Managerial audit and community mental health: a study of rationalising practices in Finnish psychiatric outpatient clinics Auditointi psykiatrisessa avohoidossa: Tutkimus mielenterveystoimistojen käytäntöjen rationalisoinnista

• Published in: European journal of social work Vol. 12; no. 1; pp. 41 - 56
• Main Authors: Saario, Sirpa, Stepney, Paul
• Format: Journal Article
• Language: English
• Published: Taylor & Francis Group 01.03.2009
• Subjects: auditointi; Finland; governmentalisation of government; hallinan hallinnallistuminen; Implementation; Iso-Britania; Management; managerial audit; mental health practice; Mental Health Services; mielenterveystyö; non-institutional psychiatric care; Outpatients; psykiatrinen avohoito; Suomi; tietojärjestelmät
• ISSN: 1369-1457; 1468-2664
• DOI: 10.1080/13691450802221030

In many European welfare states the reform of mental health services has been accompanied by the implementation of new forms of governance, including the introduction of managerial audit systems. While such systems have been developed for 'good causes', such as quality assurance, financial management and monitoring staff performance, they may simultaneously produce diverse and contradictory effects on practice. The aim of this article is to examine the role of one managerial audit system, introduced in psychiatric outpatient clinics in central Finland, and assess its impact on practice. Reference is made to modernising mental health policy in the UK as that has producedsimilar practics outcomes. The research was an empirical study of practice using a mixed-method case study design involving documentary research and semi-structured interviews. Insights from Mitchell Dean's notion of governmentalisation of government were utilised in the analysis. It was found that, although the audit system primarily served administrative needs, it began to reshape practice by reinforcing certain modes of working and excluding others. The analysis of community mental health work in Finland, with similar trends in the UK, highlights the connection between documentation, resource allocation and managerial priorities that reinforce particular styles of practice. In community mental health services it would appear that the problems of professional practice have become the problems of administration.