CMHS/CSAT Collaborative Demonstration Program for Homeless Individuals

The Collaborative Demonstration Program for Homeless Individuals is providing an opportunity for several community agencies in the United States to explore innovative intervention and treatment strategies to address the needs of homeless people with co-occurring (mental illness and substance abuse) disorders. This cooperative agreement, funded jointly by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT), is a $3 million project supporting programs in various community agencies to develop, document, and evaluate programs for persons who are homeless with co-occurring disorders to be used as models in other communities. The program models include: Assertive Community Treatment, Psychosocial Rehabilitation, Therapeutic Community, and an integrated treatment model. The first phase of the two-phase project funded 16 programs in the U.S. to develop manuals within their primary treatment modalities for homeless people with co-occurring disorders. For Phase II of the project, six of the 16 model programs were competitively selected to demonstrate program impact through formal program evaluation efforts. The data derived from the various projects will be compiled into a compendium of information for state agencies and community service providers throughout the U.S.     

Demarcating forest, containing disease: land and HIV/AIDS in southern Zambia

The ongoing HIV/AIDS pandemic in southern Africa continues to manifest itself in unexpected ways. While the consequences of the disease appear straightforward in some aspects—e.g., medical, labor, cost—in other respects the repercussions, while large, are nonetheless highly nuanced and can be counterintuitive. This paper reports on the intersection of HIV/AIDS, migration, livelihood adaptation, land tenure, and forest conservation, to outline how adaptation to the pandemic has reworked significant aspects of land tenure to result in increased forest conservation in southern Zambia in the near to medium-term. The research uses a combination of ethnography, case studies, household survey and spatial analyses and finds that HIV/AIDS is used in customary legal settings to enhance land access. We also draw links to practical and theoretical implications of the relationship between HIV/AIDS, land tenure, and deforestation in Sub-Saharan Africa.     

Coming of age

Those of us who study aging have the unique opportunity to live their subject matter. Whether we learn any personal lessons is a matter of our own reflectivity, but personal experience can make us far better scholars than can scholarship alone. As one ponders the life course, it is clear that a number of institutional influences, temporal patterning, and unexpected intervening variables are involved in the unfolding of one's life. Life-long institutional memberships furnish social capital that helps establish parameters for our personal experience, for how we view our personal trajectories and for our ability to cope with the aging process itself. But how to come to terms with unexpected occurrences that alter the anticipated futures we had in mind? Do our scholarly efforts and our experience come together in ways that enrich one or the other? These are the questions I explore in this personal essay.     

Defining Nations in Asia and Europe: A Comparative Analysis of Ethnic Return Migration Policy1

We argue that regional comparison of East Asian and European ethnic return migration policy offers important new perspectives on nationhood, nondiscrimination norms, and trans‐nationality. We find that despite international nondiscrimination norms, preferential ethnic return policy is common in both regions. These policies at least implicitly define the nation as existing across borders. However, there are significant regional differences. East Asian states use co‐ethnic preferences instrumentally for economic goals and also offer preferential treatment of co‐ethnic foreign investors. European states offer preferences to coethnics to protect these populations or express symbolic ties, sometimes at great expense. Thus, in Europe the state has an obligation to assist coethnics abroad, but in Asia, foreign coethnics assist the state.     

The Enchantment of Agriculture: State Decentering and Irrigated Rice Production in Bali

This article explores state involvement in the ‘enchanted’ aspects of irrigated rice production in Bali, Indonesia. Modernising states invariably forward what Max Weber called the rationalisation and disenchantment of the world. In irrigation management, the Indonesian colonial and postcolonial states operated staunchly on this model. ‘Enchanted’ elements of Balinese rice production involving temples and rituals were assumed irrelevant and sidelined. Recently, however, bursts of state-funded construction of irrigation temples and shrines suggest a surprising shift. The post-Suharto decentralised state appears to be supporting the enchantment of irrigated agriculture. This article deals with the relationship between legislation under the decentralised state and ritual building activities in Balinese irrigation associations (subak). We examine how contemporary farmers view the new emphasis on ‘ritual technology’. Does it constitute decentralised support of the farmers' world, of local priorities and variance, or a new homogenising project?     

Individual and Household Values of Mortality Reductions with Intrahousehold Bargaining

I derive alternative measures of maximum willingness to pay (WTP) and value of statistical life (VSL) for selfish members of two-person households who bargain efficiently over consumption of individual and household goods. There is then no systematic bias in letting one member conduct the valuation on behalf of the household. Public-good VSL may exceed private-good VSL when each member attaches (selfish) preferences to survival of the spouse, and to any income from a surviving spouse in period 2. When period 2 is a retirement period and household members’ incomes are fixed, interview surveys tend to overvalue VSL due to ignored negative effects of own survival on private of public pension budgets.JEL Classification: I12, G22, J17     

On the Inside: A Narrative Review of Mental Health Inpatient Services

This paper describes and discusses the results of a narrativereview of inpatient mental health services in the UK. Four mainthemes emerge from the review: the growing pressure on inpatienthospital services; the negative experience of inpatient servicesreported by many service users; the problematic nature of hospitaldischarge; and possible alternatives to hospital admission.This review also suggests that a failure to recognize and acton what appears to be happening in hospitals could result ininpatient care once again being subject to the scrutiny andcriticism that cast a shadow over psychiatric services in the1960s and 1970s. To stop this happening, current governmentpolicy is right to focus attention back onto acute care throughnew guidance and by commissioning research. However, changesalso need to take place at a practice level so that front lineworkers are familiar with conditions in local acute servicesand can challenge unacceptable behaviour/services in supportof their service users. With current changes in the make-upof local mental health services and a greater emphasis on partnershipworking between health and social care, it may be that socialcare practitioners can do this not only from the outside, butincreasingly ‘on the inside’ (from within integratedhealth and social care organizations).     

Everybody needs good neighbours: an evaluation of an intensive project for families facing eviction

This paper presents details of a largely qualitative evaluation of an intensive multi‐method Project, with a residential component, which aims to help families facing eviction to overcome their housing‐related difficulties. The families served by the Project had a host of other problems related to parenting, with child care and protection issues, addictions and mental health difficulties figuring prominently. Just over half the referrals came from the local authority housing services, with nearly all the remainder coming from the social work department. The majority of families made good progress, but in some cases it proved harder to have an impact on parenting than on tenancy‐related matters. Nevertheless, the Project was deemed to have helped some families stay together or be reunited, resulting in substantial financial savings for social work services. Crucial ingredients were good management, stable staff, shared ‘ownership’ by other agencies, a repertoire of challenging methods, and a holistic approach.     

The Criminal Justice System and the Politics of Scrutiny

The criminal justice system remains largely untouched by over a decade of scrutiny and restructuring of public services by consecutive Conservative administrations. This is despite the system's lack of accountability, absence of clear objectives, prolific unfettered spending patterns, and discrepancies in its treatment of suspects and offenders at all stages of the prosecution process as witnessed by regular and embarrassing “mishaps”. This paper explains the apparent contradictions in the New Right's social policy agenda showing how the overtly Thatcheritepolicies of “law and order” with its own brand of moral authoritarianism continues to immunize and protect the professional players on the criminal justice stage from the policies of scrutiny and consequent change. Ironically, it is argued, criminal justice and penal policy is one area of social policy where the machinery of appraisal, audit and management by objectives would be highly beneficial. Paul Wilding provided stimulating and helpful comments on the first draft of this paper and Howard Parker helped me to keep the contradictions of the system as the theme of the paper.