Managing care in the community: Analysis of a training workshop

Abstract

Summary Managing mental illness in the community is an anxiety provoking business. Yet the legislative emphasis on business management and rapid re-structuring both creates anxiety in workers and carers and appears to devalue those traditional psychotherapeutic skills which facilitate the containment of anxiety. Anxieties that are put out of mind (not contained) have damaging and dangerous consequences for carers, users and members of the public. This paper is about a ten-week workshop with the task of providing a safe, constructive setting where the anxieties generated by community care of the adult mentally ill could be identified, addressed and thought about. The developments within the workshop are analysed as the process shifts back and forth between paranoid-schizoid and depressive position modes of functioning gradually progressing towards the latter. Members gradually found the ability to combine therapeutic and business management skills so that they could regain their authority in relation to th...