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actors approach the obligatory passage point for, and out of different reasons and yet the obligatory passage point accommodates the different reasons. Hence obligatory passage points need not be static or one dimensional. An obligatory passage point can even be fluid to accommodate changing conditions. Schwennesen and Koch’s study (2012) concerned a first trimester prenatal risk assessment at an ultrasound clinic. Upon detection of a foetal abnormality, the clinic responded by consulting both the pregnant woman and her partner. The first trimester prenatal ultrasound equated to an obligatory passage point, which generated this responsive feedback and engagement. From this meeting a decision is made whether to continue the pregnancy or terminate it. Resources are often limited in remote locations (see Chapter 2) and accordingly, partners and significant others, of mental health patients, are included and embraced as an integral aspect of delivering mental healthcare. What Schwennesen and Koch (2012) and this study demonstrate, is that there can be various people with different requirements, needs or perspective on the personal outcome of the encounter with the obligatory passage point. Patients have requirements from remote nurses different to that of family and relatives, just as pregnant women have slightly different outcomes from the meeting compared to that of a spouse. Yet both need to attend the same obligatory passage meeting to satisfy or address their respective own needs. Schwennesen and Koch’s (2012) study reiterates that the obligatory passage point’s response does not have to be a ‘one off’ occurrence. It can be staged or staggered. The prenatal ultrasound screening scan is the first obligatory passage point and depending whether an abnormality is detected or not, the couple proceed to a second obligatory passage point of a meeting to discuss risks to the unborn and the pregnant woman’s