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Where the wicked problems are: The case of mental health

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  • Hannigan, Ben
  • Coffey, Michael
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    Abstract

    Objective To use system ideas and the concept of 'wicked problems' to frame examination of a decade-and-a-half of UK mental health policy.Methods Theoretically informed policy analysis.Results Modern health care is complex, and mental health care particularly so. In the UK the mental health system has also become a policymaking priority. Features of this system mean that many of the problems policymakers face are of the 'wicked' variety. Wicked problems are resistant. Problem formulations and their solutions are contestable. Solutions which have 'worked' in one setting may not 'work' in another, and evidence to guide change is open to challenge. Actions trigger waves with widespread system consequences. In the case of the UK's mental health field significant shifts have taken place in formulations of 'the problem' to which actions have been directed. These have included assessments of community care failure, formulations emphasising problems with the professions and, most recently, the need for action to promote mental health and wellbeing.Conclusions In their efforts to secure improvement in a neglected field UK policymakers have unleashed a torrent of top-down actions. Attention needs to be paid to constructing strong, system-wide, partnerships and to examining the cumulative impact of policy actions.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0168851010003325
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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 101 (2011)
    Issue (Month): 3 (August)
    Pages: 220-227

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    Handle: RePEc:eee:hepoli:v:101:y:2011:i:3:p:220-227

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    Web page: http://www.elsevier.com/locate/healthpol

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    Keywords: Great Britain Health policy Health services administration Mental health Organisation and administration Public policy;

    References

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    1. Casiday, Rachel Elizabeth, 2007. "Children's health and the social theory of risk: Insights from the British measles, mumps and rubella (MMR) controversy," Social Science & Medicine, Elsevier, vol. 65(5), pages 1059-1070, September.
    2. Kelly, Brendan D., 2005. "Structural violence and schizophrenia," Social Science & Medicine, Elsevier, vol. 61(3), pages 721-730, August.
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    Cited by:
    1. Hannigan, Ben, 2013. "Connections and consequences in complex systems: Insights from a case study of the emergence and local impact of crisis resolution and home treatment services," Social Science & Medicine, Elsevier, vol. 93(C), pages 212-219.
    2. Moran, Valerie & Jacobs, Rowena, 2013. "An international comparison of efficiency of inpatient mental health care systems," Health Policy, Elsevier, vol. 112(1), pages 88-99.

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