Dependence or Independence: Which Is the Dirty Word?

We are suspicious of the mob, the gang, the enmeshed relationship. We also know no one can be an island. Our heroes tend to be loners – the solo detective, those who live free under the stars – but we esteem individuals who devote themselves to others. We want to belong, but we don't want to be owned. Like a game of Snakes and Ladders, there are trap‐doors and escalators in the theme Dependence or independence: Which is the dirty word? This paper explores the frisson and the conflicts in the complex relationships between dependence and independence. Following an introductory vignette, a schematic account is presented of the diverse ways ‘dependence’ and ‘independence’ can be theoretically interpreted including by systems theory. A deeper attention is then paid to honouring the importance of ‘dependence’ and ‘independence’ as key referents in everyday subjectivity. A first‐person account of mental illness is drawn on to illustrate this theme. A final section examines the implications for family therapy practice that arise from the above analysis.     

Outcomes of a model care coordination program for adults with mental illness under guardianship/conservatorship

Adults with serious and persistent mental illnesses, such as schizophrenia, schizoaffective disorder, and bipolar disorder, who are under guardianship/conservatorship, may experience health care, social, financial, and housing concerns, which can be addressed by care coordination programs. In such programs, providers assist with communication across service sectors, assistance with monitoring of psychiatric care, and support with practical needs. Such programs are understudied in the context of guardianship/conservatorship. Through a review of electronic records for 217 consumers who were enrolled in a model program continuously for 3 years or more, we examined trends before and after enrollment in a model care coordination program for adults with serious and persistent mental illnesses under guardianship/conservatorship. We sought to describe the number of days and rates of hospitalization, emergency room visits, and arrests before and after receiving program services. Comparing utilization among consumers three years pre- to three years post-enrollment, we identified statistically significant reductions in hospitalizations and imprisonment, but no change in state hospitalizations. We also saw some (non-significant) reduction in emergency room visits. Findings provide preliminary evidence of effectiveness of the model program; future efforts could expand its reach to more adults with serious and persistent mental illnesses.     

When political values and perceptions of deservingness collide: Evaluating public support for homelessness investments in Canada

Citizen attitudes toward welfare state investments are often explained by their ideological values and their perceptions of deservingness of welfare recipients, yet recent experimental research has led to the theorization that clear deservingness cues can overwhelm otherwise strong ideological beliefs. We tested these claims with respect to homelessness in Canada using a vignette survey experiment and found evidence that citizens with very different political beliefs can support similar government investments, indeed from a shared sense of deservingness as suggested by recent experimental studies, but that support is anchored by rather different reasons. Key Practitioner Message: ? Citizen support for homelessness investments is jointly mediated by ideology and a sense of the “deservingness” of the beneficiary. ? Emphasizing the broader cost savings to taxpayers from “Housing First” does not make conservative‐leaning citizens more supportive of investments. ? Emphasizing the personal attributes of persons experiencing homelessness rather than abstract statistics may unite progressives and conservatives on “deservingness”.     

Are we doing enough? Stigma,discrimination and human rights violations of people living with schizophrenia in India: Implications for social work practice

ABSTRACT

In India, the human rights of people living with mental illness (PLMI) are poorly articulated and hence less researched. Using in-depth and focus group interviews, this study explores multiple perspectives on stigma, discrimination, and human rights violations of people living with schizophrenia (PLS) within their web of relationships in the city of Mumbai, India. Thematic analysis shows that abusive experiences at home, stigma associated with mental health services and barriers to meaningful employment contribute to human rights violations. Implications for strengthening the role of mental health professionals including social workers to promote, protect and actualize the rights of PLS are stressed.     

Religion,spirituality & chronic illness: A scoping review and implications for health care practitioners

ABSTRACT

While the influence of institutional religion has decreased over the last 40–50 years, research suggests that a substantial proportion of those not attending religious services continue to engage in religious and spiritual practices on their own and refer to religion as a very important aspect in their lives, and as linked to more positive health outcomes, particularly for those living with chronic conditions. This article provides a scoping review to not only highlight the research that views religion and spirituality as valuable tools for coping with chronic illness conditions, but also to highlight research that explores those who may experience some religious/spiritual doubts or a gradual loss of religiosity or spirituality with the diagnosis of chronic conditions. Regardless of a clinician’s beliefs, the authors argue that some awareness training of the value of religion and spirituality for some patients, can be beneficial. In a society facing an increasing plurality of faiths, this is deemed to be an invaluable discussion. In the end, clinical implications will be discussed.     

