Welfare Reform on the Web (February 2010): Mental health services - overseas

Case management for people with psychiatric disabilities in rural Sweden: experiences from the implementation of a national policy

U. Markstrom, R. Lindqvist and M. Sandlund

European Journal of Social Work, vol.12, 2009, p. 495-508

This article aims to analyse how national policy guidelines concerning case management were translated into local practices in mental health service delivery in rural areas of Sweden. A sample of 15 case management teams was studied. Results showed that rural case managers designed their work methods themselves, entailing several deviations from nation policy guidelines. Case management boards had little control over the activities of case managers, who consequently developed into welfare entrepreneurs. As a result of local negotiation and adaptation, case management in rural Sweden differed from what was envisaged in national policy guidelines.