The recovery perspective in assertive community treatment : how is it done and what does it mean to services users and service providers?
The present study proposes an exploration of the daily actions and interactions amongst various actors in an Assertive Community Treatment psychiatric team as a way to understand the practical operationalization of mental health policy orientations such as recovery. Chapters one and two illustrate some of the paradoxes, challenges and concerns related to the various conditions of mental health practice in an intensive community mental health team in the context of current mental health policies. In particular, the development and ensuing legitimacy of both Assertive Community Treatment and recovery-oriented practice in Québec as well as the current organizational contexts and intervention approaches are detailed. The third chapter outlines the framework for the study, which is based on a critical constructionist perspective and draws upon critical practice, ethnomethodology, and framing theories for data analysis. The fourth chapter summarizes the ethnographic methodology undertaken for data collection.  This transpired during 7 months of immersive participant observation with an urban Montréal team of mental health professionals and service users. Consistent with ethnographic methods, the fifth chapter presents a “thick description” of the team, the various actors, and the context of practice.  The sixth chapter illustrates the opportunities and challenges of acting and interacting in an intensive community mental health team at the intersection of traditional medical paradigms, and recent policy paradigms, such as recovery and managerialism. The seventh chapter illustrates everyday experiences of service providers and service users as seen through their activities and conversations as well as the actualization of their roles. Drawing on case examples and detailed citations and observations each of the three results chapters explains how daily actions and interactions are accomplished and influenced by context, practice routines, and conversations. The eighth chapter reflects on the ways service providers and service users in a local, urban Montréal ACT team interact in their current context.  This final discussion chapter provides a deeper reflection as to how and why relationships with each other, and with madness, are produced and mobilized.
Recovery Mental health Assertive Community Treatment Practice