Rafael Lindqvist

Vocational rehabilitation of the socially disadvantaged long-term sick: inter-organizational co-operation between welfare state agencies

Vocational rehabilitation targeted to the socially disadvantaged long-term sick requires that the client keep in touch with a number of welfare state agencies, all of which have different regulations, conflicting goals and various types of benefits. This is an arduous and time-consuming task for clients with medical, social and labour market problems. Many of these clients run the risk of ending up in a no-mans land or being endlessly circulated between agencies because their problems do not correspond to the profile of the typical client. Both government and welfare workers see institutional co-operation between welfare state agencies as the remedy to such problems. This article, which is based on interviews with participants in fourteen cooperating projects, focuses on difficulties and opportunities experienced in such co-operation. It is concluded that such co-operation, when initiated in local settings and supported by local players, is a way of rejuvenating the existing Swedish model.

'Pupils with special educational needs': a study of the assessments and categorising processes regarding pupils' school difficulties in Sweden

One important goal of Swedish educational policies is to integrate all pupils within regular education, irrespective of disability or difficulties in school, and to adjust education to individual needs. The aim of this paper was to explore how schools ‘socially construct’, i.e. identify and support, pupils with special educational needs. Another aim was to explore if there were any dominant patterns in the schools’ procedures to differentiate pupils with such needs from ‘normal’ pupils, and how such patterns can be understood in a broader context of educational policies. Interviews were conducted with school personnel from two compulsory schools in a municipality in northern Sweden. We chose to use the grounded theory approach for analysing the interview data. The analysis indicated that there were three different patterns or models for identifying and supporting pupils with special educational needs: a pedagogical, a social or a medical model. Various professionals were involved in different ways in each model. Another finding was that school personnel did not find it easy to sort out and assess ‘special educational needs’, and that the identification of such needs were conditioned upon resources available for the schools.

Are playgrounds in Norrland (Northern Sweden) accessible to children with restricted mobility

Abstract The purpose of this study was to investigate the accessibility of playgrounds to children with restricted mobility in Norrland. The investigation was carried out as a descriptive postal survey study. The questions in the survey were retrospective, i.e. addressed the issue of what had or had not been done to adapt the playgrounds for children with restricted mobility. The questionnaire was sent out to all the 54 municipalities in the province of Norrland. In the municipalities that responded to the questionnaire there were in all 2,266 playgrounds. When compiling the answers it appeared that only two of the total number of playgrounds were considered by the municipalities to be completely adapted for children with restricted mobility and that 46 playgrounds were partially adapted for them. The investigation can be seen as an illustration of the social model of disability. The inadequate adaptation of playgrounds to the needs of children with restricted mobility constitutes a very tangible societal...

What is the meaning of special education? Problem representations in Swedish policy documents: late 1970s–2014

In Sweden, as in many other countries, inclusion has been on the political agenda for a long time and has served as a blueprint and guiding principle for practical work in school. However, inclusive education has, by and large, been associated with special education measures, which seriously limit the chances of achieving the vision of inclusion. In this article, we analyse how the meaning of special education is constructed in policy documents from four distinct time periods of Swedish education policy from the late 1970s to 2014. The paper draws on an approach to scrutinise the process of problematisation in public policy-making. Based on the analysis, we argue that there are prospects of a hegemonic intervention regarding the meaning of special education during later years in Swedish education policy, emphasising an individual perspective and individual deficiencies. In contrast to inclusive ambitions, this perspective advocate segregated support measures. Finally, based on previous research and tendencies within the field, we present arguments in the concluding discussion why this hegemonic intervention in education policy also might attract the support of school personnel at the local school level and some potential consequences of the expansion of special education in Sweden.

Vocational rehabilitation between work and welfare ‐ the Swedish experience

Abstract Vocational rehabilitation and activation of the long‐term sick and unemployed have during the last decade become recognized as one of the most important objectives of welfare policy. Vocational rehabilitation incorporates several organisations, among them the medical system, the employers, social security and labour market authorities, who each have their special rules and routines. This article discusses the conditions for cooperation between organisations within this field. Are welfare agencies organised in ways that make adequate help for multi‐problems clients possible? The point of departure is the so‐called neo‐institutionalism within organisational analysis. In the article the different parties will be presented, along with their institutional context. Then different forms of cooperation will be described and analysed, as will the dilemmas and possibilities they bring with them. It is argued that cooperation between organisations is difficult to achieve when each sector of welfare is tight...

