Lendle

The deinstitutionalization of mental health care has been seen as an all-round good thing. There are, though, some unintended consequences: the effects on family caregivers and the promotion of self-management strategies have devolved responsibility from services to the individual. Is this the neo-liberal ideology extending into the home?
These questions are explored in two essays that focus on aspects of modern mental health care in the UK, but that draw on international perspectives.
The first essay looks at the experience of family caregivers who look after a relative with mental health problems. It discusses their situation in a global context that is heavily influenced by the current neo-liberal dominance in the economic and political arena. While not intending to be unsupportive of individual service users and assigning them a negative role in the discourse, the essay aims to highlight that there are also victims of deinstitutionalization: in many cases families have been let down and the promise of community care has not been followed with meaningful support and help in times of need.
The second essay looks at the promotion of self-management in schizophrenia. Here a more positive role for the service user is discussed, with strategies for the promotion of self-management based on the lived experiences of individual service users, and the wider evidence-base that underpins much of health care across the world.