Implementing a college mental health program – an overview of the first twelve months

Objective: To evaluate the demographics and clinical utilization patterns among college students during the initial 12 months of a novel, multi-disciplinary, collaborative, college mental health program (CMHP). Participants: Undergraduate and graduate students receiving treatment at the CMHP from Jan-Dec 2015. Methods: De-identified data was obtained via electronic health records for all students receiving care through the CMHP. Results: 1.2 FTE clinical providers treated 278 undergraduate and graduate students during the year (65.1% < age 26, 53.6% female, 49.6% caucasian). There were 1822 CMHP outpatient visits, 318 other medical visits and 103 total emergency room (ER)/inpatient visits. Ten students were identified as high utilizers of ER/inpatient services, while charges to the CMHP totaled $470,157 and total charges to the Health System were $2,378,315. Conclusions: Students with complex psychiatric/medical co-morbidities received cost effective, convenient and integrative treatment. Over time, we hope to intervene earlier and decrease ER/inpatient visits.     

Towards a performative understanding of deservingness: Merit,gender and the BBC pay dispute

Drawing largely on a high‐profile case of unequal pay at the BBC (British Broadcasting Corporation) as an illustrative example, this conceptual article considers differences and interrelationships between merit and deservingness, where the latter captures how, through appropriate performances, merit is given recognition and value. We propose a performative understanding of deservingness that highlights its gendered and embodied dimensions. Informed by Judith Butler's account of gender performativity, we show that, while merit is conventionally conceptualized as a relatively fixed set of attributes (qualifications, skill) 'attached' to the individual, deservingness captures how, in gendered terms, value and recognition are both claimed and conferred. As we argue, a gendered, deserving subject does not pre‐exist but is performatively constituted through embodied practices and performances of what is seen as worthy in a particular time and place.     

UNMARRIED PARENTHOOD AND REDISTRIBUTIVE POLITICS

Political survey data for nine West European countries show that women have become increasingly left‐wing compared to men, and that this trend is positively correlated with the rise of nonmarriage in these countries. This pattern is mirrored in German longitudinal data (GSOEP), where transitions out of marriage make women, but not men, significantly more left‐leaning. Analysis of public spending data for high‐income OECD countries (1980–1998) suggests that the political impact of nonmarriage extends to the allocation of State resources with increases in nonmarriage first reducing, and then increasing, State redistribution towards children. (JEL: H31, H42, J12, J13)     

A Study of the Promotion to Partner Process in a Professional Services Firm: How Women are Disadvantaged

Increasing numbers of women are attracted to careers in the professional services. However, when their progress is considered to partner positions, it is found that they are not advancing to the levels anticipated. When the literature in relation to the partnership promotion process is explored, we find explanatory models are rare, and rarer yet is work that considers the impact of sex bias on the process. The article adds to the limited work available by presenting findings from a behavioural process perspective through an empirical study with male and female management consultants in a professional services firm which indicates that the promotion to partner process is indeed sex biased. Two areas of disadvantage for women are identified: the presence of a self-managed career advancement process necessitating a proactive approach to demonstrating individual contribution; and the need to ‘fit’ a prevailing model of success within the firm which is a masculine model and is more problematic for women. The article calls for a differentiated treatment of the glass ceiling phenomenon, capable of capturing disadvantage accruing from societally based factors and sector-based factors. The implications of the findings for future research and professional service firms are discussed.     

Human Motivation and Professional Practice: of Knights, Knaves and Social Workers

Efforts to improve the efficiency and responsiveness of public services by harnessing the self‐interest of professionals in state agencies have been widely debated in the recent literature on welfare state reform. In the context of social services, one way in which British policy‐makers have sought to effect such changes has been through the “new community care” of the 1990 NHS and Community Care Act. Key to this is the concept of care management, in which the identification of needs and the provision of services are separated, purportedly with a view to improving advocacy, choice and quality for service users. This paper uses data from a wide‐ranging qualitative study of access to social care for older people to examine the success of the policy in these terms, with specific reference to its attempts to harness the rational self‐interest of professionals. While care management removes one potential conflict of interests by separating commissioning and provision, the responsibility of social care professionals to comply with organizational priorities conflicts with their role of advocacy for their clients, a tension rendered all the more problematic by the perceived inadequacy of funding. Moreover, the bureaucracy of the care management process itself further negates the approach's supposedly client‐centred ethos.     

