Precarious Interventions: Designing for Ecologies of Care

In this paper, we present ethnographic account of people's everyday behavioral health experiences in the city of Jackson, Michigan to explore community forms of care work through an infrastructural lens. Detailing people's interactions with clinical processes and health policies, local resources, and diverse social worlds, we highlight problematic healthcare delivery gaps, as well as the informal (and often invisible) practices people depend upon to manage their health needs given socioeconomic hardships and cultural concerns. We also discuss the city's efforts to support local behavioral health needs through the development of a community health record. Placing fieldwork findings in conversation with the goals of this ongoing civic design project, we propose the analytic sensibility of precarious intervention to unpack the significance of the infrastructural tensions and power relations at play when people seek solutions to complex sociotechnical problems. Precarious intervention calls for CSCW research that attends to 1) the collective labor necessary to create and maintain ecologies of care in the face of infrastructural brokenness; and 2) the high-stakes and varied costs of 'engagement' for different community stakeholders.