'Voices of concern'-a study of verbal communication about patients in a psychiatric day unit

In this study, the author employs observations from a psychiatric day unit in an analysis of regularly occurring forms of 'professional talk'. Considerable staff time is scheduled for such talk, which must be considered as part of the health professional's work. Much of the talk which occurs may be analysed as having 'technical' significance in programming staff to behave appropriately towards different patients, so as to maximize the effectiveness of hospital treatment. Very much more time than is technically necessary, however, is devoted to talking about patients. Rather than seeing this 'superfluity' of talk as an indication of inefficiency within the system, the author examines its functions in maintaining the social structure of the unit and meeting the personal needs of the staff. This appears to be of particular importance against the background (common to many psychiatric settings) of staff-patient and interdisciplinary role ambiguity, high patient chronicity, and the absence of many of the structural and symbolic 'props' of a conventional hospital. This 'excess talk' is expensive in terms of professional time, and takes time away from direct patient contact. None the less, it may be a necessary cost if staff are to continue to pursue therapeutic goals within a deliberately 'informal' psychiatric setting.