The emotional labour of peer work: encountering stigma in mental healthcare spaces.

This article focuses on the workplace experiences of peer workers with a diagnosis of borderline personality disorder (BPD) in mental healthcare settings in Australia. Our article is located at the intersection of political, social, cultural, and legislative forces that have fostered the development of peer work as a paid profession. We draw on the concept of stigma to analyse findings from qualitative interviews with peer workers conducted in [state], Australia. By examining peer work in the broader context of lifeworlds of BPD, we address the interplay of work and professional identity, and the experience of a profoundly stigmatised diagnosis at this intersection.Our findings demonstrate the physical and emotional effects of stigma and how it produces boundaries and inequalities between peer workers and other health practitioners. These boundaries are reinforced by invisible markers that delineate what is expected, 'normal' and deemed professional in the workplace. Moreover, these same medico-socio-political relations help shape peer workers' identities and experiences. The development of peer workforces in mental healthcare service delivery is a prominent area of reform in Australia and internationally. Our research highlights the urgency of efforts to transform current socio-cultural-political relations that inhibit peer workers in their roles and impact workplace experiences.

Australian cancer nurses' experiences of burnout: Exploring the job demands and job resources of metropolitan cancer nurses during 2019-2020.

BACKGROUND: Existing studies that seek to understand nurses' experiences of burnout are dominated by cross-sectional, quantitative survey designs employing predetermined measures, often overlooking important job-related stressors that can be highly dependent on industry and professional contexts. Cancer nurses are a group of professionals who warrant special attention, as burnout in this profession is often attributed to high job demands and the challenge of caring for a vulnerable cohort of patients. A deeper understanding of the job demands associated with cancer nursing is required to provide insights about the work experiences of cancer nurses and identify aspects that mitigate burnout and stress. PURPOSE: This study describes the antecedents of burnout among Australian cancer nurses by focusing on the demands and resources inherent in their work. We aim to build on the existing literature by identifying job resources that may serve to mitigate the antecedents of burnout. METHODOLOGY/APPROACH: An in-depth interview study of cancer nurses across a spectrum of age and experience in Australian metropolitan public health care services was conducted over a 2-year period that coincided with the COVID-19 pandemic. The job demands and resources model framed this study of job-related factors associated with burnout and conversely job resources that may foster work engagement. RESULTS: Patient aggression, workload, emotional demands, and abusive peers and managers were reported as distinct job demands, whereas job significance and supportive peers who demonstrated leadership, along with task variety, were identified as job resources. CONCLUSION: Australian cancer nurses work in an environment where job demands are increasingly disproportionate to job resources, leading to significant risk of burnout. PRACTICE IMPLICATIONS: Our study identifies modifiable strategies for improving work conditions for this group who play a critical role in the health care system.

The ends of an assemblage of health.

This paper identifies and responds to three key challenges that have emerged in discussions of the assemblage across health geography. These challenges concern the problem of identifying the borders or limits of an assemblage of health; the problem of clarifying how such assemblages change over time; and the more general problem of identifying the affective and material character of the assemblage such that one may distinguish 'therapeutic' from 'oppressive' arrangements. The paper argues that each challenge calls for a novel analytics of power grounded in assessments of the generative forces of stratification and selection expressed within an assemblage. Assemblages of health are composed in relations of power, affect and desire that stratify the assemblage in ongoing processes of selection, acting upon heterogeneous entities (material and immaterial, intensive and extensive, human and nonhuman), bringing them into contact, causing them to affect one another, transforming their activity. Analysis of these processes provides potent tools for rethinking how relations, events, spaces and encounters mediate experiences of health and illness, and novel grounds for intervening in the formation of an assemblage of health.

Practising recovery: New approaches and directions.

