Meeting in brackets: how mental health policy travels through meetings

Abstract

Background:Meetings are essential events for the production of a policy. Yet they are largely taken for granted in policy studies: they are perceived as tools for achieving predefined tasks and used as a means of studying other topics, such as public participation. Aims and objectives:I aim to study meetings themselves and to develop the concept of meeting in brackets, which helps understand how meetings produce the policy to which they relate. I focus on a Belgian mental health policy supporting a shift from hospital to community mental healthcare. Methods:Qualitative methods, including direct observation of 77 meetings and interviews, were combined over an eight-year period in order to comprehensively understand the relationship between meetings and policy production. Findings:The Belgian mental health policy gradually emerged from meetings that took place at international, national and local levels. As a result of references made by the participants to previous meetings or to the resulting documents, these meetings gradually formed a web, outside of which the Belgian mental health policy cannot be understood. Discussion and conclusions:The concept of meeting in brackets led to define meetings as communicative events framed by decisions about meeting structure, which I call bracketing decisions. These decisions facilitate a form of communication described as reflexive. Reflexive communication in turn leads to a collective creation: a unique vision of the policy under discussion. Such unique visions are gradually assembled as meetings succeed each other, thus forming a web of meetings which is inherent to policy production.