Culture, Medicine, and Psychiatry

, Volume 43, Issue 3, pp 425–441 | Cite as

Initiating Change: Negotiations of Subjectivity in a Danish Activation Programme for Young Adults with Psychosocial Problems and Common Mental Disorders

  • Julie Høgsgaard AndersenEmail author
  • Tine Tjørnhøj-Thomsen
  • Susanne Reventlow
  • Annette Sofie Davidsen
Original Paper


An increasing number of young adults in Denmark experience difficulties in completing their education and holding down a job. Many of these young adults have psychosocial problems and common mental disorders. To retain public income support they must attend education and work-directed activities, known as ‘activation programmes’. Based on ethnographic fieldwork, this study presents an analysis of how one such programme unfolds in practice and how the participants engaged with the activities and negotiated the underlying rationales. We argue that the activities involved in the programme constitute ‘biographical techniques’ that entail a configuration of the participants as being responsible for their own biographies and having the capability to solve their problems themselves. The participants challenged this configuration of subjectivity by recounting complex or immediate problems that could not be solved through biographical techniques and by refusing to deal with their life stories as a way of configuring their futures. Biographical techniques limited the possibilities for grappling with the complexity of the participants’ problems. We conclude that the participants are therefore subjected to biographical coercion because forms of subjectivity other than biographical subjectivity are disregarded.


Denmark Young adults Common mental disorders Psychosocial problems Biographical subjectivity 



The authors thank the participants in the activation programme and the mentors for participating in the research.


Funding was provided by Helsefonden, Produktion, Forskning og Innovation Region Sjælland, Jascha Fonden, Region Sjællands Sundhedsvidenskabelige Forskningsfonds Ordinære Pulje, Aase og Ejnar Danielsens Fond, Fonden for Almen Praksis and Multipraksisudvalget.

