Compounding the trauma: the coercive treatment of voice hearers

For more than a hundred years, voice hearing has been treated as a symptom of serious mental illnesses with biological origins. Pharmaceutical companies have expanded the range of products targeted at treating these illnesses and the diagnosis of schizophrenia now underpins a multi-billion dollar, world-wide business. Throughout the western world, nation states have vested an authority in psychiatry to compulsorily treat people who meet a set of diagnostic criteria that is widely discredited. There is considerable evidence that more effective ways of responding to people experiencing psychosis can be provided without coercion. These approaches differ in essence to traditional Kraepelinian psychiatry in that they acknowledge the role of people's life experiences in creating the problems they face, and the professionals work in partnership with the service users. The approaches recognise that people have histories which often include considerable trauma and social workers are in an ideal position to work with voice hearers to help them understand their experiences and to develop ways of coping. The authority vested in psychiatry is not static and within Europe mental health professionals can contribute to changing what is meant by ‘unsound mind’ and extending the right of liberty to voice hearers. In doing this, social workers can ensure that they do not compound the trauma by devaluing and discrediting people's experience.     

Comment on Cross,Fine, Jones,and Walsh (2012): Good Therapeutic Services— Therapeutic Advocacy and Forensic Neutrality

Cross, Fine, Jones, and Walsh (2012 Cross, T. P., Fine, J. E., Jones, L. M. and Walsh, W. A. 2012. Mental health professionals in children's advocacy centers: Is there role conflict?. Journal of Child Sexual Abuse, 21(1): 91–108. [Taylor & Francis Online] , [Google Scholar]) provided a thoughtful review and critique of a book chapter describing the interview process at Child Advocacy Centers. They observed some of the ways that concerns raised in that chapter are being addressed and described revised guidelines that further clarify issues. Ongoing research and examination of the important processes carried on by child advocacy centers and the role fulfilled by mental health professionals in the investigation of child sexual abuse contributes positively to service delivery.     

Circumstances Change Cases: Local Government and the NHS

The role of local government in health care matters in Britain has never been trouble-free. From the dissolution of the Boards of Guardians in 1929, through to the creation of the NHS in the 1940s and the introduction of the internal market in the 1990s, there have been political and professional arguments surrounding the issue and, for the most part, the case for democratic local governance of health care has failed to carry the day. This paper looks back to earlier debates, examines the current policy context, and looks ahead to possible future scenarios. It argues that the changing circumstances of both the NHS and local government makes this an apposite time to rethink established structures.     

The journey effect: how travel affects the experiences of mental health in-patient service-users and their families

The qualitative study presented in this paper explored the perspectives of service-users, family members and staff about the impact of travel issues on the lives of mental health in-patients and carers. This topic was chosen because it was prioritised by members of Xplore, a service-user and carer research group, and has received little research attention. Travel problems were a significant issue for many service-users and carers, bound-up with mental health issues and the recovery experience. Travel facilitation through the funding of taxis and the provision of guides was appreciated. A few service-users and carers positively valued distancing from their previous home environment. The meaning of travel issues could only be understood in the context of individuals’ wider lives and relationships. The significance of the findings is discussed in relation to the social model of disability.     

'Normal' Life in a Hazardous World: How Adults with Moderate Learning Difficulties and Their Carers Cope with Risks and Dangers

Semi-structured interviews were conducted with 20 adults with moderate learning difficulties attending Adult Training Centres and with their informal carers. Interviews covered friendships, relationships with the opposite sex, leisure and independent living and were analysed using a grounded theory approach. Ways of dealing with hazards emerged as an important theme. Hazards could be seen as dangers to be avoided or as risks to be calculated and minimised. Adults and informal carers usually viewed hazards in a similar way but there were conflicts of view in some families. Treating hazards as dangers to be avoided appeared to be associated with professional or skilled manual social background and the presence of both parents in the household.