In a series of earlier posts on this site (here and here), and in a piece for the LSE’s Impact Blog here, I wrote about Nicola Evans‘ and my article, ‘Critical junctures in health and social care: service user experiences, work and system connections’. This is published in the journal Social Theory & Health, and the behind-the-paywall link to the full text can be found here. Now that 18 months has passed since the article first appeared online, Palgrave’s copyright rules allow a post-peer-review, pre-copyedit, green open access version of the full text to be made publicly available. So, for a free copy of the paper downloadable from Cardiff University’s ORCA repository the link to follow is this:
The paper draws on data from Nicola’s PhD, ‘Exploring the contribution of safe uncertainty in facilitating change‘, and from my post-doctoral study of crisis resolution and home treatment services, ‘Mental health services in transition‘. For a reminder of what the paper is about, here’s the abstract in full:
This article 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.