Social Work in the Emergency Department—Implementation of a Domestic and Family Violence Screening Program

Abstract

Women who have experienced domestic and family violence use health services more frequently than women who have not. Early identification and intervention by the health system may reduce health problems associated with domestic and family violence and lead to savings for the health sector. This study aimed to evaluate the impact of a new domestic and family violence screening program, which was based on an ecological model and introduced by a social work team in the Emergency Department of a major metropolitan hospital. The evaluation method included an audit of social work case files to assess the effect on referral rates and a survey of Emergency Department staff to obtain perceptions of the impact of the program on the staff and clients. In the 3-month period following the introduction of the program, the rate of referral to social work increased by 213%. Staff agreed that the Emergency Department is an appropriate place to ask about domestic and family violence, under certain conditions. Findings suggest that an ecological social work model provides an approach to screening for domestic and family violence that not only contributes to increased identification and supportive client interventions but may also contribute to more sustainable systemic change.     

International Policy Perspectives on Independence in Old Age

The promotion of independence in old age has become a common principle in aging policies internationally. The term independence, however, has a variety of meanings that are shaped by social/political/economic contexts and the values and attitudes toward older people. Interpretations of independence affect the ways in which policies are translated into strategies and services. The promotion of independence features prominently in the aging policies of the United Nations and the World Health Organization but does not fit well with the cultural values and social contexts of some countries. A comparison of aging policies in four countries—Australia, Denmark, India, and United Kingdom—found that the principle of promoting independence is not universally adopted. The author proposes that the profile and meaning of independence in policy is shaped by values surrounding individual, family, and social responsibilities. Consideration is given to the limitations and culturally bound nature of independence as a policy principle.     

Rights to research: utilising the Convention on the Rights of Persons with Disabilities as an inclusive participatory action research tool

For those labelled disabled, disability rights are synonymous with human rights, not merely a sub-category. In this paper we consider disability rights in terms of the right of people labelled with learning difficulties to be actively involved in research. Examples from an inclusive participatory action research project undertaken in partnership with people labelled with learning difficulties demonstrate how the Convention on the Rights of Persons with Disabilities was operationalised using photo-voice to facilitate accessible research, analyse findings and promote social change.     

Methodological considerations in using complex survey data: an applied example with the Head Start Family and Child Experiences Survey

Complex survey data are collected by means other than simple random samples. This creates two analytical issues: nonindependence and unequal selection probability. Failing to address these issues results in underestimated standard errors and biased parameter estimates. Using data from the nationally representative Head Start Family and Child Experiences Survey (FACES; 1997 and 2000 cohorts), three diverse multilevel models are presented that illustrate differences in results depending on addressing or ignoring the complex sampling issues. Limitations of using complex survey data are reported, along with recommendations for reporting complex sample results.     

Complex sample data recommendations and troubleshooting

Complex survey data, as highlighted in this issue of Evaluation Review, provide a wealth of opportunities for answering methodological and/or applied research questions. However, the analytic issues of nonindependence and unequal selection probability must be addressed when analyzing this type of data. Thus, to ensure that research questions are accurately answered when using complex survey data, researchers must take extra precautions to ensure complex survey data are correctly analyzed. The purpose of this article is to provide software recommendations for analysis of and tips on troubleshooting when analyzing complex sample data.     

The relationship between maternal depression and child outcomes in a child welfare sample: implications for treatment and policy

Maternal depression is an extremely important parenting variable in relation to child general health. This investigation addressed the issue of maternal depression as it relates to the lives of children seen by child welfare authorities. Maternal depression was investigated in the context of the increasing rate of children coming to the attention of the London and Middlesex Children's Aid Society. A variety of child outcomes including those of particular relevance to child welfare, specifically disorders of attachment and neglect and physical abuse, school‐related variables, conduct disorder and psychological distress, were investigated. The relative contribution of maternal depression along with measures of socioeconomic status and social isolation to childhood risk was examined. Results indicated that the rate of maternal depression doubled during the years 1995–2001. Maternal depression was related to children entering care through wardship. Additional poor child outcomes such as attention deficit disorder, conduct disorder and emotional adjustment were also related to maternal depression. The findings are discussed in terms of treatment and policies that can lower the risk to children through effective intervention with depressed mothers.     

Language Policy and Provision in Social Service Organizations

This paper reports the findings of a survey into minority languagepolicy and provision in social service departments and largevoluntary social service agencies in England and Wales. It foundthat many organizations lacked specific policies on the provisionof services to minority language communities and that most werepoorly prepared to meet their needs.     

Volunteers, families and children in need: an evaluation of Family Friends

This paper explores the findings from a small‐scale research project that analysed the impact of Family Friends – a voluntary agency that provides support to families under stress who have children aged between 5 and 11 years. The study, funded by Family Friends, evaluated service users’ perceptions of the support they received, specifically in relation to the significance and impact of the volunteer befrienders. The research identified that there are a proportion of families in need who fail to attract services from mainstream statutory agencies. It also identified that the Family Friends voluntary agency makes a particular contribution to service provision by offering a friendly, non‐stigmatizing, caring and responsive service.     

THE ASSOCIATION OF POVERTY WITH CHILD WELFARE SERVICE AND CHILD AND FAMILY CLINICAL OUTCOMES

The influences of poverty, family status and violence in the lives of children and families seen at a large urban children's aid society are investigated. Rates of social assistance dependency of child welfare families in 1995 and 2001 are compared. While the rate of poverty of child welfare families is stable across the two time periods, the ability of families to cope with poverty has dramatically changed, with the percentage of children from impoverished families being admitted into care nearly doubling across the six-year period. Violence as a mitigating factor in the relationship between poverty, the extent of child welfare service and child and family outcomes is also reported. Suggestions for enabling women who are caught in the complexity of choosing between physical safety and poverty are reported.

Les influences de la pauvreté, de la position sociale de la famille et de la violence sur la vie des enfants et des familles vues à une grande société urbaine d'aide à l'enfance sont examinées. Les taux de dépendance des familles vis-à-vis des programmes de protection de l'enfance en 1995 et 2001 sont comparés. Tandis que le taux de pauvreté des familles qui se servent du système de protection de l'enfance est stable à travers les deux périodes de temps, la capacité des familles de faire face à la pauvreté a radicalement changé, le pourcentage d'enfants de familles appauvries qui sont placés dans des familles d'accueil ayant presque doublé à travers la période de six ans. On fait aussi compte-rendu de la violence comme facteur atténuant dans le rapport entre la pauvreté, l’étendue du service de protection des enfants et les résultats pour les enfants et les familles. On résume aussi des suggestions favorisant l'habilitation des femmes qui se trouvent coincées dans la complexité de choisir entre la sûreté physique et la pauvreté.