en nackdel för den målsägande.

In 2008, compulsory community care (CCC) for people with severe mental illness was introduced in Sweden. CCC requires co-operation between psychiatric and social services, thus further complicating the longstanding difficulties with service coordination in the mental health field.

This article investigates what happens when a new policy is introduced that assumes complex co-operation of two organisations bestowed with high degrees of discretion. The process of institutionalisation will be analysed in terms of how an idea is translated and materialised on local levels. This has been investigated by interviewing key informants within psychiatric and social services at three different locations.

The implementation was perceived as relatively successful and occurred without major conflict. The main effect of the new legislation was improvement in the coordination of services, where designing a template form for a coordinated care plan was central. The inter-organisational discussions about service coordination that arose had a spill-over effect on services for other patient groups.

In essence, respondents describe CCC as a pedagogical reform to promote the coordination of services, rather than a reform to increase coercive powers over patients. This raises concerns about the legitimacy of the reform.

In recent years, organizations within the public sector have become increasingly attentive to how they are perceived by the public. Professional news management is primarily associated with the private sector, where the rationale has been to maximize profit and market value. For organizations under democratic authority, the ultimate goals are different. The aim of this paper is to describe and compare news management in three types of public sector organizations: schools, the police and social services. The three types of organizations are chosen because of differences in that might potentially affect news management. The paper draws on data from a national survey of all 21 Swedish county police authorities and a stratified randomized sample of municipal school and social service administrations, which represents all 290 Swedish municipalities. Data are analyzed in terms of personnel and activities. With the exception of a couple of small municipalities, all organizations do have a an organizational foundation for media relations, often as a distinct organizational unit with specialized staff. The police authorities stand out in having implemented more developed strategies. The school administrations tend to be somewhat more active in their media relations than social services. Differences between the types of organizations are discussed in terms of variation in organizational conditions for news management. The reason why the police stands out as more strategic can be attributed to a higher newsworthiness, higher public visibility, less strict secrecy rules and a more distinct mission that is easier to asses. We conclude that conditions relating to public interests have the most impact on the formation of news management.