Invisible from View: Leaving and Aftercare Provision in the Republic Of Ireland

Abstract

The adequacy of provisions for young people leaving care and in aftercare in the Republic of Ireland has been the subject of recent policy attention. A landmark report, the Ryan Report (2009), into historic abuse in state institutions recommended strengthening provisions in this area. However, the legislative basis for aftercare remains relatively weak and services for young people leaving care remain ad hoc and regionally variable. This article outlines the current context of leaving and aftercare provision in the Republic of Ireland and traces some of the recent policy debates and recommendations in this area. A genealogical analysis of leaving care and aftercare provision highlights that this issue has historically only emerged as a concern in the context in which young people leaving the care system are perceived as a “threat” to social order. It is argued that the failure to adequately reform leaving and aftercare provision is reflective of wider social inequality and of a context in which young people in care are largely invisible from view.     

Caring for Persons with Serious Mental Illness

Abstract

This article places evidenced-based knowledge of practice within the social context of care and proposes five policy objectives and specific policy and program changes to address care needs of people with serious mental illness. In spite of demonstration programs that provide the basis for proposed policy initiatives throughout the United States, treatment provision for this population remains inadequate and their safety and well-being continues to be at risk. The authors suggest that treatment initiatives need to be tied to stable policies protecting the mentally ill from adverse social context changes. The authors conclude that policies are needed that will enhance housing assistance, independent social functioning, personal empowerment, and treatment engagement. In addition, efforts are needed to make better use of inpatient hospital care, to better understand the role of assisted treatment, and to better develop consistent long-term fiscal support for the seriously mentally ill. They offer specific policy recommendations for changes in HUD programs, Medicaid and Medicare funding, and treatment programming that address these needs.     

The Productivity Commission Inquiry into Aged Care: A Critical Review

Abstract

The final report of the Productivity Commission Inquiry into Aged Care has recommended a substantial restructuring of Australia's aged care system to make it fairer, more responsive to the needs of individual consumers, and more sustainable in the context of population ageing. While acknowledging the necessity of a safety net and the needs of diverse groups, the recommended reforms continue to advance the neoliberal restructuring of Australia's health and welfare systems. This paper provides a critical examination of the context and key drivers for change, and considers the reception of the report within the aged care sector. While social workers are actively engaged in the aged care system, they are largely absent from the discussion in the final report. Nonetheless, the transfer of recommendations into actual policy provides an opportunity for social work to argue its unique contribution and potential in the delivery of aged care.     

Passing the Trash: Absence of State Laws Allows for Continued Sexual Abuse of K–12 Students by School Employees

ABSTRACT

“Passing the trash,” enabling teachers who sexually abuse students to pursue another job with no record of their sexual misconduct, is common practice for K–12 school district administrators who fear legal liability and tarnished reputations. The “Prohibition on Aiding and Abetting Sexual Abuse” provision in the United States Every Student Succeeds Act (ESSA) of 2015 aims to eliminate passing the trash. This study explores states’ progress toward developing and implementing relevant law and policy to comply with the provision. Researchers collected data from representatives of state departments of education, asking whether representatives were aware of the provision and what progress their state had made toward complying with it. Overall, researchers found that just four states had fully complied; several others were in the process of creating relevant policy and legislation and a few began the process in response to researchers’ queries. However, the overwhelming majority of states—39—had no plans to create relevant legislation or policy, either because they were unaware of the provision or because they believed, erroneously, that existing laws fulfilled the ESSA mandate. Passing the trash is clearly an unacceptable practice, yet research suggests it still occurs, and state-level laws and policies to prevent it are slow to emerge. The lack of knowledge or awareness exhibited by many state representatives suggests a need to educate policymakers and education leaders about what aiding and abetting sexual offenders consists of, what consequences it can have for vulnerable students, and what provisions states can enact to prohibit it.     

Running out of time: A qualitative investigation of homeless men’s access to health services

Abstract

This study examined health beliefs and health care utilisation among 20 homeless men in Liverpool, through the voices of homeless men themselves. Using semi-structured interviews and framework analysis, narratives highlighted the interplay between the limiting structures of the health care system and an individual's ability to know how to seek out health care in order to improve their own health. Specifically, we found that individual agency was contingent on the availability of a set of minimum resources, to which homeless men did not have access. These findings have important implications in terms of practical policy recommendations for improving health care utilisation among the homeless.     

MSM's Versus Health Care Providers’ Perceptions of Barriers to Uptake of HIV/AIDS-Related Interventions: Systematic Review and Meta-Synthesis of Qualitative and Quantitative Evidence

ABSTRACT

To compare the perceptions of men who have sex with men (MSM) and health care providers (HCPs) on barriers to uptake of HIV/AIDS-related interventions using existing quantitative and qualitative data. Systematic review and meta-synthesis was employed to combine data from both groups. Based on studies focusing on MSM and HCPs, knowledge about the intervention and intervention's cost emerged as major barriers to uptake whereas HIV- or homosexuality-related stigma/discrimination was a barrier in studies focusing on MSM alone. Lack of practice guidelines was barrier among HCPs only. Few studies exist that focus on perceptions of barriers by HCPs.     

Video-Based Studies of Work Practice

The use of the visual, let alone video, is surprisingly rare within social scientific studies of work and organisations. Nevertheless there is an emerging corpus of research that use video recordings, augmented by field work, as their principal data; recordings that provide access to the fine details of work as it is accomplished within everyday organisational settings. They include studies of work in a broad range of domains, including call centres, mobile offices, operating theatres, construction sites and control centres. This paper outlines the nature of these video-based studies of work and organisation and highlights some of their major contributions to our understanding of issues such as the nature of skill and expertise, the use of technology and the organisation of teamwork. It also reflects on the impact that these studies, and this approach, are having within the practical fields of industrial and market research.     

