Aanastasios Dimopoulos - Tacit knowledge and the formation of clinical expertise in mental healthcare; the “brave new world” of remote consultations and the future of mental healthcare

Season 8 continues with a recording from our 2021 annual conference, The Future as a Present Concern. This episode features a presentation from Aanastasios Dimopoulos Abstract: Among the various effects of the recent pandemic was the need to adapt the means of delivering mental healthcare in the community. The use of online platforms which were already there as possibilities to use sparingly, suddenly became the self-evident norm to adopt. Very soon it became clear that remote consultations will not be an interim measure, relegated for the period during the pandemic. The voices suggesting that they are the future of healthcare became dominant. Advantages such as “increased patient access” were illustrated as obvious benefits to maximise available resources. The language of resource is dominant in healthcare that considerations about what cannot be measured are neglected. This is not a wilful neglect but rather an emergent self-evident attitude that appropriated in its ontological presuppositions enframes its intentional horizon in a discourse aimed to identify resources and optimise their outcomes. If the premise is right, then what will be the impact in mental healthcare. The articulation of clinical judgement in psychiatry relies heavily in the expertise gained in the context of embodied encounters between patient and clinician. What Polanyi calls the demonstrative elements that give rise to an act of recognition of something as a particular case belong to a space of encounter that is constitutionally different. Furthermore, this “difference” is still in its infancy. Intuitively, this “difference” is grasped mostly as “absence of habit” that is supplemented by pre-existing embodied encounters and of an increased reliance on ready-made theoretical constructs. This act of “filling in” will likely fade away over time 13 because it will lose the ability to flexibly understand distinctions in the phenomena. New implicit rules will take their own form, not yet possible to capture theoretically. In the coming decades, this is likely the Event with the most transformative potential and happens with Care mostly silent. Biography: Dr Anastasios Dimopoulos works as a Consultant Psychiatrist in the NHS and in the private sector. Currently, he is involved with the Community Transformation Project that aims to change the way mental health services are delivered in the community. He is trained in Daseinsanalysis and is a member of the International Federation of Daseinsanalysis. Furthermore, he holds an MA in Philosophy of Mental Health at UCL. His special interest is the introduction of philosophy to medical education in mental health, to address complexity and uncertainty. He has recently been elected chair of The Philosophy SIG of the Royal College of Psychiatry. Further Information: This recording is taken from our Annual UK Conference 2021, co-organised with University of Galway and The Irish Philosophical Society. This conference was held online consisting of live webninars with keynote presents and pre-recorded presentations from panel speakers. Biographical information of speakers is taken from the programme of that event and therefore may not be up-to-date. The British Society for Phenomenology is a not-for-profit organisation set up with the intention of promoting research and awareness in the field of Phenomenology and other cognate arms of philosophical thought. Currently, the society accomplishes these aims through its journal, events, and podcast. About our events: https://www.thebsp.org.uk/events/ About the BSP: https://www.thebsp.org.uk/about/