Deinstitutionalization and vocational rehabilitation for mental health consumers in Nova Scotia since the 1950s

In this paper we explore the broader policy determinants of the de-hospitalization of mental patients in Nova Scotia between the 1950s and 1980s and trace the background to the development of occupational rehabilitation programs in the community. For employment programs, the government chose to rely on non-profit NGOs as the suppliers of services. As a case study of such an organization, we examine the evolution of LakeCity Employment Services Association as a resource for people living with mental disabilities.     

Collective citizenship: From citizenship and mental health to citizenship and solidarity

Although the concept of citizenship is a widely used theoretical framework within political philosophy, its use in the field of mental health remains underexplored. Within this context, citizenship emphasises the social inclusion and participation of people who are marginalized and offers a more social and relational view of services and support for people with mental health problems than has been common in mental health systems of care. At the same time, however, the citizenship approach has operated in the context of systems of care in the United States that favour highly individualized conceptions of, and approaches to, care, and these systems of care operate in the social and political context of highly individualized concepts of the citizen. In this article building on the work of other citizenship scholars, we argue that a collective form of citizenship, grounded in the 5Rs framework, holds the individual and collective in creative tension. Furthermore, the paper applies this model to the domain of mental health, where people are treated in individualistic ways and experience marginalisation, making the collective dimension imperative and promoting participation, empowerment and the contribution for social change to people with mental health problems. Our theoretical framework of collective citizenship, while geared toward the needs of persons with mental health problems, also contributes to recent citizenship theory on the inclusion of marginalized, stigmatised, and excluded groups. We illustrate the application of this approach through an ethnographic-participant observation case study of a collective citizenship group with which we are associated.     

The psychiatric revolution in Quebec, 1950-1962. From asylum to community psychiatry and the open door

Psychiatry opens to the world at a time when the very basis of psychiatric practice, namely the asylum, is called into question. Studies appear in Quebec and Canadian journals concurrent to the introduction of new formulas for care, such as the delivery of psychiatric services in general hospitals and clinics, that allow patients to be treated outside the walls of psychiatric hospitals. In addition, postwar psychiatry takes an optimistic view toward the future of children with impairments through the creation of specialized schools and workshops. From the mid-20th century onward, the thinking in psychiatry centres on the open door.     

Deinstitutionalization reconsidered: geographic and demographic changes in mental health care in British Columbia and Alberta, 1950-1980

Using demographics on admission to, and discharge from, mental hospitals in Alberta and British Columbia, this paper analyzes the social process commonly framed as deinstitutionalization between 1950 and 1980. A focus on the two most western Canadian provinces permits an exploration of these changes in these regional contexts. Pressured by new funding arrangements, a shift towards community care, and growing criticism of the alleged oppressive nature of large institutions, the three main mental hospitals scaled down as of the 1950s. This trend did not mean, however, that the overall number of hospitalized patients decreased during this time period. The total number of hospitalizations, particularly short-term admissions, actually expanded, while trans-institutionalization also occurred. This case study mirrors larger trends of postwar mental health care, illustrating the social, political, and cultural challenges experienced in the reconstruction of institutional care.     

Parental mental health: disruptions to parenting and outcomes for children

The association between parental mental health problems and negative outcomes for children has been long known. This paper addresses three issues in relation to this. First, the scale of the problem is outlined, in terms of both the prevalence of mental health problems in parents and the likelihood of children exhibiting negative outcomes in these circumstances. Secondly, the specificity, or lack of it, of particular outcomes in the child in relation to different parental mental health problems is explored. Thirdly, the paper focuses on the importance of disruptions to parenting as a mechanism in the transmission of mental health problems to negative impacts on the child. Examples are given of how parenting is disrupted in non‐clinical community populations, and the subsequent impacts on the child. The case is made for the preventative importance of parenting and family support in mediating between parental mental health problems and negative impacts on the child.     

Suicide and mental health problems among Swedish youth in the wake of the 1990s recession

The purpose of this explorative study is to bring together a variety of Swedish data sources with indicators of youth mental health and living conditions in order to illuminate trends during the last decades, elucidate possible determinants of mental ill health and develop hypotheses to explain the observed trend patterns. The analyses in the study reveal some surprising inconsistencies with respect to the mental health trends among young people during the 1990s. Most striking is the pattern of increasing youth unemployment coinciding with almost inverse trends in the rates of suicide. The secular trends in fatal suicides during this period do not show any increase but some actual decrease in sub‐populations despite high sustained levels of unemployment. In contrast, survey data indicate that the general mental health of youth during this period appears to have deteriorated.     