“The Paper that You Have in Your Hand is My Freedom”: Migrant Domestic Work and the Sponsorship (Kafala) System in Lebanon

A recent report on migrant domestic work in Lebanon has cited psychological disorder among Lebanese “Madams” as the leading cause of violence against their migrant maids (Jureidini, 2011, www.kafa.org.lb/StudiesPublicationPDF/PRpdf38.pdf ). This report typifies much of the existing scholarship on the experiences of migrant domestic workers (MDWs) in the Middle East, where the focus is on employer–employee relationships, especially the abusive Arab “Madam.” In this paper, I argue that the portrayal of violations of MDW rights as abuse of one set of women by another is inherently problematic on several fronts. It privatizes the structural problem of workers’ and immigrant rights violations, delegates it to the household, and absolves the state of its responsibility. Moreover, the focus on abusive employers takes attention away from the root of the problem – the inherently exploitative system of migration and recruitment in the region, the sponsorship system. The sponsorship system not only creates conditions for much of these violations, but also systematically produces a new population of readily exploitable worker – the category of “illegal workers.” Oral histories and interviews with individual workers are employed to analyze the process by which illegal workers are “produced” in Lebanon. Finally, focus group discussions highlight critical policy recommendations made by the workers themselves, which address the systemic bases of their exploitation in Lebanon.     

The Public Face of a Private Domestic Violence

This article looks at violence against women in Indian society and gives an example of a best-practice response to domestic violence. It is divided into two parts. The first part of the paper examines the general characteristics of violence against women within India as a whole and the state of Andhra Pradesh in particular. The second part gives an example of the anti-arrack movement in Andhra Pradesh, a state in India, as an example of women's mobilization against government policy on liquor as a response to domestic violence. The paper aims to reconstruct this movement at the micro level using the experiences of women who were its chief participants.     

Micro‐pensions in India: Issues and challenges

This article aims to fill a gap in the social security literature on India by examining the role of micro‐pensions. The analysis suggests that because of the heterogeneity of the target population, micro‐pension products — with microfinance institutions (MFIs) as the main, but not only sponsors — should be voluntary and portable and permit experimentation in their design and in the delivery of services. Accordingly, decentralized micro‐pension schemes that operate within an appropriate regulatory framework and according to sound governance practices are deemed more fitting for the Indian context than centralized schemes with limited flexibility. The article discusses two case studies of recently‐initiated micro‐pension schemes in India, which reveal the need for rigorous analytical research on the micro‐pension sector, particularly concerning the structuring of pay‐out options and innovative delivery mechanisms. The article concludes that micro‐pensions have the potential to be one of the most useful components in India's multi‐tiered social security system, and should be encouraged.     

“It May Be Her Eggs But It’s My Blood”: Surrogates and Everyday Forms of Kinship in India

This ethnographic study of commercial gestational surrogacy in a small clinic in western India introduces the concept of “everyday forms of kinship”—kinship ties as the product of conscious everyday strategy, and, at times, as a vehicle for survival and/or resistance. The surrogates’ constructions of kinship as a daily process disrupt kinship theories that are based solely on biology. So, too, do they disrupt the patrilineal assumptions made in studies of Indian kinship. Kinship ties instead find their basis in shared bodily substances (blood and breast milk) and shared company, as well as in the labor of gestation and of giving birth. By emphasizing connections based on shared bodily substance and by de-emphasizing the ties the baby has with its genetic mother and the men involved in surrogacy (the genetic fathers and the surrogates’ husbands), the surrogates challenge established hierarchies in kin relationships—where genes and the male seed triumph above all. Simultaneously, by forming kinship ties with the baby, the intended mother, and other surrogates residing with them, surrogates in India form ties that cross boundaries based on class, caste and religion and sometimes even race and nation. By focusing on the notions of blood (shared substance) and sweat (labor) as basis for making kinship claims, this study both extends anthropological literature that emphasizes the non-procreative basis of kinship and feminist works that denaturalize kinship ties and make visible the labor involved in forming kinship ties and maintaining a family.