The special section Practising recovery: New approaches and directions aims to shed light on the variety of epistemological, methodological and policy-making practices that emerge in empirical studies of recovery from the use of alcohol and other drugs (AOD). 'Recovery', as a concept and policy orientation, has received significant attention in sociological research and other disciplines. However, recovery understood as a practice that is crafted daily by service-users and workers reveals infinite manifestations that sociological research has yet to explore. Shifting from the study of recovery from AOD as a specific drug policy, to a practice-oriented study of recovery as a complex process of healing that unfolds in diverse social contexts, has the potential to advance the contribution of sociology to matters of illness and wellbeing. The articles collected for this special section begin to examine the complexity of recovery with a focus on the framing of recovery as a social, temporal, spatial and affective practice . In Practising Recovery, our aim is to focus on the routine aspects that accompany recovery as both a practice and policy object, emphasising the ambivalences, rather than the polemics of empirical engagements with recovery. In what follows, we describe our thinking about, in, and with the notion of ambivalence as an attempt to expand the meanings of recovery into unchartered terrain, before exploring some of the ways the articles in this special section serve to render visible the ambivalences that accompany the practice, as well as the methods, of researching recovery.

The line of vulnerability in a recovery assemblage.

From a developmental-psychological perspective, young people's recovery from drug misuse requires building up internal resilience and mobilising external resources to develop and maintain a shield of invulnerability. Vulnerability, in this context, is typically understood in terms of the material, social and/or affective conditions of drug use. These conditions are often targeted in prevention and intervention efforts, while also featuring in the emergence of recovery-oriented policy and treatment agendas internationally. In these ways, drug treatment programs implicitly impose vulnerability as a pre-condition to justify intervention and control, just as vulnerabilities are reproduced through the physical and social isolation that individuals experience in treatment. In this article we challenge normative understandings of recovery that regard vulnerability as an inherent condition of 'risk' and 'relapse' for those 'in recovery'. The article bridges interdisciplinary research to offer an analysis grounded in Deleuzian ideas for understanding vulnerability - an area for which his philosophy has been largely overlooked. As the case of recovery unravels, we analyse vulnerability in recovery as affirmative; as an ongoing transformative force of becoming-well.

Healing Architecture in Healthcare: A Scoping Review.

OBJECTIVES: The purpose of this scoping review is to identify evidence on how characteristics of healing architecture in clinical contexts impact clinical practice and patient experiences. Based on these insights, we advance a more practice-based approach to the study of how healing architectures work. BACKGROUND: The notion of "healing architecture" has recently emerged in discussions of the spatial organization of healthcare settings, particularly in the Nordic countries. This scoping review summarizes findings from seven articles which specifically describe how patients and staff experience characteristics of healing architecture. METHODS: This scoping review was conducted using the framework developed by Arksey and O'Malley. We referred to the decision tool developed by Pollock et al. to confirm that this approach was the most appropriate evidence synthesis type to identify characteristics related to healing architecture and practice. To ensure the rigor of this review, we referred to the methodological guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. RESULTS: There are two main findings of the review. First, there is no common or operative definition of healing architecture used in the selected articles. Secondly, there is limited knowledge of how healing architecture shapes clinical and patient outcomes. CONCLUSIONS: We conclude that further research is needed into how healing architectures make a difference in everyday clinical practices, both to better inform the development of evidence-based designs in the future and to further elaborate criteria to guide postoccupancy evaluations of purpose-built sites.

"How can we make it work for you?" Enabling sporting assemblages for disabled young people.

Disabled young people have lower levels of participation in community life than nondisabled peers across a number of domains, including sporting activities, with profound implications for health, wellbeing and life course opportunities. Playing sport is a defining feature of identity for many young people in Aotearoa/New Zealand. Participation in sporting activities provides opportunities to develop competencies, to have fun and to compete, while also providing a sense of inclusion and peer group belonging. However, despite policies promoting inclusion of disabled young people in school and club sport, ableist attitudes and practices still function to exclude individuals who do not fit able-bodied norms. Drawing on recent 'assemblage thinking' in health and cultural geography, this paper explores the material, social and affective dimensions of 'enabling' and 'disabling' sporting assemblages, drawing on interviews with 35 disabled young people (12-25 years), parents and key informants. Many reported instances of demoralising exclusion in mainstream sporting activities. Some turned to adaptive sporting codes, designed for inclusion. In our exploration of participants' embodied experiences of enabling and disabling assemblages we employ assemblage theory to examine how social, affective and material forces and processes converge to either enable or constrain participation in local sporting activities. We close with a brief assessment of the implications of our analysis for ongoing efforts to promote inclusion for disabled youth in physical activity.