Unemployment and mental health: evidence from research in the Nordic countries

In this article we examine research on effects of unemployment on mental health in Denmark, Finland, Norway and Sweden. We describe studies that use cross-sectional, longitudinal and time-series data, and we discuss studies that investigated the duration-dependence issue in exit rates out of unemployment. Not surprisingly, cross-sectional studies reveal that unemployed persons have worse mental health than do others. Most longitudinal studies suggest that unemployment is associated with deteriorating mental health, even though it is somewhat unclear how long such an effect persists. Most duration-dependence studies were done using Swedish data. It turns out that unemployment benefits and labour-market policies affect the pattern of exit rates out of unemployment.     

20世纪50年代的妇女解放和男女义务平等：中国城市夫妻的经历与感受

毛泽东时代的妇女解放和男女平等实践在中外学术界引起很大争 议。一方面人们看到共产党运用法律、行政和舆论手段以确保妇女与 男子享有平等的权利和机会,大大缩小了妇女在婚姻、就业和受教育程 度等方面与男子的差距;另一方面也指出上述方面持续存在的种种不 平等以及平等措施后面隐藏的事实上的不平等。1令学者困惑的是,20 世纪50年代,男女在婚姻、就业和受教育程度等差距最大,但是中国妇 女,尤其是城市妇女对妇女解放的认同感却最强(Croll,1995;Rofel,     

A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.     

Children's understanding of mental ill health: implications for risk and resilience in relationships

Research shows that having a parent with a mental health problem has associated risks for children, but some families seem very resilient and do not always suffer these difficulties. In order for social workers to be able to support the development of resilience in families who appear to be at risk, we need to understand what factors may ameliorate some of these risks. Research seems to suggest that children who can conceptualize their parent's mental health problem as something 'outside' their representation of that parent as an attachment figure are likely to have better outcomes than children who see the mental-health problem as part of, and embedded within, their representation of that parent. However, in order to develop an understanding of how this conceptualization affects attachment relationships and outcomes, we need to know what children understand by mental ill health. We also need to consider how this conceptualization might be changed, and it appears that parents, other attachment figures and other support figures may play a key role here. This paper provides a selective review of the research area and discusses the mechanisms which may govern this complex process. The review concludes with recommendations for future research and practice.     

Odorous childhoods and scented worlds of learning: a sensory history of health and outdoor education initiatives in Western Europe (1900s-1960s)

ABSTRACT

This paper develops a sensory history of health and outdoor education initiatives which featured (non-)formal schooling, analyzing these as belonging to (a) scented and more generally sensed world(s) of learning. Working with photographs as sensory objects of affect, and using as examples Belgian and Luxembourg open-air schools and associated sanitary and social welfare provisions, the paper explores issues that have gone under-researched in sensory scholarship internationally: those of precise educational purposes, methods, processes and effects of sensory engagement, particularly pertaining to “smell”. Sensory practices and experiences and uses of senses generally are thereby traced in/as “situated, embodied” movements inextricably “enmeshed” with symbolism. The paper argues that while the educational goals underpinning the initiatives investigated and the approaches and practices characterizing these have changed, some (un)intended effects still have an impact today, for instance through Forest School as given shape in the United Kingdom. The concept of “odorous”, or rather “sensuous childhoods”, is proposed to denote ways that particular target groups have come to be imagined as in need of explicitly sensorial health and outdoor education.     

From Hollis to the Orange Book: Developing a Holistic Model of Social Work Assessment in the 1990s

Correspondence to Margaret Lloyd, School of Social Work, University of Manchester, Dover Street, Manchester M13 9PL. Summary Amidst questioning of its essential identity, social work iscurrently developing new procedures and training programmesin assessment, traditionally one of its core activities. Thedemand for this redevelopment has been created by the changingprofessional climate in both probation and social work practice,in particular the response to legislative changes such as theNational Health Service and Community Care Act 1990. This paperexamines the established model of social work assessment inhistorical context and identifies its shortcomings for practicein the 1990s. It argues that despite the apparently diverserange of assessment tasks now undertaken by social workers andprobation officers, there remains an identifiable, common setof skills. Moreover, unless social work anchors these assessmentskills in a conceptual framework, retaining a sense of its ownhistory, the essential character of social work assessment willbe lost amidst mechanistic procedures and competing philosophies.This paper suggests a typology for making sense of the rangeof assessment tasks in current practice, arguing that this mustbe rooted in a holistic theoretical and philosophical model.The term ‘social work’ is used in its generic senseto include probation practice.