Designations and Categorisation: Its Content and Consequences in the Swedish Mental Health Landscape.

Designators for people who use welfare services have been under change and are under continuous debate. This paper investigates the usage and meaning of designations used in interaction between human service organisations representatives (HSORs) and service user organisations representatives (URs). 75 unique terms were found in audio-recordings of observations of eight Swedish mental health strategic collaboration councils’ meetings. Seven analytical categories were set up in relation to characteristics, aim, when it was used, and who were using the category. These were the cog in the organisation, the representative, the ordinary but eccentric, the independent but dependent, the person in need of change, the trapped, and the member.

HSORs mostly used the Swedish equivalents of “service user”, “client”, and “patient”. The URs mostly used “members”, followed by “people”, and “persons”, or expressions like “many of us who…”. Results showed that participants were in negotiation on what characteristics service users had, where the categories were used for certain aims. URs and HSORs shared some categories, such as the ordinary but eccentric. Some categories were used with differing aims and starting points, such as the representative. One group exclusively used some, e.g. the URs and the trapped. The use of categories were divided in a collective and an individual perspective. Participants agreed on service users having complex needs but not essentially different. Service user representatives emphasised a structural perspective, a society unequipped to meet service users’ needs while respecting their citizenship. Professionals more often used the individual perspective. Their categories were better established and thus more resilient to resistance, while also connecting to the individual explanation models widely spread in mental health care. Agency was seen in both the URs’ use of alternative designations and the joint aim to emphasise the “normal” found in category the ordinary but eccentric.