Recent trends in government mental health policy encourage services delivered by trained professionals in the homes of service users (Ministry of Social Affairs and Health, 2009). Giving and receiving floating support is based on close relationships between workers and service users. Transfer has meant "changing the geography of care" or "changing the spatial context of care" in the sense that home space is increasingly the location of professional care work (Milligan, 2000; Williams, 2002; Hall, 2011).
In this research tradition, the home is considered as a complex construction that includes cultural-ideological and material aspects (Twigg.. 2005, p. 182) writes that the geography of the home is not empty, a static space takes place within care: it is constructed through material and social practices , which transform its meanings and lived materiality". She wrote (Richmond, 1899, pp. 186–189) that "the visitor has the definite object of trying to improve the condition of the family". As Margolin (1997, p. 29) puts it: According to Richmond's friendly method, “the poor must always be prevented from noticing that facts are being gathered and judgments are being made”.
Accordingly, mental health workers are expected to be supporters (not mere controllers or observers) who respect and enhance the self-determination and (home) privacy of service users. Since floating support takes place in the homes of care users and in the communities in which they live (rather than offices, care homes, assisted living or hospitals), there are good conditions for showing a 'recovery in' kind of orientation in care recipients. interaction with the employee. It is also important to pay attention to the question of whether and how self-determination of the person requesting help is present in the home visits; what kind of identities do they orient themselves towards the professional visitors.
Our study examines in detail how workers and service users balance different identities in home visiting settings.
Personal mugs and photos
Reading the conversations, it's easy to imagine that they're showing a social call interaction where host Jani wants to introduce guests Erin to her new mugs. Erin could be a friend, as she recognizes Jani's parents from the printed photos in the mug (though not necessarily a very close friend, as she does not know Jani's birthday). Jani starts the thread and presents Erin with some of her personal belongings in her home for her to look at.
He also decides what to choose from his private home environment to show and discuss. After this twist, Erin does what guests might be expected to do in our cultural sense: admires the mugs and asks polite questions about the pictures printed on them. Without the material presence of home (the photo mug and the choice to watch the mug together) this kind of social calling conversation would not be possible.
The home space and his personal belongings allow Jani to be active in interaction and have an interested audience with whom to share personal artifacts and family conversations.
No more garbage on the floor
This is the opening sequence of the home visit, right after Sofia has crossed the threshold, greeted Matt, and turned on the recorder. The materiality of the house and what Matti has done in his house are embedded in this interaction from the start. Sofia takes the first turn, which can be heard as a common compliment given by a guest who visits this house after a period of time: 'what have you done here lately, you have clearly made some improvements here at home ?' Matty? responds to the compliment in a culturally typical manner as a host, downplaying improvements made to the home's space.
This kind of assessment of the home space (its cleanliness or otherwise) presented by 'a regular guest' can easily be perceived as intrusive and offensive, as it violates the rules of fluid and polite social conversation. Remarkably, during the same home visit, the parties can switch between a social conversation and a targeted intervention conversation, and sometimes the guest/professional and host/client identity orientations almost overlap, as our next excerpts demonstrate. Ida: yeah for her, it just got a new food bowl so she somehow messed it up there and dropped half the food on the floor or on that tray ((laughs)) what's she got there done more, i'll take a quick look ((goes to look)) aha you've knocked over your head.
As in the previous fragment, the parties - Anna and Ida - orient themselves in the first turns of this interaction on the identity of the guest and the host. The materiality of the house (Ida's cat and its movement in the flat) causes the shift to informal social conversations. The cat approaches Anna, who starts talking to the cat, resulting in a different topic of conversation for the cat and her habits.
What is less usual for talk in the guest-host identity pair is Anna's question related to feeding the cat, and especially. The question is phrased in a way that treats the target of the question, Ida, as a client who may have difficulty caring for the cat. Ida accepts such assessments and orients herself towards the client identity, as she explains how, with the help of her boyfriend, she manages the tasks of looking after the cat and keeping the house clean.
What is less likely to belong to a guest's expected activities is to question the collecting hobby, as Olga does in this conversation. Olga asks an indirect question to Eeva: 'and you're still sorting out the nativity scene collection' and at the same time refers to the other orders that have just been discussed, which also need to be sorted out. Interestingly, sharing home's personal artifacts with Ida and directing Ida's everyday life to more sustainable grounds (not buying as much) triggers and enables Eeva to talk home-space, home-space talk, and identity pair.
Bought washing powder
After discussing the figures, Olga gives reasonable grounds for interrupting the order: 'if you think about the amount of money that will be saved, you can take care of your rent arrears and you can use money on something else'. In this conversation, Rosa focuses exclusively on material measures and activities of the domestic space. Her activities and home-space-related observations are aimed at ensuring Paul's health and everyday life, thus displaying a strong professional identity.
Laundry and cleaning to be done between visits
The materiality of the home is spoken into existence with reference to the laundry and the kitchen table. Homes as private spatial and physical spaces enable and require service users to move between host and client identities, and workers between guest and professional identities. Parties switch their orientations between these identities and identity pairs during home visits.
Homes as places for mental health work provide opportunities to observe and discuss the privacy and artifacts of service users. While the settings of floating support visits are the private homes of the service users and the visits often feature social mannerisms, the professional-client identity pair dominates the encounters. By this we mean that the topics discussed during visits mainly have an institutional agenda: they are goal-oriented (targeted and based on care plans) and follow certain procedures and scenarios, such as talking about the past week and planning for the next week, discussing and monitoring the condition of clients and their apartments (Heritage, 1997, p. 106).
They openly express to the service users their concerns and observations of the home space, ask direct questions about personal matters and give explicit advice. Their professional identity gives them a mandate for supervision if necessary to ensure the service users' health and safety. For example, the worker is less likely to talk about his/her personal life in the same way as is expected of the service user.
The service users accept and seem quite accustomed to the presence of the workers and even rather direct supervision in their homes and lives. The service users not only accept the workers entering their homes, but also the transformation of home spaces into places where they do professional and institutional support and care work. Are they only in the service of targeted interventions, to achieve certain institutional goals, for example to 'help' the service users.
Without denying this instrumental function, moments when clients orient to guest and host identities can create equality, symmetry, and trust between service users and workers, thus increasing the agency of service users (cf. We recognize that detailed observations of visits or videos instead of tape recordings, it would give even more opportunities for analyzing the spatial interaction of home visits and thus the possibility for a stricter combination of these two research approaches. of mental health funded by the Academy of Finland.
Space, relevance, and contingency of action: Sequential analysis of patient records in physician-patient interactions. Roadmap for Mental Health and Substance Abuse Work: Proposals from the 2009 Mieli Working Group for Developmental Health and Substance Abuse Work to 2015.
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