Probation and Social Exclusion

The paper begins with a brief discussion of the value of the term "social exclusion", before drawing on quantitative (survey) and qualitative (interview) evidence to suggest that young people on the caseload of the probation service are, in general, excluded from the full range of social goods. The basis of this exclusion is not only in poverty and unemployment, but in social and personal insecurity, lack of access to the benefits of education and training, and housing and health problems. It is argued that despite their exclusion these young people have predominantly conventional hopes and aspirations, and that there is therefore no reason to believe that a programme for their social inclusion and reintegration would be doomed to fail. The paper then reviews some aspects of present practice in probation which may tend to increase rather than reduce the exclusionary pressure on those with whom the service works, by stigmatizing and marginalizing them through a narrow focus on their offending. It concludes by suggesting strategies for more inclusionary and integrative practice in the areas of anti-custodialism, restorative justice and reintegrative shaming, community safety, and help with access to education, training and health services. The paper considers what local inter-agency structures are needed to support intensive work on offending, and sketches some characteristics of a probation service committed to social inclusion.     

Models of Disability, Work and Welfare in Australia

In discourse around disability there has been a shift away from a ‘medical model’, which perceives disability as an individual problem to be ‘cured’ or contained, towards a ‘social model’. The latter focuses on the relationship between people with disabilities and their social environment, locating the required interventions within the realm of social policy and institutional practice. Drawing upon a small qualitative study conducted in Melbourne, this article argues that recent plans by the Australian government to introduce mutual obligation requirements for recipients of the Disability Support Pension (DSP) sit in tension with this shift from the medical to the social models of disability. Mutual obligation is based on the assumption that income support recipients need to be taught how to be more ‘self‐reliant’, to ‘participate’ in society more fully and to become ‘active’, rather than ‘passive’, citizens. This language appears to overlap with that used to articulate a social model, which places emphasis on participation in the community and attempts a shift away from reliance on the medical profession. However, examples from interviews conducted with current and former DSP recipients demonstrate that, in practice, mutual obligation is likely to reinforce a medical model of disability, frame DSP recipients as ‘conditional’ citizens and ignore the obligations of the state and society regarding access and inclusiveness for people with disabilities.     

Applying a community needs profiling approach to tackling service user poverty

Summary Poverty across the United Kingdom is a growing phenomenon. Itsimpact on the users of social work services is well documented.This paper puts forward the argument that poverty is a legitimatepart of the social work agenda rather than being seen as a complexproblem which is somehow outside the scope of social work agenciesand best left to politicians and policy makers. Social workpractitioners and managers must not only begin to accept andacknowledge that poverty is a social work issue but also tobegin confronting this challenge in a changing society whereexclusion, social inequality, racism and oppression deny peopletheir citizenship. The community needs profiling approach is proposed as a usefultool in addressing service user poverty whereby practitionersand their agencies can become more aware of the needs of usersand the communities in which they live. It is argued that, armedwith this knowledge, social workers have the potential to becomepart of the solution rather than remaining on the margins ofthe lives of poor people. Using evidence and ideas drawn froma range of community needs profiling research studies and texts,the author offers working suggestions for applying the approach.     

Social Antecedents of Medical Fraud and Over-Servicing: What Makes A Doctor Criminal?

Medical fraud and overservicing are estimated to cost the Australian community between $130 and $200 million per annum, a figure far greater than the national cost of burglary and almost the same as the total property loss from all conventional crime. An examination of the social antecedents of medical fraud and overservicing suggests that the predisposition of some doctors to engage in these practices occurs because of the following: (1) medical training and professional socialization that orientate student doctors away from altruistic health issues towards narrower self-interested professional concerns; (2) career expectations of a high pattern of material consumption that are often frustrated by an increasingly competitive medical market place; and (3) professional medical organizations that lobby for national health policies which reflect the mercenary self-interest of doctors rather than the health interest of the nation.     

Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London

This ethnographic study was carried out in the aftermath of an epidemiological investigation, the first of its kind, on the health and social status of Somalis aged 60 years and over living in Tower Hamlets, east London. The main aims of the study are to explore views on mental health and well-being and identify sources of stress and support so as to gain greater understanding of background factors of life satisfaction and depression in 'first-generation' older Somali migrants in Tower Hamlets (males). Face-to-face interviews were conducted among 28 males in Somali with the help of a bilingual interpreter from the same age, sex and cultural background of participants. Several factors were perceived to decrease life satisfaction and increase vulnerability to depression in male Somalis, in particular low family support in the face of increasing physical disability, loneliness, inadequate access to community services and inability to return home. Social isolation, low level of control over one's life, helplessness and social degradation – ageism, perceived racial/religious discrimination and, to a lesser extent, racial harassment – were common themes identified in people who said to be depressed. Family support was the main buffer against depression; other coping resources were represented by religious practices and reliance on Somali peers. Avoidance coping seemed to encompass denial of depression in participants who had low mood. The study revealed multiple reasons for ill-being, in particular in people who had high expectations about medical and social care. Low levels of distress were found in Somalis who felt supported by their families. There is a need for social workers and other health professionals to advance discussions of mental-health issues in the community and for service providers to promote greater access to culturally relevant medical and social services for Somali elders in Tower Hamlets and strengthen their informal support networks.     

Creating elder-friendly communities: preparations for an aging society

Because many communities where older people live were not designed for their needs, older residents may require support to remain in the least restrictive environment. "Age-prepared communities" utilize community planning and advocacy to foster aging in place. "Elder-friendly communities" are places that actively involve, value, and support older adults, both active and frail, with infrastructure and services that effectively accommodate their changing needs. This paper presents an analysis of the literature and results of a Delphi study identifying the most important characteristics of an elder-friendly community: accessible and affordable transportation, housing, health care, safety, and community involvement opportunities. We also highlight innovative programs and identify how social workers can be instrumental in developing elder-friendly communities.     

Social Work and the Medical Profession--Arguments Against Unconditional Collaboration

Summary The history and major texts of medical social work emphasizethe need for collaboration with the medical profession. Howeverthere is a less visible history of conflict between medicineand social work. It is proposed that a critique of medicine’scontribution to health provides the foundation for a statementof principles for a social model of health for social work practice.Collaboration with medicine should be negotiated on the basisof such principles, rather than unconditional.     

Community health education for rural women: analysis of a training programme

A regional community health program established in South Orissa, India, is described. It was found that women are the best health workers and educators in rural areas since cultural beliefs are more deeply rooted among them, they look after the sick in the family, they can enter every house where men cannot, and the risk of malpractice and misuse of training is less with women. A cultural obstacle was that sickness among these people is considered a curse of the spirit of their ancestors. The 1st phase of the program is a live-in experience in which the trainees come together for training classes. The causes and treatment of nutritional deficiency diseases, especially malnutrition, early blindness, and anemia are discussed. Posters, charts, and tape recordings proved to keep their attention, as did analogies taken from their daily experience, and communication through song and dance. At the end of 3 weeks the women have to take a test and are then taken back to their villages by the staff of each health center. They have been found to communicate well with their own people, understood the difficulty of changing local beliefs, and did not need formal educational environments in order to communicate. The 2nd phase, after 3-4 months of work experience, is a training course providing them with a chance to share their experiences and gain a deeper understanding of society, teaching about the causes, effects, and treatment of common diseases, with emphasis put on health education, especially food preparation and diet. Also taught were basics of market values, social customs, and causes of poverty. The women again returned to their villages to conduct more in-depth health education. After 4 months, the women return for the 3rd phase in which they were taught home nursing and first aid, discussed social injustices, finances, and other topics. When they returned to their villages they were able to provide the people with medical, family, and personal help. Some went on to become members of the village committees and were given new respect by male members of the village. The 4th phase involved sharing experiences once again and learning organizational skills. Some major obstacles were: 1) using health workers is a part of the total system that does not really meet the needs of the common people, 2) political problems, and 3) institutional problems.     

Climate change in Alaska: Social workers’ attitudes,beliefs, and experiences

The average temperature in Alaska and the North American Arctic has risen at twice the rate of the global average due to climate change, causing changes to the natural environment that affect the physical, social, and emotional well‐being of people and communities. Social workers must be prepared to respond. Using a non‐probability, convenience sample, this study surveyed 159 social workers in Alaska to assess their attitudes and their perceptions of the effects of climate change on their clients and constituents. Results indicate that social workers in Alaska believe that climate change is happening, that human activities are responsible, and that it is a large threat to people in Alaska. Over 75% believe that climate change is dangerous for their clients now or will be dangerous in 10 years. Social workers report that in the past year their clients or constituents have experienced multiple climate change‐related problems with community infrastructure, health, and mental health.     

