Putting the parity into service‐user participation: An integrated model of social justice

Models of service‐user participation have derived from citizenship or consumerist agendas, neither of which has achieved the structural reforms important for the most marginalised social work clients. This article proposes Fraser's model of ‘parity of participation’ as an appropriately multifaceted frame for capturing the social justice aspirations of service‐user participation. A qualitative case study compared the experiences and expectations of people who had used Australian mental health services with a sample who had used Australian homelessness services to examine their expectations of participation at individual and representative levels. The findings reinforce concerns from Fraser's research about the tendency for identity‐based consumerist notions of participation to reify group identity. This leads to tokenistic service‐user involvement strategies that have little impact on participation at a structural level. Fraser's parity of participation is shown to have untested potential to reshape service‐user participation to meet the social justice aspirations of social work clients. Key Practitioner Message: ● Innovative, service‐user driven strategies for collaboration will be those which challenge existing power structures; ● Service users want their contributions to decision making to generate identifiable change in the system of social services; ● The success of service‐user participation strategies might be the extent to which political, economic and cultural opportunities are enhanced.     

Social investment,social service and the economic performance of welfare states

This article begins with an examination of the role of social services as the key instrument of social investment strategy, presenting an empirical analysis of its impact on economic performance. A pooled time series, cross‐section analysis was conducted with the data of 15 welfare states from 1990 to 2007 under the ‘social investment hypothesis’ that more social service orientedness brings about a greater positive effect on the economy. The results show that a larger share of social service spending in the total social expenditure – more social service orientedness – contributes to economic growth and labour market performance, whereas a larger aggregate size of the welfare state may have a negative effect on employment. In conclusion, this study suggests that the relatively ambiguous welfare strategy of social investment could be clarified as a ‘transition from income security to livelihood security’ in which emphasis is placed on social service. Key Practitioner Message: ● This study suggests that the key instrument of social investment strategy is social service; ● The results show that more social service orientedness contributes to economic growth and labour market performance.     

Women,trauma and substance abuse: Understanding the experiences of female survivors of childhood abuse in alcohol and drug treatment

Despite the available evidence suggesting gender should be considered in the provision of alcohol and/or drug (AOD) treatment, programmes are frequently offered in an apparent ‘gender vacuum’. This article argues that the generalist ‘one size fits all’ approach of many AOD services is not gender neutral but should be understood as implicitly gendered in that it neglects the specificity of women's needs in relation to abuse, mental illness and parenting. The discussion presented in this article is based on a qualitative study of the experiences of adult women with histories of childhood sexual abuse and/or domestic violence in AOD treatment. By examining the ways in which AOD treatments effectively ignore or minimise gender, this article uncovers intervention practices that efface the complexities underpinning AOD use among women and suggests ways in which alternative models of service delivery can create more validating and supportive environments. Key Practitioner Message: ● Some of the common assumptions underpinning alcohol and drug treatment do not adequately acknowledge the specific needs of female clients and so gender‐neutral service provision can be disenabling for women; ● Punitive service cultures or behaviour change strategies have a differential impact on female clients, many of whom have prior and ongoing experiences of abuse and violence; ● Service models that acknowledge the complex responsibilities and relational histories of female clients are more likely to engender a positive response and provide the opportunity to address the multiple and complex needs that can go unmet in non‐specialist services.     

Does social capital predict happiness,health, and life satisfaction in an urban Australian community?

Abstract

This paper investigates the extent to which social capital and participation in community activities predicts happiness, health, and life satisfaction in Australia. Residents of a Gold Coast suburb completed a random door‐to‐door survey, with a 74% response rate (n = 249). Ordinal regression analyses revealed that only two elements of social capital—Value of Life and Feelings of Trust and Safety—predicted happiness (β = 0.4, P = 0.00; β = 0.12, P = 0.00), life satisfaction (β = 0.46, P = 0.00; β = 0.09, P = 0.02), and health (β = 0.29, P =0.00; β = 0.11, P = 0.00). In terms of community activities, not participating in social activities predicted both unhappiness (β = ‐0.16, P = 0.05) and reduced life satisfaction (β = ‐0.20, P = 0.01). Such findings suggest that how social capital is defined and measured is important, as only two of the seven elements—life satisfaction and health—predicted happiness. The key implication is that implementing strategies, initiatives, and urban designs that facilitate feelings of trust and safety may foster health, happiness, and life satisfaction.     

