Work in a Psychiatric Day-hospital

Practices That Lead to an Understanding of “Repetitive Time”

Abstract

This study focuses on the practices and structure of psychiatric day-hospital based on ethnomethodological fieldwork.

Psychiatric treatment has been criticized for its committal principle, and hospitals have begun reducing the number of beds in response to this criticism. Earlier, psychiatric day-hospital primarily provided support for discharged patients to live and engage with the community. Previous studies have demonstrated that the features of psychiatric day-hospital can be characterized as “repetitive time.” Thus, this study focuses on the mechanism that enables such repetition. I particularly observed the reuse of “deviance” and “praising” linked to “club activities” in this mechanism.

As a result, I clarified how the “deviation” of a patient is transformed into a “solution” and how “club activities” associated with “praising” functioned in psychiatric day-hospital. Additionally, I found that “club activities” were organized not only to make praising patients easier but also to manage the burden on the staff. I explored the meaning of such mechanisms that enable patients to be in day-hospital through comparison with extant literature. Although features of dayhospital have been aptly characterized as “repetitive time,” the findings of this study demonstrate that the mechanisms are organized, calculated, and well thought-out.