Building aid workers’ resilience: why a gendered approach is needed

The concept of resilience is increasingly earning attention in development and humanitarian literature. Agencies and organisations are interested to learn about resilient communities, and keen to support the goal of ‘building resilience’ in developing countries. However, there is comparatively little interest in the resilience of aid workers themselves. This article will discuss the need to support aid workers to build resilience, for their own well-being and also for the effectiveness and sustainability of the essential humanitarian and development work they do. It will advocate for the need of embracing a gender-focused approach in the study of aid workers’ resilience, and more generally, in the study and promotion of aid workers’ well-being. The article draws on a qualitative study which found international women aid workers face specific stressors within the organisations they work for, in working relationships with national staff, and in their personal life. Humanitarian and development organisations need to adopt a gender-focused approach to resilience in the provision of psychosocial support for staff working in development, and emergency relief/humanitarian aid.     

Constructing Humanitarian Selves and Refugee Others

Contributing to ongoing debates about what happens when feminism is institutionalized in global governance, this article examines how gender equality is given meaning and applied in humanitarian aid to refugees, and what the implications are with regard to the production of subjectivities and their positioning in relations of power. Drawing on Foucauldian and postcolonial feminist perspectives, the analysis identifies two main representations of what it means to promote gender equality in refugee situations. Gender equality is represented as a means to aid effectiveness through the strategic mobilization of refugee women's participation, and as a project of development, involving the transformation of “traditional” or “backward” refugee cultures into modern societies. The subject positions that are produced categorically cast refugees as either passive or problematic subjects who need to be rescued, protected, assisted, activated, controlled and reformed through humanitarian interventions, while humanitarian workers are positioned as rational administrators and progressive agents of social transformation. In effect, gender equality is used to sustain power asymmetries in refugee situations and to reproduce global hierarchies.     

Love thy neighbour: Social identity and public support for humanitarian aid

Humanitarian aid can be contentious. Should finite national resources be sacrificed to serve the needy abroad? Social identity theorists argue that identification with a superordinate group, in this case the larger world community, should increase individual support for policies such as international humanitarian assistance. However, individuals can simultaneously associate with multiple identities. How does the combination of world and national identities affect support for humanitarian assistance? Using cross‐national survey data, we find evidence that support for international humanitarian aid is highest among those with a strong world identity and weak national identity relative to other identity combinations, though even those with a strong world identity and strong national identity can be supportive of aid.     

Health,wellness, and workplace experiences of lesbian,gay, and bisexual social workers

Abstract

Using data from an online survey of 6,112 licensed social workers in 13?U.S. states, rates of reported behavioral health problems and service utilization, physical health problems, adverse childhood experiences, workplace stress, and compassion satisfaction were compared between heterosexual male, heterosexual female, gay/bisexual male, and lesbian/bisexual female respondents. Sexual minority workers reported far higher rates of mental health problems and service utilization, higher rates of physical problems, more frequent reporting of adverse childhood experiences, with no differences found between groups regarding workplace stress and compassion satisfaction. Minority stress theory and historical trauma are used as frameworks to conceptualize the findings.     

Children and Families Seeking Asylum in Northern Norway: Living Conditions and Mental Health

The mental health of children seeking asylum and their families is a somewhat neglected area of research. Research on refugee children and children living with adversities suggests that environmental factors are crucial in preventing mental health problems. In this study, we aim to identify central environmental conditions that affect the mental health of children living with their families at governmental asylum processing centres in northern Norway. This study has a qualitative design, and is based on 11 focus group interviews with the staff at asylum processing centres. The interviews were transcribed verbatim and analysed focusing on important risk and protective factors for mental health problems presented by the informants. The results highlighted time spent at asylum centres and the parent's mental health as the most important risk factors. Schooling, activities, general living conditions and poor economy were also seen as crucial. The findings suggest that these children are indeed vulnerable, and at high risk of developing mental health problems. Their rights are, however, open to local interpretations, and they fall between two stools; their right to proper health care, and national and international immigration policies.     

Disaster and Response

Abstract

The Indian Ocean Tsunami of December 2004 was one of the most significant natural disasters in modern history. The response that it drew was unprecedented at both local and international levels. While a range of specific impacts and losses may be predicted within the affected populations, there is substantial evidence that adverse impacts upon mental health may represent one of the most significant outcomes of such events. People from poorer countries are disproportionately exposed to such emergencies and may experience greater psychosocial burden in the aftermath, as well as a range of adaptations. This raises important questions regarding the current capacity of response agencies to mitigate negative impacts but also concerning the cultural context in which such mental health effects are defined. It also calls into question whether “indicated” interventions are both realistic and ecologically valid in non-Western settings. The science of Disaster Mental Health is a relatively new field, currently engaged in a number of such debates. However, there is some emerging consensus about what constitutes good public mental health practice throughout the phases of emergency response and across diverse cultural settings. Existing data and practice guidelines provide frameworks that may be adapted to allow health and recovery workers to identify and reduce mental health morbidity, support healing and harness the agency of those affected for the recovery process.     

