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Housing support workers as equilibrists between instrumentality and situation

Community-based psychiatry as an arena for studying work efforts is relatively unexplored. The professional role of a housing support worker (HSW) in congregated supported housings for people with severe mental illness (SMI) is fairly new. The role has emerged due to major changes in Swedish mental care and services. Our aim was to describe the work experiences of HSWs and to understand the conditions provided when work assignments are being constructed. By doing this we provide an important piece of the puzzle in understanding the processes in contemporary congregated supported housings for people with SMI. Four focus group interviews were conducted and included 25 participants. Four different facilities of congregated supported housings for people with SMI were represented in the material. The interpretation of the material was inspired by a constructionist approach. The work of an HSW is experienced as complex and ambiguous. Together with different significant actors (including objects), the HSWs are negotiating the content of the responsibilities. Thus, different actors help co-construct the work content. Furthermore, the HSWs are caught between two different logics, one that is related to a complex practice and one that is related to instrumental and routine-based ideas. The complex emotional work of an HSW is often not supported by the principles of the organization. The findings can be helpful when organizing the work in congregated supported housings for people with SMI. This paper highlights the importance of bridging the gap between organizational demands and expectations and the individual preconditions and basic needs.