Journal Article

Futility in the Practice of Community Psychiatry

Brodwin, Paul

2011

Overview

The experience of futility among frontline clinicians in community psychiatry is produced by the temporal structuring of their work. All health care providers share the disposition to intervene in the course of disease. Specific notions about the course of severe mental illness are woven into the mission of Assertive Community Treatment (ACT) as well as the treatment plan, a key paperwork tool used to stage daily activities. The treatment plan demands a narrative of progress that ACT workers often find impossible to supply. The gap between the ideal of progress and the realities of practice produce distinctive kinds of demoralization. Drawing from an ethnography of a single ACT team in the United States, this article explores how clinicians encounter, articulate, and attempt to resolve such experiences of futility. It explores their practical strategies to reframe the time horizons of work and thereby restore the sense of their own therapeutic power.

• Publisher: Blackwell Publishing Inc,Wiley Subscription Services,Blackwell Publishing Ltd
• Subject: Activities of Daily Living / Anthropology / Assertive community treatment / Attitude of Health Personnel / Case Management / Community / Community care / Community Psychiatry / Diseases / Ethnography / Frustration / Futility / Health care / Health care industry / Health Professions / Health services / Humans / Medical anthropology / Medical case management / Medical Futility / Medical personnel / Medical practice / Medical treatment / Medications / Mental disorders / Mental Disorders - therapy / Mental health care / Mental health services / Mental Illness / Paperwork / Personality / Power / practice theory / Professional practice / Psychiatry / severe mental illness / Special Focus. After Progress: Time and Improbable Futures in Clinic Spaces / Therapeutic groups / U.S.A / United States of America / Workers