Meeting Them Where They Are: An Exploratory Study of Staff and Shelter Resident Perceptions of Homeless Women's Needs

Abstract

Only a small number of studies have surveyed homeless people about their needs, and none has compared these perceptions with those of homeless service providers. In this small, preliminary, exploratory investigation, both shelter residents and staff at one homeless shelter dedicated to serving dually-diagnosed adult women were queried about shelter resident need. Residents and staff agreed on the need for immediate, non-change-oriented services (such as assistance with overdue bills and housing) and some shorter-term services (such as education and job skills training). The two groups disagreed on the need for longer-term, change-oriented services, such as substance abuse treatment, education about activities of daily living, and health/counseling services (with more staff than residents perceiving such need). Two potential recommendations are discussed. Staff could consider altering the timing of treatment plan creation to increase engagement with homeless clients. Shelter directors and funders could consider modifying the measurement of client outcomes to include client progression toward longer-term change.     

Older and Isolated Women and Domestic Violence Project

ABSTRACT

An innovative national research project was undertaken in Australia to identify and explore the needs of older and isolated women who live with domestic violence. Face to face interviews, focus groups, and a national phone-in were conducted, and a wealth of rich information was provided by many women from metropolitan, rural and isolated areas. Older women from indigenous, non-indigenous, and diverse language and cultural communities spoke of their experiences as well as women with varying abilities and those with mental health problems. This paper will identify the significant themes that emerged from the phone-in and will highlight the major issues identified by older women needing attention by government authorities, health professionals, and service providers. Recommendations will be made for policy development, improved service provision, and prevention strategies.     

Provider perceptions of safety planning with children impacted by intimate partner violence

Safety planning is a widespread intervention used with clients who have experienced domestic violence victimization. Although children are impacted by domestic violence, attention to the unique needs of children as they relate to domestic violence safety planning has received little attention to date. The authors conducted nine focus groups with domestic violence service providers about their perceptions of child safety planning. This article reports on the findings and implications of this focus group study that can inform the safety planning needs of children impacted by domestic violence. The themes discussed include Child Protective Services, the needs of older boys, school-related issues, custody-related issues, the extent to which children should be involved in safety planning, parenting issues, tools and tips for safety planning with children, and resources and services to promote children's safety.     

Barriers to Utilization of Mental Health Services amongst Male Child Sexual Abuse Survivors: Service Providers’ Perspective

ABSTRACT

Most research on child sexual abuse has been on survivors to the exclusion of service providers. This paper focuses on one group of findings from a larger qualitative study. The aim of the paper is to identify existing services and highlight the gaps in the current programs available for male CSA survivors from the perspective of service providers. Semi-structured interviews were conducted with 11 mental health service providers, recruited from two Southern and Central Ontario cities. Findings presented here report service providers’ perspective of gaps in services for male CSA survivors. “Limited Male CSA Programs”, “Institutional Barriers”, “Attitudinal Barriers”, and “Systemic Gaps” emerged as four major themes from the data analysis. Findings demonstrate the need to re-evaluate currently available service and highlights gaps in mental health service available for male CSA survivors. Implications for policy, practice, and research are discussed.     

An interprofessional internship model for training master’s level social work and counseling students in higher education settings

ABSTRACT

The mental health needs of college students are steadily on the rise, which compels mental health service providers and educators to explore innovative ways to provide more collaborative, supportive, and interdisciplinary service models of practice and professional training. Graduate programs in social work and counseling are at the crux of producing internship training programs to help accommodate the influx of students with persistent mental health concerns across a variety of needs and cultures. This article describes an interprofessional internship program structured and designed to meet the clinical training needs of master’s level students matriculating in social work and counseling who aspire to provide mental health services in higher education settings. The interprofessional internship training model proposes an innovative interdisciplinary approach to field education which may result in positive training outcomes and learning experiences for social work and counseling students. This paper discusses the model’s emphasis on individual and interdisciplinary group supervision, objectives of the internship experience, internship site criteria, and professional and personal benefits to pre-service social workers and counselors. Recommendations for training and limitations of the model are provided.     

