Dealing with callers' racialised talk in suicide preventive helplines: Accomplishing (anti)racism in the context of unconditional support.

This article investigates how mental health counsellors on helplines in Sweden deal with racism from callers who self-categorise as non-racialised. Previous studies have identified racism as a problem in health care interactions, but there is limited knowledge about the features of racialised talk and how staff respond. In this study, we use conversation analysis and membership categorisation analysis to examine racialised talk in 17 audiorecorded calls, a subset of 458 calls to suicide preventive helplines. The analysis shows that racialisation functions as a resource for callers to make sense of their mental health difficulties. This speaks to the complexity of responding to racism in a mental health setting, as counsellors must see to callers' needs, and calling out racialised talk may alienate callers. Call-takers manage this problem in three ways: (1) questioning racialised talk, (2) supporting the callers' stance in a way that makes it ambiguous if call-takers are coproducing racism or affiliating with callers' lives being difficult and (3) supporting callers' problems as mental health issues while resisting a potentially racist trajectory. The study offers direct insight into the workings of racism in health care and how practitioners can balance health care users' needs for support with an antiracist position.

Making robots matter in dementia care: Conceptualising the triadic interaction between caregiver, resident and robot animal.

While previous research studies have focused on either caregivers' or residents' perception and use of social robots, this article offers an empirical and theoretical examination of joint activities in triadic human-robot interaction. The symptomatology of dementia creates an asymmetrical relation wherein the impetus to employ a robot often originates from the caregiver. Drawing on field work and video recorded interactions in dementia care homes, the article investigates how caregivers draw on embodied resources to involve residents and robot animals in interaction. The analysis demonstrates how caregivers promote commitment and encounter resistance with residents. We draw on the theory of sociomaterial interactionism to study situated interaction between bodies in a meaning-generating process. By re-conceptualising the theoretical notions of manipulation and recruitment, the article offers an approach for studying orientations that distinguish between reciprocity of agential objects. We show that caregivers usually distinguish between interactions with people and machines by anticipating a specific response from the robots (manipulation), while they invite participation in a broader sense from residents (recruitment). Social friction arises, however, if caregivers act upon the residents as embodied objects in manipulative ways.

Robotic misinformation in dementia care: emotions as sense-making resources in residents' encounters with robot animals.

Robot animals, designed to mimic living beings, pose ethical challenges in the context of caring for vulnerable patients, specifically concerning deception. This paper explores how emotions become a resource for dealing with the misinformative nature of robot animals in dementia care homes. Based on observations of encounters between residents, care workers, and robot animals, the study shows how persons with dementia approach the ambiguous robots as either living beings, material artifacts, or something in-between. Grounded in interactionist theory, the research demonstrates that emotions serve as tools in the sense-making process, occurring through interactions with the material object and in collaboration with care workers. The appreciation of social robots does not solely hinge on them being perceived as real or fake animals; persons with dementia may find amusement in "fake" animals and express fear of "real" ones. This observation leads us to argue that there is a gap between guidelines addressing misinformation and robots and the specific context in which the technology is in use. In situations where small talk and play are essential activities, care workers often prioritize responsiveness to residents rather than making sure that the robot's nature is transparent. In these situations, residents' emotional expressions serve not only as crucial resources for their own sense-making but also as valuable indicators for care workers to comprehend how to navigate care situations.

The subjective and objective side of helplessness: Navigating between reassurance and risk management when people seek help for suicidal others.

Social psychologists interested in interaction have demonstrated that help-seeking is a fruitful area for understanding how people relate to one another, but there is insufficient knowledge on how people navigate emotional involvement in help activities. Drawing on discursive psychology and conversation analysis, this article examines third-party calls to a crisis helpline, with emergency calls as a point of comparison, to see how participants manage emotional involvement related to callers' concerns for others. The analysis unpacks how participants orient to helplessness-callers' uncertainty and inability to move forward-as justifying a focus on the at-risk person or on the caller's emotions. While dispatchers at emergency centres work to get pertinent information to send help, call-takers at the crisis helpline are trained to offer emotional support. In the latter case, a caller's displays of helplessness may be treated as a sign of danger for the person at-risk, but it can also be taken as a disposition to worry, warranting a focus on the caller's emotional state. Showing how participants manage this challenge as they navigate 'whom to help', the paper contributes to research on the accomplishment of subjectivity and objectivity and demonstrates the utility of this framework in suicide prevention.

Users' Perspectives on Crisis Helplines in Relation to Professional Mental Health Services.

Background: Crisis helplines aim to provide a short-term intervention or guide users to professional mental health services, but many users return to helplines despite having professional mental health contacts. Aims: To contribute knowledge on users' perspectives on the role of crisis helplines in relation to their professional mental health contacts, we aimed to investigate how online helpline users describe such services. Methods: We used thematic analysis of 100 naturally occurring interactions from a Swedish online crisis helpline. Results: The users viewed the helpline as a safe space, a partner, or an alternative to bad professional services. Users oriented to ongoing helpline usage as crucial for their well-being while they described using professional mental health services to be able to stay alive. Limitations: The findings are limited to the nature of the different themes. Conclusion: The view on crisis helplines as a short-term intervention relies on an idealized view on crisis intervention that does not represent users' views. User control is at the core of the appeal of helplines, but it is also a key challenge for organizations and volunteers.

