The organisation of local mental health services in Norway: evidence, uncertainty and policy

Abstract

This article addresses questions about health authorities’ recommendations on the local organisation of services for people with mental health disorders in Norway. Analysis is made of the dynamic relationship between different evaluations, national guidelines and other knowledge that influence the organisation of services. The analysis is based upon documents about how recommendations by health authorities have shifted during a period of 15 years. The relationship between policy guidelines, the role of scientific evidence and practical organisational models is characterised by ambiguity and pragmatism. Some theoretical implications of these findings and uses of knowledge in different policy areas are discussed.

Creating and implementing local health and wellbeing policy: networks, interactions and collective knowledge creation amongst public sector managers

“…Again, it was when such details needed to be filled in that we saw inventiveness, which sometimes included extending a network to mobilise new knowledge resources. This supports theoretical claims about the role of uncertainty as a catalyst for and key component of knowledge creation (Amin & Roberts 2008, Bogenrieder 2002, Erden et al 2008, Macpherson 2005 and suggests that the ambiguity and pragmatism inherent within local policymaking may support rather than constrain organisational knowledge creation (Ramsdal & Hansen 2017).…”

“…There is, however, a large body of literature which focuses on how public sector managers import, exchange and implement knowledge generated elsewhere either individually or collectively (Birken et al 2012, Contandriopoulos et al 2010, Ferlie et al 2012. This typically focuses on the use of research-based knowledge and evidence within tightly-bounded situations and does not adequately account for the complex interrelationships between different forms of knowledge within local policymaking (Riley et al 2012, Mulgan 2005, the ambiguous and pragmatic nature of the process itself (Ramsdal & Hansen 2017) or the multiplicity of divisions between those involved (Smith & Joyce). As a result a number of questions remain about whether and how health and wellbeing (and other public sector) managers collectively create knowledge to address local challenges.…”

Coordination of services for dual diagnosis clients in the interface between specialist and community care

“…Most evaluations of collaboration models are based on the idea that there is an optimal model regardless of the context, and that clinical results for clients can be used as success criteria for such models. 16 One explanation of the difficulty in proving that one collaboration model is better than another may be that evaluations do not take sufficient account of the fact that different models fit into different contexts. It is therefore necessary to point out some of the factors that should determine the collaboration models to be used.…”

Bedre tverrfaglig innsats – styrket tverrsektorielt samarbeid om utsatte barn og unge?

“…-«ROP-team» i arbeidet med rus og psykisk helse: Dette var samhandlingsteam i tilknytning til det såkalte Romeriksprosjektet (Hansen & Ramsdal, 2015;Ramsdal & Hansen, 2012;Ramsdal & Hansen, 2017). -«Overvektsteam» ved sykehuset: Dette er multidisplinaere team som i saerlig grad fokuserer på arbeidet med å behandle pasienter med overvektslidelser ved Sykehuset Østfold HF (Fineide, Bjørkquist & Ramsdal, 2018).…”