Collaborative care for individuals with bipolar disorder or schizophrenia and co-occurring physical health conditions: A systematic review

While rates of chronic physical health conditions are increasing for the general population, individuals with severe mental illness are at greater risk. Co-occurring mental and physical health conditions are associated with poor health care utilization, socioeconomic, and patient-reported health status outcomes. This study used systematic review procedures to investigate the effectiveness of collaborative care models for improving the health of adults with bipolar disorder or schizophrenia and co-occurring chronic physical health conditions. Six studies met inclusion criteria, and included outcomes related to quality of life, physical health, and mental health. Collective and study-level results are reported and discussed, including implications for social work practice and research.     

Lights,camera, action: The images of foster care in the movies

Movies often reflect public perceptions. The portrayal of foster care in movies provides insight regarding beliefs and attitudes children, parents, and others bring with them as they interact with the foster care system. The study focus was to identify images of foster care portrayed in 37 nondocumentary movies produced in the United States and Canada between 1921 and 2012. Using Framing Theory, an iterative review process was used to derive three dominant images presented to audiences: child entrance into foster care, a broken foster care system, and life in foster care. Movie images generally misrepresented the realities of foster care in the United States, highlighting the importance of those involved in child custody and providing a more realistic image of foster care.     

Increasing College Access and Retention Rates of Youth in Foster Care: An Analysis of the Impact of 22 State Tuition Waiver Programs

Youth in foster care face educational disparities in terms of college access, retention, and graduation. To address this, 22 states have implemented tuition waiver programs targeting current and former foster youth. A comparative analysis was conducted of all 22 programs implemented since 2014. Similarities include student eligibility based on youth’s age upon foster care entry, university admission and time in care requirements. Differences include type of expenses covered, time limits on use, program oversight, and funding availability. No differences were found based on political party control, gubernatorial power, and state population composition. Recommendations for policy and practice reform are offered.     

Intergenerational Care Perceptions of Older Women and Middle Adolescents in a Resource-Constrained Community in South Africa

ABSTRACT

This study describes intergenerational care perceptions in a resource-challenged community. Ten women (aged 60+) and eight middle adolescents (3 boys and 5 girls) participated in the Mmogo-method®, a visual data-collection method. Textual data were analysed thematically, and visual data by applying Roos and Redelinghuys (2016) proposed steps. Both groups provided physical and instrumental care to the other. Older women cared for adolescents by teaching and disciplining them, while the adolescents cared for them by obtaining an education and by showing respect. Older women felt being cared for when adolescents helped them, obeyed and complied with instructions and discipline, while the youngsters expressed it when their basic needs were addressed and school attendance was enabled. Older women’s expressions of caring about were vague, while the younger people detected, act and elicited reactions from the elders. The adopted care approach informed care perceptions. Joint intergenerational activities are proposed to discover care currencies and contributions of generational members.     

Factors that Influence Physical Activity among Residents in Assisted Living

ABSTRACT

The purpose of this study was to examine factors that influence physical activity among residents in assisted living. This was a secondary data analysis using baseline data from a function-focused care intervention study including 171 residents from 4 assisted living facilities. Using structural equation modeling, we found that mood, satisfaction with staff and activities, and social support for exercise were directly associated with time spent in physical activity. Gender, cognition, depression, and comorbidities were indirectly associated with physical activity and accounted for 13% of the total variance in physical activity. Implications for future research and social work practice are presented.     

Helping foster youth find a job: a random‐assignment evaluation of an employment assistance programme for emancipating youth

A primary task for youth aging out of foster care is finding and maintaining a job. In recognition of the challenges that foster youth face, employment assistance has become an important part of child welfare agencies' efforts to prepare youth for emancipation. The current study uses random assignment to evaluate the impact of an employment assistance programme for foster youth on the rate of employment, income and other self‐sufficiency outcomes among a group of adolescents in substitute care in Kern County, California. Data were collected via multi‐wave, in‐person interviews of 254 foster youth. At the second follow‐up interview, only two‐fifths of the sample report being employed. However, three‐quarters of the sample are either working or attending school, and a quarter reports both working and attending school. Nevertheless, significant minorities report experiencing financial hardships and receiving financial assistance. No statistically significant impacts of the evaluated programme are found on any measured employment or self‐sufficiency outcome. Implications for child welfare policy are discussed.     

