The Social Construction of Reality in the Realm of Children's Mental Health Services

ABSTRACT

Across the United States, systems of care have emerged to provide mental health care to children and their families; fragmentation inhibiting the success of collaboration by stakeholders is common and compromises these systems of care. Survey data were collected from 1,428 respondents in a Midwestern state to examine problems that exist within systems of care from the perspective of the different stakeholder groups. Stakeholder group membership was based upon the respondent's employment or involvement within various child-serving systems and included those in child welfare, juvenile justice, and education, mental health providers, and consumers (i.e., caregivers/parents). Group differences revealed patterns of “finger pointing” by the stakeholder groups on where specific problems exist within systems of care. The findings provide insight into how the social construction of service delivery and practice emerges as stakeholder groups describe, understand, and evaluate problems within the system of care as a function of their own practice location within the system of care. Future research should consider exploring methods that might minimize the competitive nature of disparate child-serving systems and its potentially negative impact upon system performance and treatment outcomes.     

Stigma of ink: Tattoo attitudes among college students

We test a structural equations model of stigma against tattooed persons and attitudes toward future tattoos among 195 tattooed and 257 non-tattooed college students. Having tattooed friends and family members undermines stigma against tattooed persons while beliefs about negative side effects of tattooing reinforces stigma assignment. The variables above and the respondent having a tattoo predict attitude toward future tattoos. We test a second model, stigma victimization, drawing on data from the 195 tattooed respondents. While greater tattoo abundance results in greater stigma victimization, respondents with more tattoos also report a greater commitment to their current tattoos and less desire for removal. We discuss results using attitude theory, stigma theory, and the contact theory of prejudice.     

Recursive politics: prevention,modernity and social systems

The aim of this paper is to connect the recent interest in prevention to recent developments in social theory. It begins by recovering some of prevention's essential features from the realm of common sense, showing that what is taken to be the common sense of prevention is emblematic of modernity. For prevention is built on scientific understandings of cause and effect and the possibility of prediction; on a capacity for controlled intervention by government in social life; on a universal value base; on the authority of professional expertise; on rational, calculating, individual social subjects. As this order develops and changes, many of its constituent elements begin to be threatened by social processes which it has itself set in train. Prevention is affected by (and implicated in) these changes, too. But far from being eclipsed by them it becomes more prominent. Drawing on systems theory, the paper argues that prevention meets the essential purpose of boundary maintenance by which the functioning of social systems is sustained. For reasons both external and internal to welfare agencies, including an increased burden of social risk and increasing organisational complexity, this need to mark and maintain system boundaries is ever more pressing. At the same time, at least part of the problem of the fragility of boundaries is attributable to attempts to maintain them. It is for this reason that preventive policy making can be described as recursive, or self-propelling. Copyright © 1999 John Wiley & Sons, Ltd.