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Paper short abstract

This paper explores care as a temporal practice, showing how Emergency Care and Recovery Centres (ECRCs) in South India respond to psychosocial distress rooted in structural vulnerability, balancing rapid routines, discharge pressures, and needs that predate institutional care.

Paper long abstract

Emergency Care and Recovery Centres (ECRCs) in South India respond to acute psychosocial crisis among people experiencing homelessness, engaged with psychiatric care. Organised as short-term inpatient interventions, they operate through a bounded temporal logic in which crisis is identified, stabilised, and resolved within a limited clinical window. They are also mandated to facilitate access to social entitlements, embedding care within longer bureaucratic processes.

Ethnographic engagement across three centres suggests distress and care rarely unfold along a single temporality. Chronicity here is not framed as a psychiatric condition but as enduring psychosocial distress shaped by structural vulnerability. Drawing on fieldwork, we explore how care is practised amid coexisting temporal demands. Clinical work moves rapidly through medication titration, observation, and measurable improvement, while bureaucratic processes follow an uneven tempo shaped by documentation and thresholds. Alongside these, care is organised around sustained attentiveness to bodily and psychosocial needs: turning bed positions, feeding, unpredictable demands for presence or reassurance. This work is structured by regular intervals yet continually disrupted by psychosocial distress, producing a tempo that is neither cyclical nor episodic.

Rather than treating these temporalities as coherent or hierarchical, the paper explores how care emerges within them. Interruptions, delays, and waiting are central to sustaining life in the ECRCs. These moments rarely enter records or outcome metrics, yet they shape who remains in care, who is discharged, and who becomes suspended between institutional categories. The paper asks how care unfolds when chronic distress must be made legible through time-bound forms of clinical knowledge.