‘More time for what?’ Exploring intersecting notions of gender,work, age and leisure time among people with cognitive disabilities

This article explores intersecting notions of leisure among middle‐aged people with intellectual disabilities in the setting of the Swedish welfare state. The participants are recipients of long‐term disability services and have experienced the changing ideological frameworks of the welfare effort, which has recently focused on normalisation, inclusion and participation. Structured activities are arranged by disability services in order to normalise living conditions and provide recreation for disabled people. However, the range of activities is constrained by financial resources, by notions of gender and age and by an institutionalised emphasis on the work ethic – leading to constructions of leisure partly as ‘time beside’ where ‘free time’ activities should not interfere with the duties of the working week. The participants' limited resources and their lack of a strong voice limit their ability to demand their legal rights and leave many of them with ‘too much time with too little to do’. Key Practitioner Message: ● A common idea of leisure is the relationship between social and physical activities, well‐being and health; ● People with disabilities, regardless of age, engage in fewer leisure activities than the general population due to a lack of resources; ● Even with legal rights, the lack of a strong voice as well as institutional constraints limit their leisure opportunities.     

Sen and Aristotle on Wellbeing

A significant body of research and analysis concerning wellbeing has emerged across a number of social research disciplines, yet the concept of wellbeing does not admit of any unified meaning. Philosophical accounts of wellbeing are traditionally divided into three categories: hedonistic, desire‐satisfaction and objective list theories, reflecting longstanding doctrinal divisions in normative ethics. Rejecting the foundational monism associated with these approaches, Amartya Sen has proposed a pluralist ‘capabilities’ approach to personal wellbeing based on freedom of choice and the Aristotelian notion of a ‘function’. Recent Australian wellbeing research also shows promising signs of moving beyond reductive income‐based metrics towards plural indicators of poverty and social disadvantage. This paper reprises Aristotle's distinctive account of perfect wellbeing (eudaimonia) in the Nicomachean Ethics and investigates Sen's approach in its light, suggesting that future Australian research in the spirit of Sen's pluralism may benefit from Aristotelian insights into the ‘thickness’ of freedom implicated in personal wellbeing.     

Impact of enforcing a statutory minimum wage on work and quality of life of vulnerable groups in Hong Kong

The statutory minimum wage (SMW) law was enforced in Hong Kong on 1 May 2011. To examine its impact, this longitudinal study measured the quality of life, job and pay satisfaction, monthly income, hourly rate and working hours of vulnerable groups (n = 253) before and after the legislation. The findings confirmed that the enforcement of the SMW induced a positive impact as intended. The introduction of the SMW induced a positive wage and employment effect on the vulnerable groups in Hong Kong without harming their employment rate. Job and pay satisfaction, as well as most domains of the quality of life (i.e., physical and psychological health, and environment), increased significantly. In general, the positive impact of the SMW was more prominent for employees who previously worked less than 18 hours a week and who had hourly rates less than 28 HKD. The implications of the findings are discussed in the social context of Hong Kong. Key Practitioner Message: ● Enforcing minimum wage induced a positive impact on quality of life, job and pay satisfaction, and a monthly income of vulnerable groups. ● The social relations (quality of life) decreased after implementing minimum wage for workers working longer than 18 hours a week. ● Longer working hours is a key factor for the increase of a monthly income among the vulnerable groups.     

Economic well‐being of low‐income single‐mother families following welfare reform in the USA

This study explored changes in net disposable income for low‐income single‐mother families before and after the 1996 welfare reform in the USA. Although many studies on welfare reform have focused on employment or total family income as a way to measure low‐income single‐mother families’ economic well‐being, little is known about their net income after expenses related to entering the workforce. This study analyzed net disposable income after tax deductions and childcare costs to provide a more accurate understanding of income changes using data from the Survey of Income and Program Participation conducted by the US Census Bureau. The results revealed that while low‐income single mothers were working more after welfare reform, their net disposable income decreased during this time because their earnings were low and offset by an increase in childcare costs and a decline in means‐tested benefits, including Temporary Assistance for Needy Families benefits. Key Practitioner Message: ● To understand effects of the 1996 welfare reform on low‐income families’ economic well‐being; ● To understand comprehensive income sources and work related expenses of low‐income families; ● To provide policy suggestions for comprehensive childcare subsidies to support low‐income single mothers’ employment.     

