Actor-Networking European Union Mental Health Governance, 1999-2018

Abstract

Over the past three decades, a system of European-Union mental health governance (EUMHG) has emerged that incorporates a wide variety of stakeholders and consists of soft law instruments like Green Papers, Joint Actions, and Frameworks for Action. This paper applies actor-network theory (ANT) to EUMHG as it operated between 1999-2018, to understand its operation and significance. ANT is a process of identifying the moments of ‘translation‘—the means and processes that integrate disparate actors—into networks. Such moments in EUMHG include the problematisation of mental health, the enrolment of actors and actants in EU-level governance processes, and the use of obligatory passage points through which actors must mediate their actions and views to join a network. This analysis shows that three distinct though sometimes concurrent actor-networks have operated within EUMHG from 1999-2018, distinguishable by their core problematisations of mental ill health and its role in European societies: a public health actor-network, a disease-burden actor network, and a de-institutionalisation and Community Mental Health actor-network. This analysis shows that the Commission of the European Union has acted as actor-network builder in the former and last networks, but not the middle, where international health organisations have played that role. In each network, different actors are the recognized experts. The paper therefore indicates that because mental health and mental ill health have not been stable scientific concepts, a specific ‘epistemic community’, e.g., of psychiatrists or psychologists, has not held a definitive role in EUMHG. Indeed, it shows that EUMHG has produced varying constellations of actors, actions, and expertise at any given time, and that they may contradict each other's purposes. These findings contribute to scholarly understanding of changes in EU governance from the early 2000s, specifically in terms of the Commission's role as an executive body, its engagement of scientific expertise, and its relations to civil society and international organizations.