EXPRESS: Continuity as Patterning: A Process Perspective on Continuity

2021 ◽  
pp. 147612702110468
Author(s):  
Martha Feldman ◽  
Monica Worline ◽  
Victoria Lowerson Bredow ◽  
Natalie Baker

This article extends previous research on how work continues in the face of disruption by theorizing continuity as patterning and highlighting the difference between continuity of a thing and continuity as a process. Based on interviews with people who continued providing mental health care during and after the disruption caused by Hurricane Katrina, we show that continuity is a dynamic process that entails people orienting to what actions they can take and how they can connect these actions into paths in an unfolding material, social and personal situation. The paths, taken together, are a pattern of work (in our case a pattern of mental health care). While recognizing that exogenous goals play a role, we highlight the importance of the endogenous experience of an activity in taking action and creating paths. Viewing continuity as patterning suggests new roles for organizations in supporting flexible responses to disruption.

2012 ◽  
Vol 6 (3) ◽  
pp. 311-315 ◽  
Author(s):  
Natalie D. Baker ◽  
Martha S. Feldman ◽  
Victoria Lowerson

ABSTRACTObjective: Our research explored how mental health care providers continued to work during and after Hurricane Katrina.Methods: We interviewed 32 practitioners working in the New Orleans mental health care community during and after Hurricane Katrina. Through qualitative data analysis, we developed three temporal periods of disruption: the evacuation period, the surreal period, and the new normal period. We analyzed the actions informants took during these time periods.Results: The mental health care providers adapted to disruption by displaying two forms of flexibility: doing different tasks and doing tasks differently. How much and how they engaged in these forms of flexibility varied during the three periods.Conclusions: Informants' actions helped to create system resilience by adjusting the extent to which they were doing different tasks and the ways in which they were doing tasks differently during the three time periods. Their flexibility allowed them to provide basic care and adapt to changed circumstances. Their flexibility also contributed to maintaining a skilled workforce in the affected region.(Disaster Med Public Health Preparedness. 2012;6:311–315)


2020 ◽  
Vol 8 (9) ◽  
pp. 146-150
Author(s):  
Ann Carlock ◽  
Susanne Beier ◽  
John Sienrukos

One in six senior citizens (age 65 years and older) living alone in the United States faces physical, cultural, and/or geographical barriers that isolate them from their peers and communities. This isolation can prevent them from receiving benefits and services that can improve their economic security and ability to live healthy, independent lives. Although it is generally known that depression is not directly related to the aging process, adults 65 years and older are more likely to experience depression due the onset of physical limitations, living alone, decreases in mobility, feelings of purposeless, cognitive decline, and fear of dying (Neff 2020). Prior to COVID-19, older adults attending senior activities centers (SAC) were instrumental in decreasing episodes of depression. This is largely based on socialization with peers, getting out of the home and, and listening to the life experiences of the much older adults. Since COVID-19, social distancing has been encouraged and the elimination of social gathering has been emphasized, which was, heretofore, expected in senior activities center settings. In the authors’ combined experience, the primary goal of successfully transitioning senior citizens returning to senior activities centers can best be accomplished by mental health care workers use of the EASE method. EASE stands for E: educate: Mental health care workers must educate older adults on the importance of social distancing in decreasing the spread of COVID-19 to the most vulnerable population (based on age and pre morbid conditions). By training staff to educate older adults on CDC guidelines relative to COVID-19 on proper handwashing, the wearing of facemasks to cover the mouth and nose, and to seek medical attention if Covid-19 symptoms are present, is essential. A: avoid: mental health care workers must constantly remind older adults to avoid the touching of the face and eyes. From picking up objects to turning doorknobs, people are constantly touching surfaces contaminated with pathogens. These pathogens can be picked up by our hands and get into the body through mucous membranes on the face — eyes, nose, and mouth — that act as pathways to the throat and lungs (Elder NC, Sawyer W, Pallerla H, Khaja S, Blacker M, 2014). S: support: Mental health care workers who work in senior activities centers. Senior should strive to support and provide an environment for older adults engaging them in opportunities for socialization, exercise, and education. The more active a senior citizen is, the healthier they will be. Recent research suggests when older adults consistently engage in social activities, they experience significant improvements in their physical, mental, and emotional health. Much of this improvement results from the ability to maintain healthy relationships and a continued sense of being part of society. E: Eliminate: mental health care workers should convey to older adults the need to eliminate activities that may contribute to contracting Covid-19, such as smoking and decreasing contact with those that smoke. Educating mental health workers on the benefits of transitioning the (EASE) of senior citizens back to attending the senior activities center will better assist this population to return to and overcome their fears to participate in the “new normal” beyond convid-19. Senior activities centers have been and will continue to be valuable community assets providing significant benefit to older adults and their families. Change  in these programs will have to be significant enough to make a difference for this large demographic group. Using the EASE Method will assist with meeting the scale of change with the scale of the demand for Seniors to feel safe to return to Senior activities Centers.


2007 ◽  
Vol 31 (5) ◽  
pp. 122 ◽  
Author(s):  
Gavin Andrews ◽  
Nickolai Titov

Mental disorders contribute to the burden of human disease. The National Survey of Mental Health and Wellbeing revealed low participation in treatment. The Tolkien II report provided evidence that a mental health service that utilised needsbased stepped care was likely to be effective and affordable to the point that a 30% increase in budget would treat 60% more people and produce a 90% increase in health gain. Five priorities were identified: � Solve the crisis in psychosis by providing more step-down beds for people with schizophrenia who need long-term accommodation. � Educate the workforce by providing a nationwide web-based basic curriculum. � Use clinician guided, step-down web-based therapy for patients who are mild or moderate, and web-based education to enhance clinical treatment for patients who are more severe. � Educate patients and their families about treatments that work and about lifestyle changes that facilitate these treatments. � Reduce the onset of common mental disorders by using proven web-based prevention programs in schools. With resources such as these in place, changing the face of mental health care might just be within our reach.


2010 ◽  
pp. n/a-n/a ◽  
Author(s):  
Lisa H. Jaycox ◽  
Judith A. Cohen ◽  
Anthony P. Mannarino ◽  
Douglas W. Walker ◽  
Audra K. Langley ◽  
...  

2004 ◽  
Vol 28 (8) ◽  
pp. 275-276 ◽  
Author(s):  
Tom Burns

The 1990s witnessed a strikingly accelerated rate of change in the structure and delivery of mental health care in the UK. The preceding 15 years had been marked, in my practice, by two inexorable processes which transformed the face of clinical psychiatry, but without the convulsive upheavals and discontinuities that we have come to live with since. The first was the running down and eventual closure of the large mental hospitals – a change so fundamental that it may be difficult for those trained recently to grasp just how different mental health care was then. The second was the internationalisation of research, and the growing influence of evidence and formal instruction as a determinant of practice, rather than simply relying on the consultants to whom one was apprenticed. For all the occasional criticisms of it, evidence-based medicine dominates modern psychiatry, and this is evident in the much greater consistency of practice than 30 years ago. The changes in the 1970s and early 1980s were essentially egosyntonic within the profession; the past 15 years have been more dramatic and less comfortable.


1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.


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