Changing Belgian Mental Healthcare Delivery - Enacting Policy Learning

Based on sociological analyses of Belgian mental healthcare reforms, this paper demonstrates how policy learning occurs in that field –through the process of devising policy change – and how it impacts on policy change, such as mediated through collective action and social interactions taking place in relation to policy change. It first defines coalitions of actors, institutional power struggles and conflicts of paradigms representing barriers and opportunities for policy change. Then, by using the phenomenology of Embodied, Inscribed and Enacted Knowledge in Policy (Freeman & Sturdy, 2014), it identifies policy learning resulting from the process of preparing and devising the ongoing “Reform 107”. By providing means to attend to the transformation of policy-relevant knowledge through social interactions, the phenomenology enabled us to identify three ways of learning (by assembling, meeting and anticipating), which are associated to three types of changes in mental health policies (negotiated change, innovation and strategic change).