The discussions have thrown up lots of examples of definitions -systems reform, place based- that are not commonly understood. This is a feature of era two. In era one, the problem was more a dearth of definition.

If we take children’s services as an example, and the narrow area of children in care. Such children were classified as ‘beyond parental control’ or ‘in moral danger’, terms that gave the state permission to intervene just a little more. By definition all children are beyond parental control at multiple points in their development and most adolescents aspire to some moral danger.

In psychiatry, a patent’s designation tended to reflect the training and outlook of the clinician. It was a subjective judgement with behaviourists tending the world differently than say a psycho-analyst.

Having a defined problem was a necessary condition not only for access to services but also for exit. One of my early books dealt with the contribution of what were called therapeutic communities to child outcomes. As we prepped for the study we overheard two boys chatting outside therapist’s office in one of these communities. One boy says to the other, ‘what are you in for then?’, generating the reply, ‘I don’t know, I haven’t got any problems’. To which the more experienced resident says, ‘Well you better get some quick otherwise you will never get out of here’.

I set this out as a backdrop to the entries that come next. There are many problems with the era two approach to definition, but it lifted us out of the darkness that pervaded era one, and some of the many consequent abuses to patients rights.

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