Blog Action Day: Imagine a generation taking nothing for granted from the start

Blog Action Day 2009:

"Climate change" - these words spoken in so many different languages may be the first uttered by the World's infants over the next decade. It really could happen! If these words are the constant they need to be, on the lips of all parents, teachers, leaders and all who 'know'.

That would be no bad thing for the (near) future.

Just imagine:
a generation taking nothing for granted from the start.

People respond best to change they see. In particular change in their environment. We are hard-wired to react to change that represents a threat. We respond with flight or fight. On island Earth, this rock we share, the options are becoming ever more limited, limite, limit, limi. ...

In order to respond now, we must rely on several forms of vision. We must take into account not just ourselves, but as is often highlighted:

• future generations, our legacy - their inheritance (SOCIOLOGY)
• other individuals - our brothers and sisters - and their situation (INTERPERSONAL)
• the evidence for climate change and solutions (SCIENCES)
• those in power and their translation of the agenda for positive change (POLITICAL)
• the effect of climate change on flora and flora (SCIENCE, SOCIOLOGY and POLITICAL)
• the physical health impact (SCIENCES)
• the emotional and mental health impact (INTERPERSONAL)
• the changes needed in policy and political change succession (POLITICAL)
• the ethical values that are shared and debated - consumerism (business at any price $1, £1, €1 .... stores), Deep Ecology (INTERPERSONAL & POLITICAL).

Things, especially human 'things' are never that straight forward. The impact of climate change is writ large in that last word - change. Perhaps in erecting the faces the lesson of Easter Island is environmental dominoes. For us of course this means that as the climate changes so does the environment. For some the change is quickly evident if you live by the ocean, tundra or mountainous glaciated regions.

Change happens on local, regional, national and international levels.

From the Earth observing satellites above, to survey vessels on the oceans, and the research stations in the Antarctic and Arctic vision is everything in hearts and minds paving the way for action in classrooms, homes and eco-prise. ...

Additional links:
How psychology can help the planet stay cool, New Scientist

Maldives government takes a dive for climate change, NatGeo

Hodges' model SCIENCES links 'Environment, Sustainability, Ecology & Eco-system Health'

Image source: Easter Island photo -
http://www.fractalenlightenment.com/2007/08/easter-island-and-us.html

New: NHS Change Model (and a question from the future 20:20 vision?)

The NHS has a new model to help deliver change, a critical objective over the months and years as new commissioning arrangements are also implemented. The introduction below is from the website, from where the components of the model are also explained following registration and this is a chat forum:

Welcome to the NHS Change Model

The model has been created to support the NHS to adopt a shared approach to leading change and transformation.  We hope to build this website further and add practical information, tools and support over the coming months.  Please tell us what you think to help us shape this model and the ongoing future work using the chat room facility.

Why do we need a change model?
Building on what we collectively know about successful change the ‘NHS Change Model’ has been developed with hundreds of our senior leaders, clinicians, commissioners, providers and improvement activists who want to get involved in building the energy for change across the NHS by adopting a systematic and sustainable approach to improving quality of care.  

What does the model do?

The model brings together collective improvement knowledge and experience from across the NHS into eight key components. Through applying all eight components change can happen. This means no matter whom or wherever you are in the NHS you can use the approach to fit your own context as a way of making sense at every level of the ‘how and why’ for delivering improvement, to consistently make a bigger difference.

NHS Change Model [link no longer available]

Q. Does the NHS and Social Care still need a change model?

Review: iii "Climate Change and the People's Health"

So to the book proper ...

When a book's Forward has 19 references you are primed for many more. The Introduction reinforces this expectation and also defines concepts, specifically health inequality and health inequity. I'm also bound to be drawn-in by a text that:

"... calls for interdisciplinary responses that employ knowledge and analytical tools from across the sciences, social sciences, and even the humanities". p.xxii.

That 'even' is priceless, in terms of the relationship between social sciences and the humanities and the prospective role (that is already being applied?) they will play in solutions, vis-à-vis the communication of climate change and public (mental) health themes using the arts, media, creativity, history and communities.

The Introduction provides a brief primer on global action on the Social Determinants of Health [SDoH] and climate change. A critique of key policies, programmes and reports is provided leading to the arrival of the Sustainable Development Goals. The politics of the above is discussed, with shortcomings and avenues of progress noted. The three chapters to follow are described and as befits a 'small' book we are informed of what the book does not address. The book's focus is climate change. For a text on population growth and transition to alternate energy sources readers should look elsewhere.

Chapter 1. Climate Change, Global Justice, and Health Inequities

The book uses 'Boxes' asides to elaborate on certain points, e.g. Box 1.1 The Earth System. There are tables and figures too. Many make for troubled 'reading' and not for reasons of size or legibility. The text is dense in terms of the information delivered, but that is to be expected. This is serious stuff. "Climate Change - (really) Is a Global Justice Issue" p.16.

While in the open source and open access movements we celebrate the Commons, Friel points to the way that climate change has the characteristics of a "global commons" problem. p.16. Politics permeates the book as noted in post ii.

 individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- MECHANISTIC

SOCIOLOGY : POLITICAL

|

group - population

	"Together, the least-developed and developing economies contributed, since the mid-eighteenth century, less than 25% of global cumulative CO2 emissions (Lykkeboe and Johansen, 1975)". p.16.

The problem of having all states adopt the same transformative behaviour is described mechanistically.

There is presently no mechanism. 

Ethics is brought up as it must be in the years, decades to follow. (I was minded to think of Maslow's hierarchy applied to the whole of humanity: now that would be a great levelling. p.20.) Now, there is a new measure beyond the perverse capitalism debate. Why should people be able to live in luxury at the expense of even the basic needs of other peoples being met? Intergenerational inequity has a small section of its own (p.22). Those with the means will be able to move, to mitigate the impacts of climate change. Millions of others are effectively trapped by geography, health inequities and life chances. So many are without political and economic power to make for positive change.

As I was working on a paper on h2cm, SDoH and the SDGs the update on health inequity within and between countries was very welcome (p.24). On "food consumption gaps" I wondered about the plethora of 'gaps' that must exist and (sadly) operate in climate change and people's health (p.28). Globally foodborne disease is not uncommon, but to this degree (p.29)? With an estimated 3,037 deaths annually in the United States. Key health issues are discussed, malnutrition, non-communicable diseases, air pollution - ambient and indoor. A point about Bourdieu (1989) and an individual's life choices, is bound to remind me of 'life chances' within Hodges' model. This is what lies behind the idea of the "Health Career". This is not the professional's career, but the varying status of a person's health and wellbeing through their life (and even before birth and approaching end of life). Friel's discussion of Michael Marmot et al. (1991) and the "Whitehall studies demonstrated that, in addition to maternal security, a  range of psychosocial factors are important for health and are contributors to health inequities, including social support, social capital and social cohesion". p.33.

There are conceptual models for SDoH, the Eco-Social Model of Health, which obviously keeps me turning the pages (p.34).  Friel notes historically how environmental epidemiology has tended towards being reductive and mechanistic in approach, rarely taking onboard the influence of social, economics and political contexts. I scribbled the following as a review quote:

"Appreciation of this global scale and of the range of influences on human health required a significant conceptual as well as a methodological shift". p.35.