Accepting and Negotiating Service Users' Choices in Mental Health Transition Meetings

Across Western welfare regimes, policies emphasize that service users should have more choices regarding their services. This article examines how service choices are presented, responded to and decided in interactions between service users and professionals in mental health transition meetings. Choice is often associated with consumerist user involvement ideas, but in mental health choice also relates to the democratic user involvement approach and to shared decision making between professionals and service users. The results of the study show that professionals construct service users as consumers by offering service options in choice making sequences, expecting users to make appropriate choices. Service users mostly act like consumers by responding to these choice options. However, the study also demonstrates that the professionals do not always accept the user's first choice but respond to them as non‐preferred. Sometimes, they also suggest choices on behalf of the users. In these ‘non‐accepting’ sequences, choices are negotiated in interaction between the parties, rather than users acting as autonomous choice makers. The sequences are based on two kinds of professional reasoning: first, the professional‐led needs assessment and, second, the structure of the service package that the user is being offered. This negotiation has elements of shared decision making and the ‘logic of care’. But it also has elements of paternalist control which challenge both consumerist and democratic service user involvement and suggests consideration of more collectively oriented service user actions.     

Stilling the tremors: Resurrecting HIV services in Haiti's post‐earthquake tent cities

The January 12, 2010 earthquake in Haiti severely undermined HIV service provision in the country. Almost 10 percent of Haitians were displaced and now live in temporary tent communities. Little is known about how HIV services are being provided to Haitians with HIV in these encampments. This study addresses this lacuna by conducting a process evaluation of the manner in which a collaboration among Haitian community‐based HIV service providers, a US‐based HIV service provider, and a US‐based academic research team resurrected HIV services in the encampments. Efforts to set up HIV services in the encampments proceeded through three stages: (i) an initial crisis response that activated established networks and identified feasible goals; (ii) the development of services by building research capacity, conducting needs assessments, addressing logistical challenges, and establishing community‐based services; and (iii) the sustaining of the initiative by targeting resources and negotiating in the political arena. Implications of the protocol for future efforts are discussed. Key Practitioner Message: ● Resurrecting HIV services in post‐disaster zones; ● Utilizing cross‐country, provider–academic partnerships to develop service capacity; ● Targeting structural barriers to establish HIV services in resource‐poor settings.     

Social networks and immigration stress among first‐generation Mandarin‐speaking Chinese immigrants in Los Angeles

This study examined relationships between social networks and immigration stress among first‐generation Chinese immigrants. Using data from a larger study of health behavior among first‐generation Mandarin/English‐speaking immigrants residing in the Los Angeles metropolitan area (N = 1,183), this study found that Chinese immigrants living closer to immediate family and maintaining larger social networks experienced lower immigration stress. Unexpectedly, immigrants with larger family sizes and who participated in voluntary associations (e.g., religious, alumni, and nationality associations) reported increased immigration stress. The findings suggest that practitioners need to be cautious of a possible downside in designing interventions to expand social networks among immigrant clients. The study is especially important in the context of a rapidly increasing immigrant population from Mainland China to the USA. Key Practitioner Message: ● Working with immigration families should incorporate assessment of their social network; ● Interventions designed to facilitate supportive social networks should differentiate different social network ties; ● Different social network ties may affect the stress level of immigrants differently.     

An evaluation of a groupwork intervention for teenage mothers and their families

This paper describes the implementation of a specific, community‐based, multi‐family group (MFG) intervention strategy (Families and Schools Together [FAST] babies) aimed at improving the outcomes for infants of teenage mothers in 11 Canadian communities. The aims of this social work group intervention were (1) to engage the teenage mothers into a socially inclusive experience that might challenge the social disapproval they often experience, (2) to enhance the mother–infant bond, while increasing feelings of parental efficacy, and (3) to enhance the social context of the teenage mother by reducing stress, social isolation and intergenerational family conflict. Groups were co‐led by teams of service users (a young mother, a grandmother of the baby of a teenage mother and a father of the baby of a teenage mother) collaborating with multi‐agency professionals (health visitors and social workers). Teams that reflected the ethnic diversity of the participating family members were trained to facilitate eight weekly group meetings. They showed respect for the young women's ‘voice’, and supported her ‘choice’ to prioritize motherhood as her defining identity. The meetings comprised a range of activities, including crafts and singing, discussion of ‘conflict scenarios’ in cross‐familial, cross‐generational groups, infant massage delivered to babies by the young mothers, grandmother support groups, and a shared community meal. Where necessary, teams made referrals for specialist help. One hundred twenty‐eight young mothers came once to 17 groups, and 90% graduated having attended a minimum of six sessions. Evaluation data from mothers and grandmothers showed positive change when comparing pre and post, based on standardized questionnaires. One‐tailed, paired t‐tests showed statistically significant increases in parental self‐efficacy for the teenage mothers, improved parent–child bonds, reductions in stress and family conflict, and increases in social support. Given that rates of teenage pregnancy in the UK are among the highest in Europe, this paper concludes with a discussion of the feasibility and possible merits of introducing FAST babies to England.     

