This paper was written on the occasion of the third edition of the “Prize for humane mental health care”, organized by the psychiatric hospital in Sleidinge. It is an account of my first year as a social worker in mental health care, in which I focus on the struggle one can experience while working within the rules set up to ensure “quality care”. This set of rules has a profound effect on the bodily and psychological wellbeing of the patients. Its one-sided focus on safety and organization makes it difficult for social workers to work with their patients on a psychological level. Furthermore, constant adherence to these rules seems to provoke aggression when they primarily target the body. I will present several clinical examples that describe how “quality care” does not achieve its own goals, and can lead to ridiculous situations. The conceptualization of mental health care should not be fixed, but something we have to invent every day anew.
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