New epistemologies are needed: enter eco-epidemiology. Time is a factor in integrating our view of disease and disease prevention. I visualise this as a series of frames for an individual, the same for a community. Many of the figures are Creative Commons Attribution 4.0 license. I have not read the book "The Uninhabitable Earth - Life After Warming, By David Wallace-Wells, but a review declared a depressing quality in the scenarios rendered. I had this in mind noting the statistics and reporting that Friel provides. This is worrying too - future rates of mortality - the overall increase; those attributable to specific effects - diarrhea, childhood undernutrition, heat exposure and more... (p.38). There's a small Box on the Disability-Adjusted Life Year. The effect on sea level rise, food production, heat stress, the movement of disease vectors are the subject of the remainder of chapter 1. This is a sobering read, but necessary. Bizarrely - a contribution to global ecoliteracy: medicine for eco-anxiety?

To be continued ...

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities

Chapter 3. Challenges and Future Prospects


Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York.

Review: v "Climate Change and the People's Health"

Climate Change and the People's Health

At just over 30 pages chapter 3 the last is also the shortest, we all hope this does not reflect the length of the future?

Chapter 3. Challenges and Future Prospects

Before beginning to review Chapter 3 I need to revisit the closing sentences of the preceding chapter's conclusion - if you 'get' Hodges' model you will understand why:

"I [Friel] pick up on these ideas of complexity in chapter 3, arguing that how we understand and characterize these phenomena depends on our standpoint and also evolves as knowledge develops and available evidence accumulates. Given those complexities, responding to climate change and health inequity requires the development of policies that transcend doctrinal boundaries and draw on insights from a range of disciplines, including those in the sciences, social sciences, and humanities". p.112.

I hope you can see and will please excuse my reference to Hodges' model, but I've another.

Friel refers to how research is primarily based upon reductive pathologizing and needs to shift [ ;-) ] "towards research that is attentive to, and actively engaged with, policymaking processes". (p.114).

In Hodges' model, the Sciences and Politics are mechanistic, the sciences invariably (with some exceptions) reductive and the 4Ps I have attributed to the model as follows:

1. SCIENCES -PROCESS
2. POLITICAL - POLICY
3. SOCIOLOGY - Practice
4. INTRA- INTERPERSONAL - Purpose

(As in a previous part of this review I have been wondering how policy can (best) permeate the other care (knowledge) domains?)

Being where this review is posted I would be remiss not to state this, picking up on Friel's thought.

OK, let us get back on track. Taking the lead from chapter 2, in Chapter 3 Friel argues the need to take research, advocacy, and policy forward to address environmental degradation, social justice and health equity by breaking down the disciplinary, sectoral and various silos that exist in the many systems that are encountered. Systems research can increase our understanding and the evidence base. Interesting to note also then solutions can be crafted. (p.113). The evidence base on more equal societies is discussed. With the stress on systems research, systems and systems thinking are explained briefly and referenced. As will already be obvious I am all for the plurality of disciplinary approaches that is needed, but as Friel will conclude this, with systems science, and improved understanding of policy processes (hybridised: is this the Green Marshall Plan that is referred to?) to counter the resistance to change that is already being experienced now (p.115).

Perhaps above, I have fallen into Friel's trap. I have been caught out as a model monger (p.115)?

Scale is a concurrent consideration in Hodges' model, as with Friel's account of systems thinking. To macro- meso- and micro-levels let us add nano, there is much still unclear from the presence of plastics and other pollutants in the environment. The arrival of eco-epidemiology is to be applauded (p.116).

Any mention of 'systems' takes me to the Health System Redesign book I reviewed over a year ago on W2tQ. This is a very useful companion to "Climate Change ..." but is not referenced here. Box 3.1 'Systems Approach to Childhood Obesity Prevention' brought home the connection and the visual representation referred to (p.120). I could readily go off again with Friel's section on Politics, Policies, and Processes (p.122). Thank goodness for this - I feel better now - as Friel "shamelessly plugs" personal involvement with a research program at the CRE (p.124). The Centre for Research Excellence in the Social Determinants of Health Equity needs to be, not just on the 'map' (Sciences - located geographically) but affecting policies, practices and purposes (individual and organisational). Friel provides several references - very useful and timely. I will reference this, as I'll explain next time. Again the much needed call for a move from reductionist pathologizing.

Box 3.3 Policy Principles for the World We Want is simplistic (like Hodges' model), but if delivered would be very impactful in terms of the positive change (p.128) that would ensue. Against p.134 my note is "It's a small world!" I'm not sure if this a reference to the Disney song as a perverse consumptagenic global eco-anthem, or to Schumacher? What could be noted (p.134) is the potential role of blockchain in assuring land tenure and ownership. This technology is much vaunted in health, education and the obvious application of economics. In terms of developing nations protection of land rights is critical (even as I write and you read). The chapter closes on policy from "The first 1000 days of Life" to "Health in All Policies" which I reflected upon as "Policies in All the (#h2cm) Domains"? How do we do this? There are avenues as Friel writes of macroeconomics and progressive policy development. There is much on the Social Development Goals and how cities (despite the critique on urbanization) are working together internationally to mitigate climate change effects, even as some governments fail to meet set objectives and global agreements.

The print and layout is excellent, a content listing of sections complements the index (invaluable). The next book I've to review has no index.

Small book, big ideas - correct on both counts and a very informative if rightly troubling read.
One last plea. Do buy this book, but don't leave it on your shelf; read it. There is no excuse, it's small, but your ideas on climate change and the people's health will grow!

I would like to thank OUP

CHAD ZIMMERMAN │ Senior Editor, Medicine and Public Health

Oxford University Press │ 198 Madison Avenue │ New York, NY

and Prof. Nancy Krieger for the review copy and Prof. Sharon Friel for engagement on twitter and RTs.

While I appreciate I make the request to review and this places absolutely no obligation on others, it helps a lot when a publisher / author / conference organiser ... acknowledges the effort - even just a thank you. As ever, the thanks is in the learning gained, not the thanks lost. Many do - lift a hand, nod their head ... of course, making this even more worthwhile here. TY


Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities


Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Review: ii "Climate Change and the People's Health"

Climate Change and the People's Health

You could read this excellent little book in a couple of hours, but me being me ...

Part of a Series of 'Small Books, Big Ideas' in population health this is an important and timely text of a type that sadly will need to be a constant stream. Constant, not only to keep the message and issue in people's consciousness, but to update the research of a still new interdisciplinary field. Not only that but some sense (measure) of the socio-economic-political state must be realised to identify change (progress). This small book argues for the big change in attitudes, behaviours and systems that must follow.

The book prompts me to imagine the day (whether or not in my future) when the media can report on the gradual reverse of climate change? We have heard of positive changes in the size and behaviour of the Antarctic ozone layer for example; only for progress to be challenged once again. It is not enough to hope for our children, their children ...  and the biosphere of Earth.

