Young Service Users with Mental Health Problems: Barriers to Implementing a Symmetrical Human Service Relationship

Based on a multi-sited qualitative research study, this article applies a service user perspective when exploring how young service users with mental health problems experience the everyday relationship with service providers. Utilizing theoretical aspects from Institutional Ethnography, the article illustrates how different ruling ‘texts’ coordinate the everyday interactions between service users and professional front-line workers. The article argues that the institutional practice of distinguishing between the formal and informal sphere clashes with the study participants’ individual needs for a symmetrical relationship built on lasting and more personal care relations. The article further discusses the dilemmas of implementing a service relationship that requires the street-level bureaucrat to step outside the bureaucratically and formally defined work assignment to build informal and individual relations to the service users as an official part of their everyday work.