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Welfare Reform on the Web (October 2010): Mental health services - overseas

A consideration of medicalisation: choice, engagement and other responsibilities of parents of children with autism spectrum disorder

K. Valentine

Social Science and Medicine, vol. 71, 2010, p. 950-957

Classic studies of medicalisation point to the 'rise of the experts' as disempowering patients and refusing to acknowledge their expertise in their own lives. In an apparent shift from medicalisation, individual choice is increasingly privileged in the delivery of health and human services. This paper reports on a qualitative study of the experiences of parents of young children with autism conducted in four states in Australia in 2008-2009. It discusses the burden of choice and responsibility with which parents are often presented, and the strategies used by practitioners and policymakers to engage parents as decision-makers while also trying to minimise that burden. It highlights the confusion and anxiety experienced by some parents who were obliged to make decisions for which they felt ill-equipped. Other parents took on the responsibility of choice and engagement, becoming experts in their child's symptoms and in the research literature and practices of treating autism.

Falling through the cracks: gaps and barriers in the mental health system for America's disadvantaged children

E.H. Bringewatt and E.T. Gershoff

Children and Youth Services Review, vol. 32, 2010, p. 1291-1299

The system for providing mental health services to children in the US is fragmented and complex, and families face multiple barriers to accessing care. Children in low-income families have the highest rate of under-use of services, in spite of disproportionally high levels of need. This article provides a brief overview of the history of children's mental health policies, followed by an outline of the types of service currently available which highlights the problems with the system. This is followed by a discussion of the barriers that families face in accessing care.

Landscapes of care: comparative perspectives on family caregiving

A. Power

Farnham: Ashgate, 2010

Given the increasing shift of care from state residential services to community-based support, this book examines the complex geographies of family caregiving for young adults with intellectual disabilities. It traces how family 'carers' are directly and indirectly affected by a broad array of law and policy, including family policy, disability legislation, and health and community care restructuring policy. Each of these has material and institutional effects and is premised on the discourses, ideologies, and interactions in the state over time. Focusing on the welfare models of England, the US and Ireland, this book compares the welfare ideologies in each country and examines how the specific historical, cultural, and political contexts give rise to different landscapes of care and disability. Further, the book explores the everyday lives of family carers of young adults with intellectual disability within the broader landscape of care in which they are situated.

Mental health of refugees and asylum seekers

D. Bhugra, T. Craig and K. Bhui (editors)

Oxford: OUP, 2010

Throughout the world the number of refugees and asylum seekers continues to increase at an astonishing rate. Given that most will have left their country due to persecution, war, or appalling violations of their human rights, many will have specific mental health needs. Cultural and socioeconomic factors play a major role in expressions of distress, help seeking, pathways into care, and acceptance or rejection of treatments. Being a refugee or asylum seeker raises questions about an individual's self respect and altered identity. Too often though, the needs of this population are ignored by policy makers and clinicians, and these people are left to fend for themselves. This book presents both the theoretical and practical aspects of the mental health needs of refugees and asylum seekers. It looks at the impact of migration on mental health and adjustment, collective trauma, individual identity, and diagnostic fallacies. A practical section highlights cultural factors, therapeutic interaction, therapeutic expectation and psychotherapy. The final part of the book focuses on special problems - such as bereavement, sexual violence, and post traumatic stress disorders, as well as considering mental health problems in special groups, such as child refugees.

Outcome measurement in mental health: theory and practice

T. Trauer (editor)

Cambridge: CUP, 2010

In order to operate in an evidence-based fashion, mental health services rely on accurate, relevant, and systematic information. One important type of information is the nature of the problems experienced by recipients of mental health care, and how these problems change over the course of time. Outcome measurement involves the systematic, repeated assessment of aspects of health and illness, either by service providers, service recipients, or both. From outcome measurement clinicians and service recipients achieve a common language whereby they can plan treatment and track progress, team leaders and managers secure a basis to compare their services with others and to promote quality, while policy makers and funders derive evidence of effectiveness. This book presents a global perspective on outcome measurement and compares and contrasts practices around the world.

User-oriented mental health reform in Sweden: featuring 'professional friendship'

U. J. Berggren and E. Gunnarsson

Disability and Society, vol. 25, 2010, p. 565-577

Desinstitutionalisation in psychiatric care and subsequent difficulties experienced by mental health service users in exercising their rights as citizens have brought about the need to implement new forms of community-based support. In Sweden, representations from user organisations led to the introduction in 2001 of the new role of 'personligt ombud' or personal ombudsman (PO), to provide short-term individual support. This article describes the characteristics of the Swedish PO through the actual experiences of service users, focusing on what they found to be most helpful in their relationships with their PO.

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