Political dimensions in the actions of health-care practitioners: Reflections for occupational science based on the Chilean psychiatric reform

Abstract

ABSTRACTThis discussion focuses on the political dimensions of health-care practitioners’ actions as a key aspect in occupational science reflections. To understand politics and its relationship with occupational science, a brief explanation is offered about the conceptual framework of governmentality studies. From this understanding, a proposal is developed to discuss the specific form taken by power relations in the practices of health practitioners. Based on the notion of occupational apartheid, this analysis is aimed at reflecting on political actions towards greater occupational justice. The concept of extitution is used to explain how to shape power relations under the current mental health systems, discussing the case of the Chilean psychiatric reform as an example of a political process that engaged different practitioners. There is evidence that some of the impacts of the reforms are not as expected under an occupational justice perspective, both for users and families, and/or for practitioners themselves. The findings suggest that—consistent with certain theories on power—there are some restrictions to the understanding of the political dimension of practitioners’ actions. New aspects are proposed as a focus for an occupational science committed to an occupational justice framework.