Care without coercion – mental health rights,personal recovery and trauma‐informed care

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.     

Atos Healthcare withdraws from the Work Capability Assessment: a comment

In March 2014 Atos Healthcare withdrew a year early from its contract to provide the UK’s health assessment – the Work Capability Assessment (WCA) – that is supposed to sort disabled people into administrative categories according to their adjudged capability to do paid work. This move was welcomed by political elites, with, for example, UK Coalition Government Minister for Disabled People Mike Penning using it to criticise previous Labour governments for the contractual arrangements they put in place – although while the Coalition may have been concerned with the contractual arrangements soon after being formed, it extended the contract for five years. For the UK disability movement, the withdrawal of Atos Healthcare early from the WCA contract was a victory and, at least in part, a consequence of disabled activists’ resistance to the Employment and Support Allowance generally, and the WCA in particular.     

Factors That May Influence Parent Treatment Decision Making for Young Children with Autism Spectrum Disorder

ABSTRACT

The number of interventions available for children with autism spectrum disorder (ASD) has expanded greatly in recent years, although relatively little is known about the factors that influence family caregivers as they make treatment decisions for their children. This study involved a statewide survey of parents of young children with ASD to examine the relative weights of the factors that influenced their treatment decisions. Results suggested that caregivers rely on their own intuition for much decision making, although selected professionals are also influential. Implications for professionals working with children with ASD and their families are discussed.     

The Collapsing Choice Theory: Dissociating Choice and Judgment in Decision Making

Decision making theory in general, and mental models in particular, associate judgment and choice. Decision choice follows probability estimates and errors in choice derive mainly from errors in judgment. In the studies reported here we use the Monty Hall dilemma to illustrate that judgment and choice do not always go together, and that such a dissociation can lead to better decision-making. Specifically, we demonstrate that in certain decision problems, exceeding working memory limitations can actually improve decision choice. We show across four experiments that increasing the number of choice alternatives forces people to collapse choices together, resulting in better decision-making. While choice performance improves, probability judgments do not change, thus demonstrating an important dissociation between choice and probability judgments. We propose the Collapsing Choice Theory (CCT) which explains how working memory capacity, probability estimation, choice alternatives, judgment, and regret all interact and effect decision quality.      

Asymmetries in Information Processing in a Decision Theory Framework

Research in psychology suggests that some individuals are more sensitive to positive than to negative information while others are more sensitive to negative rather than positive information. I take these cognitive positive–negative asymmetries in information processing to a Bayesian decision-theory model and explore its consequences in terms of decisions and payoffs. I show that in monotone decision problems economic agents with more positive-responsive information structures are always better off, ex ante, when they face problems where payoffs are relatively more sensitive to the action chosen when the state of nature is favorable.      

Unwanted sexual experiences and sexual risks in gay and bisexual men: Associations among revictimization,substance use,and psychiatric symptoms

The data set of 2,182 gay/bisexual men's month‐long sexual diaries collected by the United Kingdom Socio‐sexual Investigations of Gay Men and Aids (Project SIGMA) was used to analyse the extent to which acts of anal intercourse (AI) are distributed among gay men, using the Lorenz/Gini methodology for measuring concentration. Most individuals (60%) who engage in AI do so only once or twice a month, but there is a long tail of those who do it much more. In terms of the amount of AI acts, one tenth of the individuals are performing half of the acts of AI. The Gini coefficient of concentration is high (0.55). Factors most affecting rates and concentration of risk behaviour include relationship status, HIV sero‐status and concordant/discordant partner status.     

Sexual Minority Adolescents

Abstract

Most ethical dilemmas confronting professional school counselors (PSCs) do not involve simple solutions. Therefore, to practice ethically, PSCs need to possess and have the ability to articulate their ethical decision-making process with a clear and defendable professional explanation. Specifically, this article details the ethical decision-making process for PSCs working with lesbian, gay, bisexual, and transgendered (LGBT) adolescents. Additionally, ethical standards and legal statutes relating to counseling LGBT adolescents, ethical decision-making processes, and implications are discussed.     

Statisticians Can Matter

Statisticians fall far short of their potential as guides to enlightened decision making in business. Two important explanations are: (1) Decision makers are often more easily convinced by concrete examples, however fragmentary and misleading, than by competent statistical analysis. (2) The effective use of statistics in the process of decision making requires hard thinking by decision makers, thinking that cannot be delegated entirely to the statistical specialist. Modern developments in interactive statistical computing may help to reduce the force of these limitations on exploitation of statistics; used properly, computing can encourage, almost force, the student or business user of statistics to think statistically.     

Automatic locally adaptive smoothing for tree-based set estimation

Tree-based methods similar to CART have recently been utilized for problems in which the main goal is to estimate some set of interest. It is often the case that the boundary of the true set is smooth in some sense, however tree-based estimates will not be smooth, as they will be a union of ‘boxes’. We propose a general methodology for smoothing such sets that allows for varying levels of smoothness on the boundary automatically. The method is similar to the idea underlying support vector machines, which is applying a computationally simple technique to data after a non-linear mapping to produce smooth estimates in the original space. In particular, we consider the problem of level-set estimation for regression functions and the dyadic tree-based method of Willett and Nowak [Minimax optimal level-set estimation, IEEE Trans. Image Process. 16 (2007), pp. 2965–2979].     

Follow the leader! The peer effect in aid supply decisions

This study assesses the existence of imitative behaviour among donors in terms of their aid supply. The urgency in addressing this subject is motivated by an increasing degree of aid volatility and unpredictability which may be linked to this imitative behaviour. Our results highlight that while any connection among donor peers is a potential channel for the transmission of aid volatility, the extent of such volatility decreases significantly in the presence of established imitative behaviour. This result suggests that the promotion of donor imitative behaviour would contribute to containing the current and growing trend of volatility in aid supply.