Coherence in intersectoral collaboration between psychiatric centres and community mental healthcare: A critical discourse analysis

Abstract

There is scarce research studying healthcare professionals’ and users’ perceptions in relation to creating coherence in intersectoral collaboration between psychiatric centres and community mental healthcare. Drawing on the discourse analysis framework of Fairclough, this study aimed to explore how healthcare professionals and users could perceive coherence in intersectoral collaboration between psychiatric centres and community mental healthcare. But also to explore their perception of how coherence could be maintained through an intersectoral journey, and what discourses manifested themselves within the field of mental healthcare. Data were collected through 11 focus group interviews, five of which with healthcare professionals ( n = 20) and six with users ( n = 18). Fairclough’s three-dimensional model for the studying of discourse was used to analyse the transcribed texts. This study is reported in accordance with the COREQ checklist. Coherence in intersectoral collaboration was interpreted to exist in tension between being predominantly steered by the healthcare professionals while the users had a desire to be more involved in decisions regarding their own intersectoral journey. The users were subjected to a paternalistic steering, expressed by the power of the healthcare professionals to select the right efforts as well as the purpose of the users’ journeys. The findings showed that coherence in intersectoral collaboration in general was articulated from an overall discourse of neoliberal governance, with its embedded discourses of rationality and structure, and discourses of linearity, objectivity, paternalism, biomedicine and evidence have a controlling influence on how users should guide themselves based on the discourse of self-care.