Changing Places: Men Replace Women in Mental Health Beds in Britain

Based on census materials collected in England and Wales from 1921 to 1991, this study focuses on gender differences in occupancy rates in hospitals and other mental health facilities in Britain. The results suggest that since 1991, or for the first time in the twentieth century, there are more males than females in residential mental health facilities in Britain. Furthermore, this pattern of association holds for all age groups except those aged 65 years and over. Second, there are currently two distinct subpopulations in mental health facilities—a male group which is predominantly of working age, and a female group, which is predominantly of retirement age. The existence of these two "care" populations will impact significantly on current and future resourcing of mental health services. The policy implications of the research findings are discussed within the context of the debates on the changing relationship between gender and mental health.     

Social Movement Studies,Social Movement Studies,and the Challenges of Parochialism: A Rejoinder to Poulson,Caswell and Gray

In this short rejoinder, I briefly contextualise and discuss the implications of Poulson, Caswell and Gray's article for Social Movement Studies.     

Dysfunctional control by client verbal behavior: The context of reason-giving

Dysfunctional control exerted by reason-giving in adult psychopathology is interpreted from a radical behavioral perspective. Verbal-social contingencies which support the establishment of reason-giving and its control over maladaptive actions are reviewed. A contextual approach to psychotherapy, comprehensive distancing, which attempts to weaken dysfunctional verbal control is described briefly. Data relevant to therapeutic process are presented. The overall results suggest that comprehensive distancing facilitates therapeutic change through a process consistent with a behavioral analysis of reason-giving. Suggestions for further research and radical behavioral approaches to psychotherapy are discussed.

     

Design of human immunodeficiency virus intervention trials in developing countries

Randomized controlled trials are recognized as the 'gold standard' for evaluating the effect of health interventions, yet few such trials of human immunodeficiency virus (HIV) preventive interventions have been conducted. We discuss the role of randomized trials in the evaluation of such interventions, and we review the strengths and weaknesses of this and other approaches. Randomization of clusters (groups of individuals) may sometimes be appropriate, and we discuss several issues in the design of such cluster-randomized trials, including sample size, the definition and size of clusters, matching and the role of base-line data. Finally we review some general issues in the design of HIV prevention trials, including the choice of the study population, trial end points and ethical issues. It is argued that randomized trials have an important role to play in the evolution of HIV control.