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New public policy patterns in Belgium. The case of mental health

Research project SO/10/037 (Research action SO)

Persons :

  • M.  DE MUNCK Jean - Université Catholique de Louvain (UCLouvain)
    Financed belgian partner
    Duration: 1/12/2000-28/2/2003
  • Prof. dr.  GENARD Jean-Luc - Université Libre de Bruxelles (ULB)
    Financed belgian partner
    Duration: 1/12/2000-28/2/2003
  • Prof. dr.  KUTY Olgierd - Université de Liège (ULiège)
    Financed belgian partner
    Duration: 1/12/2000-28/2/2003

Description :

This research project represents stage two of a venture designed to federate sociologists, lawyers and philosophers from Belgium’s four French-speaking universities (FUSL, UCL, ULB, ULG) around a common problem involving production of the standard. Stage one (now underway) is receiving FNRS funding (1998-2000) under the title: "Transforming methods of state regulation in the face of flexibility imperatives". This first stage does not allow the funding of research fields, but is aimed solely at supporting the constitution of transversal theories based on existing research. Stage two will involve initiating field research in common specific areas, the first of which will be mental health (2001-2002). This project is set to continue thereafter (2003-2004) in other areas that are also chosen in line with their capacity to delimit the recent changes to ways of defining and institutionalising public policies. At this stage, our project has three objectives (in order of importance):

1. Systematic exploration of recent modifications in the area of mental health

The choice of area is based on the observation that its formal appearance is extremely representative of the movement to govern public service missions on a contractual basis, and on the fact that (in material terms) diffraction of its sets of problems towards other areas of public action, has been a major phenomenon of the last fifteen years. We expect the research to clarify three aspects of this transformation now underway:

- Reconstitute the historical background of the field in Belgium since the 1960s by specifying the respective changes to mechanisms inside and outside hospitals.
- Provide an analytical description of the type of relation between State and civil society and articulate this around the concepts of "centralising regulation" and "collective, cognitive mechanisms".
- Elucidate critically the new normative issues that public action faces in this area.

2. Working with the actors

Following the major upheavals we have just evoked, powerful issues emerge from this sphere concerning its professional identity, its political role, its institutional structure and the ethical rules of the partnership. The project will offer the chance to bring together a group of professionals from the sector in order to engage in a collective learning effort with researchers. This is set to result in the compilation of a report into mental health policy in French-speaking Belgium. Thus, in addition to the scientific report, the research will result in a second report reflecting the preoccupations of a professional group. This is the "change-driven" aspect of the project.

3. Methodology fine-tuning for basic theories

The central idea behind the research is that these rounds of co-ordination and co-operation between actors are made possible through mechanisms that articulate centralising regulation (Crozier) and joint regulation (Reynaud) and that they format cognitive and normative frameworks (Favereau). The project’s aim in methodology terms is to enable these concepts to function empirically in comprehensive sociology efforts involving sweeping areas of public action. It also wants to show the contribution made by this conceptualisation to an updated critical State theory adapted to the structures of the post-industrial society and integrating the contributions of organisational sociology, political sociology and philosophy.

The specific PROJECT tasks are as follows:

A. Reconstruction of the institutional landscape and changes to the mental health sphere in Belgium over the past 25 years. Construction of an historical sequence and explanation of the internal dynamic behind the formation of public policies.

A.1 The major phases of the dynamic behind the institutionalisation of mechanisms in mental health, approached on the basis of State philosophies (method: interviews with resources/actors/grey literature) (CERAP, ULB)
A.2 The major phases in the professional dynamic of protagonists in mental health, based on discussions within the professional field (method: interviews with actors /grey literature) (CRIS, ULG)

B. Firstly, analysis of present-day mechanisms: implementation of mechanisms concerning harassment at work (CRIS, ULG)

B.1 Reconstruction of the genesis of the problem with the help of strategic analysis and comprehensive sociology methods via case studies.
B.2 Analysis of cognitive and normative categories of harassment, produced via the regulation of a new sphere for public action. Survey of the professionals involved.

C. Secondly, analysis of present-day mechanisms: supervised accommodation, guidance centres, or another "conventional" sector of mental health (field to be determined) (CERAP, ULB)

C.1 Reconstruction of the formation of compromises between managers emanating from the mental health field (mental health critiques and theories) and requirements stemming from public administration imperatives
C.2 Analysis of forms of public intervention (territorialisation, partnerships with experts, evaluation of public action, partnerships with associative circles, etc.)

D. Thirdly, analysis of present-day mechanisms: new forms of drug addition management (CRIS, ULG)

D.1 Construction and deconstruction of new cognitive categories ("hard use of soft drugs"/"soft use of hard drugs"; abstinence versus controlled use, etc.)
D.2 Pluralisation of legal treatments; pluralisation of medical treatments for uses; surveillance monitoring of "at risk" and/or "problem" groups.

E. Working group involving professionals (organisation of a regular seminar) (CPDR, UCL)

E.1. Co-opting of a group
E.2. Ten meetings spread over a year

F Drafting of reports

F.1 Report summarising research results, produced jointly by the three teams
F.2 Adjoining report (in English) on research progress (CPDR, UCL)
F.3 Report from the group of professionals (CPDR, UCL)

Documentation :

Santé mentale et citoyenneté : les mutations d'un champ de l'action publique : rapport final  De Munck, Jean - Genard, Jean-Louis - Kuty, Olgierd ... et al  Gent : Academia Press, 2003 (PB6010)

Bibliografic references :

A propos des réseaux  GENARD J.L. Actes de la journée préparatoire des assises de l'ambulatoire, COCOF, 2003/Jun 

Les exigences et antinomies éthiques des nouvelles politiques publiques en matière de santé mentale  GENARD J.L., DONNAY J.Y. Ethique publique, vol. 5, n° 1, Montréal, 2003/Apr 

Santé mentale et citoyenneté: les mutations d’un champ de l’action publique.  DE MUNCK J. e.a. Gent, Academia Press, 2003