Human Service Organizations: Useful Category or Useless Jargon?

In recent years a growing body of literature has examined the peculiar features of human service organizations and the difficulties which these pose for their administrators. This paper begins by reviewing recent writings on this subject, noting the differing emphases emerging from social welfare and public administration backgrounds respectively. The definition of human service organizations is then reconsidered, suggesting that it is useful to examine their characteristics in terms of two clusters of features: one related to their public source of mandate and resources, and the other related to the nature of the services they provide. A proposed definition based on these two clusters of features makes explicit two characteristics generally assumed in previous definitions of human service organizations; their purpose of meeting socially recognized needs, and the relatively powerless position of their clients. The definition proposed, rather than setting categorical boundaries, provides a model against which the features of a variety of organizations which wholly or partly fit it may be examined. The implications of the identified features of human service organizations for their administration are considered briefly, with particular reference to such problematic issues as the clarification of goals, the rights of consumers and the evaluation of services. It is suggested that the training and development of administrators for human service organizations must be based on an understanding of the particular difficulties and challenges arising from the nature of these organizations.     

How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study

Adult mental health clinicians face a range of challenges that hinder their use of family‐focused practices when working with consumers who are parents. The purpose of this study was (a) to examine clinicians' experiences when working with parents and (b) identify strategies they found to be effective when working with parents. Eleven Australian mental health clinicians were recruited who regularly worked with consumers who are parents. Semistructured interviews were conducted within a qualitative paradigm and analysed using interpretative phenomenological analysis. Themes were identified which related to (a) managing sensitive parenting conversations, (b) making decisions about child safety in unclear or unpredictable situations, and (c) working with child protection services. Participants had developed strategies for managing the challenges of the first two practice issues and suggested organizational changes that could facilitate collaboration with child protection services. The findings highlight that the challenges of working with parents with mental health issues cannot be addressed with a one‐size‐fits‐all approach. Initiatives to facilitate the effective support of parents and their children need to be informed by contextual factors, including clinical practice.     

Co-Production and Self-Care: New Approaches to Managing Community Care Services for Older People1

A lack of management theory which is relevant to human service agencies, combined with a failure to recognize the very large contribution which older people make to their own care, makes it difficult to deliver supportive services effectively. Self care by elders is divided, in this preliminary classification, into new strategies for everyday living, the reallocation of time and the avoidance of risk. Managers who understand that service users are co-producers of care and recognize the need to manage the users, as well as their own staff and relations with other agencies, are more likely to be able to deliver good services. However the management of co-production is at present only theorized for the private sector where ethical issues are less pressing and users are customers. In future a greater understanding of co-production and the development of theory and practice which will combine the management of co-production with the empowerment of users within the public sector will be essential.     

“Keeping It Real”: An Evaluation Audit of Five Years of Youth-Led Program Evaluation

Youth are increasingly seen as competent in participating in research and program evaluation, two activities previously reserved for adults. This article is a report of the findings from an evaluation audit of Stand Up! Help Out!, a participatory action after-school youth leadership development program for disadvantaged urban youth that utilized youth evaluations to develop a best practices service model. The youths' feedback assisted providers in improving services so that youth engagement in the program was 99% (by comparison with national highs of 79%). Here, the authors describe an important aspect of the process of youth-led program evaluation leading to such high youth engagement: how youth interviewed each other so as to optimize the authenticity of their program evaluations and contributions to program design. Drawing from over 5 years of program evaluation data collected by youth, the authors report on the youths' experiences as informants and coresearchers, consider strategies used to help youth best describe their experiences in the program, and describe implications for other settings looking to incorporate youth-led program evaluation. Youth-led program evaluation has considerable promise for helping service providers make programs more meaningful for disadvantaged youth.     