Prioritising care services: Do the oldest users lose out?

Population ageing is a major concern in most European countries. Demands for health‐ and care services will increase, as older people typically have a higher need for such services. What is often overlooked, however, is that older users increasingly compete with younger users for the same limited care resources. We ask: How do employees in the Norwegian care sector make decisions regarding the allocation of services to younger and older users? To answer this question, we interviewed decision‐makers in Norwegian municipalities. Despite providing for equal rights to services, laws allow for an interpretation of needs and this can result in the unequal distribution of services. Our study indicates that needs are defined differently for younger and older users, which affects the amount, type and content of the services allocated to younger and older people. When resources are scarce and priorities must be established, the services to the oldest suffer. Key Practitioner Message: ● The article lays the groundwork for an open debate about the allocation of resources to users in different life phases; ● The analysis conceptualises and makes explicit important normative decisions made by practitioners.     

Evaluating social assistance reforms under programme heterogeneity and alternative measures of success

This article presents an assessment of welfare reforms under a framework of programme heterogeneity and alternative measures of success. The study focused on a specific programme – Madrid's Ingreso Madrileño de Integración (Madrid Regional Government's Welfare Programme) – which comprises heterogeneous sub‐programmes. We tested whether work‐related sub‐programmes performed better than general activities aimed at improving life skills by analysing the effects on different types of outcomes. We also tried to identify which work‐related sub‐programme worked best. Our results show that intensive employment activities yield remarkably better results than general work‐related schemes or life‐skills activities. However, increasing work participation does not automatically lift participants out of material hardship. Key Practitioner Message: ● Strategies to reduce the dependence of low‐income households on government support by improving employment opportunities; ● Evaluation of alternative work‐related sub‐programmes in welfare policies; ● New evidence on approaches that consider heterogeneous sub‐programmes and different types of outcomes might inform and partially shape the future public policy agenda in the welfare reform debate.     

Service user experience of participation in child welfare case management

Child welfare case management systems were designed, in part, to standardize participatory practices for both young people and their parents. This paper reports the findings of a qualitative study of Australian service users' experiences of participation when using the case management systems, Looking After Children and Supporting Children and Responding to Families. Findings indicate that the majority of service users reported positive experiences of participating in the use of these systems. However, participatory relations were often slow to develop and frequently involved conflict. Some service users used their power to control the flow and accuracy of information, or resisted workers in other ways. Some children and young people were excluded from the opportunity to participate because the systems did not have a ‘text‐based’ format to ‘ensure’ that this process occurred. These findings indicate that case management systems did not result in relationships which consistently informed the intervention in a way that the systems' authors had envisaged. Service users did not necessarily take up the openings offered to them and workers did not necessarily comply with the systems' obligations. The findings cause us to question the assumptions that power can be bestowed or withdrawn, in the way suggested by these case management systems.     

Middle‐Class Political Activism and Middle‐Class Advantage in Relation to Public Services: A Realist Synthesis of the Evidence Base

Since the late 1960s social policy scholarship has been concerned with the distribution of the resources or benefits across social gradients. This article presents a review of the literature on one mechanism by which inequity might be produced – activism by middle‐class service‐users enabling them to capture a disproportionate share of resources. The review used the methodology of realist synthesis to bring together evidence from the UK, the USA and Scandinavian countries over the past 30 years. The aim was to construct a ‘middle‐theory’ to understand how and in which contexts collective and individual activity by middle‐class service‐users might produce inequitable resource allocation or rationing decisions that disproportionately benefit middle‐class service‐users. The article identifies four causal theories which nuance the view that it is the ‘sharp elbows’ of the middle‐classes which confer advantage on this group. It shows how advantage accrues via the interplay between service‐users, providers and the broader policy and social context.     

