Brugerinddragelse i psykiatrien: Professionel viden, ansvar og relationsarbejde i forandring.

The paradigm of user involvement expects citizens to take responsibility for managing, monitoring and surveilling their own health. User involvement consequently prepares a path for more basic changes in the relations between citizens and professionals, and existing hierarchies of knowledge and responsibility become challenged. In this article, we explore how professionals in psychiatry translate user involvement in practice, and how their professional responsibility, knowledge and relational work is set under pressure and transformed. The analysis is based on an investigation of professional work and the perspectives of professionals in a part of psychiatric care, where user involvement is an integrated part, i.e. in out-reach psychiatry. Through qualitative in-depth narrative interviews, the article investigates how professionals create a balance between different forms of knowledge and construct quality when they engage in user involvement with citizens. The analysis shows, how especially the balance between risk and responsibility are being played out and negotiated in new ways between professionals and citizens. We illuminate how the perspectives and goals of citizens play a part in the spaces of negotiation of user involvement, and how these often will conflict with goals and professional decision- making. Furthermore, the article presents an analysis of how professionals engage in and create long-term relations to citizens. Relations are seen by professionals as central to succeeding in care and treatment, and emotional work becomes a means in negotiating the goals of citizens, and to reach professional goals. Furthermore emotional work also becomes a means for professionals to process their own feelings and reactions in relation to the difficult practice of user involvement.