“It's a gap in awareness”: Exploring service provision for LGBTQ2S survivors of intimate partner violence in Ontario,Canada

ABSTRACT

Intimate partner violence (IPV) is a prevalent issue in all relationship configurations, including lesbian, gay, bisexual, transgender, queer, and two-spirit (LGBTQ2S) relationships. While the experiences of LGBTQ2S IPV survivors are understood, there are issues, needs, and challenges associated with service provision for them. Semi-structured interviews were conducted with a sample (N = 10) of professionals (e.g., counselors, shelter managers, program directors) affiliated with organizations that provide services for IPV survivors in Ontario, Canada. Participants answered questions pertaining to the inclusion of LGBTQ2S IPV survivors into their existing services, and what service provision should look like. Data was analyzed using a thematic analysis to uncover themes that reflected participants' responses. The data was organized into recommendations for service provision at three different levels: direct service provision, organizational transformation, and underlying principles and values. Findings reveal suggestions for service providers to consider modifying their current organizations, to adequately include LGBTQ2S IPV survivors.     

Integrated care workforce development: university-community collaboration

ABSTRACT

Behavioral health workforce shortages to provide quality care services for children, adolescents, and transitional age youth are well established. This paper highlights the workforce shortage and the need to infuse interprofessional education to engage in integrated care for children, adolescents and transitional age youth with behavioral health needs. A specialized training curriculum to build behavioral health workforce in Nevada was conceptualized and delivered through 10 workshops under the auspices of the Health Resources & Services Administration (HRSA) funded Behavioral Health Workforce Education and Training (BHWET) grant funded in 2014. To train existing workforce and in alignment with the spirit of the grant to build behavioral health workforce and existing workforce, workshops were extended to social service providers in the community. In an effort to enhance university-community collaboration, workshop presenters were invited from various units in the University and from social service agencies in the community. Implications of such training are addressed from a policy, practice, research, and university-community collaboration perspective.     

Service Provision for Men with Eating Issues in Australia: An Analysis of Organisations', Practitioners', and Men's Experiences

Abstract

Research was undertaken to explore issues surrounding service provision for men with eating issues in Australia. Qualitative and quantitative data were gathered from key stakeholders—organisations that provide treatment (n=15), practitioners that have worked with men with eating issues (n=10), and individual men with eating issues (n=5). Four key areas were explored: rates of access to services, the expression and development of eating issues in men, factors inhibiting or facilitating the recovery process, and recommendations to improve service provision. Results highlighted the need for increased awareness about men's eating issues within society generally, but for health professionals specifically, the need for better recognition of the expression of eating issues in men, and the expansion of existing services to be more “male friendly”. It is anticipated that service providers will benefit from these findings by identifying ways to reduce barriers and encourage help-seeking behaviour in men. Future research should seek to replicate and expand these findings using a larger sample size.     

An Assessment of Independent Living Needs Among Emancipating Foster Youth

This study used a mixed methods approach to assess the independent living services needs of emancipating foster youth in Lucas County (Toledo), Ohio. It included (a) an examination of administrative client data from the Lucas County Department of Children Services (LCCS) Independent Living Program; (b) focus groups with current and former foster youth; and, (c) a self-administered survey of public and private agency transitional and independent living service providers. Both the focus group participants and the service providers identified what they perceived to be the needs of emancipating foster youth. Focus group members also displayed a lack of awareness of existing independent living resources in the community, and limited interest in post-emancipation support services. The results were used to generate ten recommendations for LCCS, community service providers, and philanthropic funders.     

The Perceptions of Welfare Reform by Michigan Families Whose Children Have Disabilities and Welfare Caseworkers

Abstract

This article examines family and caseworker perceptions of welfare reform and services as they relate to families who have a child with a disability. Interviews were conducted with 39 families and 77 caseworkers. Family questions addressed their perceptions of the welfare system, factors impacting their self-sufficiency, and their perceptions of needed program changes. Caseworker questions addressed their perceptions of welfare practices and policies and their education needs related to serving families who have children with disabilities. Familial perceptions of the welfare system were validated by caseworker reports. Implications for service improvement are discussed.     

