The illusion of inclusion : an analysis of participation, empowerment and community-based decision-making in mental health planning
Date
1993
Authors
Tate, Mary Elizabeth
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
This study explores how participation, empowerment and community-based decision-making materialize in the everyday world of consumers and community members seeking to be involved in policy and planning for publicly-funded government mental health services.
Using a method of inquiry called institutional ethnography and working within a participatory framework, data was collected through participant observation , documentary analysis and interviews over a period of 10 months. Using the experience of those with less power (consumers, family members and a community advisory group) as the entry point to the study and then linking those experiences to the larger organizational and political context provided an examination of the activities and social relations that construct "participation" "empowerment" and " community-based decision-making".
The analysis revealed two sets of practices arising from two different paradigms of action that worked together to create compliance and an acceptance of non decision-making by the community group. Facilitative practices, designed to create opportunities for inclusion, worked in conjunction with the set of decision-making practices that dominate government bureaucracies to create an environment where community members began to organize themselves to have less involvement in decision-making. This "knitting together " of the apparently contradictory sets of practices as ruling relations served to keep community members feeling good , viewed as competent contributors to community planning processes, but disempowered, and created the illusion of participation and inclusion.