Service Users and Experts in Finnish Mental Health Care Planning : Three Phases of Expansion and Inclusion
Keywords:
Finland, medicalization, mental health policy, psychiatry, service usersAbstract
The article examines the roles of experts and service users in Finnish mental health care planning over the past fifty years. It analyses the expansion of mental health care as a societal question and suggests that the governing narrative of a clear-cut general medicalization and expert-drivenness needs to be re- assessed. The analysis points out three distinct trends in terms of experts’ and service users’ roles. From the 1960s to the 1980s, mental health policy documents discussed the inclusion of a greater number of voluntary and healthier users of psychiatric treatment and practice. During the 1990s, the position of mental health care service users shifted from being a matter for specialists to being part of general and basic welfare services such as primary health care. The policy documents from this second phase also emphasize the need for professionals to refrain from taking expert positions. A third phase began in the 2000s highlighting the value of “user expertise” – a perspective embedding the idea of service users as the experts in mental health care. The views of expertise in the second and particularly the third phases contradict the traditional emphasis on the expertise of health care professionals.