Exploring the Hidden Nature of Gambling Problems among People Who Are Homeless

Abstract

Although people with gambling problems are now recognised to be among those groups of people at increased risk of homelessness, little research has explored their experiences. This qualitative interpretive study explored the experiences of people who were homeless and had gambling problems, and the housing and gambling service providers assisting them. In-depth interviews were conducted with 17 service users and 18 service providers. A key finding was that gambling problems among those experiencing homelessness are often hidden; few people presented to housing services admitting to gambling problems. Shame, stigma, and identity issues were described as the main reasons service users did not disclose their gambling activities. The research highlighted that the relationship between service providers and service users was infused with power imbalances and shaped by social discourses and policies that demand self-responsibility and hinder information sharing between service providers and service users.     

Community College Health Service Programs: A Progress Report

Abstract

What progress has been made in improving the health service programs available to the millions of students attending the nation's public community colleges? This question was investigated by sending a follow-up survey to deans of students in 1977; the original study was done five years earlier and resulted in a national profile of health service programs at public two-year institutions.

Some of the significant findings were: the percent of colleges offering health service programs has increased from 41.5% to 51.3%; the campus nurse continues to be the most common health professionals available to students; facilities are considered to be adequate and accessible; and a broad range of student health needs are met. New elements in the survey covered health education and mental health services, and these were positively evaluated.

On the basis of survey results it was concluded that community colleges have made considerable progress in improving student health services, but there is still much to be done.     

Parents’ and Professionals’ Perceptions of the Services of Families of Children with Intellectual Developmental Disabilities

This study aims to investigate differences in perception among Kuwaiti parents, teachers, and employees regarding the services that are needed in different special education settings. The participants (n = 135) included 45 parents of children with intellectual developmental disabilities (IDD), 63 teachers in special education schools, and 27 employees working in the Higher Council of the Disabled. A survey was conducted using Hassan’s (The needs of parents of children with disabilities in relationship with child’s age, gender, and type of disability, 1992) Arabic version of the Family Need Inventory. The findings showed differences in perception among parents, teachers, and employees regarding what they consider to be the most important services for families of children with IDD. Another result showed significant differences in perception among the three groups regarding services (match or/and mismatch of responses), except for 3 out of 35 types of services. Suggestions and implications are discussed to provide information to social service providers to help them evaluate the laws that pertain to disability in Kuwait. The findings of this study will help social service providers determine and implement laws that meet the needs of parents of children with IDD and give them the right to be full partners in their children’s education.     

An Evaluation of Mental Health Services for the Culturally Diverse

ABSTRACT

The purpose of this project was to examine the needs of multicultural populations in the mental health system, and see how these needs get addressed in current policies. As a social worker in the mental health system, I wanted to investigate the strengths and weaknesses of service providers in their ability to meet the needs of diverse populations. In doing this research, I hoped to make a space for people whose families have had to deal with mental health services, and explore the experiences of those who have not had the opportunity to discuss them. In addition, the purpose of this paper is to contribute to a body of increased knowledge on how the mental health system treats people who belong to a cultural minority.     

Reflections of the Annual Meeting

Abstract

In preparation for planning counseling and mental health services at Columbia University, the authors conducted a mental health needs assessment survey that sampled representative numbers of students. Respondents were most concerned about academic and school-related issues, followed by concerns in the area of love relationships. Multiple regression analysis revealed certain subgroups that were more likely to have these concerns and certain health and mental health problems that were significantly associated with these concerns. The study identified serious psychological problems, including suicidal/homicidal thoughts and sexual abuse, and surveyed respondents' treatment preferences. Finally, the authors discuss how the study findings contributed to sharpening and expanding focus on different aspects of program development in the collaboration between mental health and health education.     

