11 - The time dimension: the process phase  pp. 129-140

The time dimension: the process phase

By Graham Thornicroft and Michele Tansella

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Defining the process phase

The Concise Oxford Dictionary defines process as ‘a course of action or proceeding, especially a series of stages in manufacture or some other operation’ or as ‘the progress or course of something.’ [1]

We define as process ‘those activities which take place in the delivery of mental health care’.

In relation to the theme of this book, the process phase therefore refers to a wide range of activities (clinical and non-clinical) which occur in the mental health system (seeTable 11.1).

These processes include direct interventions for people with mental illness (such as admissions to hospital, prescriptions of medications or the provision of psychological treatment) as well as non-clinical processes (such as administrative activities). Although our primary emphasis is upon outcomes (see Chapter 12), processes are important because they affect outcomes in important ways. For example, a staff decision of whether to admit a person to hospital or not, or a decision to take or not to take medication as prescribed, by a person with mental illness (two types of clinical process), may have serious implications for that person's treatment outcome. There may also be complex interactions between different processes. For example, increased individual satisfaction with services (perhaps because of better information provision) can improve consequent treatment adherence.

Process at the country/regional level

The many processes taking place within the whole mental health care system are largely invisible unless they are systematically described in ways that allow comparisons between places or across time.

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