Critical junctures in health and social care: Service user experiences, work and system connections

Hannigan, Ben ORCID: https://orcid.org/0000-0002-2512-6721 and Evans, Nicola ORCID: https://orcid.org/0000-0001-5154-0478 2013. Critical junctures in health and social care: Service user experiences, work and system connections. Social Theory & Health 11 (4) , pp. 428-444. 10.1057/sth.2013.16

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Abstract

This paper makes an original contribution through the revitalisation, refinement and exemplification of the idea of the ‘critical juncture’. In the health and illness context a critical juncture is a temporally bounded sequence of events and interactions which alters, significantly and in a lasting way, both the experience of the person most directly affected and the caring work which is done. It is a punctuating moment initiating or embedded within a longer trajectory and is characterised by uncertainty. As contingencies come to the fore individual actions have a higher-than-usual chance of affecting future, enduring, arrangements. These ideas we illustrate with detailed qualitative data relating to one individual’s journey through an interconnected system of mental health care. We then draw on observations made in a second study, concerned with the improvement of mental health services, to show how micro-level critical junctures can be purposefully used to introduce instability at the meso-level in the pursuit of larger organisational change. In addition to demonstrating why scholars and practitioners should pay closer attention to understanding and responding to critical junctures we are, therefore, also able to demonstrate how their emergence and impact can be examined vertically, as well as horizontally.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Healthcare Sciences
Subjects:	R Medicine > RT Nursing
Uncontrolled Keywords:	child and adolescent mental health services; crisis resolution and home treatment services; critical junctures; mental health; systems; trajectory
Additional Information:	Pdf uploaded in accordance with the publisher’s policy at http://www.sherpa.ac.uk/romeo/issn/1477-8211/ (accessed 19/01/2015)
Publisher:	Palgrave Macmillan
ISSN:	1477-8211
Related URLs:	Publisher
Date of First Compliant Deposit:	30 March 2016
Last Modified:	13 Dec 2024 13:40
URI:	https://orca.cardiff.ac.uk/id/eprint/46890

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