Incremental change without policy learning: Explaining information rejection in English mental health services

Abstract

This paper reviews recent policy changes in English mental health services and the nature of the evidence base that has guided these changes. In particular, the paper focuses on different groups within mental health policy and practice, citing examples of information rejection by each of the key stakeholders. Drawing on a neo-Durkheimian institutionalist framework, the paper argues that each group classifies the world, remembers and forgets, and rejects the information that they do, in order to solve or at least to cope with the organizational challenges and pressures they face, which in turn are the product of informal institutions. As a result of this, the ideas and assumptions underpinning English mental health policy have remained remarkably consistent over time, due in part to the fact that different stakeholders have been institutionally disposed to hear only a limited range of messages from the growing evidence base and correspondingly find it very difficult to engage in constructive debate with each other or reach consensus.

Additional information

Notes on contributors

Perri 6

Perri 6 is Professor of Social Policy at Nottingham Trent University. He has recently conducted a major study on how settlements are reached between inter-agency working and client confidentiality. Recent publications include: Beyond Delivery with E. Peck, Managing Networks of Twenty First Century Organisations with N. Goodwin, E. Peck and T. Freeman, and E-governance: Styles of Political Judgment in the Information Age Polity

Jon Glasby

Dr Jon Glasby is a Reader in Health and Social Care at the Health Services Management Centre, University of Birmingham. A qualified social worker by background, he leads a national programme of research, teaching and development around inter-agency collaboration

Helen Lester

Helen Lester is a GP and Professor of Primary Care at the National Primary Care Research and Development Centre at the University of Manchester, with a particular interest in health inequalities, mental health and quality of care. She is the primary care lead for the national mental health research network and heads the expert panel that advises the Department of Health in the UK about the primary care Quality and Outcomes Framework. Her work on the views of GPs and patients on the quality of care for people with serious mental illness was awarded the RCGP paper of the year in 2005, and in 2006 she was awarded the John Fry medal for her contribution to UK primary care