Making sense of experiences in suicide helpline calls: Offering empathy without endorsing suicidal ideation.

The question of how people make sense of experiences in relation to health is central to medical sociology and lies at the heart of suicide helpline practice. This article draws on a corpus of 900 audio-recorded suicide helpline calls to examine how call-takers respond to the challenge of reframing callers' suicidal ideation while still treating their experiences as legitimate. Conversation analysis of a subselection of calls revealed two call-taker practices, involving the framing of the caller's suicidal ideation as (1) being ambivalent or (2) having legitimate feelings in a difficult situation. While callers resisted the former, 'feeling formulations' laid the interactional foundations for exploring alternatives to suicide. This may be because call-takers' empathy increased their rights to subtly negotiate callers' experiences. By focusing on recipients' contributions in these critical interactional moments, the article widens the sociological approach to examining sense-making of health experiences as a thoroughly social process.

Beyond accessing information: Claiming to understand in child social welfare interviews.

The present article investigates how people manage understanding of personal experiences in an institutional setting in which shared understanding of one party's experience can become an issue at stake: social welfare interviews with child victims of abuse. New recommendations on how to respond to child interviewees limit interviewers' support to experiences of which they have direct access. Using conversation analysis and discursive psychology to examine cases in which interviewers respond to children's reports of experiences by claiming to understand, the current article shows that interviewers primarily use such claims after interviewees have indicated that the interviewer may not understand. By claiming to understand, interviewers orient to a difference between an interview requirement - not assuming they know the children's specific experiences - and their ability to interpret the children's situations. The study shows how interviewers use claims of understanding to distinguish themselves as understanding persons from their information-eliciting approach as social welfare investigators. Findings contribute to social psychological research on how people manage challenges related to eliciting and recognizing experience in interaction. In particular, the study offers research on interviews with child victims of abuse a new angle on the tension between information elicitation and support.

Now or never: smoking cessation discussions in the face of serious illness.

Sociological research on medical discussions of lifestyle suggests that smoking patients may be seen as knowingly causing their medical problems. Therefore, it may be interactionally problematic for doctors to raise the issue of smoking cessation in relation to patients' serious health problems. While a serious illness can be expected to bring to the fore the relevance of smoking cessation advice, it may also give rise to questions about patients' right to treatment. This study uses conversation analysis to explicate how patients and doctors manage issues of responsibility in smoking cessation discussions in the face of a serious medical problem that strongly correlates with smoking. The findings show that whilst ill health can be referred to in a confrontational manner, it can also give smoking cessation a 'now or never' status that downplays patients' responsibility for not having quit before. Based on these findings, the paper concludes that for warranting further smoking cessation advice, how doctors and patients verbalise the link between smoking and a serious medical problem matters more than whether they do so.

Balancing task focus and relationship building: asking sleepy patients about traffic risk in treatment initiation consultations.

BACKGROUND: The use of traffic risk assessment questions is an understudied area in nursing research. Obstructive sleep apnoea is associated with an increased risk of traffic accidents. Therefore, traffic safety authorities demand adherent continuous positive airway pressure use. Nurses act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by prohibiting obstructive sleep apnoea patients from drowsy driving. OBJECTIVE: To examine how nurses and obstructive sleep apnoea patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations. METHODS: To study, in detail, the actual practice of risk assessment, we used conversation analysis of 19 video-recorded initial treatment consultations with nurses and recently diagnosed obstructive sleep apnoea patients. ETHICS: The study received ethical approval from the Central Ethical Review Board in Linköping (registration number 214/231-32) and follows the ethical guidelines for qualitative research. RESULTS: Patients influence how nurses phrase questions about traffic risk by taking a stance to daytime sleepiness prior to the risk question. Nurses ask traffic risk questions in a way that assumes that driving is unproblematic if patients have not previously indicated problems. It may pose a significant problem when nurses, by accepting patients' prior stance when asking about traffic risk, orient to relationship building rather than task focus. CONCLUSION: To clarify the difference between their two potentially conflicting roles, nurses need to refer to existing laws and official guidelines when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. Traffic risk assessment is sensitive yet important, as obstructive sleep apnoea is a highly prevalent problem causing excessive sleepiness. It is essential to acknowledge nurses' double roles with regard to coaching continuous positive airway pressure treatment and assessing traffic risk.

'I don't know if I should believe him': Knowledge and believability in interviews with children.

Social psychologists interested in social interaction have, in recent years, addressed the ways that people negotiate 'who is entitled to know what' across a variety of conversational settings. Using recordings of interviews conducted as a part of a Swedish national evaluation of interventions for abused children, the current article examines how children navigate knowledge and its moral implications. The analysis focuses on a particular question ('What do you believe [the perpetrator] thinks about what he has done'), which draws on the psychological concept of mentalization: the cognitive ability to picture others' mental states based on their behaviour. The findings suggest that the concept of mentalization fails to account for the moral properties of knowing someone's thoughts: The perpetrator, most often the child's father, must be believable - recognized as both credible and knowable - for the children to claim access to his thoughts. The interviewees used contrastive constructions in claims of (no) access to their fathers' thoughts as they simultaneously contested idiomatic knowledge that undermined their claims. The article contributes to recent developments in discursive social psychology concerning how subjectivity, in particular, epistemic stance, is managed in institutional interaction, and continues the discursive psychological project of respecifying concepts such as mentalization.