Conducting a Hispanic Health Needs Assessment in rural Kansas: Building the foundation for community action

Healthy People 2020 states ethnic health disparities are a priority for the US. Although considerable national statistics document ethnic-related health disparities, information specific to rural areas is scarce and does not provide direction for implementing chronic disease prevention programming. Therefore, the purpose of our project was to use the Hispanic Health Needs Assessment (HHNA), a tool designed by the National Alliance for Hispanic Health (NAHH), in culturally diverse, rural Southwest Kansas. Our focus areas included: access to healthcare, heart disease, diabetes, overweight, nutrition, and physical activity.MethodsThe assessment followed six steps: (1) developing the assessment team, (2) data gathering using community member surveys, existing statistics and community leader interviews, (3) assembling the findings, (4) formulating recommendations for action at individual, institutional, community and policy levels, (5) sharing findings and program planning, and (6) sharing findings with NAHH. We identified several challenges collecting health related data in rural communities, but overall, the HHNA was a comprehensive and useful tool for guiding a community level health assessment.ConclusionThis process has provided our community partners with locally relevant statistics regarding the current status of health, health behaviors, and perceived community needs to inform resource allocation, program planning and applications for new funding initiatives.     

Responding to the Mental Health and Grief Concerns of Homeless HIV-Infected Gay Men

Summary

Aging, homeless HIV-infected gay men confront multiple bereavement and mental health issues. Needs assessment interviews with this population in the streets of New York City facilitate the initial review and provision of clinically and culturally appropriate service delivery strategies for these disenfranchised gay men to access bereavement support and mental health care systems.     

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.     

Families and Mental Illness: Contested Perspectives and Implications for Practice and Policy

Abstract

Mental health research, policy, and service provision over the last 50 years have constructed families and their connections with mental illness in various and contradictory ways. Three distinct but intersecting perspectives derive from the clinical mental illness literature, the family advocacy movement, and mental health policy. Within the clinical literature, the perspective of families is largely one of blame and pathology. By contrast, the family advocacy movement has generated the perspective of the burdened family, whereas mental health policy has created the perspective of the obligated caregiver. The result is an ambiguous understanding of the role of the family in both contributing and responding to mental illness. Implications for policy and practice include the need for a commitment to the principles of partnership with families, a recognition of diversity within families, recognising the difference between carer and family positions, and a need for policy to reflect the position of family as both intimately concerned, but not necessarily responsible, for patient care.     

Aboriginal Practitioners Speak Out: Contextualising Child Protection Interventions

Abstract

One month before the June 2007 Federal Government Emergency Intervention in the Northern Territory some 55 West Australian Aboriginal child protection workers attended a 3-day summit in Fremantle. Their purpose as front-line practitioners from across the State was to identify how more nurturing and healing communities could be developed and supported in a climate of despair. This paper reports on how the summit was designed and on some of the ideas and concerns that emerged within this dialogical space of cooperative inquiry. The project was a partnership between Aboriginal and non-Aboriginal representatives of university, government, and community-service bodies. Aboriginal practitioners identified the complexity of what was happening in their experience and where changes were needed. Integral to this participation and coproduction of knowledge by Aboriginal child protection workers was the provision of a safe space for the articulation of reflected experience. Implications for policy, practice, and curriculum of both process and outcome dimensions to considering Aboriginal views on this contentious issue are discussed.     

Long-Term Care Funding in Canada

Summary

When Canada was founded, health care was delegated as a provincial responsibility. Although the federal government shares a portion of health care costs, it is not directly responsible for the planning, delivery, and governance of health services. The 1984 Canada Health Act set national standards for the provision of physician and hospital services, but it does not apply to home care and long-term care facilities. Consequently, each province has established a unique approach to long-term care, resulting in a health policy mosaic. This paper examines different approaches to funding long-term care with a particular emphasis on the impacts of regionalization and of the implementation of case-mix-based funding systems.     

Lessons Learned from Programs for Unaccompanied Refugee Minors

SUMMARY

A policy for priority admissions and subsequent care of unaccompanied refugee entrant minors was established in 1978 in response to the influx of Southeast Asian refugee minors. This article describes the child welfare system's response and workers' experiences in meeting the needs of this population. Lessons learned can be applied to permanency planning for children from varying cultural backgrounds.     

Community e-gateways: locating networks and learning for social inclusion

The provision of community e-gateways (community-based facilities providing public access to computers and the Internet) has been seen as a way to address the 'digital divide', particularly for people from deprived neighbourhoods. In the UK, policy and practitioner literature has stressed that for these centres to be successful they need to have strong social connections and be able to provide opportunities for interactive learning and content creation. Through a detailed analysis of one community e-gateway, which formed part of a wider study of public access provision, this article analyses the strengths and weaknesses of this advice drawing on broader sociological literature relating to social networks, network mapping and communities of practice. It concludes that greater attention needs to be paid to the significance of weak ties, two-way boundary spanning and the resource requirements of social networks for the policy objectives to be fully achieved.     

Challenges of Safe Motherhood: Program and Policy Recommendations

ABSTRACT

This article synthesizes the major findings from research and case studies on safe motherhood and focuses on best practices and changes in public policy. Many factors that negatively influence safe motherhood can be ameliorated—and have been in numerous societies through education, access to resources, public–private partnerships, and grassroots efforts. A model identifying the interrelationship of variable is provided. Policy recommendations are discussed.