Assembling and diversifying social contexts of recovery.

Recovery from drug use is receiving increased attention in critical drug studies. Researchers point out the importance of scrutinizing the term and its meanings anew in order to better understand drug use treatment policies and their effects on the individuals they target. Informed by relational ontological thinking, this article analyses a series of empirical accounts of recovery experiences, and offers a critical assessment of the social contexts of recovery. Qualitative data collected in Azerbaijan and Germany provide distinctive reports of the differentiated experiences of youth as they make and re-make sense of their recovery within specific recovery contexts. Discussions reveal how recovery advances in relations between human and nonhuman actors including spaces, bodies, affects, and practices. On the basis of this analysis, we argue that recovery may be framed as an emergent and dynamic context that becomes with and from drug use.

'Whole onflow', the productive event: an articulation through health.

In this paper we develop an understanding of 'whole onflow'. Extending philosopher Ralph Pred's original descriptions in materialist directions consistent with posthumanist and non-representational theory, we treat whole onflow as the progressing moment ever-materializing; as a never-ending more-than-human event happening everywhere that is existed in, registered, malleable and productive. In particular, using examples in health, we describe whole onflow's core qualities that lend it, as a vital forceful becoming, its productive capacities. We argue that whole onflow offers compelling ways of understanding the processual origins of health and many productions besides in all their diversity. Moreover, we argue that it offers ways of understanding how humans figure as part of the Universe's becoming.

WITHDRAWN: A Geology of Drug Morals.

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Atmospheres of engagement within a German drug consumption room.

Drug consumption rooms directly attempt to intervene in and govern the place and time of drug use. Whilst the risk-reducing potentials of these interventions have been thoroughly evaluated, the consumption room literature offers fewer insights into the embodied, affective and situated dynamics that underscore service delivery. In this paper, we take up the notion of atmosphere to explore these dynamics in greater depth. Drawing on 12 months of ethnographic research in a German drug consumption room, we describe the manner in which atmospheres came to pervade and condition service encounters. More than simply providing texture to activities within the consumption room, we show how atmospheres gave rise to a distinct range of bodily capacities and therapeutic effects. Critically, these atmospheric affordances exceeded the risk-reducing objectives of the consumption room to encompass an emergent capacity to find repose, enact respite and foster modes of sociality and care. Our analysis further highlights the contextual contingencies through which the atmospheres of the consumption room emerged, including the efforts of both staff and clients to cultivate and control particular atmospheric qualities. We conclude by considering how closer attention to the atmospheric and affective dimensions of service delivery may challenge how consumption room interventions are enacted, valued and researched. This is to gesture towards a novel, atmospheric mode of harm reduction that has effects by transforming embodied potentials for both staff and clients.

On the legacy of normalization.

In 1998 Howard Parker, Judith Aldridge & Fiona Measham published Illegal Leisure, a ground-breaking study of profound changes in British youth cultures in the 1990s, and the place of drugs and drug use in these upheavals. This work introduced the 'normalization thesis' to the social sciences, offering a novel vocabulary for re-imagining the normative character of young people's attitudes towards and experiences of illicit drug use. Arriving at the dawn of the new century, the book offered a thoroughgoing re-thinking of the character of youth cultures at a time of great social, cultural, economic and technological disruption. In so doing, the book deftly anticipated many of the most interesting currents of critical drug studies that followed.

Healing architecture and psychiatric practice: (re)ordering work and space in an in-patient ward in Denmark.

Healing architecture is a defining feature of contemporary hospital design in many parts of the world, with psychiatric in-patient facilities in Denmark at the forefront of this innovation. The approach rests on the contention that designed clinical spaces and the particular dispositions they express may promote patient recovery. Although the idea that health may be spatially mediated is well-established, the means of this mediation are far from settled. This article contributes to this debate by analysing medical encounters in the context of a new purpose-built psychiatric hospital opened in Slagelse, Denmark in late 2015 as an example of healing architecture for the region. Grounded in qualitative research conducted in two wards between 2016 and 2017, we explore the key material and social effects of the hospital's healing architecture, and the spaces and practices it enacts. Following the work of Michael Lynch, we consider both the designed 'spatial order' of the in-patient wards and the 'spatial orderings' unfolding therein with a particular interest in how order is accomplished in psychiatric work. With much of the existing discussion of healing architectures focusing on their impacts on patient wellbeing, we consider how healing architectures may also be transforming psychiatric work.