The impact of parental incarceration on children's care: identifying good practice principles from the perspective of imprisoned primary carer parents

Parental incarceration has wide‐ranging impacts on families. One key effect may be disruption to the care and legal custody of children, yet few studies have examined processes and outcomes relating to care planning for children of prisoners. This paper presents findings of interviews with 151 primary carer prisoners in two Australian states which aimed to address this research gap. The study examined care planning for children upon parental arrest, sentencing and imprisonment, stability of care arrangements and primary carer prisoners' involvement and satisfaction with care planning. Around one third of prisoners had discussions regarding children's care arrangements at arrest and imprisonment, although the issue was more commonly raised at sentencing. While there was much variation in the stability of care arrangements, children placed in out‐of‐home care experienced the most instability. A minority of prisoners reported being involved in care planning and decision‐making for children upon imprisonment, and around one third rated care planning process poorly. Prisoners were more satisfied with care planning when there were fewer movements of children, where prisoners felt involved with decision‐making, and when police officers, lawyers and corrections staff inquired about the welfare of their children. Implications for policy and future research are discussed.     

Risk,resilience and identity construction in the life narratives of young people leaving residential care

The role of residential care for children has developed very differently internationally, but in all cultural contexts, there are questions about the extent to which it can help young people recover from high risk backgrounds. In the UK, residential care has come to be seen as the placement of last resort, yet new government guidance on permanence has suggested that residential care can provide security and a sense of belonging. Narrative analysis of interviews with 20 care leavers identified their different pathways from birth families through residential care to early adulthood. Some experienced a transformation from a negative sense of self as victims or ‘bad children’ to survivors, while others continued to struggle. Key to successful turning points were four interacting factors, all associated with resilience; connection, agency, activity and coherence. These narratives revealed the importance of nurturing relationships and a sense of ‘family’, and also the role of support after leaving residential care, when transitions workers helped them to move on but stay connected. The study highlighted how residential care leavers from adverse backgrounds attribute very different meanings to their experiences, which affects identity construction, resilience and the need for support.     

Is the Lack of Specific Lesbian,Gay, Bisexual,Transgender and Queer/Questioning (LGBTQ) Health Care Education in Medical School a Cause for Concern? Evidence From a Survey of Knowledge and Practice Among UK Medical Students

Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people frequently report negative health care encounters. Medical professionals may inadequately manage LGBTQ persons’ health if they have not received training in this area. An anonymous survey measuring efficacy in health situations among LGBTQ persons was answered by 166 medical students across all years of a UK university. Results show that 84.9% of participants reported a lack of LGBTQ health care education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ patients. Most participants reported that they would not clarify gender pronouns or ask about gender or sexual identity in mental health or reproductive health settings. Participants reported infrequently observing doctors making similar inquiries. Participants held positive attitudes toward LGBTQ patients, with attitude scores positively correlating with LGBTQ terminology knowledge scores (r_s = 0.5052, p < .01). Addressing gender identity and sexuality issues within medical curricula may remove barriers to accessing health care and improve encounters for LGBTQ patients.     

Exploring Perceived Discrimination Among LGBT Individuals in Turkey in Education,Employment, and Health Care: Results of an Online Survey

This article explores the discrimination practices encountered by lesbian, gay, bisexual, and transgender (LGBT) individuals in education, income, employment, and health care in Turkey. Limited quantitative data on LGBT individuals are available in Turkey. This study collected data from 2,875 LGBT individuals through a Web-based survey. The findings suggest that LGBT individuals report perceived direct and indirect discrimination in accessing education, employment, and health care. In a country where LGBT rights are not yet recognized and antidiscrimination legislation covering sexual orientation and gender identity is still nonexistent, findings demonstrate perceived discrimination of LGBTs rarely turns into a legal complaint. Even when they do, most LGBTs in our sample report that they did not feel that the justice system addressed their grievances.