The book has just three chapters in 146 pages; 188 pages including the references and index. The 'small' quality relates not only to page number but a hardback size of 18 x 15 cms, such that my copy has been on tour (petrol car and alone) over the summer. A Forward by Nancy Krieger refers to the book series as a whole and points to the political dimensions and how inevitably practitioners must be part of this 'game'. Not just what we oppose but what people stand for. The dynamism in this field is apparent in the reference to expressed opposition alone given rise to despair. This book is very current (2019) but 'eco-anxiety' did not make the index, such is the pace of events (Greta Thunberg). This is not a criticism but speaks of the dynamism and hope that action can (and must) bring as Krieger writes. The fact of this being a political struggle is acknowledged by Friel in the conclusion.

This is not just important but critical. You should never generalise and many nurses (for example) are politically very literate and Active. They seek to protect, sustain and improve the values, the health and health care systems they hold dear. Many other nurses focus on the 'job' of caring. The thought follows that while politics starts in the staff-room and rota; the Politics begins in the ward office and the various meetings and committees. They conclude that they'll leave that to others. For all healthcare workers we can no longer take this stance. Population health demands a population response.

To be continued (of course you don't have to wait to obtain your copy - this is essential reading):

Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 2. It's a Consumptagenic World: Producing Climate Change, Exacerbating Health Inequities

Chapter 3. Challenges and Future Prospects


Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Interactive Radio Drama Training - Theatre for a Change - Online

From: Ryan Borcherding

Learn how to produce Interactive Radio Drama (IRD) for a wide range of gender, SRHR, SGBV and COVID-19 behaviour change and advocacy objectives.

IRD is a unique social and behaviour change communication tool from Theatre for a Change. It has been used in multiple countries since 2010 to improve the sexual and reproductive health and rights of marginalised and vulnerable women and girls, with documented results.

IRD enables audiences to call in to the radio station and replace the main character in the radio drama, to show what they could do differently to change the story for the better. It enables behaviour change and advocacy to happen on a large scale. In Malawi, we reach over 550,000 listeners through interactive broadcasts each week.

We are now offering online training in our IRD approach to enable other organisations to use IRD in their gender, SRHR, SGBV and COVID-19 behaviour change and advocacy work.

To view the full course outline, including eligibility requirements, please see www.tfacafrica.com/online-training

For more information, please contact Ryan Borcherding on ryan.borcherding AT tfacafrica.com

Ryan Borcherding

My source:

The Communication Initiative Network

Navigating Climate Anxiety - Resurgence & Ecologist magazine

INDIVIDUAL

|

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

Resurgence & Ecologist magazine	CHANGE
change	CHANGE

  Navigating Climate Anxiety - Resurgence & Ecologist magazine Issue 341 • November/December 2023.

'Change' as an urgent need and source of pressure.

Our individual mindset's need to change - is this the (apt) snowball to change our collective (cultural) mindset?

If the spiritual domain which encompasses Hodges' model was truly at 'one' then no change would be needed 'there'? Discuss.

Even as I clear books, journals, papers ... I have bought a copy.

 See also previously: 'holism', 'navigation'.

Designing for Changing Values (Event & Journal CfP)

I learned of the following research project via

Philos-L "The Liverpool List" Department of Philosophy, University of Liverpool
[ https://www.liverpool.ac.uk/philosophy/philos-l/ @PhilosL ]

- with news of a call for papers:

CFP: Corpus Analysis, Conceptual Change, and Socially Disruptive Technologies

Hodges' model is ideally to suited to critique of systems and socio-technical dimensions as previously described:

Jones, P. (2009) Socio-Technical Structures, the Scope of Informatics and Hodges’ model, IN, Staudinger, R., Ostermann, H., Bettina Staudinger, B. (Eds.), Handbook of Research in Nursing Informatics and Socio-Technical Structures, Idea Group Publishing, Inc. Chap. 11, pp. 160-174.

Plus, there are many posts tagged 'socio-technical' - hyphenated to emphasize the inter- multi- trans-disciplinary bridges that the model provides (some posts are also tagged 'sociotechnical').

The research project Designing for Changing Values provides encouragement here for the increasing relevance of Hodges' model:

How to Deal with Value Change in Sociotechnical System Design

"Not value neutral

A key insight from philosophy of technology is that technological artifacts and sociotechnical systems are not value neutral, but support or inhibit certain values. Several philosophical accounts for understanding the embedding of values in technological artifacts have been proposed and approaches like Value Sensitive Design, Design for Values and Responsible Innovation have been established for integrating values into technical design.

A theoretical blind spot

A blind spot is, however, the possibility of value change after a sociotechnical system has been designed. For example, when many of our current energy and transportation systems were designed sustainability was not yet a central value, and we are now struggling to incorporate this value into these systems. Progress in the field is currently inhibited by the lack of a philosophical theory of value change in sociotechnical systems.

Better design strategies

This project fills the gap by developing such a theory. It moves beyond the state of the art by proposing a dynamic rather than a static account of values, by developing insights in the dynamics of value change, by extending analysis about the embedding of values in technical artefacts to sociotechnical systems and by developing design strategies that aim at designing sociotechnical systems that can better deal with value change."

https://www.valuechange.eu/

I do wonder about the subjective-objective and qualitative-quantitative 'metrics' of value and values (and other metrics - change, complexity, emergence). In human and mechanistic terms there are marked differences too between value and values. Values are, should, must be, embedded in individual nurses and hence the domains of Hodges' model. This is how (in part) the model supports reflection, and critical thinking.

No surprise then being created for practice, Hodges' model is dynamic. The model can help capture and present an ongoing sequence of frames. Where were we? Where are we going? How have things changed? (This is

Hodges' model prompted the thought of 'holistic bandwidth', the call for papers on corpus analysis seeks examples of formal work. The model, initially blank provides a conceptual framework upon which to capture a conceptually situated corpus. The structure of Hodges' model is a foundation for a relational ontology that draws upon semantic distance between the model's two axes (as per the table below):

INDIVIDUAL <-> GROUP 

HUMANISTIC <-> MECHANISTIC

Not just that but the synonyms that may apply. So for 'individual': person, patient, client, self, client, 'I', 'me', Peter, Chi, student, teacher and whatever role is applicable. This point is vital as there is a potential and workflow that runs from:

1. Neutral, blank, non-judgemental (the model as a template): the content - empty, null state.

2. The model's essential structure.

With a potential for conceptual explosion - from a basic (very simplistic) inherent corpus, to one that is explicit:

3. A response to a situation, a context.

4. That then changes according to events, aims, objectives, strategies, philosophical perspective (recovery, strengths, self-care), policy emphasis ...

In health and social care as suggested above we would hope that the model is employed to shift from the general to the specific - person-centred approach.

 INDIVIDUAL
|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

value(S)	VALUE(S)
value(s)	VALUE(S)

This conceptual framework is not limited to strategy either, but can also encompass deliberation on operational and tactical concerns.


See also:

Soc. Philosophy & Technology Conf: Charleston, S.C. 8-11 July 2007

20/20 vision minus 1, 2, or 4 blind spots....