Perspectives on person-centred care for borderline personality disorder: a critical research agenda.

Borderline Personality Disorder (BPD) is a highly contentious psychiatric diagnosis with ongoing tensions over nomenclature, aetiology and treatment recommendations. This article examines a number of these tensions and assesses how greater attention to the voices of people living with BPD may help inform the delivery of new modes of person-centred care. To this end, we present a critical social science research agenda for investigating the experiences, social contexts and support needs of people living with BPD. We canvass issues pertaining to the diagnosis of BPD (including its name), the strongly gendered dimensions of BPD, and the pressing need to improve support for people living with this condition. Throughout our analysis, we indicate how critical interdisciplinary inquiry may drive new responses to these challenges. Our analysis is illustrated with reference to experiences of BPD recounted in two Australia-wide surveys conducted in 2011 and 2017. We argue that greater progress towards person-centred care requires novel forms of evidence grounded in critical social inquiry into experiences of treatment and support among people living with BPD, and the varied social, cultural and political contexts underpinning these experiences.

Understanding the vital emergence and expression of aging: How matter comes to matter in gerontology's posthumanist turn.

Recent years have witnessed the beginnings of a posthumanist turn in critical/cultural gerontology. This is a turn that is partly demanded by, and provides means for illuminating, the posthuman social condition that older people experience in the twenty-first century. That has incorporated contributions from a range of theoretical and empirical traditions including new materialisms, non-representational theory, science and technology studies, arts, performance and sensory studies. A turn that, decentring the human subject, has envisaged aging as a distributed process involving multiple interacting living/biological and material/technological actors and excessive forces. This paper describes three ontological understandings of the vital emergence and expression of aging that the turn has ultimately generated (aging emerging and expressed through relational material assemblages; aging enacted and performed by open vital bodies with vibrant objects; aging in immediate, pre-personal, more-than-representational space-times). It then describes how, rather than being sidelined, four longstanding humanistic concerns have been reimagined in scholarship in 'more-than-human', 'other-than-fully conscious' terms (meaning, disadvantage, agency, communication). It is suggested that together these understandings and reimaginings constitute an open theory on aging, and a possible way to frame future studies. However, acknowledging that there is still much to do, the paper concludes with some thoughts on future challenges and possibilities for posthumanist research on aging.

Unravelling subjectivity, embodied experience and (taking) psychotropic medication.

This paper explores how distinctions between 'intended' and 'side' effects are troubled in personal narratives of taking psychotropic medications. Grounded in interviews with 29 participants diagnosed with mental illness in Victoria, Australia between February and December 2014, we consider how people interpret pharmaceutical compounds beyond their desired or intended effects, and how such effects shape and transform subjectivity and their relationship with their bodies. This paper contributes to recent discussions of mental illness and medication effects, informed by feminist science studies. It emphasises the co-constitution of social, affective and material relations in the context of 'taking' psychotropic medication. This paper discusses three key themes as important to the phenomenology of the nexus of illness and psychotropic medication: movement, ambivalence, and sociality. Our analysis demonstrates how psychotropic drugs are productive of subjectivity through their promises and potential, their unexpected harms and the institutions from which they are inseparable.

Matter beginning to matter: On posthumanist understandings of the vital emergence of health.

In recent years much health research across the social sciences and humanities has undergone a noticeable, albeit by no means cohesive or comprehensive, 'turn' towards a posthumanist theoretical orientation. This paper reviews the radical ideas about health's emergence that have accompanied this turn, noting the core processes that are understood to always be in play. In particular, while acknowledging that not all humanistic ideas have been rejected in this work, it describes how some have been reworked and extended in 'other-than-fully conscious' and 'more-than-human' terms. The paper assesses and synthesizes this diverse literature, emphasising the novel understandings of corporeality, materiality, assemblage, relationality, vitality and affect that have become distinctive features of it.