This article analyzes doctor-patient communication at admission interviews in an outpatient mental health care service at a public hospital in Buenos Aires, Argentina. These interviews are the first contact between professionals and patients, and they result in the admission or rejection of the latter into the medical institution. In particular, we observe how context, understood as a sociocognitive and scalar concept, is reshaped with gaze direction and agenda-setting through interaction, resulting in three hierarchical spaces which can be represented as degrees in a scale: the public, the private, and the intimate level. This description will allow us to understand a series of communicative difficulties that may result from scale maladjustments, in which professionals interact with patients at different levels and therefore cannot give adequate feedback to satisfy mental health care needs.

This article is part of a larger research project, the aim of which is to understand the discursive conditions of access and adherence to an outpatient mental health service at a public hospital in Buenos Aires, Argentina. The focus is on the historical conflict between medical discourse and psychoanalytical discourse as it emerges in the negotiation of treatment and diagnostic sequences at first consultations. It can be seen that patients who are socialized in medical discourse--and even in psychiatric discourse--expect the usual procedure in which a diagnosis, however transitory, is offered first and then followed by a treatment recommendation. However, psychoanalysts, in contrast, tend to reject diagnostic labels and offer treatment without further justification. This has an impact on the adherence of patients, and we can argue for the need to negotiate with medical discourse in order to guarantee engagement and continuity in treatment.

This article analyzes expanded responses to statistical-epidemiological questions at a mental health outpatient service at a public hospital in Buenos Aires, Argentina. Bureaucratic questioning is a highly routine activity which supplies information to the biopolitical apparatus of the modern State. We understand that expanded answers are meaningful actions which not only serve individual, local tactics (such as raising personal concerns), but also index higher contextual levels. In this sense, resisting the constraints of a question may also imply resisting State-defined policies of biopolitical classification and exclusion. We examine, from a discursive interactional point of view, 41 admission interviews held at the outpatient mental health care service. We observe four types of expanded answers which: (a) display competence in bureaucratic discourse; (b) move from the sphere of the public to the private; (c) deal with potential facethreats; and (d) pre-empt rejection. Although the former is actually an optimized way of collaboration with the biopolitical order, the latter three types can be seen as actions of resistance to classification, not only symbolically but also in material terms: resisting statistical criteria of exclusion allows clients to negotiate access to mental healthcare.En este art ıculo analizamos respuestas expandidas a preguntas estad ıstico-epidemiol ogicas en un hospital p ublico de Buenos Aires, Argentina. Los cuestionarios burocr aticos son una actividad rutinaria que alimenta el aparato biopol ıtico del Estado moderno. Consideramos que este tipo de respuesta es una acci on significativa que no s olo responde a t acticas locales individuales (como presentar preocupaciones personales), sino que tambi en indexicaliza niveles contextuales m as altos. En ese sentido, responder resistiendo los condicionamientos impuestos por una pregunta puede tambi en suponer una resistencia a las pol ıticas estatales de clasificaci on y exclusi on. Examinamos, desde una perspectiva discursiva interaccional, 41 entrevistas de admisi on a los consultorios externos de salud mental. Observamos cuatro tipos de expansi on, las cuales: muestran competencia en el discurso burocr atico; se desplazan de la esfera p ublica a la privada; enfrentan amenazas potenciales a la autoimagen; buscan anticiparse al rechazo. Aunque el primero pueda verse como una forma optima de colaboraci on, los otros tres tipos pueden verse como forma de resistencia a la clasificaci on, no s olo en t erminos simb olicos, sino tambi en materiales:Journal of Sociolinguistics 18/5, 2014: 685-707 © 2014 John Wiley & Sons Ltd resistirse a los criterios estad ısticos de exclusi on le permite a los pacientes negociar el acceso a la salud mental. [Spanish]

This article analyzes narratives of the Malvinas war by a group of Argentine non-recognized veterans. Our aim is to understand the discursive conditions of their situation, which leaves them in an unequal position with respect to other veterans. Analysis will show that their stories are shaped in a way which is not compatible with the hegemonic narratives about war, thus receiving an unequal legal treatment.

In this article, we contribute to understanding the interactional aspects of making clinical diagnosis in mental health care. We observe that therapists, during the "problem presentation" sequence in clinical encounters, often use a specific form of diagnostic formulations to elicit more diagnostically relevant information. By doing so, they often substitute one type of verb with another, following a diagnostic hypothesis. Specifically, in interviews that arrive at a diagnosis of neurosis, therapists formulate with behavioral verbal processes; in interviews that arrive at a diagnosis of psychosis, they do so with material ones. Such formulations often prove useful to define clinical diagnoses. They can, however, also be dangerous in that they may favor the therapist's agenda over the patient's. Our analysis helps therapists not only better understand the diagnostic process but also reflect upon their own use of diagnostic formulations and become aware of the clinical effects of their interactional performance.