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EU mental health governance and citizen participation: a global governmentality perspective

Published online by Cambridge University Press:  17 August 2020

Kristin Edquist Open the ORCID record for Kristin Edquist [Opens in a new window]
Kristin Edquist*
Affiliation:
Department of Political Science, International Affairs, & Public Administration, Eastern Washington University, 526 Fifth Street, Patterson 233K, Cheney, WA99004, USA
*
Corresponding author. Email: [email protected]
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Abstract

Over the last three decades, a system of European Union mental health governance (EUMHG) emerged, via instruments including strategies for action, joint actions, pacts and high-level expert groups. It sponsored multiple projects, initiatives and research, and involved state, non-state and European institutional actors. This paper attempts to understand how EUMHG operated and the structure of political relations within it, attending especially to opportunities for citizen participation. It adopts a global governmentality approach that focuses on practices and discourses. It finds that EUMHG practices including benchmarks, best practices and risk-thinking reinforced larger EU policy goals of market-optimisation, and that the central discourses of de-institutionalisation (DI) and community mental health (CMH) shifted meaning over time, first apprehending mental health as a public-health goal, then targeting mental ill-health as a burden to states. Finally, it finds that non-governmental organisations' (NGOs) work within EUMHG rendered them both objects and subjects of government. Through these dynamics, citizens usually were positioned outside governance, and NGO identities were altered, though CMH's transformative potential remained. Citizen participation in EUMHG was heavily conditioned. NGO and citizen power will need vigilant protection in any future EUMHG.