Needs and Perceptions of LGBTQ Caregivers: The Challenges of Services and Support

Increasing attention has been paid to the lack of services and support afforded older lesbian, gay, bisexual, transgender, and queer (LGBTQ) women in same-sex relationships, including caregivers. This study was designed to investigate the needs and perceptions of LGBTQ women from ages 35 to 91, including informal caregivers and older adults regarding services and support from health care providers. Questionnaires were completed by older LGBTQ women (N = 76), and follow-up interviews were conducted with 25% of caregiver respondents. The majority of subjects indicated a fear of future challenges and discrimination. Four main themes emerged when analyzing the open-ended responses: the need for health care workers who were both supportive and knowledgeable about LGBTQ issues; better and consistent recognition of same-sex partners and their rights to make decisions as primary caregivers; increased sensitivity training regarding the needs of LGBTQ patients and caregivers; and more open and accepting environments where LGBTQ patients and caregivers could feel comfortable discussing issues with the staff.     

“We Have to Create Family”: Aging Support Issues and Needs Among Older Lesbians

Gay and lesbian seniors are more likely to be single, live alone, and be childless. The current evidence base suggests that limited social supports are associated with a variety of health disparities among all older adults. Research regarding the aging issues of lesbian seniors is scarce. This instrumental collective case study of 4 older lesbians (ages 59 and older) illustrates unique aging support concerns, issues, and needs. The purpose of the case study is to increase provider sensitivity and provide supportive evidence of the need for more research. Findings suggest that limited biological family support, childlessness, and “families of choice” may be important factors in support service and health care decisions for older lesbians. Implications for care providers in working with the older lesbian population include exploring existing supports and assisting with the formation of culturally acceptable support systems and services. Given the current evidence base regarding the impact of social support on elder health, it is critical for providers to have a better understanding of elder lesbians’ unique concerns and needs relating to support and health care services in order to prevent health disparities among this vulnerable population.     

Interactive Health Communication Technologies in the Public Health Sector: Positive Perceptions Still Outpace Actual Utilization

ABSTRACT

Effective population-based and patient-centered public health care is highly dependent on timely and reliable health-related information. The continuous growth and availability of health-related information brought about by the emergence of a new digital communications environment offers a range of opportunities that facilitate access to useful health information for the public health sector–for providers as well as patients. Such advancements, however, can only be realized if public health professionals are knowledgeable about existing sources of online health information, have the ability to successfully judge the reliability of online health information, and are able to acquire the information in a timely and efficient manner. This research follows on the heels of a survey of public health professionals in New York State that concluded that limited access and knowledge negatively impacted utilization of interactive health communication technologies. In this study, a survey was administered to providers at a large county health department located in central Michigan. Results indicate that perceptions regarding the advantages of online health information still far outweigh actual utilization. Barriers to actual utilization include lack of easy access to computers with high-speed connections, trusted and timely online information, training and staff development issues, and organizational policies concerning computer access and usage.     

An in-depth mixed-methods approach to Ryan White HIV/AIDS care program comprehensive needs assessment from the Northeast Georgia Public Health District: The significance of patient privacy,psychological health,and social stigma to care

We apply a social-ecological interpretive framework to understanding relationships among patient privacy, psychological health, social stigma, and continuity in care in the HIV treatment cascade in the rural southeastern US. This research was conducted as part of the 2013 comprehensive needs assessment for the Northeast Georgia Ryan White Consortium using an anthropologically informed mixed-methods design, and a deductive-inductive approach to thematic analysis of qualitative data obtained in interviews and focus groups with service providers and service utilizers. Our comprehensive needs assessment yielded two key components. First, we identified salient phenomena influencing introduction to, retention among, and satisfaction of patients in the Ryan White-coordinated treatment cascade in NE-GA. Second, we formulated actionable recommendations around leverage points identified in the current district-wide system of care. Results highlight spatial, institutional, and interpersonal aspects of the system of care that intersect around issues of patient privacy, psychological health, and social stigma. These intersections constitute pathways by which persons living with HIV are exposed to stigma and other negative social signals regarding their health status without sufficient access to behavioral health services. These negative issues, in turn, can erect significant barriers to long-term continuity in care.