Responsive engagement in mental health services for foster youth transitioning to adulthood

ABSTRACT

As youth near the transition to adulthood and aging out of the foster care system, exposure to stress increases, especially for youth who have less-than-adequate support systems. Although mental health problems among foster youth often continue into adulthood, service use decreases dramatically within a year of turning age 18. Understanding how foster youth experience mental health services as they transition from care provides social workers and other mental health professionals important insight that can lead to specific, targetable strategies. This study sought to explore what situations were helpful in supporting mental health as foster youth transitioned to adulthood. Focus groups and interviews with former foster youth and professionals informed the development of a quantitative instrument, which was used to identify the most supportive and frequently encountered situations former foster youth experienced. Findings indicate the most helpful situations were those in which professionals and mentors were flexible and responsive to their individual needs and trusted their ability to make decisions. Supportive adults who honored their choices and collaborated in decision-making were also helpful. Engaging, empowering, and partnering with transition-age youth may increase the likelihood of positive mental health outcomes for this population, offering implications for family-centered, strengths-based practice.     

Ignoring rights is wrong: re-politicizing gender equality and development with the rights-based approach

Corporate sponsors and humanitarian organizations have joined popular authors and international institutions in bringing attention to gender inequality though “smart economics” and “investing in women.” These social marketing messages and donor strategies mimic arguments for gender equality from the 1970s and 1980s. Rather than building on the rights-based development and best practices of the 1990s, they ignore the critical roles of political capacity and participation that the past forty years and feminist analysis of development achievements and failures have taught us are essential to taking on gender and economic inequality. Certain trends in foreign aid accountability share this silence on the importance of political capacity. In contrast, the rights-based approach to gender equality and development (RBA) is a political approach to development. We reconcile the need for aid accountability with the need for a focus on politics by outlining key political processes of the rights-based approach. The RBA is a way of doing development that is attentive to process and power. We can use the RBA not just as a guide for how to do development, but also as a way to think about processes as outcome measures. The processes that the RBA requires are processes that build capacity for marginalized women and people.     

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns.MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained.ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation.ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.     

Secondary traumatic stress and self-care inextricably linked

ABSTRACT

Increasingly trauma scholars are exploring the susceptibility of mental health providers to secondary trauma reactions. The current study explores the relationship between clinical social work practice with trauma-exposed clients and secondary traumatic stress among social workers. The intent of this study is to identify the role various factors play in the development of secondary trauma (also known as compassion fatigue). A simple random sample of National Association of Social Workers members were asked to participate. Participants completed an online survey that explored their exposure and responses to secondary traumatic stress. The online survey consisted of standardized measures including the Secondary Traumatic Stress Scale and The Coping Strategies Inventory which assesses secondary trauma and self-care strategies, respectively (Bober, Regehr, & Zhou, 2006; Bride, Robinson, Yegidis, & Figley, 2003). The magnitude of work (the extent and intensity of time working with trauma-exposed clients) is assessed by a non-standardized measure which consists of clinical caseloads composition questions. Job satisfaction is measured by items taken from the National Association of Social Workers’ workplace questionnaire (Whitaker & Arrington, 2008). 161 social workers completed the online survey. It required approximately 35 minutes to complete. This project empirically demonstrated that high-magnitude social work practice (providing therapeutic intervention to trauma survivors, i.e. military service members and veterans) is associated with higher levels of secondary trauma. There is also empirical evidence that self-care strategies can mitigate the impact of the secondary trauma. Educational and workforce implications for study findings are discussed.     

Sexual Behavior,Mental Health,Substance Use,and HIV Risk Among Agency-Based Male Escorts in a Small U.S. City

Abstract

Relatively little research has examined the personal sex lives of indoor male sex workers (MSWs) or possible connections in this group between sexual behavior and factors related to HIV risk. As part of a larger project, this study collected data from 30 agency-based indoor MSWs (mean = 22.4 years) about their sexual behavior, mental health, and substance use. Few HIV risk behaviors with clients occurred. Drug use and mental health problems were relatively frequent, but not related to increased risk behavior. Instead, MSWs appeared to employ rational decision-making and harm-reduction strategies. Conceptualization of MSW sexual behavior may be required where HIV risk is not attributed to sex work per se, but to other influences such as economic and relational factors.     