Keywords

Critical IR theorydiscursive practicesEuropean Unionnew governancesoft law
Type
Article
Information
Health Economics, Policy and Law , Volume 16 , Special Issue 1: SPECIAL ISSUE: The future of EU health law and policy , January 2021 , pp. 38 - 50
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Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Alemanno, A (2018) Beyond Consultations: Reimagining EU Participatory Politics. Part of the Reshaping European Democracy project, Democracy, Conflict, and Governance Program, Carnegie Europe, Carnegie Endowment for International Peace.Google Scholar
Babini, VP (2014) Looking back: Italian psychiatry from its origins to law 180 of 1978. The Journal of Nervous and Mental Disease 202, 428–431.Google ScholarPubMed
Bendell, J (2006) Debating NGO Accountability. Geneva: UN Non-Governmental Liaison (NGLS), August.Google Scholar
Bogard, W (1998) Sense and segmentarity: some markers of a Deleuzian-Guattarian sociology. Sociological Theory 16, 52–74.CrossRefGoogle Scholar
Borrás, S and Greve, B (2004) Concluding remarks: new method or just cheap talk? Journal of European Public Policy 11, 326–336.CrossRefGoogle Scholar
Bueger, C (2017) Territory, authority, expertise: global governance and the counter-piracy assemblage. European Journal of International Relations 24, 614–637. doi: 10.1177/1354066117725155CrossRefGoogle Scholar
Bueger, C and Gadinger, F (2018) International Practice Theory, 2nd Edn. Cham: Palgrave/Macmillan.CrossRefGoogle Scholar
Chandler, JA (2014) Introduction. In Chandler, JA (ed.), Comparative Public Administration. New York: Routledge, pp. 1–7.CrossRefGoogle Scholar
Coldefy, M and Curtis, SE (2010) The geography of institutional psychiatric care in France 1800–2000: historical analysis of the spatial diffusion of specialised facilities for institutional care of mental illness. Social Science & Medicine 71, 2117–2129.CrossRefGoogle ScholarPubMed
Commission of the European Communities (2005) Green Paper: Improving the Mental Health of the Population. Towards a Strategy on Mental Health for the European Union. COM(2005) 484 Final. Brussels: Commission of the European Communities.Google Scholar
Commission of the European Communities, Directorate-General of Consumers, Health and Food (2013) Joint Action on Mental Health and Wellbeing. Public Health Programme, European Union. 1 February. Brussels. Available at http://www.mentalhealthandwellbeing.eu/the-joint-action/#organization (Accessed 12 December 2019).Google Scholar
Dale, R (2004) Forms of governance, governmentality, and the EU's open method of coordination. In Larner, W and Walters, W (eds), Global Governmentality: Governing International Spaces. London: Routledge, pp. 174–194.Google Scholar
Drake, RE, Green, AI, Mueser, KT and Goldman, HH (2003) The history of community mental health treatment and rehabilitation for persons with severe mental illness. Community Mental Health Journal 39, 427–440.CrossRefGoogle ScholarPubMed
Edquist, K (2008) Globalizing pathologies: mental health assemblage and spreading diagnoses of eating disorders. International Political Sociology 2, 375–391.CrossRefGoogle Scholar
Edwards, M and Hulme, D (1996) Introduction. In Edwards, M and Hulme, D (eds), Beyond the Magic Bullet: NGO Performance and Accountability in the Post-Cold War World. West Hartford, Connecticut: Kumarian Press, pp. 1–20.Google Scholar
EU Compass Consortium (2018) EU Compass for Action on Mental Health and Well-being Good Practices Brochure: Good Practices in Mental Health and Well-being. European Union in the frame of the 3rd EU Health Programme (2014–2020).Google Scholar
EU High-Level Conference on Mental Health and Well-Being (2008) European Pact for Mental Health and Well-being. Pact of the EU High-Level Conference on Mental Health and Well-Being, Brussels: Commission of the European Union.Google Scholar
EU Joint Action on Mental Health and Wellbeing (2016) European Framework for Action on Mental Health and Wellbeing. Joint Action on Mental Health and Wellbeing, Commission of the European Communities, Brussels: Commission of the European Communities.Google Scholar
European Parliamentary Research Service (2014) The Open Method of Coordination. At a glance, October.Google Scholar
European Public Health Alliance (2007) European Public Health Alliance Home Page. 4 May. Available at http://www.epha.org/a/28.Google Scholar
EU WMH The EU Contribution to the World Mental Health Surveys Initiative (2009–2011) EU WMH The EU Contribution to the World Mental Health Surveys Initiative. Available at http://www.eu-wmh.org/ (Accessed 30 March 2019).Google Scholar
Fears, R and Höschle, C (2011) European mental health policy: opportunities for science and innovation, challenges for implementation. European Journal of Public Health 21, 550–553.Google ScholarPubMed
Fierlbeck, K (2014) The changing contours of experimental governance in European health care. Social Science & Medicine 108, 89–96.CrossRefGoogle ScholarPubMed
Fioritti, A (2018) Is freedom (still) therapy? The 40th anniversary of the Italian mental health care reform. Epidemiology and Psychiatric Sciences 4, 1–5. doi: 10.1017/S2045796017000671Google Scholar
Flear, M (2015) Governing Public Health: EU Law, Regulation and Biopolitics. Oxford: Hart Publishing.Google Scholar
Flynn, R (2002) Clinical governance and governmentality. Health, Risk & Society 4, 155–173.CrossRefGoogle Scholar
Global Alliance of Mental Illness Advocacy Networks (2007) History. 4 May. Available at http://www.gamian-europe-history.org/.Google Scholar
Goldman, M (2005) Imperial Nature: The World Bank and Struggles for Social Justice in the Age of Globalization. New Haven: Yale University Press.Google Scholar
