Young people with complex needs meet complex organizations: an interview study with Swedish professionals about sustainable work practices

ABSTRACT

This paper concerns preconditions for the well-being of young people with mental ill-health combined with social vulnerabilities, also referred to as youth with complex needs. Research questions are: What barriers to sustainable work practices for young people labelled as having complex needs do professionals encounter? What do professionals identify as possible ways to overcome these barriers? Sustainable work practices are reflected in three themes: empowerment, relationships and collaboration. The findings are based on semi-structured interviews with 24 professionals, 3 men and 21 women, working in psychiatric care and the social services in two Swedish municipalities in 2016 and 2017. Major barriers are lack of continuity and co-ordination in staff and support, and fragmentation of work practices. As a consequence of the increased specialization of human service organizations, young people have to interact with many different professionals which could cause disparate interventions. Possible ways mentioned to overcome these barriers are supported through good interactional skills, using keyworkers as well therapeutic alliances, wrap-around services and case management. Complexity is linked to organizations and work practices rather than to young people. An often dysfunctional service delivery system in organizations with rigid boundaries may also affect professionals’ aim for sustainable support.

RÉSUMÉ

Cet article concerne les conditions préalables au bien-être des jeunes souffrant de maladies mentales associées à des vulnérabilités sociales, également appelées jeunes ayant des besoins complexes. Les questions de recherche sont les suivantes: Quels sont les obstacles aux pratiques de travail durable pour les jeunes considérés comme ayant des besoins complexes? Qu'est-ce que les professionnels identifient comme moyens possibles de surmonter ces obstacles? Les pratiques de travail durable se reflètent dans trois thèmes: l'autonomisation, les relations et la collaboration. Les résultats sont basés sur des entretiens semi-structuré avec vingt-quatre professionnels, trois hommes et vingt et une femmes, travaillant en psychiatrie et dans les services sociaux dans deux municipalités suédoises en 2016 et 2017. Les principaux obstacles sont le manque de continuité et de coordination, dans le personnel et le soutien, et la fragmentation des pratiques de travail. En conséquence de la spécialisation accrue des organisations de services humains, les jeunes doivent interagir avec de nombreux professionnels différents, ce qui peut entraîner des interventions a disparetres. Les moyens possibles de surmonter ces obstacles sont le soutien par de bonnes compétences interactionnelles, l’utilisation de travailleurs clés ainsi que des alliances thérapeutiques, des services complets et la gestion de cas. La complexité est liée aux organisations et aux pratiques de travail plutôt qu'aux jeunes. Un système de prestation de services souvent disfonctionnels dans des organisations aux frontières rigides peut également affecter l’objectif des professionnels en matière de soutien durable.

KEYWORDS:

• Complex needs
• sustainability
• Sweden
• well-being
• work practices
• young people

MOTS-CLÉS:

• Besoins complexes
• durabilité
• Suède
• bien-être
• pratiques de travail
• jeunes

Acknowledgement

We would like to thank the participants for the generous sharing of their experiences.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Anna-Lena Almqvist is an Associate Professor in Social work from Mälardalen University, Eskilstuna, Sweden. Her research focuses on work, youth and their families, and policy issues, often in a comparative perspective. Recent projects concern youth with complex needs, families with two mothers and teenage parenthood in Thailand. She has recently published in the American Journal of Men’s Health, Child and Adolescent Social Work Journal, and Men and Masculinities.

Kitty Lassinantti is a Senior Lecturer in Social Work from Mälardalen University, Eskilstuna, Sweden. Her research focuses on critical medical sociology, with a particular focus on psychiatric diagnoses and identity construction, disability and gender. Her thesis ‘The Dilemmas of Diagnosis’ is a qualitative study of how women negotiate identity in relation to a neuropsychiatric diagnosis. She has recently published in Child and Adolescent Social Work Journal.

ORCID

Anna-Lena Almqvist http://orcid.org/0000-0002-6223-1109

Kitty Lassinantti http://orcid.org/0000-0001-5387-325X

Additional information

Funding

Mälardalen Skills Centre for Health and Welfare (MKHV) has funded the project ‘Young people with complex needs', grant No. 2016/2198.