The clinical governance of the soul: 'deep management' and the self-regulating subject in integrated community mental health teams.
Health professionals have often been described as if they were in conflict with the new managerialist spirit in health care. However, because of their distributed and mobile sites of intervention, the work of community teams presents particular problems for traditional notions of management. In this UK study we identify how mental health team members are regulated by means of a subtle 'deep management'. Team members point to a lack of management direction from senior colleagues, even though some of them participate in the management process themselves. However, the lack of overt management leads them to prioritise clients and foreground professional identities in performing their duties and much additional administrative work besides. This also meant that the organisational structure-the team-was defined in subjective terms. Participants had become self-regulating 'deep managed' subjects under a largely hands-off management regime.
Brown
Brian
B
Faculty of Health and Community Studies, De Montfort University, Milton Keynes, UK. brown@dmu.ac.uk
Crawford
Paul
P
D000288:Administrative Personnel; D002983:Clinical Competence; D003156:Community Mental Health Services / Q000458:organization & administration*; D003659:Decision Making, Organizational; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D009788:Occupational Therapy; D010348:Patient Care Team / Q000458:organization & administration*; D017064:Process Assessment, Health Care; D017009:Professional Autonomy; D011570:Psychiatry; D011586:Psychology, Clinical; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration; D012949:Social Work, Psychiatric; D013647:Task Performance and Analysis; D006113:United Kingdom; D000078329:Workforce