The Plan d'action en santé mentale 2005-2010 commands a substantial reform of mental health services organization. In order to achieve this, the Plan draws upon a set of ideas that appear somewhat unsubstantiated in regards to the sciences of organization. This article examines a few of these ideas. The managerial rhetoric of the Plan is anchored in an organizational and mechanistic archetype known for its inadequacy in the central mission of organizations of complex human services such as those concerning mental health. The mechanist rationality adopted marginalizes the real source of the value of mental health services, of practitioners and their social institutions. It participates in a movement that renders organizations always bigger, more abstract and impersonal steered from a distance by superficial indicators. There are good reasons to believe that this approach of organizational engineering will accentuate the eroding of the individual and collective capacities of delivering services of great value.
This article describes the organization of the psychiatric out-patient and in-patient care both the treatment methods of the psychiatric care. The services of the psychiatric out-patient are departments, the rehabilitation-homes, housing for psychiatric patients, an action-centre and a day-ward. The in-patient treatment is given in the Salmijärvi hospitals and there are 121 beds. The treatment as a rule consists of the community therapy, the supportive psychotherapy, family- and group therapy and a medication.
The modern trend in the Republic on Karelia has been to discharge a lot of patients from psychiatric hospitals and to arrange out-patient treatment and follow-up near their homes. The day-care units have been found to be beneficial to many patients. In addition to the medical treatment, many rehabilitating aspects such as work therapy, physiotherapy and patient meetings have an effect on the recovery. Especially treatment of elderly patients can be most reasonably arranged at home.