'corpus'

Jones, P. (2012). Exploring several dimensions of local, global and glocal using the generic conceptual framework Hodges's model. The Journal Of Community Informatics. 8(3). Retrieved from https://openjournals.uwaterloo.ca/index.php/JoCI/article/view/3034

Jones P. Exploring the relationship of threshold concepts and Hodges’ model of care from the individual to populations and global health. Rev Cuid. 2017; 8(3): 1697-720. http://dx.doi.org/10.15649/cuidarte.v8i3.464

Ada Lovelace Day: Enid Mumford - Socio-technical perfume down the mine

I had to enter a pledge and join the call today to post in response to Ada Lovelace Day - an international day of blogging to draw attention to women excelling in technology.

Women’s contributions often go unacknowledged, their innovations seldom mentioned, their faces rarely recognised. We want you to tell the world about these unsung heroines. Entrepreneurs, innovators, sysadmins, programmers, designers, games developers, hardware experts, tech journalists, tech consultants. The list of tech-related careers is endless.

Recent research by psychologist Penelope Lockwood discovered that women need to see female role models more than men need to see male ones. That’s a relatively simple problem to begin to address. If women need female role models, let’s come together to highlight the women in technology that we look up to. Let’s create new role models and make sure that whenever the question “Who are the leading women in tech?” is asked, that we all have a list of candidates on the tips of our tongues.

It was soon after this blog first appeared that I learned of the news of Enid Mumford's death. I never had the pleasure of meeting Prof. Mumford, but came across her work whilst doing my own studies and a degree at Bolton. We have something in common in being raised in Merseyside. In the NW of England there is also a tradition of mining...

Studying geology at school we went on a field trip down the pit at Golborne Colliery. Strange to be told after an underground train ride we where under the East Lancashire A580. Enid Mumford's early work took her underground, but her impact extended far beyond her perfume bottle:

'A woman down the mines?" Enid Mumford's classic sociological research for the National Coal Board had a strong impact on unbelieving miners. Later, as an active advocate for women's rights, Enid, who has died aged 82, enjoyed recounting her early experiences: "They were terribly nice to me whenever I turned up, but they were awfully embarrassed at what I might catch them doing." Enid would "drench herself with perfume", so that the ventilation system would give the miners a chance to prepare themselves for her arrival at the coalface. In such ways, Enid began her contributions to social theory, with its challenges to action researchers like herself.
The Guardian obituary

As posted previously this year sees a chapter published on Hodges' model and socio-technical structures in nursing informatics (See bibliography in the blog's side bar). I really latched on to Enid Mumford's approach and needless to say Professor Mumford's invaluable work figures in my overview:

Background: Existing socio-technical structures and methods

This section scratches the pages of the socio-technical literature by introducing two seminal contributions and briefly references other sources. The two authors discussed are Mumford (1983) in the socio-technical sense and Giddens (1984) who is more generic socially and organisational oriented. Enid Mumford created ETHICS, a systems design methodology: Effective Technical and Human Implementation of Computer-based Systems. The need for ETHICS is to help manage change with three objectives.

First, ETHICS stresses that the future users of computer systems, whether directly or indirectly involved should play a major part in designing these systems. User involvement is closely related to subsequent job satisfaction and efficiency gains and hence the realization of benefits. The users of systems are credited as experts; if this knowledge and experience is recognized and utilized then job satisfaction gains are likely as the users are active agents in the change process and not passive. There is an interesting correspondence here with the continuing emphasis on patients and carers being acknowledged as experts in their care assessment, management and evaluation.

The second objective focuses on the human – behavioural response to change. It is important that specific job satisfaction objectives are factored into the design from the outset and not left to chance, lost amid technical specifications and objectives. In this way potential negative change impacting the quality of work life can be anticipated and avoided or at least ameliorated. Technology has frequently been associated with de-skilling and of course the loss of traditional jobs. The prospect of technical, management led change can cause consternation in the user community. If alienated employees may be absent, seek alternate employment, and overall be less productive.

ETHICS is not restricted to the computer system; the third objective highlights the need for a new computer system to be ‘surrounded by a compatible, well functioning organizational system’ (Mumford, 1983). Design must be viewed globally as a whole. The technical design is just one part of a very complex design process that must also incorporate the details of human-machine interaction; what would be called gap analysis, the differences in existing processes and proposed new processes and procedures. In addition, as per objectives one and two, individual jobs and workgroup activities must be reviewed; how are existing roles and relationships altered and newly defined? What new management arrangements are needed, since (middle) management is rarely untouched?

<>

I wish I could spend more time on Hodges' model, socio-technical thought and its application. Women in ICT? This is not a new call.

Women must have role in IT - not just to ensure the social in SOCIO-technical.

Not just to ensure that the 'c' in ICT happens.

Whether in programming, instructional technology, internet infrastructure, semantic web, the games industry and a whole host of other areas - Ada Lovelace, Enid Mumford - and of course others past and present must not be lone pioneers. ...

Additional links:

BCS Women

Daphne Jackson Trust

The Register (2008) Women IT EU Job Shortage

For BR

The Communication Initiative Network and holistic bandwidth

In 2004 I attended a day at a community informatics conference in Brighton, UK (see the side bar for details). My interest in that event stems from recognising the different schools of informatics and the multidisciplinary potential for Hodges' model that extends beyond health and social care. The model provides a cognitive gymnasium for us to test and exercise our holistic bandwidth.

The notion of 'holistic bandwidth' really comes into its own within global development and communication. In 2004, or soon after I discovered The Communication Initiative Network. They kindly posted the Brighton position paper on their site and were very encouraging regards the model. Now they are developing a new Communication Initiative Social Networking Platform - http://groups.comminit.com/

There are many groups including:

• The Future of ICTs and Development
• Communication and Climate Change Adaptation

In the above group I learned of the following initiative :

There is an interesting initiative in Africa called AfricaAdapt. It is a network that works to facilitate the flow of climate change adaptation knowledge for sustainable livelihoods between researchers, policy makers, civil society organisations, and communities who are vulnerable to climate variability and change across Africa. There is a whole section on their website that allows for communities to upload their own information on how they are adapting to climate change. The initiative also offers an award for best community project which helps elicit contributions.

Africa: never far from the news. Lets hope this next week there is some +ve news from COP15 Copenhagen.

• Students - Communication for Development
• HIV/AIDS Strategy: Future Directions
• Polio Communication Consultation Group

There are diseases lost to the developed nations and with diseases like polio and leprosy communication and education are central to those who are ill and their families. Even as a nurse there is a stark reminder in the need for an International Leprosy Day.

• Gender, Education, and HIV/AIDS

On the teaching psychology list someone asked this past week about alternatives to structure a student's lifespan assignment. I suggested Hodges' model an approach that can also be adapted to educate people about disease ....

SCIENCES: aetiology, prevention, transmission, hygiene, diagnosis, prognosis, evidence, research, physical resources, drugs, nutrition, age, weight...
INTRAPERSONAL: attitudes, beliefs, education, literacy, personal responsibility, mood...
SOCIOLOGY: social networks, cultural beliefs, gender expectations, community, family, friends, trust...
POLITICAL: policy, leadership, funding, activism, infrastructure: housing heating..., access to services, media, employment, governance...

