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Introduction


SYMPOSIUM: THE “CHAIN” OF PSYCHIATRIC EMERGENCY ACCORDING TO THE DIALOGICAL MODEL

General Psychology Department, Padova & “altreStrade” Social Cooperative, Padova; Italy.

INTRODUCTION

Authors: Claudia Della Torre; Co-authors: Gian Piero Turchi, Roberta Durante

General Psychology Department, Padova, Italy.

Slide 1

Slide 2

This symposium starts from the reflection that the modalities we use in order to manage emergency have an implication in maintaining or changing the situation, since they arise from specific theoretical and epistemological assumptions, and use a peculiar operational model. Therefore the symposium will show how psychiatric emergency can be managed according to a specific operational model, that is the dialogical one.

Slide 3

When the actors into a social and domestic context report a risk or emergency situation, it will be take-charge by health and welfare services. At this point two different biographical sceneries can be opened:

the signalling can become an event that pervades biography and primes a biographical career, this because the signalled person will describe himself and will be described by others into an univocal and unchangeable way always having reference to that event. So both in the present and future time all discourses will be like I’m sick, I will always be so bad, so connected to the taking-charge of the services.

Into a different way, the signalling can remain a biographical episode, and in this case the signalled person will describe himself and will be described by others into a processual way (es. how can I go on?). In this second case biography is intended as a series of developing events which keep different possibilities and not a univocal and pre-defined definition

Slide 4

At present in Italy, on one hand health services manage the critical situations aiming to treat the physiological implications –ex in case of substances’ consumption- leaving aside social implications; on the other hand, welfare services refer to medical model’s dichotomy of cause and effect, supposing a biographical event as the cause of the so called psychiatric situation.

In both two cases, the intervention consists in eliminating the causes (for ex. a traumatic event or a psychopathology) of a situation described generically as ‘emergency’. By this way the services’ intervention will be not sufficient to avoid for the person an “escalation” within services with higher and higher threshold and a possible evolution into a definitive “psychiatric case”, with implications in terms of welfare and health systems’ costs.

Referring to the dichotomy we have just presented between biography and biographical career, the present architecture of services goes into the direction of priming an “ill person” biographical career instead of maintaining biography as an “on going process”. So we underline the need for a different type of intervention, in order to make competent the social and domestic context in managing the situation and to change the emergency situation instead of to generate a psychiatric case.

Slide 5

In order to do it, we propose to adopt the dialogical model as operational and scientific point of reference for dealing with emergency: the main assumption is that reality isn’t a “fact” ontologically intended, but a discursive configuration, that is a process generated into a specific interactive context. The dialogical model also defines the “rhetorical artifices” as the praxis that operators can use in order to change the configuration of reality defined as “emergency”.

Coherently with these assumptions, the symposium defines psychiatric emergency as a processual, “on going” reality, generated into a specific territory, that is into a peculiar dialogical and interactive context, instead of an individual level.

Slide 6

Therefore, the object of the intervention is represented by all discursive processes that are coherent with the maintenance of the emergency and that drive the discourses toward a pathology/illness configuration. The intervention we propose has the aim to change the discursive processes, promoting the developing of a biography instead of the crystallization of processes which define people as “ill” and the situation as “unchangeable”.

This possibility implies that services take-charge of all the context and not only the signalled person and this aspect is able to generate benefits for all the territory also in terms of decreasing costs for health and welfare systems. About this, in the last presentation of this symposium we’ll show how can we evaluate costs and benefits according to the dialogical model.

Within the scenery we have just presented, operators represent the “expert voice” in the context and so they have a peculiar power in generating configurations of reality. So training for operators becomes a very relevant aspect in order to promote health. The first paper oh the symposium will present how the training is carried out according to the dialogical model, and the second speech will present a project realized in the North part of Italy as an example of “dialogical” intervention.

CONNECTED TO THIS PAPER YOU CAN FIND:

In the section “DIALOGICAL MODEL”

- Epistemological foundation and methodological exactness regarding research in discursive science, symposium and slides files

In the section “HEALTH PSYCHOLOGY”

The biographical emergency service, paper and slides files

Health in the territory as shared responsibility, paper and slides files

The architecture of services as a tool for the health promotion within the territory, paper and slides files

CONTACTS

labsalute.psicologia@unipd.it

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