‘Doing it right?’– accessing the narratives of identity of newly qualified social workers through the lens of resilience: ‘I am,I have,I can’

Using narrative enquiry, this paper accesses the construct of identity through exploring resilience in newly qualified social workers based in statutory children's services. In seeking to avoid deficit‐based models of this role, this paper aims to present inductively the ‘voice’ of three social workers in a semi‐rural authority, storying the positive ways in which resilience has developed during their first year. Using the Grotberg resilience framework (1995) –‘I am, I have, I can’– as an analytical tool at the interface of personal, professional and organizational identities, we conclude that ‘I am’ and ‘I have’ are more important than the skills dimension of ‘I can’. Positive role models, trust, ‘managed’ optimism, flexibility of support in and beyond induction, and, crucially, self‐efficacy and space for reflexivity, are more prominent as sources of resilience and strong identity. The reflexivity, inspired by the process of narrative enquiry, is an important contributor to self‐efficacy. We propose that a positive view of growth and identity is preferable to deficit models in the context of the transition between the two ‘communities of practice’ and of the challenges of the workplace. Organizational approaches based on this view will be more likely to promote a sustainable workforce.     

“It's hard work,believe me!”: Active efforts to optimise housing by people who live with mental illness and access housing assistance

Secure and appropriate housing is critical for the well‐being of people living with mental illness (consumers). Yet it is often difficult to achieve. Housing assistance is available, but is often difficult for consumers to access and negotiate. While the need for support is well‐recognised, little is known about the active part consumers play in finding and keeping appropriate accommodation. This paper addresses the research question: How do consumers who use housing assistance actively manage their housing situations? In‐depth interviews were conducted with 18 consumers who had used housing assistance within the past five years. These were analysed using constant comparative analysis, based on a grounded theory approach. Participants engaged in a range of activities to address six major concerns: working toward my home; following the rules to keep what I have; managing and improving my accommodation; working with housing services; living within my current situation; and finding and using supports. All participants described times when their mental health negatively affected their ability to do these activities. The findings highlight the need for housing services and mental health services to collaborate to develop policies and protocols that place reasonable demands on consumers and support their abilities to actively manage their housing situations.     

A comparison of systems and outcomes for safeguarding children in Australia and Norway

Using aggregated national data, this paper compares outcomes of Australian ‘child protection’ (CP) and Norwegian ‘child welfare services’ (CWS). We highlight each nation's context and key elements of their CP/CWS organizations, with emphasis on policy and programme orientation. System outcomes are examined along with the implications of their different approaches. The main policy focus in Australia is protection and risk, while Norway's systemic approach stresses prevention, early intervention and support. These differences influence practitioner's intervention strategies and how the needs of children and parents are met. In Norway, approximately 80% of the children in the CWS receive some sort of supportive services. In contrast, Australian services for supporting families are narrowly targeted. Both countries share the ‘best interest of the child’ principle and an increased focus on children's rights, and have experienced increased service demands and rates of children in out‐of‐home care. The paper explores the relative merits of these systems.     

The relationships between organisational networking,quality of life,and community integration among people with mental illnesses in South Korea: a multi-level analysis

This study investigated the relationships between organisational networking and the outcomes of people with mental illnesses (MI) and the extent to which the relationships are mediated by availability of services. Two levels of data were collected: organisational-level data from 22 community-based mental health service agencies and consumer-level data from 431 consumers. A multi-level analysis found that organisational networking increased the availability of services. However, service availability was not found to have a mediating effect on the relationship between organisational networking and client outcomes. Service coordination in the same mental health sector should be addressed.     

The Role of Intuition in Risk/Benefit Decision-Making in Human Subjects Research

One of the key principles of ethical research involving human subjects is that the risks of research to should be acceptable in relation to expected benefits. Institutional review board (IRB) members often rely on intuition to make risk/benefit decisions concerning proposed human studies. Some have objected to using intuition to make these decisions because intuition is unreliable and biased and lacks transparency. In this article, I examine the role of intuition in IRB risk/benefit decision-making and argue that there are practical and philosophical limits to our ability to reduce our reliance on intuition in this process. The fact that IRB risk/benefit decision-making involves intuition need not imply that it is hopelessly subjective or biased, however, since there are strategies that IRBs can employ to improve their decisions, such as using empirical data to estimate the probability of potential harms and benefits, developing classification systems to guide the evaluation of harms and benefits, and engaging in moral reasoning concerning the acceptability of risks.     