Struggling for recognition and inclusion–parents’ and pupils’ experiences of special support measures in school

During the last decade an increasing use of differentiated support measures for pupils with special educational needs, indicative of a discrepancy between educational policies and practices, has been witnessed in Sweden. Another trend has been the increased use of medical diagnoses in school. The aim of this study was to explore the main concern of support given to pupils with special educational needs and how pupils and parents experience and handle this. Interviews were conducted with eight pupils in Grades 7–9—and their parents—at two compulsory schools in a city in northern Sweden. A grounded theory approach was used for analyzing the interview data. A conceptual model was generated illuminating the main concern of special support measures for pupils and parents. The core category of the model, struggling for recognition and inclusion, was related to two categories, which further described how this process was experienced and handled by the participants. These categories were labeled negotiating expertise knowledge within a fragmented support structure and coping with stigma, ambivalence, and special support measures. The developed conceptual model provides a deeper understanding of an ongoing process of struggle for recognition and inclusion in school as described by the pupils and parents.

Case management for people with psychiatric disabilities in rural Sweden; experiences from the implementation of a national policy

The aim is to analyse the implementation of a case manager-model in rural Sweden. A sample of 15 case management teams was selected. Written materials were collected and interviews on location were carried out. Results: rural case managers design their work methods themselves, which entail several deviations from the national policy guidelines in this field. The case management boards have a low capacity to direct and manage the activities of the case managers. Consequently, case managers develop into ‘welfare entrepreneurs’. One salient risk is that teams become isolated from the surrounding welfare system. In conclusion, the Swedish version of case management in rural areas is a result of local processes of adaptation and negotiation that result in services that differ from those envisaged in national policy guidelines.

Establishment of community mental health systems in a postdeinstitutional era: a study of organizational structures and service provision in Sweden.

This article analyzes the state of community mental health services for people with psychiatric disabilities and the interplay between different organizational levels. The study is based on document analysis and interviews with stakeholders in 10 Swedish municipalities. The results show how systems are slow to change and are linked to local traditions. The services are often delivered in closed settings, and the organizations struggle to meet the needs of a new generation of users. There is a gap between local systems and national policies because the latter pays attention to the attributes of a recovery approach.

Rehabilitation in the home ‐ interplay and conflicts between different parties

In this article an organisational and professional perspective is combined with a user approach to analyse the difficulties and obstacles that arise when rehabilitation takes place in the home. The reason for this is that organisations appear to play an increasingly important role in the implementation of welfare policies such as care, home help services and rehabilitation in step with decreasing stringency of central government steering. This increased leeway also brings the potential for increased autonomy for the elderly and the disabled in need of rehabilitation. The fact that professional groups belong to different organisations, have various administrative procedures and aims for their activities means that the goals of professional helpers are not always in accord with the needs and wishes of the care receiver. The article highlights a number of collisions and difficulties that occur when rehabilitation is provided in a home‐setting. It is argued that the opportunities of success in rehabilitation in the home lie in the rehabilitation staff respecting and starting out from the care receivers values, preferences, goals and needs. Professionals must increasingly organise their work around the holistic needs of the disabled person rather than around the individual fields of specialists, who are needed to meet these needs.

The social location of need – surveying psychiatric disability in the community

The majority of studies related to the needs of individuals with psychiatric disabilities focus on their meeting with, and use of, the traditional mental health system. Environmentally relative conceptions of disability have only shown limited success in expanding the views of the field of community psychiatry to include social and organizational contexts. Swedish disability policy emphasizes the individuals ability to participate in community life and may therefore be said to reflect a social approach to disability, in contrast to an exclusively medical perspective that focuses on deficits and the individuals need for psychiatrically defined services. In this study, inventories of need for people with psychiatric disabilities, a legislated responsibility of the social service system in Sweden, were completed for three municipalities. Results indicated that these individuals resist psychiatrically defined categories as they seek supports based on their own experience of need in the community.