Ending poverty in Mongolia: From socialism to social development

While recent literature on social welfare has included Asian countries, less is known about low‐income and former socialist countries in Central Asia. This article combines a documentary‐historical method with a value‐critical approach to analyze Mongolia's social policy response to poverty. Mongolia is unique in Asia because it transformed from nomadic pastoralism to socialism without a phase of capitalist industrial development. The case study found that Mongolia lost social welfare when it transitioned from socialism, a statist model, to market liberalism and multiparty democracy. In the 21st century, Mongolia has been aspiring to promote social development by redirecting mining revenues to a human development fund. Mongolia is potentially an exemplar of social development strategies affirmed at the United Nations Conference for Social Development (Rio+20) regarding a green economy for inclusive growth and poverty elimination. Future social welfare research should consider the importance of sustainability. Key Practitioner Message: ● Global standards for tracking poverty alleviation will be integrated with sustainability measures beginning in 2015; ● Mongolia hopes to foster social development and sustainable livelihoods by reinvesting revenues from mining into human capital and health care; ● To sustain future generations, social policy needs to consider the relationship between natural capital, social capital, and financial capital.     

Life Satisfaction of Rural Migrant Workers in Urban China: The Roles of Community Service Participation and Identity Integration

Abstract

China is home to approximately 245 million rural-to-urban migrant workers. The influx of migrants into urban areas has posed various challenges for local social service systems. Recently, increasing number of community services have been developed to meet the growing service demands from the migrant population. However, whether increase in community service use results in improved wellbeing among migrant workers remains critically unexplored. As such, this study examines the role of community service use in migrant workers’ life satisfaction and the potential mediating effect of identity integration in Shenzhen, China. Bootstrapped models were adopted to examine relationship among variables. Drawing from a sample of 1,087 rural-to-urban migrant workers, we found that community service use is positively correlated with both identity integration and migrant workers’ life satisfaction. Moreover, identity integration served as a partial mediator between community service use and life satisfaction. The mediating effect of identity integration was found to increase with age. This study highlights that diverse services should be implemented to address divergent needs of migrants in different age groups. Community service can also serve as a vehicle to foster integration among migrant workers in host communities, especially for older age groups. Future studies may further investigate the relationships between community social capital, community social support, quality of community-based organization and frequency of service use so as to optimize the life satisfaction of migrant workers.     

Autonomy,Choice and Control for Older Users of Home Care Services: Current Developments in Swedish Eldercare

In Sweden, a policy shift towards more individualized eldercare, with an emphasis on consumer choice, has taken place. The aim of this study was to analyze the processes and practices of individualized eldercare, focusing on preconditions for older peoples’ choice and control. Data consist of qualitative interviews with users of home care services (n – 12) and staff (n – 12) and participant observations (n – 7) of meetings between staff and older people. The choice and control available to older users emerged as decisions about ‘what’ care and services, ‘who’ should provide the care and services, and ‘how’ the care and services should be performed. Three approaches to enable older people choice and control over their home care services were revealed: test and revise, services elaborated in close collaboration between users, care managers and home care staff; choices in the moment, users could choose services at each occasion; and quality improvement through competition, competing providers develop attractive services. The findings could guide policy makers in combining the strengths of these approaches to enable older people in need of support to become co-producers in designing, managing, as well as consuming, care and services. Future quantitative research is needed to achieve generalizable knowledge about the strengths and weaknesses of different ways to organize eldercare services.     

Public Policy and Inequalities of Choice and Autonomy

Choice by service users has been promoted in social policy across many developed welfare states, often on the grounds that it will incentivize providers to enhance quality and efficiency. But this instrumental motivation for the promotion of choice overlooks the possibility that choice, understood in the deeper sense of autonomy, has intrinsic value, as suggested by egalitarian and capability‐based theories of social justice. This article argues that the narrow motivation of choice policies leads to a focus on services rather than outcomes for individuals and fails to address deep‐seated inequalities in the opportunities people have for real autonomy. We test this concept using newly collected data for the UK. Our empirical findings indicate that disabled people are more likely to experience constrained autonomy in all respects, while being from a low socio‐economic group and/or lacking educational qualifications is a risk factor across several components. We conclude that improving the ‘choice’ agenda for policy requires: (1) adopting a more sophisticated concept of ‘choice’ such as the conceptualization of ‘choice as autonomy’ outlined here; (2) developing a better understanding of existing inequalities in autonomy, such as we begin to explore in our empirical results; and (3) tackling these inequalities through, for example, the removal of obstacles to active decision‐making by providing effective support and advocacy, especially for disabled people, and addressing the major structural barriers – poverty, ill health and geographical inequality – which place significant restrictions on the autonomy of those who are already disadvantaged.