Using social support for LGBTQ clients with mental illness to be out of the closet,in treatment,and in the community

ABSTRACT

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are often faced with societal challenges that can lead to mental health or substance abuse issues. They may be misunderstood or mistreated when seeking services because of a lack of training in offering culturally sensitive treatment by service providers. A program, the Rainbow Heights Club, was developed to support LGBTQ individuals with a mental health diagnosis. All of the members are in treatment for their mental health and/or substance abuse problems, but prior to the development of the program did not have a place to feel accepted, supported, or have a sense of community. Members were surveyed determine if Rainbow Heights was helpful in maintaining themselves in the community. Results indicated that 75% of members are more consistent in following prescribed treatments, keeping them free from inpatient hospitalization, and 79% reported being clean and sober since coming to the Club.     

The barriers to the effectiveness of culturally sensitive practices in health and social care services for Chinese people in Britain

This paper studies the problem that health and social care practitioners, intending to satisfy their ethnic minority users’ cultural preferences, end up providing services against their wishes. In particular it points out that this problem is caused by over-emphasising two key assumptions of ethnic minority groups. The first assumption is that all members of the same ethnic minority group organise their health and social care according to their cultural principles. The second assumption is that their cultural principles are monolithic. Demonstrating that these two assumptions may not necessarily be applicable to all ethnic minority groups, this paper discusses the diverse strategies used by Chinese people in Britain to organise their health and social care, and the differences between their two important cultural principles, Taoism and Confucianism. In order to demonstrate to professionals and the Government that they should not over-emphasise these two assumptions and that they need to pay attention to ethnic minority groups’ diverse needs, the paper suggests that different ethnic minority groups may need to unite to increase their influence in the service provision process. However it also warns that this tactic may lead to the subordination of minority group interests in the articulation of those large groups.

     

Organizational structure,leadership and readiness for change and the implementation of organizational cultural competence in addiction health services

Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed.     

Understanding the role of Australian Aboriginal maternal infant care workers: bringing a cultural dimension to a critique of the ideal worker concept

Models of care that include a prominent role for Aboriginal workers are fundamental to improving the health of Aboriginal Australians. However, tension arises when these models co-exist with mainstream models, contributing to difficulties sustaining an Aboriginal workforce. The ‘ideal worker’ theory is drawn on to explore whether historical workplace norms undermine the roles of Aboriginal workers in an Australian hospital setting. In-depth interviews were conducted with 30 staff and clients of an innovative maternity service, featuring Aboriginal Maternal Infant Care (AMIC) workers caring for Aboriginal women in partnership with midwives. A phenomenological methodology highlighted that unrealistic and inappropriate assumptions embedded in the ideal worker notion underpin many challenges facing AMIC workers. These workers have deep ties to their communities, with extensive responsibilities beyond the workplace. Although the hospital system relies on these ties to engage clients, this time commitment and the unbounded ways in which AMIC workers provide care are not acknowledged. Findings illustrate how the ideal worker concept has a cultural and gender dimension, which undermines AMIC workers and does not value culturally relevant care. This work has implications for ingraining cultural competence into health care, suggesting the wide-ranging contributions of Aboriginal workers must be recognised to achieve sustainable reform.     

Disaster Relief and Crisis Intervention with Deaf Communities: Lessons Learned from the Japanese Deaf Community

ABSTRACT

During natural disasters and crises, the deaf and hard of hearing community might not have full accessibility to all of the information shared with the larger hearing community. This could be due to the lack of awareness among social work professionals about these cultural and linguistic needs of this minority population. The purpose of this article is to explore the challenges faced by the deaf community and to discuss culturally and linguistically appropriate crisis intervention and mobilization to natural disaster situations based on the experiences of the Japanese deaf communities affected by the Kobe and Tohoku earthquakes.     

The impact of the COVID-19 pandemic on the mental health and well-being of children and young people

The COVID-19 pandemic has had an enormous impact across the world. In this discussion paper, we examine the effect that lockdown has had on the mental health and well-being of children and young people. We write from a UK perspective in the light of the international evidence. Many of the discussion points raised resonate globally. We discuss how these issues can be dealt with and set out potential solutions as we emerge from this global crisis.     

