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Welfare Reform on the Web (July 2009): Mental health services - overseas

Community management of intellectual disabilities in Pakistan: a mixed methods study

I. Mirza and others

Journal of Intellectual Disabilities Research, vol. 53, 2009, p.559-570

Pakistan has one of the highest reported rates of childhood intellectual disabilities in the world. Services for such individuals are rudimentary. This mixed-methods study of childhood intellectual disability in Pakistan showed that:

  1. detection is delayed because of the lack of an effective system of routine child health checks
  2. there is a significant time lag between parental identification of developmental concerns and presentation to a healthcare provider
  3. a fundamental barrier to treatment is the lack of awareness of effective interventions which are likely to improve outcomes
  4. management at home consists of physical restraint and strict family supervision
  5. there is significant stigma associated with ID resulting in decreased opportunities for these families to participate in community activities and high levels of stress in carers.

There is a need to develop feasible, cost-effective, community level interventions which can be integrated into existing healthcare systems.

An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research

S. McDaid

Disability and Society, vol. 24, 2009, p. 461-474

Discussions about user involvement in mental health services throw up four major areas of concern: the capacity of service users to participate, their lack of participation skills, the need for a positive organisational culture, and the need for arenas of participation. This article presents evidence from participatory action research with Irish mental health service users which explored how they could more effectively participate in advisory committees. Service users identified barriers to their equal participation which fall within Baker's 2004 equality of condition framework. These include unequal cultural, physical, mental, economic and time resources, stigma, and lack of respect for experiential knowledge.

How employment support and social integration programmes are viewed by the intellectually disabled

J.M. Cramm and others

Journal of Intellectual Disabilities Research, vol. 53, 2009, p. 512-520

During the last decade Dutch healthcare organisations have developed programmes to support the employment of people with learning difficulties in the ordinary workplace, an innovation that follows from a broader government policy to facilitate the empowerment and social integration of such citizens. Supported employment programmes provide assistance in the form of job coaches, transportation, technology, specialised job training and client-specific supervision. This study used the innovative Q-methodology to investigate supported employees' own views of their employment, focusing on the characteristics they felt best contributed to their social integration. Two views on the impact of supported employment on social integration emerged: 'work as participation' and 'work as structure'. The group with the first view placed greater value on participation, task variety, feeling appreciated and belonging, while the second valued working independently, clear working agreements, and friendly co-workers.

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