Does vegetation matter for the criminal behavior among people with serious mental illness?

This study attempts to examine the effect of vegetation on arrests of offenders with and without serious mental illness (SMI). Data from the MacArthur mental health court study were analyzed. Objective arrest data were obtained 12–18 months pre‐ and post‐court involvement between 2005 and 2007. Vegetation data were captured by the normalized difference vegetation index, which can be regarded as a general measure of “vegetation” and linked with GeoID, obtained from the American Community Survey. We analyzed data of sociodemographic factors (e.g., age, gender), crime‐related factors (e.g., age of first arrest), and vegetation in related to the crime on 652 offenders with mental illness. Multilevel negative binomial regression revealed no significant effect of vegetation on arrests among offenders without SMI; however, for those with SMI, a significant variation in vegetation on arrests was found among all study models. Our findings suggest that vegetation is significantly associated with arrests, with a positive effect on reducing the recidivism only among offenders with SMI. Given that practice and policy almost exclusively focus on individual factors of crimes, it is important to have more considerations about how neighborhood factors affect criminal behavior, depending on SMI in order to have more comprehensive methods of crime prevention.     

Joint model for bivariate zero-inflated recurrent event data with terminal events

Bivariate recurrent event data are observed when subjects are at risk of experiencing two different type of recurrent events. In this paper, our interest is to suggest statistical model when there is a substantial portion of subjects not experiencing recurrent events but having a terminal event. In a context of recurrent event data, zero events can be related with either the risk free group or a terminal event. For simultaneously reflecting both a zero inflation and a terminal event in a context of bivariate recurrent event data, a joint model is implemented with bivariate frailty effects. Simulation studies are performed to evaluate the suggested models. Infection data from AML (acute myeloid leukemia) patients are analyzed as an application.     

Adult children of parents with mental illness: Family stigma and coping on sense of self

Family stigma is associated with persistent negative outcomes among adult children of parents with mental illness (ACOPMI). Loss of sense of self has been reported by ACOPMI; however, the role of family stigma on sense of self remains unclear. Additionally, research suggests coping behaviour (i.e. adaptive or maladaptive) influences the effect of stigmatization on sense of self. This study investigated the impact of family stigma and coping on sense of self among ACOPMI (N = 134, 63.4% female). As hypothesized, high family stigma was associated with weak sense of self (p < 0.001), and ACOPMI who endorsed adaptive coping demonstrated higher sense of self than those who coped maladaptively (p < 0.001). Further, coping moderated the relationship between family stigma and sense of self (p < 0.001). Unexpectedly, this relationship was only significant for ACOPMI with adaptive coping skills (p < 0.001). At higher levels of stigmatization, post hoc analysis revealed coping styles did not exert an influence on sense of self. Results suggest family stigma contributes to loss of sense of self among ACOPMI, with adaptive coping being protective only at lower levels of family stigma. Findings highlight the need for a systemic approach to eradicate family stigma.     

微电影线上平台运作形式探讨

从微电影的产业形态看,它的整个产业流程有着明显的互联网平台特性。前期融资平台目前以带资金的任务发布和众筹形式为主。与创作相关的制片平台建设在团队组建、剧本选择等方面起到了作用,但合理的形式尚需摸索。发行、放映环节的线上平台已经初具规模,并且充分体现了微电影的数字化新媒体传播属性。而这些微电影平台脱离传统线下收益的模式,尤其是针对移动媒体的收益形式,是平台发展需要着重探索的方向。     

Gender Differences in Self-Reported Reasons for Homelessness

The purpose of this paper is to illustrate some of the ways in which the perceived pathways into homelessness are socially structured. We do this by examining the relative frequency of 11 different reasons homeless males and females cite for being homeless. Males were more likely to cite the following as their main reasons for homelessness: loss of a job, discharge from an institution, mental health problems, and alcohol or drug problems. Women were more likely to cite the following as their main reason for homelessness: eviction, interpersonal conflict, and someone no longer able or willing to help. Self-reported reasons for being homeless are also related to age, marital status, race, and being a veteran. As expected, they are also linked to receptiveness to treatment. Gender differences in reasons for homelessness may require different approaches to building helping relationships with homeless men and women.