Time to ask and tell: Voices of older gay and bisexual male veterans regarding community services

ABSTRACT

This participatory action study involved lesbian, gay, bisexual, transgender, and queer (LGBTQ) veterans in determining community-based service needs for health and wellness, illuminating perspectives of older LGBTQ veterans regarding community services. This study explored veterans' perceptions of being LGBTQ later in life. The study included data from interviews with gay and bisexual male veterans ages 51 to 87. Participants valued engagement as part of community. Their recommendations for action included communal meals, transportation, housing, and the coming-out process. Community services facilitated community engagement to support health and wellness for LGBTQ older veterans. The authors used participatory action research (PAR), a method of systematic inquiry integrating the perspective of persons living the experience, to organize the study. Further PAR is recommended to implement community services to meeting health and wellness needs of participants.     

Reducing bias through indirect social contact: assessing the impact of student involvement with faculty-led research on unauthorized immigration

This paper explores how working on a faculty-led research project influenced the views of Master of Social Work students concerning unauthorized immigrants. Five graduate assistants worked for one year with two faculty members and one doctoral student to code data from interviews with social workers at immigrant-serving organizations in South Carolina. The master’s students then reflected on what they learned from participating in data analysis tasks, indicating that the experience had further sensitized them to the social justice concerns confronting unauthorized immigrants. Drawing on social contact theory, we argue that student participation in faculty-led research can provide a form of indirect social exposure to other groups, which reduce bias, and suggest that such experiences be included in how educators conceptualize the implicit curriculum in schools of social work.     

Using participatory and creative methods to facilitate emancipatory research with people facing multiple disadvantage: a role for health and care professionals

Participatory and creative research methods are a powerful tool for enabling active engagement in the research process of marginalised people. It can be particularly hard for people living with multiple disadvantage, such as disabled people from ethnic minority backgrounds, to access research projects that are relevant to their lived experience. This article argues that creative and participatory methods facilitate the co-researchers’ engagement in the research process, which thus becomes more empowering. Exploring the congruence of these methods with their professional ethos, health and care professionals can use their skills to develop them further. Both theory and practice examples are presented.     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.     

Modeling the impact of social discrimination on the physical and mental health of Portuguese gay,lesbian and bisexual people

Background: Despite growing acceptance of same-sex sexuality in Portugal, identity development of lesbian, gay and bisexual (LGB) individuals is still restricted by negative societal attitudes, which maintain the experience of stigmatization and discrimination. The purpose of this study is to document the frequency of discriminatory events experienced by sexual minorities and their association with indicators of physical and mental health in Portugal. Methods: A total of 610 LGB participants completed an online survey (mean age?=?34.48, SD?=?11.54). Most participants were single and self-identified as gay (73.8%). The survey included five categories of survey items: demographic information, social support, physical health, mental health, and discrimination experiences. Results: Physical and mental health results revealed that bisexual people were more likely to report higher levels of psychological distress than gay men. Overall, between one-fifth and one-fourth of the participants in this sample frequently felt the need to hide their sexual orientation to prevent discrimination experiences across the different settings. Regarding actual discrimination experiences, close to 20% reported having suffered from verbal abuse, followed by close to 10% who suffered from written threats, harassment, and physical threats. A hierarchical multiple regression analysis was performed to assess the effects of anticipated and actual discrimination on mental health. Possible confounding variables were added in the first block – age, sexual orientation, being in a relationship, body mass index, and HIV status. Anticipated and actual discrimination experiences were added in the second block. The first block of the analysis explained 6% of the overall variance, while the second block – discrimination experiences – explained an additional 17%. Conclusion: Portuguese culture and stigma/discrimination create discriminatory experiences which impact LGB people's health. Unless policies are changed to allow for the acceptance of LGB people, they will continue to experience violence and discrimination as a result of homophobia.     

The role of source and the factors audiences rely on in evaluating credibility of health information

In the wake of public relations crises of credibility such as FEMA's staged press conference in response to the California wildfires, source credibility merits increased scholarly and practitioner scrutiny in order to maximize the effectiveness of the information practitioners release, particularly when the objective is to promote action vital to public health and well-being. Through a random national telephone survey (n = 400), this research analyzes how the source itself moderates credibility as well as the criteria important to audience evaluations of credibility. Results indicate practitioners are perceived as credible sources of health information and that audiences take a rather mindful route in their evaluations of source credibility.     