Capability Traps Impeding Homeless Services: A Community-Based System Dynamics Evaluation

Continuums of Care (CoCs) are the primary coordinating bodies for homeless services in the United States. However, the complexities involved in delivering homeless services across interagency networks challenges coordination and system improvement. CoC governance, planning, and service provision have received little attention in academic literature, and thus, Continuums attempt to manage complex systems with little guidance. This evaluation applied community-based system dynamics with homeless consumers and service providers to (1) identify capability traps that impede services delivery and to (2) engage stakeholders in a structured system improvement process. Results revealed organizational structures for governance and planning that inhibit system outcomes. Insights led to policy and practice recommendations for the homeless system.     

The Quality Dimension. Evaluating Quality of Service and Quality of Life in Human Services

Correspondence to Stephen P. Osborne, Public Sector Management Research Centre, Aston Business School, Aston University, Aston Triangle, Birmingham B4 7ET. Summary This paper addresses the issues, for those involved in planningand managing human services, of evaluating the quality of suchservices as part of the service provision process. It beginsby examining the nature of quality itself and moves on to lookat the links between quality of life and quality of servicein human services. It then assesses existing models of evaluationwhich might be applied and highlights their strengths and limitations. The paper argues that many of the models have their roots inareas outside of direct service provision and consequently arenot appropriate for implementation in this context. It concludesby reviewing some principles to guide the evaluation of servicequality by service managers, and suggests how these might beapplied in practice to the evaluation of the quality of humanservices.     

Whisper campaigns: market risks through online rumours on the Chinese Internet

The rapid growth of the Chinese Internet has brought about the emergence of many new channels of communication between businesses (B2B), between businesses and consumers (B2C and C2B) and between customers (C2C). Amidst this growth, Chinese Internet users have demonstrated a fondness for online rumours that has become dangerous for a variety of organisations and businesses. Within the Chinese market consumers have emerged as actors whose interactions are posing a new form of risk for companies wishing to enter the Chinese market. Since 2009, companies have repeatedly been harmed by fast-spreading online rumours that called the quality of products into question, or attacked their ethics in dealing with the general public. Starting in 2010, online rumour campaigns have also been on sale to harm rivals, or to promote one’s own product. Using a few example cases from food-related incidents, this article will argue that companies operating in this highly suspicious and fraught environment should shift their focus from pure marketing to a much deeper level of engagement with their customers, and also keep track of the online chatter about their brand, their products and their image so as to minimise risks to their enterprise and to successfully sell their products and services.     

Integrating Health and Social Care at the Micro Level: Health Care Professionals as Care Managers for Older People

A common problem in the provision of coordinated long‐term care is the separation of health and social care. The present government has been increasingly concerned with promoting convenient, user‐centred services and improving integration of health and social care. One arrangement that could contribute to this for some older service users is for health care staff to act as care managers, coordinating the provision of both health and social care. This paper presents the findings of a survey of arrangements in place in local authorities for health staff to work as care managers for older people. This was designed to provide details about the range and scope of care management activities undertaken by health care professionals. Key areas of enquiry included: which kinds of health care staff undertook care management and in what settings; how long the arrangements had been in place and how widely available they were; whether there was a distinction between the types of cases and care management processes undertaken by health care staff compared with their social service department counterparts; and what management and training arrangements were in place for the health care staff.     

Does product complexity matter for competition in experimental retail markets?

