1 DIAGNOSING AS AN INTERACTIONAL ACHIEVEMENT IN PSYCHIATRIC INTERVIEWS Carles Roca-Cuberes (Universitat Pompeu Fabra, Barcelona, Spain) Chapter contents 1. Introduction 2. Project overview 3. Initiating the exploration of patients’ mental state 4. Exploring the circumstances that triggered admission 5. Is he an ‘ex-patient’? 6. Announcing the verdict 7. Clinical relevance 8. Summary 9. References 10. Recommended reading 11. Clinical practice highlights Introduction What is involved in exploring a patient’s mental state? How is a diagnosis or a decision about a patient’s psychopathological status accomplished? How do psychiatrists make patients talk about their problems? The first encounter, in a psychiatric hospital, between a psychiatrist and the prospective patient is quite significant for the fate of the latter. In a psychiatric intake interview (PII) the psychiatrist’s official task is to determine whether a person should be hospitalised – voluntarily or involuntarily – as a patient on the basis of the person’s observable behaviour during the interview. Customarily, this implies that the psychiatrist needs to solicit the patient to talk about