Evaluation approaches in mental health: Implications of the new federalism

Since the introduction of federal mental health legislation in 1963, there has been a changing emphasis on evaluation and accountability. With direct federal funding of community mental health services, accountability demands were met through expectations for local agency evaluation activities which were overseen by federal authorities. The advent of the New Federalism and the shift to block grant funding of mental health services to state mental health authorities have shifted responsibility for evaluation to the states and local programs. This paper reviews federal mental health statutes to trace the extent and locus of required evaluation activities and discusses two approaches to carrying out program evaluation: "top-down" where the evaluation topic, method, and data collection are mandated by an administering or funding body; and "bottom-up" approaches where the subject, method of study, and data to be collected are developed in response to a felt need at the local agency level. A case study of each approach as used at the state level in mental health is examined. Based on the literature and the case studies, conclusions are presented on the pro's and con's of each method in meeting accountability demands and the barriers which must be overcome for either method to be successful.     

Permissions and the social context

By focusing on formal intensive interview research, this essay explores how the sociohistorical context influences the routine procedures by which sociologists obtained permission to conduct their studies. We examine the permissions process within the specific historical context of the 1950s and contrast it with contemporary issues of informed consent. The need for a more theoretical and situational understanding of permissions is identified, both in regard to human—subjects regulations and social control. Her most recent books areMadwives: Schizophrenic Women in the 1950s (Rutgers University Press, 1987) andGender Issues in Field Research (Sage, 1988). She has written extensively in the fields of mental illness and social control. Her current research focuses on the sociological analysis of art and culture as well as the processes of doing and writing fieldwork. She is also the co-managing editor of theMid-American Review of Sociology.     

The Mexicans and “Us Gringos”: A Case Study of Activist Work With Unauthorized Migrants

Lacking access to social services, unauthorized Mexican day laborers constitute a vulnerable population. This case study uses a critical theory perspective to examine activist efforts to support migrants when professional social workers were unavailable. Using qualitative methods, this study sought to answer three questions: (1) What strategies did unauthorized day laborers and activists deploy to contest anti-immigrant sentiments in a suburban community; (2) how were these strategies shaped by the workers' subterranean status as undocumented and poor; and (3) what are the implications for social work practice? This study seeks to delineate interventions and to identify how migrants themselves perceive such efforts.     

Narratives of exile twenty years on: long-term impacts of Indonesia’s 1998 violence on transnational Chinese-Indonesian women

ABSTRACT

In response to Indonesia’s 1998 riots, which included mass rape of Chinese-Indonesian women, many Chinese-Indonesian families sent their daughters out of country to try and ensure their safety. Drawing on interviews with Chinese-Indonesian women currently living in Singapore and Australia, this article considers the long-term effects on transnational families of this departure. In contrast to current views of Chinese-Indonesians as an affluent diaspora, we show Chinese-Indonesian women’s experience to be that of exile, living outside Indonesia with little possibility of permanent return. We illuminate the subtle and enduring effects of political violence on women’s marital, reproductive, and childrearing practices. Interviews reveal fragmented identities and contingent household formations which enabled family resilience for some but created long-term fissures for the majority. We argue for more critical attention to how gender mutually constitutes experiences of exile, and the long-term impacts of political violence on reproduction and family relations for Chinese-Indonesian women.     

Working mothers,injury and embodied care work

In this article, we examine how mothers respond when injury interrupts maternal care, using the lens of embodied care, which we conceptualize as a form of ‘body work’. We draw on findings from a qualitative research project with two organizations in Australia that help people with injuries to return to work, examining the experiences of workers who are also mothers of dependent children. Mothers' inability to care for children during periods of injury was a significant concern for our interviewees; constraints on physical labour and physical affection were particularly troubling, indicating the importance of embodied maternal caregiving to maternal roles. Yet, while these mothers inhabited the spheres of paid work and unpaid care work simultaneously, service providers did not consider embodied care work or its relevance to injured women's ongoing needs for support. While our findings reflect the experiences of injured women, they also suggest the need for a materialist analysis of the ways that both paid work and care activities are deeply enmeshed in and through the bodies of those doing the work. Employers and service organizations still fail to recognize maternal ‘body work’, and this may be typical of social attitudes more widely.     

Qualitative insights into women's personal experiences of perinatal depression and anxiety

Background and aimSymptoms of perinatal depression and anxiety are usually described and understood from a nosological perspective. This research sought to gain insight into women's lived experience of postnatal depression and anxiety, the factors that contribute to these symptoms and the context in which they develop.MethodFace to face and telephone interviews were conducted with 28 women from metropolitan and rural areas across Australia, who had experienced postnatal depression and/or anxiety within the last five years. Analysis was conducted from a grounded theory perspective.FindingsParticular symptoms of anxiety and depression develop in the context of the numerous changes inherent to the transition to motherhood and contribute to a common experience of frustration and loss. Symptoms were also associated with feelings of dissatisfaction with the pregnancy and motherhood experience.ConclusionsThe findings provide useful insights into women's experiences of mental health symptoms during the perinatal period, how these symptoms present and the factors involved in their development and maintenance. The need to consider women's perspectives to develop resources and health promotions strategies, as well as within the context of relationships with health professionals is highlighted. The study emphasizes the need for greater, more accurate information surrounding perinatal depression and the need to increase the profile and awareness of anxiety disorders.     

Females and Precarious Board Positions: Further Evidence of the Glass Cliff

The ‘glass cliff’ posits that when women achieve high profile roles, these are at firms in precarious positions. Previous research analysed appointments (male/female), estimated the precariousness of firms involved and drew inferences about the glass cliff. This study is different as it directly tests the relationship between a precarious situation and changes in board gender diversity. The sample is companies listed on the UK stock exchange reporting an initial loss in the years 2004–2006. A matched control sample is used in a difference‐in‐differences analysis to avoid inadvertently attributing improvements arising from societal/regulatory changes in gender diversity to the loss event. Findings suggest that when the loss is ‘big’ there is a difference in the increase in gender diversity versus both the control and the ‘small’ loss subsamples, i.e. compelling evidence of the glass cliff. In the context of ongoing political and social debates about women on boards our work (i) identifies continuing structural barriers for women ascending to board level in that women are more likely to be over‐represented on boards of companies that are more precarious and (ii) sounds a note of caution about celebrating increased gender diversity on boards without considering the precariousness of the company involved.     

Abstinence-Based Versus Service Learning Prevention Education in Small Groups: Effects on the Life Plans of Young Adolescents

The purpose of this study was to assess the impact of two types of pregnancy prevention programs on youths’ behavioral intentions. Before and after participating in a series of adolescent pregnancy prevention support group meetings guided by abstinence OR service learning curricula, 88 youth, ages 13 and 14 years, forecasted their future life plans. Repeated measures analysis with two groups by two time points was conducted to assess changes in life forecasts over time and differences between the programs. From pre-test to post-test in the abstinence-based program there was reduction in plans to have first baby before marriage (p < .05). There were no significant changes in youths’ forecasts regarding sexual debut in either group. Implications for research and practice are discussed.     

PROJECTIVE IDENTIFICATION IN COMMON COUPLE DANCES

This paper integrates the object relations concept of projective identification and the systemic concept of marital dances to develop a more powerful model for working with more difficult and distressed couples. This integrated model explains how some couples use the defenses of splitting and projective identification to externalize and transpose internal conflicts into interpersonal conflicts in five common marital dances. The author suggests how object relations techniques can be used to interrupt the projective identifications, help clients to reown their disowned and projected affects and resolve the conflict on the intrapsychic level so that the marital dance is no longer necessary to resolve the intrapsychic issues.