How do we think with Data, Desire, Discipline
Database Addiction took place at Lorraine Hewitt House which is situated in the heart of Brixton. It is staffed by busy, engaged and dedicated drugs workers, clinical psychologists, social workers, psychiatrists and administrators including reception staff, who all have a high workload. The clinic sits at the nexus of several databases, the National Drug Treatment Monitoring System (NDTMS), Electronic Patient Journey System(ePJS), NHS Spine and others.
How do databases act in Lorraine Hewitt House? All the work at the centre is interrelated to collections of information, that in turn evidence decisions, events and result in quantifiable structures that reciprocally create other individual actions. This table is an attempt to think through the structural coupling of databases and the intention of the clinic. Databases are more often than not regarded as a technical solution with scant regard given to their culturalisation, sociality or the way the knowledge/power, or architectural relations are altered by them.
The enterprise of the clinic in it's own words is to 'support anyone over the age of 18 with alcohol or drug problems who lives in Lambeth. Providing a key worker to a service user working with them to formulate a care plan for a journey through other services.' Most people work with the ePJS which has background processes, sorting algorithms that extract information into other systems such as the NDTMS whose enterprise is summarised as: 'process information from and for those involved in and around the governance of drug treatment.'
The databases investigated are a form of list architecture that produce an abstraction of the clinic's modalities. They afford methods by which the materiality of the clinic's work can be managed and governed at multiple scales with computation. This process of abstraction while allowing distance and overview from the gritty work of dealing with addiction is always incomplete and structurally flawed representation of the experience of the clinic.
The structure of the NDTMS unlocks what is articulated about addiction from an ideological, technical, political, bureaucratic or governmental viewpoint which is used amongst other things for monetising addiction services. The NDTMS can be seen as pointers to a fluid formation of power that is a strategy in action. While this formulation can be useful in understanding this strategy as a navigable fluid architecture it tells us very little about how individuals manipulate/resist the modalities it creates.
The logics represented on these tables interrelate through disciplining the organisation and forcing compliance with various databases through such mechanisms as the Treatment Outcomes Profile (TOP) which purportedly 'measures change and progress in key areas of the lives of people being treated within drug and alcohol services.' This form of compliance affects overall funding and polices staffs efficiency and the security of their jobs.
Staff at Lorraine Hewitt House addictions clinic
Dr. Luke Mitcheson (Consultant Clinical Psychologist)
Anila Ladwa (Producer)
Stephen Fortune (Researcher on Data Flow)
Database Addiction: Databases, Health Governance and Arts Enquiry (2015) is a research project by YoHa with the Clinical Academic Group – Addictions and the South London and Maudsley NHS Foundation Trust, supported by the Wellcome Trust Arts Award.