Sundet Rolf
Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, Center for Mental Health and Substance Abuse, University of South-Eastern Norway, Drammen, Norway.
Front Psychol. 2021 Aug 10;12:725385. doi: 10.3389/fpsyg.2021.725385. eCollection 2021.
Basic to the Norwegian welfare state is the principle of universality; every citizen has the right to equal health care and social services. Experiences from a family team in mental health care for children and adolescents exemplify challenges for mental health work in this welfare state. These experiences indicate an ongoing process of dismantling the welfare state, disguised as managerial changes and reorganizations. The argument is put forth that these changes and reorganizations that are claimed to benefit service users actually have negative consequences for many of them. These negative consequences are related to how psychological research on and knowledge of mental health and treatment are combined with organizational principles. The concept of an assemblage is introduced as a manner of describing the dominating relationships in health care between the medical model, the randomized controlled trial and new public management in order to provide responsible health care practices. Rooted in a supposition that how we look upon, describe and understand causation defines our views of science in general, how to produce knowledge, what kind of scientific knowledge is most productive, and how it should be implemented in practice, an alternative assemblage is suggested that better realizes the principle of universality. Here justice is about equal opportunities and equal rights to treatments and sets of practices that fit people as unique individuals. Such an assemblage would bring together diverse models of mental health care, a network of multiple research-based knowledges, and service organizations that include the differences and diversity of the population.
挪威福利国家的基础是普遍性原则；每个公民都有权获得平等的医疗保健和社会服务。一个儿童和青少年心理健康护理家庭团队的经验体现了这个福利国家心理健康工作所面临的挑战。这些经验表明，福利国家正在经历一个被伪装成管理变革和重组的拆解过程。有人认为，这些声称有利于服务使用者的变革和重组实际上对他们中的许多人产生了负面影响。这些负面影响与心理健康及治疗的心理学研究和知识如何与组织原则相结合有关。引入“组合”概念，作为一种描述医疗模式、随机对照试验和新公共管理在医疗保健中主导关系的方式，以便提供负责任的医疗保健实践。基于一种假设，即我们如何看待、描述和理解因果关系决定了我们对一般科学的看法、如何产生知识、哪种科学知识最具成效以及应如何在实践中实施，本文提出了一种更好地实现普遍性原则的替代组合。这里的公平是指获得适合作为独特个体的人的治疗和一套实践的平等机会和平等权利。这样一种组合将汇集不同的心理健康护理模式、基于多种研究的知识网络以及包含人群差异和多样性的服务组织。
