Community care for adults with severe mental disorders in rural China: A case study

In China, family care is the dominant form of care for people with mental disorders. Since 2004, the government has been developing a community‐care model that places more responsibility on community organisations and the local governments at the provincial, municipal and county levels for the provision of formal care. As a large number of people with severe mental disorders live in rural China, this case study was conducted in a rural county in order to examine the development of community care. It was found that, although family care remains dominant, families’ need for formal care is increasing. Community services have improved, but their development is constrained by several contextual and micro factors. In this study, it is argued that the community‐care model introduces a process of reconfiguration of the relative responsibility for care among the family, social organisations and the government, but progress depends on further administrative and fiscal reforms.     

Open Data on a Closed Shop? Assessing the potential of transparency initiatives with a focus on efforts to strengthen capacity development support

Despite strong political commitment, actual gains in improving accountability in development co‐operation have been limited. Main reasons for this include the low level of transparency and high number of actors, as well as the limitations of the self‐reported and input‐oriented OECD reporting system. Efforts through the International Aid Transparency Initiative (IATI) and related transparency initiatives are ill‐equipped to change this given their decision to adhere to the same system. This article uses the specific area of support to capacity development to illustrate this. While further disaggregation of reporting on technical co‐operation could respond to a transparency gap, overcoming the accountability gap requires moving beyond promoting ‘supply‐side’ reform and re‐engaging in efforts to promote collective action.     

An evaluation capacity building toolkit for principal investigators of undergraduate research experiences: A demonstration of transforming theory into practice

This paper describes the approach and process undertaken to develop evaluation capacity among the leaders of a federally funded undergraduate research program. An evaluation toolkit was developed for Computer and Information Sciences and Engineering¹ Research Experiences for Undergraduates² (CISE REU) programs to address the ongoing need for evaluation capacity among principal investigators who manage program evaluation. The toolkit was the result of collaboration within the CISE REU community with the purpose being to provide targeted instructional resources and tools for quality program evaluation. Challenges were to balance the desire for standardized assessment with the responsibility to account for individual program contexts. Toolkit contents included instructional materials about evaluation practice, a standardized applicant management tool, and a modulated outcomes measure. Resulting benefits from toolkit deployment were having cost effective, sustainable evaluation tools, a community evaluation forum, and aggregate measurement of key program outcomes for the national program. Lessons learned included the imperative of understanding the evaluation context, engaging stakeholders, and building stakeholder trust. Results from project measures are presented along with a discussion of guidelines for facilitating evaluation capacity building that will serve a variety of contexts.     

Implementation of a school-wide prevention programme-teachers’ and headmasters’ perceptions of organizational capacity

This study focuses on schools’ organizational capacity to implement a Swedish school-wide programme, Prevention in School (PS). It is based on semi-structured interviews with seven headmasters and 13 teachers from seven Swedish schools. The interviews were analyzed by the use of qualitative content analysis.The findings show that the adoption of a comprehensive intervention like PS challenges the school organization as the staff encountered a variety of organizational barriers when implementing the programme. Factors connected to lack of consensus, collaboration and insufficient programme management were the main barriers that were identified. Teachers wanted a more extensive support from their headmasters in terms of participation in different programme activities. It was emphasized that peer coaches need to be prepared for their task, although the headmasters found it difficult to be able to choose those teachers who they perceived as the most suitable.It is concluded that leadership, coaching and staff selection need particular attention when implementing a programme like PS, since those factors have been defined as important implementation drivers, both in this study and previously.     

Flood Risk Management: US Army Corps of Engineers and Layperson Perceptions

Recent severe storm experiences in the U.S. Gulf Coast illustrate the importance of an integrated approach to flood preparedness planning that harmonizes stakeholder and agency efforts. Risk management decisions that are informed by and address decision maker and stakeholder risk perceptions and behavior are essential for effective risk management policy. A literature review and two expert models/mental models studies were undertaken to identify areas of importance in the flood risk management process for layperson, non‐USACE‐expert, and two USACE‐expert groups. In characterizing and mapping stakeholder beliefs about risks in the literature onto current risk management practice, recommendations for accommodating and changing stakeholder perceptions of flood risks and their management are identified. Needs of the U.S. Army Corps of Engineers (USACE) flood preparedness and response program are discussed in the context of flood risk mental models.     