Welfare Mothers' Reflections on Personal Responsibility

This article discusses personal responsibility, fulfilling one's moral and social obligations as a purposeful and self-reliant agent, from the viewpoint of 20 White welfare mothers completing a community college program. In their stories, the participants revealed that they behaved in responsible ways under difficult conditions. Their accounts demonstrated that the most responsible decision for a single mother in many cases may be welfare, rather than a paying job and unstable employment. The women described a new type of personal responsibility in the context of community college: setting and working toward long-term goals rather than focusing purely on survival. Personal responsibility did not seem to reside in the individual, but was the result of the interaction between individual agency and context, an interpersonal responsibility.     

Capacity Building and the Reconception of Political Participation: A Role for Social Care Workers?

This paper explores a citizen-based approach to social workwhich may counter modern negative managerialist pressures onpractice. It links the discourse concerning the growth of userinvolvement in public policy with the discourse about participationin political activity and suggests a role for social workersin supporting service users in initiatives such as self-help,campaigning and community action which offer a new interpretationof community-based social work. By engaging in this activity,health and social care professionals can support people to participatein emerging forms of active and inclusive citizenship. Whileparticipation in traditional political activity such as votingand political party membership is declining in the UK, peoplein marginalized groups are finding ways to have their voicesheard about issues which directly concern them. Increasingly,groups such as disabled people, older people and mental healthservice users/survivors are taking part in activity which marksa shift of focus to include both self-help and campaigning.In contrast to their disillusion with traditional politicalactivity, people across a range of groups have gained strengthand encouragement from campaigning achievements. The paper drawson a national research study which offers fresh insights onthese issues as a basis for exploring participative approachesto social work practice.     

Psychosocial and relationship-based theories for child and family social work: political philosophy, psychology and welfare practice

Psychosocial perspectives on children’s development are allied to theories that recognize the ‘self’ as essentially a social entity. The quality of relationships that children experience in their social environment have a profound effect on their socio-emotional development, personality formation and social competence. To this extent, psychosocial theories of children’s development and wellbeing can provide child and family social workers with a powerful framework within which to analyse, assess and practise. However, it is also recognized that the character of child welfare practices and policies are influenced by prevailing political climates. A simple dichotomy is described between political philosophies of the right and left; libertarianism and communitarianism; individual freedom and collective action. It is argued that the present swing to libertarian individualism has brought about major changes in the policy and practice of much child and family social work, including a preference for theories that emphasize people’s psychological independence, rationality and personal responsibility. In such a climate, child and family social work becomes more legalistic, orientated towards principles of justice rather than welfare, and towards rights and responsibilities rather than personal relationships and social competence. Psychosocial developmental theories, with their emphasis on the importance of social relationships and the emotional interconnectedness of people in community, fare less well under the rigours of psychological individualism and free-market economics. The paper concludes that if children’s psychosocial development and competence are a product of their social history, practices that psychologically ‘disembed’ people from their relationship environment are unable to consider children’s needs within a coherent, well-grounded theoretical framework. If child and family social work is premised on helping children develop social understanding and emotional wellbeing, theory and practice are best served by taking a psychosocial perspective.     

The Development of State Welfare in the Asian NICs with Special Reference to Taiwan

This paper explores Taiwan's welfare development from its specific politico-economic situation. Although education and public health are well developed in Taiwan and social insurance is expanding to cover more and more Taiwanese people, the govenmental welfare effort is still too low to meet the welfare needs of the public. This is especially so given our discovery that military servicemen and related groups receive over 70% of the welfare expenditure of the central government while the disadvantaged receive only around 3%. Furthermore, political crises are often accompanied by a significant growth in social expenditure, implying that the purpose of state welfare is to maintain the stability of the Taiwanese state rather than to protect the well-being of Taiwanese people. Political isolation forces the Kuomintang (KMT) to secure Taiwan's role in the international community via economic growth. The development of state welfare cannot be allowed to have a negative effect on this highest priority. The limited resources, therefore, are allocated to economic goals as well as to the KMT–state apparatus in order to keep the KMT in power. However, the democratization of Taiwanese politics since the 1980s has forced the KMT to consolidate its legitimacy from the people and the improvement of social welfare is one measure for this purpose. Whether or not Taiwan becomes a Western-style welfare state through the expansion of state welfare in the near future, it furnishes a useful example with which to examine existing welfare theories.     

