Paper short abstract

This paper explores hospital-to-community shift in England’s mental health system as an ambivalent form of anti-policy. Using Tess Lea's policy ecology framework, it looks at how care is enabled through community while responsibility and accountability are displaced onto boundary-spanning roles.

Paper long abstract

This paper analyses England’s hospital-to-community shift in mental health reform through the lens of anti-policy. It argues that governance can operate as anti-policy not only through arbitrariness, but also through under-specification, delegation, and the displacement of responsibility, allowing reform to proceed without durable commitments to resourcing, entitlement, and accountability. The paper draws on Tess Lea’s artefactual, ambient, and hauntological modalities of policy and is based on ongoing ethnographic research with Community Connectors in London, with fieldwork beginning in early 2026.

At the artefactual level, strategies, service specifications, and programme designs present community-based provision as the answer to need while leaving responsibility and resourcing flexible and provisional. At the ambient level, reform is enacted through diffuse expectations and moral pressures, as connectors are expected to make fragmented systems workable through coordination, mediation, and everyday improvisation. At the hauntological level, withdrawn services and earlier promises of comprehensive provision continue to structure practice, influencing what connectors and communities are expected to absorb.

The paper takes community-based provision seriously as a site of support, while also showing how the work of making it function can stabilise anti-policy by relocating coherence and burden onto boundary-spanning roles and under-resourced infrastructures. It contributes to the panel by reframing anti-policy as governance through ambivalence rather than chaos alone.