Complex Caring Trajectories in Community Mental Health: Contingencies, Divisions of Labor and Care Coordination

The concept of ‘trajectory’ refers to the unfolding of individual service users’ health and illness experiences, the organization
of health and social care work surrounding them and the impact this work has on people involved. Using qualitative data from
a study completed in two sites in Wales we first reveal the complex character of trajectories encountered in the community
mental health field. We show how these can be shaped by features peculiar to mental ill-health per se, and by features with
organizational origins. We then use our data to lay bare true divisions of labor. Mental health professionals featured prominently
in our study. We also reveal relatively invisible contributions made by professionals on the periphery, support workers, unpaid
lay carers and service users. In examining the significance of our findings we identify particular lessons for mental health
practitioners, managers and policymakers sharing concerns for the coordination of care.