Entrepreneurship as conditionality: New geographies of work(fare) in mental health services under austerity

Abstract

This paper investigates work undertaken by clients of voluntary sector mental health services in the context of austerity. While mental health geographers have often interrogated ‘work cures’, little attention has been paid to client work within traditional care-oriented services. Drawing on interviews and fieldwork in a mental health day centre threatened with closure, I demonstrate that client fundraising can become a crucial source of income when marketised services face budget cuts. Clients are incentivised to act as entrepreneurs, developing creative strategies to secure funding. I conceptualise this as a novel form of conditionality, as access to services comes to depend on entrepreneurial activities. Existing theories offer a narrow conception of conditionality, as behavioural standards imposed through rules. Entrepreneurship appears more flexible, autonomous and voluntary than such rule-based conditionalities. Yet in practice clients face the same choice: work or lose access to welfare provision. I argue that entrepreneurship transforms the institutional geographies of services, directing them towards economic productivity. This can undermine longstanding practices of care, leading some clients to withdraw from services. By focussing on client responses to austerity, this paper makes a crucial contribution to geographical research into voluntary sector precarity, which has tended to focus on staff. More broadly, it advances understandings of the institutional geographies which embed the politics and economics of austerity within everyday experiences of care provision.