Abstract
The deinstitutionalization of psychiatric care has not only altered the living conditions for people with severe mental illness but has also greatly affected social services staff. In the Mental Health Act launched by the Swedish government in 1995, a new kind of service called ‘housing support’ and a new occupational group, ‘housing support workers,’ was introduced. However, housing support does not currently operate under any specific guidelines regarding the content of the service. This study explores housing support at local level in various municipalities of one Swedish county. The data is based on discussion with three focus groups: care managers, managers for home and community‐based support, and housing supporter workers. The perspective of institutional logics as a specific set of frames that creates a standard for what should or could be done, or alternately what cannot be questioned, is applied to analyze the constructed meaning of housing support. The meaning of housing support is constructed through three dichotomies: process and product, independence and dependence, and flexibility and structure. These dichotomies can be understood as dilemmas inherent in the work and organizing of housing support. With no clear guidelines, the levels of organizational and professional discretion create a space for local flexibility but may also contribute to tremendous differences in defining and implementing housing support. We discuss the potential consequences for housing support users implied by the identified discrepancies.
Highlights
This article focuses on housing support (HS) and its mean‐ ing in the context of deinstitutionalized mental healthSocial Inclusion, 2021, Volume 9, Issue 3, Pages 276–285 care in Sweden
The above excerpts are examples of the ways in which housing support workers (HSWs) deal with the specific chal‐ lenges within their practice, which we describe here as diverse dichotomies
Peo‐ ple with severe mental illness (SMI) are faced with the task of managing their social life, interacting with others, and establishing their home life in the community context
Summary
This article focuses on housing support (HS) and its mean‐ ing in the context of deinstitutionalized mental healthSocial Inclusion, 2021, Volume 9, Issue 3, Pages 276–285 care in Sweden. With no guidelines nor policies regulating its provision or organization, HS remains surrounded by organizational and professional uncertainty as well as a lack of clarity about contacts and relations between housing support workers (HSWs) and users. In addressing these uncertainties, this article brings to the fore the understandings of, and meanings assigned to, HS by the HSWs themselves, their imme‐ diate team leaders, and managers of community‐based mental health support
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