Compliance with Ethical Standards

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


  1. Baines, Rebecca, L., and Sam Regan de Bere (2018). Optimizing patient and public involvement (PPI): Identifying its “essential” and “desirable” principles using a systematic review and modified Delphi methodology. Health Expectations, 21, 327-335.CrossRefGoogle Scholar
  2. Barbour, Rosaline. (2007). Doing Focus Groups. Los Angeles: Sage Publications.CrossRefGoogle Scholar
  3. Bengry-Howell, Andrew, and Christine Griffin. (2012). Negotiating access in ethnographic research with ‘hard to reach’ young people: establishing common ground or a process of methodological grooming? International Journal of Social Research Methodology, 15, 403-416.CrossRefGoogle Scholar
  4. Bernard, Russell. (2011). Research Methods in Anthropology, Qualitative and Quantitative Approaches. Lanham: Dawsonera, AltaMira Press.Google Scholar
  5. Beskæftigelsesministeriet. (2013). Aftale om en reform af kontanthjælpssystemet - flere i uddannelse og job. København: Beskæftigelsesministeriet.Google Scholar
  6. Desjarlais, Robert. (1994). Struggling Along: The Possibilities for Experience Among the Homeless Mentally Ill. American Anthropologist, 96, 886-901.CrossRefGoogle Scholar
  7. Emmerson, Robert, Rachel Fretz, and Linda Shaw. (1995). Writing Ethnographic Fieldnotes. Chicago: The University of Chicago Press.CrossRefGoogle Scholar
  8. Foucault, Michel. (1988). Technologies of the self. In L.H. Martin, H. Gutman, & P.H. Hutton (Ed), Technologies of the self. A seminar with Michel Foucault, 16-49. Amherst: The University of Massachusetts Press.Google Scholar
  9. Foucault, Michel. (2014). Afterword. The Subject and Power. In H.L. Dreyfus, and P. Rabinow (Ed) Michel Foucault: Beyond Structuralism and Hermeneutics, 208-226. New York: ProQuest Ebook Central, Routledge.Google Scholar
  10. Frank, Arthur. (2013). The Wounded Storyteller, body, illness and ethics. Chicago: The University of Chicago Press.Google Scholar
  11. Gubrium, Jaber, F., and James A. Holstein (Ed) (2001). Institutional selves, troubled identities in a postmodern world. New York: Oxford University Press.Google Scholar
  12. Görlich, Anne. (2016). Uden uddannelse og arbejde. Unges tilblivelser i komplekse transitioner. Institut for Læring og Filosofi. Aalborg: Aalborg University.Google Scholar
  13. Görlich, Anne and Noemi Katznelson (2015). Educational trust: relational and structural perspectives on young people on the margins of the education system. Educational Research, 57, 201-215.CrossRefGoogle Scholar
  14. Hansen, Magnus P. (2017). Trying the Unemployed. Justification and Critique, Empancipation and Coercion Towards the ‘Active Society’. A Study of Contemporary Reforms in France and Denmark. Doctoral School of Organisation and Management Studies, Department of Business and Politics. Copenhagen: Copenhagen Business School.Google Scholar
  15. Katznelson, Noemi. (2004). Udsatte unge, aktivering og uddannelse. Dømt til individualisering. Center for Ungdomsforskning, Learning Lap Denmark. København: Danmarks Pædagogiske Universitet.Google Scholar
  16. Katznelson, Noemi, Jørgensen, Helene E. D. Jørgensen, and Niels U. Sørensen. (2015). Hvem er de unge på kanten af det danske samfund? Om hverdagsliv, ungdomskultur og indsatser der gør en positiv forskel. Aalborg: Aalborg Universitetsforlag.Google Scholar
  17. Kvale, Steinar. (1996). Interviews: an introduction to qualitative research interviewing. Thousand Oaks California: Sage.Google Scholar
  18. Lock, Margaret. (2007). Unbound Subjectivities and New Biomedical Technologies. In C. Casey and R.B. Edgerton: A Companion to Psychological Anthropology: Modernity and psychocultural change, 298-314: Hoboken: Blackwell Publishing Ltd.Google Scholar
  19. Lupton, Deborah. (1997). The Imperative of Health. London: Sage Publications.Google Scholar
  20. McDonald, Catherine, and Greg Marston. (2005). Workfare as welfare: governing unemployment in the advanced liberal state. Critical Social Policy, 25, 374-401.CrossRefGoogle Scholar
  21. Modini, Matthew, Leona Tan, Beate Brinchmann, Min-Jung Wang, Eoin Killackey, Nicholas Glozier, Arnstein Mykletun, Samuel B. Harvey. (2016). Supported employment for people with severe mental illness: Systematic review and meta-analysis of the international evidence. British Journal of Psychiatry, 209, 14-22.CrossRefGoogle Scholar
  22. Møller, Jane, E. (2010). Lack of motivation as suffering. Tidsskrift for forskning i sygdom og samfund, 13, 89-107.Google Scholar
  23. Nielsen, Annegrethe J., and Lone Grøn. (2012). Standardising the Lay. Logics of Change in Programs of Disease Self-Management. Culture Unbound: Journal of Current Cultural Research, 4, 425-442.CrossRefGoogle Scholar
  24. OECD (2012). Sick on the Job?: Myths and Realities about Mental Health and Work. Mental Health and Work. Paris: OECD Publishing. Scholar
  25. Olsen, Terje, and Jenny Tägtström (Ed.) (2013). For That Which Grows. Mental Health, Disability Pension and Youth in the Nordic Countries. Stockholm: Nordic Centre for Welfare and Social Issues.Google Scholar
  26. Otto, Lene. (2001). Livshistorier og biografisk subjektivitet. Dansk Pædagogisk Tidsskift, 1, 3-11.Google Scholar
  27. Pihl, Mie D., and Troels D. Jensen (2016). Unge på kanten. 186.000 unge er hverken i job eller i uddannelse. København: Arbejderbevægelsens Erhvervsråd.Google Scholar
  28. Psykiatrifonden 2011 Psykiske problemer er den primære årsag til frafald på erhvervsuddannelserne. Psykiatrifonden.Google Scholar
  29. Reiss, Franziska. (2013). Socioeconomic inequalities and mental health problems in children and adolescents: A systematic review. Soc Sci Med, 90, 24-31.CrossRefGoogle Scholar
  30. Rose, Nicholas. (1996a). Governing “advanced” liberal democracies. In A. Barry, T. Osborne, and N. Rose (Ed), Foucault and political reason, liberalism, neoliberalism and rationalities of government, 37-64. ProQuest Ebook Central: Taylor and Francis Group.Google Scholar
  31. Rose, Nicholas. (1996b). Inventing our selves: Psychology, power, and personhood. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  32. Schlæger, Kristine, Mikkel Zimmermann, and Heidi A. Christensen, (2011). Offentligt forsørgede, 16-64 årige. København: Danmarks Statistik.Google Scholar
  33. Simmons, Robin, and Ron Thompson. (2013). Reclaiming the disengaged: critical perspectives on young people not in education, employment or training. Research in Post-Compulsory Education, 18, 1-11.CrossRefGoogle Scholar
  34. Smyth, John, Peter McInerney, and Tim Fish. (2013). Re-engagement to where? Low SES students in alternative-education programmes on the path to low-status destinations? Research in Post-Compulsory Education, 18, 194-207.CrossRefGoogle Scholar
  35. Spradley, James. (1980). Participant Observation. Belmont: Wadsworth Thomsom Learning.Google Scholar
  36. Sundhedsstyrelsen. (2012). Kortlægning af indsatsen for mennesker med psykisk sygdom - udvikling i diagnoser og behandling. København: Sundhedsstyrelsen.Google Scholar
  37. Tjørnhøj-Thomsen, Tine, and Helle P. Hansen (2009) Overskridelsens Etik. Erfaring, analyse og repræsentation. In Mellem Mennesker. En grundbog i antropologisk forskningsetik. K. Hastrup, ed. København: Hans Reitzels Forlag.Google Scholar
  38. Villadsen, Kaspar, and Thomas Gruber. (1999). Socialpolitiske diskurser - på tværs af sektorer og organisationer. Roskilde: Roskilde Universitetscenter.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.The Research Unit for General Practice and Section of General Practice, Department of Public HealthUniversity of CopenhagenKøbenhavn KDenmark
  2. 2.National Institute of Public HealthUniversity of Southern DenmarkKøbenhavn KDenmark

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