Public services need new approaches in encountering vulnerable individuals

In her dissertation, Päivi Kirjavainen examines narrative videotaped accounts of individuals with severe mental illnesses and those recovering from substance abuse. In Finnish public healthcare services, their experiences of inclusion often remain unrealised due to prejudices, power dynamics, and staff turnover. In contrast, interactions within third-sector services and with close relatives are perceived as more humane and respectful.

– A respectful interaction, where a person feels heard and seen as themselves without fear of stigma, is key to experiencing inclusion. For vulnerable individuals, this experience is often weak within public healthcare services, says Kirjavainen, who will defend her dissertation at the University of Vaasa on 28 November.

New methods through experiential knowledge and collaboration

According to Kirjavainen, fostering a sense of inclusion among vulnerable individuals can be improved by enhancing public sector employees’ abilities to engage with people from diverse backgrounds. For vulnerable individuals, acting as experiential experts often increases their sense of purpose. Services could be developed collaboratively, allowing vulnerable individuals to express their needs within their capacities.

– Strengthening inclusion is possible if experiential knowledge is genuinely and open-mindedly heard. Collaboration should be increased at all levels of the service ecosystem. The complementary role of third-sector activities and their innovative models of interaction can enrich public sector services, especially when resources are scarce, Kirjavainen notes.

The study’s material consists of 150 videotaped accounts from vulnerable individuals in Finland, where they shared their experiences of receiving help and support within the Finnish public healthcare system. These narratives were analysed using narrative methodology, with a focus on theories and prior studies related to inclusion.

Although the study is based in Finland, Kirjavainen notes that the results can be partially generalisable to other contexts. The importance of respectful interaction where individuals feel heard and seen as themselves rather than as a diagnosis, may be applicable to other vulnerable groups and service systems.

Public defence

The public examination of M.Sc. (Health Sci.) Päivi Kirjavainen’s doctoral dissertation ”Haavoittuvassa asemassa olevan osallisuuden kokemuksen muodostuminen. Kohtaamisia julkisessa palvelujärjestelmässä” will be held on Thursday 28 November at 2 pm in auditorium Nissi at the University of Vaasa.

Participation in the defence is possible also online:

https://uwasa.zoom.us/j/65531459579?pwd=LD9KuoX9Z7MGm66LOLvKnEzpZq7RbI.1

(password: 494328)

Docent Anna-Maria Isola (Finnish Institute for Health and Welfare) will act as opponent and Professor Harri Jalonen as custos.

Doctoral dissertation

Kirjavainen, Päivi (2024) Haavoittuvassa asemassa olevan osallisuuden kokemuksen muodostuminen. Kohtaamisia julkisessa palvelujärjestelmässä. Acta Wasaensia 544. Doctoral dissertation. University of Vaasa.

Publication pdf