Having it all overseas: Aid workers and the international division of reproductive labour

This article examines the dynamics of power and privilege at work in international development through the prism of domestic service for expat aid workers in developing countries. Drawing on ethnographic fieldwork amid aid workers and their domestic staff in Dakar, Senegal, I argue that access to affordable care work greatly enhances the lives of women who work overseas in development. The postcolonial underdevelopment and poverty that aid work addresses is paradoxically critical to the aid workers' own access to affordable care, family balance and the means to do their jobs. I put this insight into the larger scholarly conversation about domestic work and global inequality, including on the Global Care Chain.     

Applied ethics and allocation of foreign aid: disparity in pretensions and practice

We explore the applied ethics of development aid and humanitarian assistance, and juxtapose these with claimed objectives and factors that influence the choice of recipients. Despite some diversity among donors, ethical considerations appear not to be a prominent factor for allocation of aid. Although recipients’ need is not entirely ignored, donors’ self‐interest and herd behaviour, and recipients’ merits and voting in the United Nations, play crucial roles in allocation decisions. Likely to be shunned are complex emergencies and fragile states, the overlapping settings for action of development and humanitarian aid. Donors should take to heart and put into practice that allocation of aid is an ethical endeavour that should rest on proper needs assessment, established objectives and adopted agreements.     

Geropsychiatric education programs. Providing skills and understanding

1. The treatment of mental health problems is a growing concern in long-term care facilities; up to 80% of nursing home residents suffer from some type of mental illness, but most receive no active treatment. 2. Nursing home staff do not receive sufficient training on mental health issues, the aging process, and assessment and management of psychiatric symptoms in the elderly. 3. Psychiatric nurses can provide a number of quality geriatric mental health programs to increase staff knowledge and promote quality of care.     

A comparative study of experiences of client violence and its impact among Iranian and Swedish social workers

Client violence toward social workers has been recognized as a serious problem, and major concern has been raised with regard to its impacts on social workers' practice and physical and psychological health. There is recognition among researchers and policy-makers that it is time for the international social work community to develop conventions and agreements to address this issue globally. A cross-cultural study between Sweden and Iran was conducted to compare and contrast levels of violence between the two countries. Prevalence of violence was 72% in Sweden and 68% in Iran. Iranian social workers show a significantly higher increase in general mental health problems regarding client violence compared to Swedish social workers. Despite differences in rules and regulations between Sweden and Iran, client violence was found to be common in the two countries. Preventive policies for detecting potential violence situation are good but not enough. We suggest taking actions on building trust and supportive structures within organisations.     

Adolescents' Self-Reported Substance Risks and Need to Talk About Them in Mental Health Counseling

Summary

Although adolescents seeking mental health services may not consider them related, the prevalent co-morbidity of substance use and mental health problems makes it imperative that practitioners find ways of engaging troubled youth about substance issues. Based on their responses to a clinical self-assessment questionnaire (Adquest), this study shows that mental health service applicants are willing to disclose their substance use behaviors and are open to talking about them to intake workers. Age and gender differences in substance use patterns and willingness to talk are explored.     

Coming Out Issues of Gay and Lesbian Mental Health Professionals in Voluntary and Involuntary Settings

Abstract

Mental health professionals are increasingly called upon to provide consultation and treatment in settings different from the traditional outpatient and hospital inpatient settings. This paper provides an overview of the unique problems posed when considering self-disclosure by gay or lesbian mental health professionals working with institutionalized populations. A review of literature concerning self-disclosure to patients in outpatient settings is provided and applied to institutionalized settings. Benefits of, as well as cautionary notes regarding, self-disclosure of homosexuality by mental health staff are reviewed.     

What Do Social Workers Need to Know About Mental Health Courts?

Abstract

Mental health courts are an emerging strategy to engage mentally ill offenders in treatment and to avoid unnecessary incarceration. These courts began in 1997 based upon the drug court model; there are currently over 70 courts nationwide. These courts are heterogeneous in structure, work with interdisciplinary teams, and seek to engage the consumer in treatment rather than use judicial sanctions. Social workers are integral members of these teams; yet, no research has been published in social work journals on mental health courts. This article explains the background and context of the courts, describes their features, discusses what social workers need to know about mental health courts, and concludes with ideas for how social workers may work effectively with mental health courts.     

The space between us: feminist values and humanitarian power dynamics in research with refugees

ABSTRACT

International humanitarian and development agencies striving to promote gender equality and women’s empowerment sometimes neglect to recognise the power hierarchies present in their own engagement with communities. Drawing on research on Syrian refugees and humanitarian workers in Jordan, this article explores the research and monitoring and evaluation practices of international humanitarian agencies. It suggests that the emphasis on generating evidence has resulted in more transactional and less relational engagement with refugees. This paper asks how feminist values can inform research with refugees, and explores how these values may provide less-extractive ways of engaging with displaced populations.     

A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.