• Ethics in Communication for Development
• Gathering Theories and Models

This group only has 5 members and is of obvious interest to me. I can't recall whether I signed up: must check! Planning and development in this context covers topics and issues I know nothing of and yet I am sure that dressed in its socio-technical guise Hodges' model can contribute to the theoretical development here. It could be that there are other perspectives, models and conceptual frameworks to be found that can inform the global health agenda?

• DRAFT: Technical Update on Social Change Communication and HIV/AIDS
• Human Rights and Technology
• Web Site Directors

So, do visit the Communication Initiative both the new groups above and the general website.

A free online-learning opportunity for those interested in Implementation Science

INSPIRING CHANGE

Open for enrollment March 9 to May 18, 2020

A FREE mini-course providing a high level overview on how to create impact with evidence-based implementation

This mini-course will help you:

• Understand what evidence-based implementation is and how to proactively plan for change.
• Discover how process models, theories, and frameworks can be the backbone of your change plan.
• Be inspired to use behavior change theory.
• Be more purposeful with your time, by addressing high-priority areas and anticipating resistance to change.
• Learn simple tips and tricks that can set you up for success.

Cost: FREE

Time to complete: It takes about 1.5 hours to complete the videos and activities.

Available: Enrollment open twice a year (from March to May; and from September to October)


My source:
Julia E. Moore, Ph.D.
Senior Director
647-390-1929
thecenterforimplementation.com
https://www.linkedin.com/in/julia-e-moore/

Follow us on Twitter: @TCI_ca

We urgently need funding to continue our work in 2020. Support the HIFA Appeal: www.hifa.org/appeal

To send a message to HIFA simply send an email to: hifa AT hifaforums.org

HIFA: Healthcare Information For All: www.hifa.org

n.b. My revalidation is due and in (hopeful) preparation for a further three years 2020-2023 I will apply for this myself.

Book: 'Logic on the Track of Social Change'

When I walked into Lancaster Univ. library in February, I had no idea I was being followed.

From the maths shelves, the lights switching on as you progress, I decided to walk across to the more familiar realm of sociology. Looking for something, it was nice to see the parity in lighting, even as my struggle for mathematical enlightenment continues.

Logic on the Track of Social Change    

I do use the e-library, and other e-resources, but sometimes real shelves and varying levels of mustiness (remember the 'new acquisitions' - fewer these days?) invite a bit of serendipity. Suddenly, over my shoulders, the stranger,  pointed (with four arms of course). Was it my shadow? Or, was it my unconscious that 'read': LOGIC and TRACK and SOCIAL CHANGE, on the spine of -

David Braybrooke, Bryson Brown & Peter K. Schotch (eds.), Logic on the Track of Social Change, Oxford University Press. 1995?

In the early decades of health informatics, there was much talk - and still is(?) - of  'languages for health', even languages for nursing. Coding and classification systems were constantly developing, as posted here, but while physical diagnoses were the driver, the psychosocial dimensions of person - patienthood proved more nebulous. DSM is still subject much debate.

 Chapter 8 in Braybrook et al. is brilliant: A Rules-Analysis, Following Foucault, of the Birth of Clinical Medicine.

I've been in situations when surgery is suggested for an older person, and family, friends wonder is this really necessary? This chapter literally brings the history home, and not only that, but the emergence of the hospital system, versus care at home, in the community. The social determinants of health have been ever-present. This is essential reading for students, with the history of ICD, and the history of medicine. There are insights too into public attitudes and expectations to health services and provision here in the UK and in France.

For me, and Hodges' model, the significance of Braybrook, Brown, Schotch and Byrne is that it precedes:

Sallach, D.L. Categorical Social Science: Theory, Methodology and Design. September 2012
Conference: Fourth World Congress on Social Simulation. Taipei, Taiwan.
https://www2.econ.iastate.edu/tesfatsi/Sallach2012CategoricalSoSci4.WCSS-SS.pdf

And so, I do need my own secondhand copy of  Logic on the Track of Social Change. More to follow (indeed)! ... and help still welcome and needed.

 

Previously: Re. Sallach - 'Distance: Shoulders and ships that pass...' : 'history of medicine'

Book: Stories from Care Experienced Adults to Inspire Change

 INDIVIDUAL

|

 INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

"In this poignant book, Lisa Cherry brings together a collection of candid and personal reflections on the care system in the UK, offering alternative ways of thinking about the care experience, supporting better ways of working, and providing justification for a trauma-informed lens to be applied to all forms of work with those in care. Through personal insights and reflections, the book brings often-unheard stories vividly to life, beginning with the author’s own. These are stories about love and pain; hurt and isolation; the depth of lived experience that makes up a life; how we live our lives through our relationships with others and where we feel we fit in. In this thoughtfully compiled third edition, original contributors look back on their own reflections from the lives that they live now, new stories bring new perspectives, and discussion points provide the opportunity to consider the realities of the care experience as well as life beyond."

The Brightness of Stars: Stories from Care Experienced Adults to Inspire Change

Stories from Care Experienced Adults to Inspire Change

"Whilst each story is unique, shared themes reveal the truth of the care system and, coming at a time where there is a real opportunity for change, the narratives in this book are ultimately stories of hope and connection. This is crucial reading for policy makers, those working in social work, education and adoption, as well as care experienced adults." [Text c/o Routledge]

Lisa Cherry (2022) The Brightness of Stars: Stories from Care Experienced Adults to Inspire Change
London: Routledge. ISBN 9781032191584 

https://www.routledge.com/The-Brightness-of-Stars-Stories-from-Care-Experienced-Adults-to-Inspire/Cherry/p/book/9781032191584#

My source:

https://twitter.com/CareExp_Culture/status/1606208952437420032?s=20&t=nacOiLCrUFCCuNQiEY4dKw

ICT and Brexit Change Survey – Extended deadline

Date:    Fri, 10 Mar 2023 09:16:49 +0000

From:    e.lomas AT UCL.AC.UK

Subject: ICT and Brexit change survey – extended deadline

Apologies for cross posting

We have been asked to extend this survey (https://opinio.ucl.ac.uk/s?s=80453) for a further month in line with the time previous surveys ran. It will therefore close on Tuesday 11th April straight after Easter. This is because a lot of people are part way through and in addition a number of people had not seen the save button which appears at the bottom of each survey page. We would further note that the survey is intended to be neither remain or leave in its questioning – both sides have queried this. We are keen to understand perspectives of the ICT/information sectors following Brexit. We appreciate everyone’s time and perspectives on this. Below is the original text when posted with an update on timeframes…

Brexit has been a significant change for the UK and EU, including in the contexts of  the ICT sector and those who manage information, whether in the public or private sectors. At the three-year departure point we are seeking the views of information professionals on the shifting opportunities and threats for the ICT/information sector in the light of Brexit. Whilst Brexit was a UK decision, it has had potentially global ramifications and therefore we are looking to draw in perspectives from across the globe. We understand that there will be differing views both negative and positive – we want to hear all these perspectives.

We would be so grateful if you would respond to this survey at  - it will take 10-20 minutes to complete depending on if you just check the multiple-choice boxes or if you wish to share further written comments. All questions are optional. The survey is anonymous and no IP addresses are being collected. We know that you are busy and appreciate your time. The survey will close on 11th April 2023.

