title: Opening the gift: social inclusion, professional codes and gift-giving in long-term mental healthcare.
abstract: Deinstitutionalisation has not only made the social inclusion of clients a key objective in long-term mental healthcare, it may also affect the role of the care professional. This article investigates whether the social inclusion objective clashes with other long-standing professional values, specifically when clients give gifts to care professionals. In making a typology of gifts, we compare the literature on gift-giving with professional codes for gifts and relate both to the objective of social inclusion of clients. Our typology draws on an analysis of ethnographic fieldwork carried out in 2007/2008 at a Dutch mental healthcare centre. We identify four types of gifts for professionals in long-term mental healthcare, each relating individually to professional codes and the objective of social inclusion of clients. Only the 'personal gift' directly supports social inclusion, by fostering personal relationships between professionals and clients. Acceptance of this type of gift is advocated only for long-term care professionals. We suggest that professional codes need to consider this typology of gifts, and we advocate promoting reflexivity as a means of accounting for professional behaviour in deinstitutionalised care settings.
authors.affiliation: Department of General Practice, Academic Medical Centre/University of Amsterdam, Medical Ethics Section, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands. s.t.ootes@amc.uva.nl
authors.forename: S T C
authors.initials: ST
authors.lastname: Ootes
authors.forename: A J
authors.initials: AJ
authors.lastname: Pols
authors.forename: E H
authors.initials: EH
authors.lastname: Tonkens
authors.forename: D L
authors.initials: DL
authors.lastname: Willems
mesh_terms: D003156:Community Mental Health Services / Q000941:ethics*; D016265:Conflict of Interest; D037921:Gift Giving / Q000941:ethics*; D017408:Guidelines as Topic; D006282:Health Personnel / Q000941:ethics*; D006801:Humans; D008134:Long-Term Care / Q000941:ethics*; D009426:Netherlands; D011369:Professional-Patient Relations / Q000941:ethics*; D012933:Social Identification