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Psychiatric Services: Organizing Impossibility

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Human Relations

Abstract

This paper explores the proposition thatelements of the work of psychiatric services areimpossible. The notion of impossibility is consideredfrom three perspectives: societal, interpersonal, andorganizational.Organizational elements of impossibility areevidenced in attempts to work with madness, a phenomenonthat defies clear definition. Resultant confusion inrole and task boundaries is exacerbated by madinterpersonal interactions. The situation iscompounded by societal conflicts between the mad and thesane. Attempts to house and treat the mad over the past200 years are reviewed, and recent illustrativecase material is presented from two communitytreatment teams. It is argued that primarilysolution-focused approaches to madness have limitedsuccess. To acknowledge impossible elements of the workmay enable psychiatric institutions to be designedin ways that help make individual and collective madnessmore bearable rather than something to be controlled andor denied.

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  1. Lynette Willshire

    Present address: Swinburne University of Technology, P.O. Box 218, 3122, Hawthorn, Victoria, Australia

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  1. Swinburne University of Technology, Hawthorn, Victoria, Australia

    Lynette Willshire

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Willshire, L. Psychiatric Services: Organizing Impossibility. Human Relations 52, 775–804 (1999). https://doi.org/10.1023/A:1016994532507

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