Please do forward on this email so that we can reach as many people as possible and tweet:

Please complete survey on information/ICT professionals’ views on Brexit and  change https://opinio.ucl.ac.uk/s?s=80453 #Brexit #ICT

The results of this survey will be published in an open access form. Please note this survey follows four earlier surveys charting change through the Brexit process, the first immediately after the Referendum (written up at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0186452), one at a mid-point which was accompanied by workshops (written up at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227089) and the others from the transition points onwards. Whether or not you have completed any earlier surveys, we would appreciate your input now. This is likely to be the last survey we publish tracing the changes.

The research is a partnership between the iSchools at UCL (Dr Elizabeth Lomas) and Northumbria University (Emerita Professor Julie McLeod). The survey is being facilitated by Dr Elizabeth Lomas (mailto:e.lomas AT ucl.ac.uk).

Thank you for your help.

Elizabeth and Julie

Dr Elizabeth Lomas

University College London

Email: e.lomas AT ucl.ac.uk

Emerita Professor Julie McLeod

Northumbria University

Email: julie.mcleod AT northumbria.ac.uk

My source:
www.jiscmail.ac.uk/FREEDOM-OF-INFORMATION
a mailing list hosted by www.jiscmail.ac.uk

Innovation & Change: Pick an edge, any edge...

individual

INTERPERSONAL : SCIENCES

humanistic ------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

group-population

PURPOSE ...  "change always starts with the activists  and it always starts at the edge". p.23 subjective	PROCESS "Very often our change management approaches aren't very sophisticated. We'll pretend this change is an objective process when it can't be."  Endless transformation using the same processes is another well trodden path. p.23   objective
PRACTICE	POLICY  "... there is no clearly understood model for how services can adapt to changing population needs." p.23

Gbadamosi, N. (2015) Turn the tables on top-down change, Health Service Journal, 16 January, 125, 6430: pp. 22-23.

Review: iv "Climate Change and the People's Health"

Climate Change and the People's Health

Whatever your educational philosophy when a book offers new concepts that is welcome learning. Learning enhanced when the concept, as is often the case, is a hybrid of terms.

Chapter 2 It's a Consumptagenic World looks at the veritable production of climate change. Our dependence on fossil fuels not just for our transport, but the transport of food and agricultural products is explored. Perhaps there is a political irony in the former slogan of education, education, education amid relentless growth, growth, growth. At least now there is a constant message regards there being "No Planet 'B'".

If chapter 1 considered food security, this chapter attends to the industrial food system. Once again the themes are first introduced and related back. Very interesting here is the rise of urbanisation and the drivers for this. In chapter 1 I noticed the word shift. Nurses are one occupational group that recognise this word only too well. Here though it is the shifts in population that is very worrying. Especially so when many people may be putting themselves in harm's way as chapter 1 described. It is encouraging to see references going back to the 1940s. There is an evidence trail.

Current economic systems seems to reward monopolies and creates externalities (p.60). Unfortunately there is a lack of evidence in the production of pollution if remediation is to be sought. The emission of greenhouse gases where products are produced may be remote from where they are consumed. Friel argues for accountability at the origin of products not where they are consumed. Such externalities are 'out of the box' and need to be put back in the box and properly accounted for - (ecological governance). Often industrial concerns also follow the cheapest ('best value?') labour markets, relocating when needed.

Friel really annoyed me. Yes, in a positive way. Figure 2.2 compares a range of consumer goods and how their cost has changed over time; food, housing, health care, versus technology, media goods for example (p.68). The need for sustainable health care services is a constant topic it seems (Centres of research, journal special issues, conferences, twitter chats...), but when the essentials of living are so expensive does this not undermine and load - displace the disparity - the inequity no-less on to the health sector, its workforce and funding? It is as if the scientific-economic-industrial complex is saying to the health care (and social care) sector "Carry This!". There is no choice. It is a consequence of the society in which the bulk of us live. As Friel writes, processed foods lend themselves to concentrated control of supply chains which can introduce pricing volatility (p.78). The price of good quality nutritional food is a health inequality (p.76); figure 2.3  (p.77) illustrates the system.

While reading I thought of how amid the emotional, social and economic ravages of dementia we talk (well some of us ...) of organisational memory, while having forgotten what 'local' means. The rise of glocalism and the pursuit of growth - at any price it seems - in some quarters even prompts a re-evaluation of philanthropy in the 21st relative to the 19th and 20th? I found myself wondering how we would recognise a shift (the shift) in the market's thinking when watching the business TV channels CNBC, Bloomberg and similar ilk? The consumptagenic system has an effect on organisational memory, it is a behaviour known as perseveration; repetition of the word: profit. For all the thoughts provoked in me, this book is not a capitalism bashing exercise. Far from it, it deals objectively with what remains a sad and dangerous reality.

If it were not for the realist and critical perspectives that must also be present, the efforts of technologists, policy makers and researchers (urban informatics) and others to create Smart cities would seem to guarantee success. The discussion on cities (pp. 93-112), their sustainability, projected populations and the health inequities arising from them is very illuminating. In a teaching situation there is a lot to engage students, not just in the 'city' but in the text overall.


Chapter 1. Climate Change, Global Justice, and Health Inequities

Chapter 3. Challenges and Future Prospects


Friel, S. (2019) Climate Change and the People's Health, Oxford University Press, New York

Jarvis's book 'public parts' [i]: The sanctity of clinical data, INFORMATION, knowledge ....

In New Scientist last week another book, a brief review caught my eye. This one concerns a topic of great sociological, clinical and political interest to me. To be clear this is not a review; consider it raised eyebrows at the book's arrival and some speculations. Here is the intro from New Scientist's website:

WHEN writer Jeff Jarvis decided to tell the world about his prostate cancer he didn't spare the gory details: he happily blogged about his "malfunctioning penis" after surgery, and the adult diaper he had to wear.

Too much information, some may say. Not for Jarvis. He is an outspoken advocate for living one's digital life in the open and his latest book, Public Parts, is one of the first to analyse the shift towards more transparency thanks to Facebook, Twitter and the other big names of this new digital age.

(Niall Firth, CultureLab, New Scientist)

For quite a while I've been wondering about the informational form of 'climate' change. The existence of the NHS's HealthSpace, Google Health, and Microsoft HealthVault had me watching for erosion of the public's attitudes towards clinical confidentiality. Jarvis refers to this as publicness. Like a coast line this particular form of erosion occurs on many levels, given the vagaries of starting conditions (the patient-doctor relationship, the medical establishment), geography, tides, weather and local policies. Would the temperatures change within health care itself - professional values, disciplinary outcomes, The Royal Colleges?

Even if HealthSpace et al. are provided on the basis of being secure, encrypted, meeting the local requirements of data protection and information governance...; is this tantamount to making confidentiality soluble AND throwing it into the water? How big a step is it to the public's posting their personal health information in public online arenas: open and closed? Suddenly the patient becomes the data entry administrator, if that information can be shared and accessed by the health establishment. From a business model and policy perspective this also saves money in an Ikea flat-pack-transport-and-assemble-it-yourself kind of way.