Green, D (2002) Constructivist comparative politics: foundations and framework. In Green, DM (ed.), Constructivism and Comparative Politics London. London: M.E. Sharpe, pp. 3–59.Google Scholar
Greer, SL and Vanhercke, B (2010) The hard politics of soft law: the case of health. Chap. 4. In Mossialos, E, Permanand, G, Baeten, R and Hervey, T (eds), Health Systems Governance in Europe. Cambridge: Cambridge University Press, pp. 186–230.CrossRefGoogle Scholar
Grob, GN (1995) The paradox of deinstitutionalization. Society 32, 51–59.Google Scholar
Grugel, J and Iusmen, I (2013) The European Commission as guardian angel: the challenges of agenda-setting for children's rights. Journal of European Public Policy 20, 77–94.Google Scholar
Harper, D and Speed, E (2012) Uncovering recovery: the resistible rise of recovery and resilience. Studies in Social Justice 1, 9–16.CrossRefGoogle Scholar
Jones, J (2000) Mental health care reforms in Britain and Italy since 1950: a cross-national comparative study. Health and Place 6, 171–187.CrossRefGoogle ScholarPubMed
Jones, J (2001) The geography of mental health. Epidemiologia e Psichiatria Sociale 10, 219–224.CrossRefGoogle ScholarPubMed
Killaspy, H, McPherson, P, Samele, C, Keet, R and Caldas de Almeida, JM (2018) Providing Community-based Mental Health Services. Position Paper, EU Compass for Action on Mental Health and Well-being, Commission of the European Union.Google Scholar
Kingdom, J (2014) The United Kingdom. In Chandler, JA (ed.), Comparative Public Administration, 2nd Edn. New York: Routledge, pp. 7–34.Google Scholar
Larner, W and Le Heron, R (2004) Global benchmarking: participating ‘at a distance’ in the global economy. In Larner, W and Walters, W (eds), Global Governmentality: Governing International Spaces. London: Routledge, pp. 212–232.CrossRefGoogle Scholar
Li, TM (2007) Practices of assemblage and community forest management. Economy & Society 36, 263–293.Google Scholar
McAdam, R and O'Neill, L (2002) Evaluating best value through clustered benchmarking in UK local government: building control services. The International Journal of Public Sector Management 15, 438–457.Google Scholar
Mental Health Europe (2007) Mental Health Europe – Sante Mentale Europe aisbl. Available at http://www.mhe-sme.org/assets/files/MHE%20response_final.pdf (Accessed 30 September 2007).Google Scholar
Nakov, V and Hinkov, H (2018) Mental Health Services in Bulgaria. Final Programme Third EU Compass Forum on Mental Health and Well-being. Luxembourg: Third EU Compass Forum on Mental Health and Well-being.Google Scholar
O'Malley, P (1995) Indigenous governance. Economy and Society 25, 310–326.CrossRefGoogle Scholar
Overman, ES and Boyd, KJ (1994) Best practice research and postbureaucratic reform. Journal of Public Administration Research and Theory 4, 67–84.Google Scholar
Park, S (2004) The role of transnational advocacy networks in reconstituting international organization identities. Seton Hall Journal of Diplomacy and International Relations V, 79–92.Google Scholar
Priebe, S, Matanov, A, Demi, N, Blagovcanin Simic, J, Jovanovic, S, Gajic, M, Radoni, E, Bajraktarov, S, Boderscova, L, Konatar, M, Nica, R and Muijen, M (2012) Community mental health centres initiated by the South-Eastern Europe stability pact: evaluation in seven countries. Community Mental Health Journal 48, 352–362.Google ScholarPubMed
Rose, N (1998) Governing risky individuals: the role of psychiatry in new regimes of control. Psychiatry, Psychology and Law 5, 177–195.Google Scholar
Samen Sterk Zonder Stigma (2018) Stronger Together without Stigma (Samen Sterk Zonder Stigma). Third EU Compass Forum Day One session. Luxembourg City, 2 February.Google Scholar
Sending, O and Neumann, I (2006) Governance to governmentality: analyzing NGOs, states, and power. International Studies Quarterly 50, 651–672.Google Scholar
Simonet, D (2008) The New public management theory and European health-care reforms. Canadian Public Administration/Administration Publique Du Canada 51, 617–635.Google Scholar
Sklair, L (2001) The Transnational Capitalist Class. London: Blackwell.Google Scholar
South-Eastern Europe Health Network (2008) Mental Health Project for south-eastern Europe Dubravka Velasevic. 1 October. Available at https://ec.europa.eu/health/ph_international/int_organisations/docs/ev_20081001_co06_en.pdf (Accessed 29 January 2020).Google Scholar
Ventriglio, A (2016) Editorial: community mental health services and responsibility of psychiatrists in Italy: lessons for the globe. International Journal of Social Psychiatry 62, 501–504.Google Scholar
Wahlbeck, K (2011) European mental health policy should target everybody. European Journal of Public Health 21, 551–553.Google ScholarPubMed
Wahlberg, A and Rose, N (2015) The governmentalization of living: calculating global health. Economy and Society 44, 60–90.Google Scholar
Walters, BH, Heerink, F, Steenhuis, C and Petrea, I (2016) Good practices in mental health and wellbeing. Deliverable 11a of the EU Compass Consortium under the service contract number 2014 71 03, European Union in the frame of the 3rd EU Health Programme (2014-2020).Google Scholar
Warwick, J (2005) Review of Soft Law in European Community Law, by Linda Senden (2004). Common Market Law Review. Vol. 42. Kluwer Law International. 1203–1205.Google Scholar
WHO European Ministerial Conference on Mental Health (2005) Mental Health Action Plan for Europe: Facing Challenges, Building Solutions. EUR/04/5047810/7, Helsinki: WHO Europe.Google Scholar
World Health Organization (1999) Balancing Mental Health Promotion and Mental Health Care: A joint World Health Organization/European Commission meeting. MNH/NAM/99.2, Nations for Mental Health, Department of Mental Health, Social Change and Mental Health, World Health Organization and European Commission, Directorate Public Health & Safety at Work, Geneva: World Health Organization.Google Scholar