Where has all the care management gone? The challenge of Parkinson's disease to the health and social care interface

Summary The delivery of health and social care has undergone massivechange in the UK in the 1990s. A key factor in the drive forreform was the failure of joint working arrangements betweenhealth and social services and the need to provide integratedcare for people who have overlapping health and social careneeds. This article draws on a research study investigatingthe community care provided to people with Parkinson's diseasein the wake of the 1990 National Health Service and CommunityCare Act. As a chronic progressive disease predominantly affectingolder people, the management of Parkinson's provides an exemplarof some of the key features of supporting people with continuingcare needs. This study found serious deficits in the assessmentand meeting of need, arising from weaknesses at the health andsocial care interface. The article concludes by consideringan approach which resources and supports the service user/carerin managing their own care pathway.     

关于我国发展城市公共卫生事业的若干思考

健康不仅是城市人与社会发挥功能的前提条件,也是城市人与社会全面、协调、可持续发展的一种社会财富。要大力发展城市公共卫生事业就必须加强对城市公共卫生事业发展的经济支持和社会政策支持,同时还要积极推进社区卫生服务体系,进而通过发展公共卫生事业来促进城市社会公平。     

昆明市空巢老人健康与照顾需求的评估

“空巢”是中国科技与社会发展、独生子女政策落实的必然。日益增长的“空巢老人”为国家福利、代际和谐和社区照顾带来了严峻挑战。本文从社会保障的视角,采用健康自测量表（SRHMS）,从生理、心理和社会健康的维度,对昆明市10所养老机构和18个社区的289位空巢老人和212名非空巢老人进行了比较分析,发现空巢老人社会健康与心理支持令人担忧。文章就构建“空巢老人”长期照顾网络作了讨论和建议。     

Gender and health among older people: What is the role of social policies?

The study investigated how social policies moderate the association between gender and health among older people across European countries. The study is the first to take a comprehensive view on the role of social policies in connection with gender inequality in health among older Europeans. The association between gender and poor self‐rated health and limiting long‐standing illness was investigated in a multilevel framework. Cross‐level interaction effects showed that more generous minimum pensions, higher spending on eldercare and a higher degree of eldercare formalisation are associated with relatively better health among women, while more generous standard pensions are associated with relatively better health among men. The conclusion is that policies directed towards older people are not gender neutral; rather they are likely to affect men and women differently. By shaping the distribution of resources as well as of unpaid work, social policies can contribute to either strengthening or weakening the link between gender and health.     

Is the Internet Changing Social Life? It Seems the More Things Change, the More They Stay the Same

Although there has been a tremendous amount of discussion in the popular press about how the Internet is changing all facets of social life, research on the impact of the Internet is only beginning to emerge. A review of the studies reported in this issue suggests that the Internet may have had less impact on many aspects of social life than is frequently supposed. In many cases, the Internet seems to have created a new way of doing old things, rather than being a technology that changes the manner in which people live their lives. As a consequence, the policy implications of increasing Internet use may be less than is often believed.     

医务社会工作在医疗服务中的运用——以肾透析病人为例

肾透析病人在承受肾功能衰竭及治疗带来痛苦的同时,面对巨额医药费和健康（工作）丧失、成为家庭负担的压力。现行医疗体制下的医护很难关注影响肾透析病人康复的社会心理、经济、行为、文化因素,其需求与感受可能在诊断和治疗中被忽略。本文从医务社会工作的视角,用个案工作方法对该人群做出社会诊断,并就医务社工在协助病人及家属解决相关社会、经济、家庭、职业、心理问题,提高生活质量、促进社会回归方面提出建议。     

集体性社会资本对社区参与的影响——基于多层次数据的分析

“社会资本的后果”是社会资本研究的一个重要议题。现有研究倾向于认为,中国城市社区中的集体性社会资本对社区参与具有积极的影响。本文认为,由于社会资本与社区参与都具有多个维度,两者的关系不能一概而论。基于2006-2007年在上海收集的调查数据,本研究使用多层次logistic回归模型考察了集体性社会资本对三种类型的社区参与（抗议型、体制化与公共型参与）的影响。统计结果证实了社会资本与社区参与之间复杂的联系。此外,对多层次模型的方差成份分析发现,社区社会资本可以解释60%或更多的社区间的差异。这说明,社区参与的影响因素不仅取决于居民的个人特征,还取决于居民所在的社区特征。