Jarvis's book is evidence, that demonstrates the ability of social media like Facebook, LinkedIn and Twitter to alter attitudes towards disclosure of personal data. Medical details are usually restricted to the medical consulting room and centrally held clinical record. Google Health is closing down though; it has failed to have the broad impact they hoped for (see Google's blogpost). I wonder if this is reflected upon in the text? With the NHS behind HealthSpace perhaps these three 'solutions' are far from equivalent examples?

If we take information as the concept around which this debate revolves with an individual, a person also at the center ('data subject') then several dimensions can be found. Usually, I am increasingly transparent to a greater degree from my work colleagues, friends, family to my partner. This is one of the many ways that relationships are defined and differentiated. Certain things are opaque to the public and commercial world at large, because they are considered private. Clinically, such a class of information is vested in a professional relationship. This does not mean I have signed a contract to only divulge my medical history to my doctor. Even there - a need to know assumption usually pertains.

As Firth notes it is good that Jarvis is stimulating a debate about what is privacy. How has the concept changed, since the 1950s, 1980s in the media (old and new) and in health care?

Apparently Jarvis makes an analogy with Gutenberg's original printing press and its social and political effects. There may be other subtle aspects though that any such revolution must either work around or overthrow. In the first instance though I consider - without reading the book I have to add - some of the main points which are illustrated below.

Information exchange (disclosure) is always within some context or other: interpersonal, political, social; scientific (clinical) and spiritual hence the inclusion of the clinical - social axis. Tied with this is 'space'. Although the spaces defined by virtual and mobile have assumed primacy physical spaces still count: surgery consulting room, clinic, community health center, hospital ward, patient's home, nursing home. ... I've added transparent - opaque to contrast with public - private these are related yes, but analysis may reveal they are distinct in their application?

Although society has changed markedly in terms of technology and the communications it affords - the modes, tools, languages, access, networks, distribution; there is surely still a notion of what is personal and what might become social - (public)?

Technology, technological means and the arrival of social media does not itself constitute universal attitudinal change in health as Google have found (perhaps the pace of change in attitudes was not quick enough for Google Health so they moved on). Amid the hectic pace of life we should be pleased if some things - like public health disclosure - prove to be laggards in terms of change.

I'll expand on this soon with a few more axes - continua to flare.

Axes image original source from: https://den.dev/

Book review: iii Critical Mental Health Nursing: observations from the inside

Following on from Part i and Part ii.

Alec Grant's chapter 2 presents a 'critical meta-autoethnographic performance'. The chapter uses a dialogue approach, as with chapters 3,4 and 9. While not needed this does break up the prose format for the reader. For a 'nursing' book it is good that Grant puts the initial accent on the future and the classroom. There's a conversation with a Deputy Head on establishing debating societies (p.34), another highlights how skills in reflection, critical thinking and critique are never complete at undergraduate level, but applied through narrative inquiry and critical autoethnography at masters research level (p.40).

The first classroom 'chat' begins with a question: What is the student's "understanding of the following social psychological phenomena: confirmation bias, fundamental attribution error and actor-observer effect?" (p.30).

Critical Mental Health Nursing

On fundamental attribution error, taking a couple of patients to Goodison Park and while the final score eludes me I can remember the change in the patient's behaviour while 'outside' away from the ward. Likewise, going to a nearby pub to 'find' a patient, his speech, disposition and humour were as liberated as his taste buds and that wasn't just the 'alcohol talking'. On the actor-observer effect, judgemental terms would often presage the arrival of; if not an admission, but a re-admission. Even then I would take cognizance of what was said, but also derive my own conclusion. I discuss 'attention seeking' and manipulative (p.31) and other pejorative terms with students. Also explained is our then Director of Nurse Education, who stated that "All behaviour is significant". Grant reflects on 'narrative entrapment' and how things are in community mh services, as surely that is better? The quality of referrals is raised. I've always thought that referrals, or more accurately, reasons for referral need to be qualified. That said, this has improved over the past 10-15 years, but there are still examples were the 'problem' and the level of information provided is missed / lacking.

Throughout the text, there is much for students to learn and reflect upon. Grant is Socratic in approach, creates discomfort and signposts how learners can become students for change and change agents. There are insights on 'ideology',  Žižek and efforts to find a position in the world that is 'ideologically neutral' (p.37). Even now, I continue to see h2cm as, if not, ideologically neutral [impossible], then it is 'ideology' stripped back to absolute basics; a fundamental stucuture that can represent and encompass a[ny] situation. That can include, as Grant notes, time, place, people, events, institutions, culture and professional groups.

Grant's critique of the Tidal model is brief (p.37), but the way to which the Tidal model is challenged within the average busy acute ward, can be extended if the health AND justice 'care' context is considered. While there are only two references to Hodges' model within health justice, I am sure there are potentially many more. Without change, Grant suggests that mhn is "condemned to be the constant administrative and social policing arm of institutional psychiatry." (p.37).

A section on reader - response theory takes us - in a sense - back to where we started. The final dialogue may be 'heavy' for some (me too?) on the neoliberal agenda and its impact upon education - professionally, institutionally, mental health nurse education and curricula. Universities as institutions for learning and learning institutions have been called into question (safe spaces, freedom of speech, value for money, quality...), as by Grant also:

"With regards to mental health nursing, a technical rational training, as opposed to education curricula, fails to adequately address the skilled, multi-contextual knowledge and skills needed by students to help them engage in the unruly and complex identities, relationships, and life and treatment environments of contemporary mental health service users (Grant, 2015c)." (pp.41-42).

"... we put forward the argument that such engagement requires an explicit, un-apologetic educational curriculum." (p.42).

 Grant calls for 'professional artistry' through the literature, which -

"... requires increasing levels of critically reflexive organisational and political awareness. This is because, in all of its aspects, mental health nursing practice is political, historically contingent and socially and environmentally contextual." (p.42).

Finally (here at least), Grant references Alvesson and Spicer's (2012) "functional stupidity theory of organisations"

(In the margin - my pencil notes: Is it really about who has the keys?)

The functional stupidity theory of organisations argues that such organisations have, "a cognitively- and affectively-informed unwillingness or inability to employ reflexivity, justification and substantive reasoning in work organisations." (p.43). Grant expands on each, but of substantive reasoning:

".. constitutes the act of engaging thinking as broadly as possible in relation to professional practice and related work problems." (p.43).

Mental health nurse education, according to Grant exhibits functional stupidity.  (p.44). Oh! I wince at the sound. Finger nails scraping all the way down the ivory of the tower.

As a critique of this and other reviews on W2tQ will no doubt show, my quotes are quite obviously  selective. Precarity has also become obvious over the past decade, as austerity has bitten and even now continues to 'chew'. Grant's references show his work in this area. As many people, academics and practitioners (across all professions including social work and the chapter's author) reach retirement, it will be interesting to see (to say the least) if precarity also applies to:

• mhn
• the mhn education system
• the reasons and values that students bring to the profession

Paradoxically, will this loss of experience in academia, practitioner and management, bring the positive change that this book calls for?

Just two chapters and buy, buy...

More (still) to follow and apologies for the unconventional review...

