What leads to innovation in mental healthcare? Reflections on clinical expertise in a bureaucratic age

是什么推动了精神卫生保健领域的创新?对官僚时代临床专业知识的反思

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Abstract

SummaryThis paper considers a witness seminar in which healthcare professionals discussed working on an acute admissions ward run along therapeutic community lines from the 1960s to the 1980s. Participants remarked that older styles of working are 'unimaginable' today. This paper discusses why. Literature from the humanities and social sciences suggest healthcare is reactive, reflecting wider cultural changes, including a preference for a more bureaucratic, standardised, explicit style of reasoning and a high valuation of personal autonomy. Such a reflection prompts questions about the nature of professional expertise, the role of evidence and the importance of the humanities and social sciences.Declaration of interestNone.

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