Suppressed voices and lost opportunities in education and the psychiatric healthcare system – a structural analysis of dilemmas in inter-professional collaboration between sectors

Abstract

This article will discuss the dilemmas, limitations and lost opportunities arising in collaborative inter-professional everyday practice across education and psychiatric healthcare systems in a national Danish context. The analysis in the article builds on empirical findings derived from a development project initiated by several regional child psychiatry centres in various Danish municipalities which aimed to develop inter-professional collaboration on early intervention for children and young people who experience mental health problems. The article will provide a structural analysis emphasising the relationship between structural conditions and subjective possibilities and limitations (Dreier 2009) of inter-professional collaboration. Focusing on organisational challenges in inter-professional everyday professional practice, the article will discuss difficulties in providing timely help and resources for children and families who are in contact with the psychiatric system. The article takes its point of departure in empirical findings derived from a development project on collaborative inter-professional practice between school professionals, educational psychologists and child psychiatrists related to early inter-professional and cross-sectoral interventions. Drawing on concepts from social practice theory and critical psychology of situated inequality (Højholt 2017), the positions and possibilities of professionals in collaboration as well as of children and families will be discussed. The empirical analysis shows that situated inequality as part of structural dilemmas may result in suppressed voices and lost opportunities in early inter-professional and cross-sectoral interventions.