Part i 

Part ii

Part iv

Bull, P., Gadsby, J., Williams, S. (Eds.) (2018) Critical Mental Health Nursing: observations from the inside, Monmouth: PCCS Books. ISBN 9781910919408

ii 'Thinking outside the box ...' by Amber Javis

Second reply to a blog post by Amber Jarvis on The Mental Elf:

Thinking outside the box: alternatives to standard inpatient mental health care

Amber's post considers a study by:

Griffiths, J. L., Baldwin, H., Vasikaran, J., Jarvis, R., Pillutla, R., Saunders, K. R., … & Johnson, S. (2025). Alternative approaches to standard inpatient mental health care: development of a typology of service models. International Journal of Mental Health Systems, 19(1), 1-13: https://pubmed.ncbi.nlm.nih.gov/40247283/

Jarvis highlights concern within inpatient services of:

'use of coercive practices ... (Nyttingnes et al., 2018; Belayneh et al., 2024). These include physical restraint (physically holding a person), seclusion (holding a person in a locked room) and chemical restraint (the use of sedating medication to manage distress or behaviour, sometimes administered “as needed” rather than as part of any planned treatment). Poor relationships between staff and service users have also been noted, ...'

Reflecting since the previous post, I realise that I encountered efforts to prevent admission and treat in the community prior to going part-time. A short stay unit at a general hospital. Being a member of Intermediate Support for older adults; shifts ran 0800-2000 - early or late. Then working part-time, there were short-stay placements in the community that the recovery team would visit providing support.

Mental distress is distressing (a truism of course), both as lived experience (with or without self-awareness in-situ/crisis) and for others in the vicinity. Family, friends - who see a person they thought they knew, perhaps even thought they were a friend, a person who loved them; but now!? They present as distant, aggressive, subdued, agitated, unpredictable, inconsolable and possibly expressing thoughts of self-harm, threats to harm others, or totally bizarre, 'psychotic' ideas. This is not the person they thought they knew. For the person affected, familiars are strangers. A relational breakdown. We forget the severely mentally ill at our peril. A pervasive sense of helplessness is readily transferred: the reflex conclusion that help is needed - and fast.

To say we are creatures of habit, is to also acknowledge that change our environment results in a change in our behaviour. When relatives did arrive on the psychogeriatric ward I mentioned previously, they cried. Apologising for the environment, yes; efforts to reassure ensued and eventually family, friends were won over. They shouldn't have been. Unless we're in a game, play, or movie, who wants to find themselves in a Victorian era institution?

I've posted previously (or is it in draft?) on the importance of design in the design of care environments. It was a relative's visit to a care home, that resulted in a nursing home design business (Sunday Times). 

A person who is severely mentally ill needs service-centred care, not purely person-centred care. Person-centredness is key, but safety of self, and the public soon makes itself known. We also forget this at our peril. The problem is that control, and law literally take over. Plus, it's our place not yours. Loss of power the person struggling, ill, in crisis then follows. Amber continues:

'The concerns described above chime uncomfortably with modern mental health agendas of prioritising autonomy, compassion, trauma-informed and person-centred care. In light of these tensions, and the growing number of crisis alternatives – ranging from crisis cafes to intensive home treatment services – researchers  at the NIHR Policy Research Unit in Mental Health set out to map current alternatives to traditional inpatient care, both nationally and internationally. Griffiths and Baldwin’s findings raise important questions about how mental health services could evolve to better suit people’s needs, providing a valuable starting point for service planners considering developments in care.'

Hodges' model is ideal to help reflect and critique the relation-ship between 'a person' and 'the service'. I passed two gentlemen in London over the weekend. Clearly unkempt, standing but gesticulating, freely verbalising, incoherent on passing. Neither appeared intoxicated ( but I wasn't that close) or 'stoned'. That's the other question; passing-by what was I going to do? Does the 'community' care? On 'X' you encounter the extremes of debate. Anti-psychiatry, resort to and risks of dependence on medication - anti-depressants, anxiolytics; the damage from anti-psychotic drugs and atypical antipsychotics. The continuous debate about ECT. A dizzying stream of texts about mental health, over-diagnosis and wellbeing:

Medical prescribing has a partner. Social prescribing is well established, with organisations, events, publications and research emerging. People, have scoffed at the suggestion that gardening can help; or going for a run. Especially when you can't get out of bed. Chronic fatigue syndrome, long-COVID are seemingly monolithic in their resistance to change. A real challenge and so counter to the person's 'pre-morbid' personality and lifestyle.

For several years the state of mental health nursing as a specialty has been questioned. Is the mental health nursing curriculum being genericised? Enrollment of students nurses in learning disability has also dropped.

RCN questions separation of mental health nurse training (28 March 2025)

Medical prescribing has a partner. Social prescribing is well established, with organisations, events, publications and research emerging. People, have scoffed at the suggestion that gardening can help; or going for a run. Especially when they can't get out of bed. Chronic fatigue syndrome, long-COVID are seemingly monolithic in their resistance to change. A real challenge and so counter to the person's 'pre-morbid' personality and lifestyle. As a conceptual framework Hodges' model is ideal as a semantic net, to reflect and critique concepts that stretch and so disrupt (for a time) out norms. Concepts with a dual character. If social prescribing is one example, take crisis cafe mentioned by Jarvis above. If you think in physical - environmental terms where do you envisage a crisis occuring or playing out? What about a cafe? What is the ambience of these places?

I noticed a little visual game, an animation of characters running, jumping, climbing over an obstacle course. You focus on one figure and follow them for a time. This makes a difference, called distraction. In psychosocial intervention and managment of psychosis and anxiety audio - music, poetry, repetition has also bee used. The essence here must be when the intervention begins. Recognising relapse triggers, requires preparatory work. The Griffith reference is provided, but Jarvis begins to describe the results:

'Researchers identified 65 alternative service models to standard inpatient care. These were organised broadly organised according to the setting (e.g., community-based, hospital-based, or cross-setting) and the target population (e.g., adults versus children). Across these categories, ‘community-based alternatives’ were the most common category of alternative service models, followed by hospital-based and cross-setting approaches. We’ll explore each of these in more detail below.'

In post (i) and here I suppose I am advocating for mental health nursing as a distinct programme of study, practice and proven competence. For several years the state of mental health nursing as a specialty has been questioned. Is the mental health nursing curriculum being genericised? Enrollment of students nurses in learning disability has also dropped. 

RCN questions separation of mental health nurse training (28 March 2025)

There is a saying: 'You get what you pay for'. There is a sense that there are people who would like to ignore, deny, erase 'mental health'. After all, the truth really is that you can 'see' a broken leg. This isn't an issue if you can afford a private psychotherapist, or a psychoanalyst.

The elephant here (well, there always is one) is education and the literacies. For prevention: the ultimate change - this is where we must focus. But of course for the problem at hand - and mind it is too late.

(Post iii likely to follow.)

Individual

|

      INTERPERSONAL    :     SCIENCES               

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

subjectivity          mental state - crisis - mind quality	objectivity hand - physical state - crisis quantity
Social prescribing Cafe	Housing - crisis Cost of living - crisis

See also: 'literacy' : 'prevention' : 'service' : 'severe' : 'change'

'Thinking outside the box ...' i

iii 'Thinking outside the box ...'