Independence, Risk and Compulsion: Conflicts In Mental Health Policy

During the second half of the 20th century the mental hospital population in England and Wales has fallen by some two-thirds. This dramatic shift in mental health policy has been based, in part, upon a policy assumption concerning the therapeutic benefits of hospital discharge for mental patients. This view derives from an acknowledgement of the potentially negative impact of institutional life and, conversely, a recognition of the beneficial effect of a return to independent living in the community. Yet, in recent years, concern has grown about the risks posed to the health and safety of patients and to the safety of other members of the community as a result of hospital discharge. In turn this has led to a policy shift in favour of increasing use of compulsory community powers. This article identifies the tensions in policy that exist between the goal of independence, the recognition of risk and the implementation of compulsory community powers, and seeks to provide an assessment of the extent to which they can be reconciled.     

‘I want to be better than you:’ lived experiences of intergenerational child maltreatment prevention among teenage mothers in and beyond foster care

The growing body of research on teenage motherhood in foster care has largely focused on the risks involved for both mother and child, yet these mothers depict a much more complex picture of their own experience of becoming and being mothers. The current study employed interpretative phenomenological analysis to explore 18 in‐depth, qualitative interviews from six participants on the meaning and experience of motherhood among teenage mothers in foster care and in the years immediately after ageing out. This study focused on a particular dimension of motherhood: participants' efforts to break the cycle of child abuse and neglect with their own children. Two themes emerged as characteristic of these experiences: (i) treating children well/parenting differently and avoiding the system; and (ii) reducing isolation and enhancing support. Given the increased likelihood of the children of teen mothers – particularly those who have been maltreated – becoming involved with the child welfare system, study findings suggest possible strategies for disrupting cycles of intergenerational child welfare involvement generated by young mothers themselves. Practice implications for addressing possible substance abuse, mental health and relational and parenting needs are discussed.