Problem-Sustaining Interaction Patterns

In this paper we propose the concept of a problem-sustaining interaction pattern, or ‘ψ‑pattern,’ as a central normative idea for the practice of mental health care. This concept emerged from six years of collaboration within the Redesigning Psychiatry program. It may be defined as follows:

ψ‑pattern: a pattern of dynamic interaction between biological, psychological, and/or sociological factors that persistently or recurrently counteracts or undermines our everyday problem-solving activities.

The purpose of this concept is to revise the established concept of a mental disorder. Our proposal is revisionary in the sense that we aim to redesign the role of this concept in the practice of mental health care. The need for such a proposal arose from several stakeholder workshops in the Netherlands. Participants in these workshops included service users, care practitioners, experience workers, designers, clinical researchers, managers, and ethicists. Our aim in this paper is to explain how various reasons, which came up during these workshops, contributed to the concept of ψ‑patterns.