An Interface Between Mental Health Systems and the Community: Italian Social Cooperatives

ABSTRACT

For more than two decades, Italian B-type social cooperatives have represented a sustainable social business model of working with disadvantaged people, especially the mentally disabled. The purpose of this article is to identify the major factors that make this business model successful. By drawing on his recent work of Italian social cooperatives, including a case study, the author explores organizational goals and repertoires as well as support structures and networks of those organizations. This study explores three major factors that account for the sustainability and growth of this model: good regulation; a supportive system of infrastructures; and democratic operational governance. These make the social cooperative an inspiring example of the outcomes that are possible when the mentally disabled are properly trained in a supportive environment. The social cooperative is a model that could well prove similarly successful if copied in other parts of the world.     

Home for now: A mixed-methods evaluation of a short-term housing support program for homeless families

The use of short-term rental subsidy vouchers offers a new approach to addressing the housing needs of families facing homelessness. In Massachusetts, the Family Home pilot program placed homeless families in housing instead of shelter, providing two years of rental subsidy plus support services with the goal of enabling families to maintain market rate housing. This mixed-method case study complements staff and participant interview data with participant survey and administrative data to evaluate the implementation and short-term outcomes of Family Home in one region. Data point to improved family well-being in housing but also persistent barriers to achieving longer-term housing and economic stability. Of the families who had exited the program at the end of the study, one quarter were able to retain their housing at market rate, only 9% returned to shelter, and one in five moved in with families/friends. Lack of affordable housing in a high rental cost region and jobs that pay living wages were among the major reasons that families struggled to maintain housing. This research points to the need for integrating supportive services from the program's start, including targeted workforce development, to plan for the end of the short-term rental subsidy.     

Strategic Management of Public Interest Organizations

This paper argues that strategic management of a public interest organization not only needs to be aimed at the interests it represents, but it also has to incorporate the organization's internal workings. The functioning of a public interest organization is seen to suffer from a primary dilemma of membership and influence and a secondary dilemma of representation and control. If these dilemmas are not handled adequately, the public interest organization will suffer from a vicious circle of contradiction and conflict, eventually threatening the organization's long-term viability. A case study is elaborated to empirically underpin this proposition.     

“I’m not homeless,I’m houseless”: identifying as homeless and associations with service utilization among Los Angeles homeless young people

Little is known about homeless young people’s identification of being homeless and how that identity may or may not be associated with service utilization. This study of 444 homeless young people attending Los Angeles area drop-in centers explores the associations of demographic characteristics, homelessness characteristics, negative lifetime experiences, mental health symptoms, technology use, and past month service utilization with identifying as homeless. Fifty-two percent of the sample identified as being homeless. Being Black, a current traveler, and history of injection drug use were all significantly associated with a decreased likelihood in identifying as homeless. However, having fair/poor health, accessing shelter services, and reporting one’s own substance use as a reason for homelessness were all significantly associated with identifying as homeless. There are important service implications for reaching young people who are in need of services but may not identify with the target population label of homeless.     

A community of singers: employing exploratory cluster analysis to reveal profiles of psychosocial characteristics among members of a street choir for homeless and formerly homeless individuals

This exploratory study employed cluster analysis to identify profiles of resilience, social support, stress, and mental health among members of a homeless and formerly homeless street choir; we examined the association between choir attendance and cluster membership, and the interaction of cluster membership and race. Respondents (N?=?111, 66% African American, 84% homeless) had participated in the choir for an average of 12 months (SD?=?12.02). We stratified the analysis according to homelessness status. Among those housed, k-means cluster analysis revealed two profiles: (1) relatively resourced but lower resilience, and (2) high resilience. Three profiles emerged among the homeless: (1) psychologically vulnerable, high stress and mental health concerns; (2) relatively resourced, showing average levels of mental health concerns and social support, minimally elevated stress, and higher resilience; and (3) low resilience. Examining the interaction, non-African American, housed participants in the high resilience cluster reported the most frequent choir attendance (M?=?4.00, SD?=?0.00); among the homeless, non-African Americans in the psychologically vulnerable cluster reported the most frequent attendance (M?=?3.88, SD?=?1.25). Results support the need for programs that address higher order needs concurrently with housing; they also highlight the ongoing need to provide particular outreach to minority populations.     

Part III: A student learns casework

Abstract

When homeless and severely mentally ill individuals leave housing programs designed to help them achieve stability, their very lives become at risk. Despite the prevalence of this problem and its potentially life-threatening consequences, there is a complete dearth of case studies examining why clients in programs for the homeless and mentally ill suddenly depart from those programs, and how paranoid and other seemingly unreachable clients can significantly improve the quality of their lives. This single case study, utilizing a naturalistic methodology, provides a before and after picture of a client who precipitously left a housing program, then returned two years later in a state of severe physical and mental decompensation. The study focuses on understanding why the client left the program the first time and what could be done to prevent another premature discharge. The findings point to a lack of coordination of care and problems with stable human interaction on the part of those caring for Charles, and are critical to understanding how to engage successfully with homeless and severely mentally ill clients.     

HIV Seroprevalence and Clinical Characteristics of Severe Inpatient Mentally III Homeless

Two related studies were carried out at a state psychiatric center unit designed for the long-term hospitalization of homeless mentally ill people removed from the streets of New York City and taken to hospitals for psychiatric treatment. The first study, a charl review of 102 patients, documented high rates of severe psychiatric illness, alcohol and other substance use, and untreated medical problems. Patient histories showed significant social disadvantages, including high rates of criminal activity and inability to complete high school or establish long-term relationships. Our second study anonymously tested 87 patients between the ages of 18 and 59 for the presence of HIV antibodies. An overall seroprevalence rate of 5.8% is reported. Men and women in this population are likely to have similar rates of HIV infection. Being young, and Black, or Hispanic appears to be associated with increased risk. This disenfranchised population urgently needs a broad array of social, medical and psychiatric selVices. Assertive community outreach programs are necessary to assure delivery of services to this population.     

信托分层--我国银行不良资产证券化的现实分析

结合信托本身的特点,论述了在我国当前情况下,通过信托分层处置不良资产的难点和价值,并对信托产品的流通机制进行了初步探索.     

论精神病人的社会保障权

精神病人社会保障方面的专门立法尚缺,在鉴定、收治、管控和治疗等各个环节也存在不足,精神病人处于无人监管的状态大量存在,导致精神病人被伤害和精神病人损害社会及他人权利的隐患已成为不能回避的社会问题。政府应该对精神病人实施特殊保护,重视精神病人的社会保障权,建立多元化的保障和防控体系,减少精神病人对社会的危害。