Exploring long-term economic well-being and child outcomes with the Supplemental Poverty Measure: evidence from the Panel Study of Income Dynamics

This study is the first to use the Supplemental Poverty Measure (SPM) to reexamine the relationships between long-term economic well-being and child outcomes. We decompose the differences between the Official Poverty Measure (OPM) and the SPM and examine such relationships with 15 cognitive, physical, and social–emotional outcomes for 754 ten- to nineteen-year-olds as reported in the Panel Study of Income Dynamics (PSID) 2007 Child Development Supplement. Using PSID data from 1998 to 2006, we measure long-term economic well-being using the average natural logarithm of the ratio of family resources to the poverty threshold with a series of models, beginning with the OPM and converting it step-by-step into the SPM. We find that some steps in constructing the SPM, especially including in-kind benefits and using the SPM thresholds, weaken the relationships between our economic well-being measure and the cognitive outcomes, although including in-kind benefits strengthens the relationships with many of the physical and social–emotional outcomes. Better understanding the relationships between different poverty measures and outcomes of interest can open new avenues for research on mitigating the adverse effects of poverty and could perhaps allow us to better target interventions to individuals who are at greatest risk for adverse outcomes.     

Prevention in integrated children's services: the impact of sure start on referrals to social services and child protection registrations

Every Child Matters, the English government's plans for integrated children's services, proposed that preventative approaches such as those developed through Sure Start should be able to reduce the numbers of children requiring more intensive support from children's social services and, by implication, the numbers of children on the child protection register. This study examined the impact of Sure Start local programmes (SSLPs) on four local authorities with social services responsibilities in the northeast of England. The researchers analysed routinely collected statistical data concerning over 10,000 referrals of children under four years and over 1,600 child protection registrations (CPRs) in an eight‐year period before and after the introduction of 19 SSLPs. They also analysed interviews with 36 key informants in eight case study SSLP areas. Contrary to expectations, the quantitative data revealed no discernable short‐term effect on the numbers of referrals, or on CPRs. Interview data showed broad agreement on the potential impact of preventative work undertaken by SSLPs and many respondents believed that it was too early to draw conclusions. Alternatively, the universal approach to prevention within the Sure Start areas and the attempts to provide non‐stigmatising and non‐intrusive community‐based services may be ineffective in reducing the need for intensive support for ‘at risk’ families. The findings are discussed in relation to ‘targeted’ prevention programmes and government policy intentions. Copyright © 2007 John Wiley & Sons, Ltd.     

Decrypting cultural nuances: using drama techniques from the theatre of the oppressed to strengthen cross cultural communication in social work students

ABSTRACT

Despite widening participation in social work education in the UK, social work students from black and minority ethnic (BME) backgrounds can find that they have less positive experiences on social work courses than their counterparts. This can happen when courses do not equip students to navigate the subtle rules of communication with service users that are premised on dominant UK values. As a consequence BME students can be assessed as having poor interpersonal skills and poor skills in engaging service users. However, the issue is often more one of cultural differences and high expectations of cultural integration than one of incompetence.

This paper reports on a drama workshop using techniques from the Theatre of the Oppressed to foster awareness of the complexities of cross cultural communication that BME students may face. The workshop facilitates insight into the nuances of culturally informed values that differ from dominant UK values.

Drawing on student workshop evaluations, the authors highlight the positive use of techniques from the Theatre of the Oppressed as a pro-active pedagogical approach to equipping BME students with insight and skill to circumnavigate cross cultural communication in practice and develop awareness of empowering strategies to combat negative paradigms about BME cultures.     

Living on a knife edge: the responses of people with physical health conditions to changes in disability benefits

Abstract

This article documents the experiences of people with a physical health condition or disability who have experienced a loss of or change in disability benefits under the welfare reform programme in the United Kingdom. A theoretical model was constructed using in-depth interviews and grounded theory methods. The findings show that participants experienced the benefits system as dehumanising, and felt that they lived in a judgemental and invalidating society, where they were perceived as ‘scroungers’ and faced discrimination from others. These experiences negatively affected their mental and physical health and well-being. They also negatively affected participants’ identity, leading to experiences of shame, hopelessness and social isolation. However, many participants attempted to resist these negative impacts (e.g. through seeking support or taking political action). The findings demonstrate the significant impact of benefit changes on well-being and identity, thus highlighting important implications for claimants, and staff in healthcare, the benefits system and government.