We describe a first experiment on whether product complexity affects competition and consumers in retail markets. We are unable to detect a significant effect of product complexity on prices, except insofar as the demand elasticity for complex products is higher. However, there is qualified evidence that complex products have the potential to induce consumers to buy more than they would otherwise. In this sense, consumer exploitability in quantities cannot be ruled out. We also find evidence for shaping effects: consumers’ preferences are shaped by past experience with prices, and firms may in principle exploit this to sell more.     

Outcomes assessment: evaluation in routine practice

Evaluating the quality and effectiveness of human services, whether social services or medical services, is critically important for the providers, for the organization, and for the payers of those services. We propose that outcomes assessment, a continuous model of evaluation designed for routine services settings, can be considered for use in evaluating the effectiveness of human services on a routine basis. In medical care, outcomes assessment measures initial and subsequent disorder-specific and generic outcomes domains as well as prognostic or case-mix characteristics that can be used to adjust outcomes among groups. We describe a current implementation of outcomes assessment in a state mental health system in the US and make recommendations for the future of the field.     

The effectiveness of services marketing: perceptions of executive directors of gerontological programs

Interest in marketing services, as opposed to products, has gained considerable momentum in recent years. The author conducted a survey of human service executives in six metropolitan areas to gauge the current status and efficacy of marketing efforts in programs for the aged. Findings confirm that the majority of health and social service organizations now employ marketing strategies of some kind, although somewhat insensitive and inadequate. The most common indicator of marketing success has been increments in the number of clients served. Health organizations are significantly more likely to measure the effectiveness of marketing efforts than social service agencies. Agencies commonly employ multiple marketing strategies, with face-to-face approaches proving to be the most effective. Least effective are public service messages and commercials on television/radio. The author suggests recommendations for mounting more efficacious and sensitive marketing programs in the human services.     

Consumer processing of hazard warning information

Using data obtained from a field experiment involving 957 consumers, this study investigates the linkage between hazard warnings and precautionary behavior, as well as the structure of the information about product usage and risks that consumers store in their memories. Through the use of a methodology based on an open-ended memory recall task, we measure how consumer recall of information on product labels is affected by the type and format of the information and infer the structure by which this information is stored in their memory. The methodology also allows us to explore the importance of limitations on consumers' cognitive abilities. In particular, we find that consumers substitute greater recall of risk information for recall of usage information, indicating a tradeoff among the different types of information conveyed on a product label. We also found that in the case of cluttered labels, as typified by many existing product labels, information overload results, which may make labeling ineffective in achieving its intended informational objective.     

Locus of Control, Coping and Proto Prevention in Child and Family Care

Despite a sustained emphasis that appropriate responses aremade to children and families in need, recent policy documentsexpress a concern about the high thresholds for receipt of children’sservices preventing many high-need families from accessing help.Where this is the case, families are liable to have to fallback on their own resources. This raises the question: how dothese families, particularly mothers (frequently the primarycare-givers), cope? Locus of Control (LoC) has been shown tobe a significant factor in the confidence, and capacity, ofindividuals to respond to their external environment. This articlefocuses on applicants for children’s services who didnot meet the thresholds for service receipt, focusing on theircoping strategies in the light of the LoC of the women. Thefindings show that LoC did have an impact on coping strategies,and, in particular, points to the greater likelihood of avoidancestrategies in those with an external LoC and of stress underminingActive Coping by those with internal LoC, in the absence ofservices. These are discussed in the light of prevention, recentlyconceptually extended to include activities by the families,as well as the provision of services.     

Evaluation of a Carer Support Scheme for Elderly People: the Importance of 'Coping'

Correspondence to Dr Derek Milne, District Psychology Service, St George's Hospital, Morpeth, Northumberland NE61 2NU. Summary One year's consecutive referrals to an Age Concern carer supportscheme entered an evaluation of the carers' stress, coping andstrain. Unlike a comparison group who did not use the scheme,these carers of elderly dependants had significantly poorerpersonal coping strategies, which were bolstered by the scheme.Stress and strain were high for both groups of carers, indicatingthat the critical variable in their continued role as carerswas coping. Implications for the formal services are discussed.