Recovery From Mental Health Problems: Scratching The Surface Without Ethnography

This article examines a central plank of mental health policy (‘recovery’) in societies which have attempted to reverse the long-term warehousing of those with a diagnosis of mental disorder (de-institutionalisation). The emergence of the concept is traced in relation to the shift from an institutional to a more dispersed and community-based form of service organisation. Different usages of the term ‘recovery’, each with distinct implications for practice are considered on the part of three main interest groups (traditional bio-medical psychiatrists; social psychiatrists emphasising social skills training; and dissenting service users). These different usages suggest that ‘recovery’ is a polyvalent concept that creates an uneasy consensus point to define the management philosophies of local services enacting mental health policy. Also mental health work is about more than the group of patients mainly considered in relation to recovery (those with ‘severe and enduring mental health problems’). Practice-near research strategies are now required to investigate the varied practical scenarios these contradictions generate and ethnographic research is therefore indicated. Without multiple ethnographies, we will be left with competing rhetoric about recovery and its meaning or meanings may be rendered worthless.     

Enhancing the Career Planning Self-Determination of Young Adults with Mental Health Challenges

The impact of an intervention on the self-determination and career planning engagement of young adults with mental health challenges was studied. Sixty-seven young adults, 20 to 30 years of age, with mental health diagnoses (e.g., depression, bipolar disorder) were randomly assigned to intervention and control groups. Statistically significant greater increases were made by the intervention group versus the control group for self-determination and career planning engagement, and self-determination at least partially mediated increases in career planning engagement. With career planning self-determination interventions, young adults with mental health challenges might be able to achieve better career and life outcomes than is typical for this population.     

Videoconferencing in Telepsychiatry

SUMMARY

Interactive videoconferencing is an easy, fast, and relatively inexpensive method of providing psychiatric services over long distances. The experiences of telepsychiatry practitioners have been promising in Finland, Norway, the United Kingdom, the USA, Canada, and Australia.

The first practical telepsychiatry experiments in Finland were carried out at the Department of Psychiatry of the University of Oulu, where videoconferencing has been used for family therapy, psychiatric supervision, consultation, patient negotiations, and teaching. During 1998, out of a total of 400 hours, 35% of the online time was used for teaching, 24% for occupational counseling, 21% for consultations and patient negotiations, and 20% for methodological development and other activities (mainly testing the connections). The costs of inpatient negotiations via teleconferencing is half those of conventional negotiations. In general, cost analyses have also shown that telepsychiatric services are economically cost-effective in most European countries and in Australia, where a relatively small number of connections exists, while in the USA and Canada, high telecommunications costs make telemedicine more prohibitive compared to conventional care.     

Supportive Housing for Addicted,Incarcerated Homeless Adults

ABSTRACT

Homeless populations often suffer from mental illness, substance abuse, and criminality. Interventions, such as supportive housing, can have positive impacts, although benefits can be limited. This study examined outcomes for clients (N = 102) of a new supportive housing intervention. Use of formal treatment, jail contact, and community stability were compared pre- and post-housing. Jail bookings and residential substance abuse treatment significantly declined post-housing, while clients improved in income level, access to food, and housing stability. Results from official justice and treatment system data suggest that supportive housing can lead to significant changes. Future research is necessary to understand the relationship between client characteristics and outcomes.     

Client Personality,Working Alliance and Outcome

Abstract

The relationship of the five-factor model of personality to working alliance, symptoms and well-being was examined in a diverse community mental health sample (N = 103). Agreeableness, openness, extraversion and conscientiousness were associated with alliance. Neuroticism was strongly associated with symptoms, and negatively associated with well-being. Extraversion was moderately associated with well-being. Personality is deserving of further study as a potentially important influence on therapy process and outcome. Part of the much-replicated association of alliance with outcome may be accounted for by personality. Implications for social work practice and research are discussed.