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Welfare Reform on the Web (June 2004): Mental Health Services - Overseas

GEOGRAPHICAL VARIATION IN ACUTE PSYCHIATRIC ADMISSIONS WITHIN NEW YORK CITY 1990-2000: GROWING INEQUALITIES IN SERVICE USE?

M. Almog and others

Social Science & Medicine, Vol. 59, 2004, p.361-376

The paper examines geographical inequalities in patterns of use for inpatient psychiatric care in New York City. It considers links between population characteristics and use of inpatient psychiatric facilities in order to identify "types" of area where people make the most use of hospital mental health services. Psychiatric inpatient admissions and bed days were also analysed to determine whether hospitalisation became more or less concentrated during the 1990s. Results show that areas close to psychiatric hospitals have high admission levels. As the decade progressed, high admission levels were also increasingly concentrated in zip code areas with a high poverty ratio, African American residents or persons living alone. The paper offers several explanations for these findings, but concludes that the trends are more likely to result from changes in hospital management and funding affecting access to services rather than increasing intensity of poverty in disadvantaged areas.

RATIONING SANITY: ETHICAL ISSUES IN MANAGED MENTAL HEALTH CARE

J. L. Nelson

Washington D.C.: Georgetown University Press, 2004

The ethical issues of managed care are more pronounced for mental health than for other areas, yet little systematic attention has been paid to them. This book includes contributions to the ongoing effort to rethink professional and institutional values in the managed care environment. It focuses on both the ethics of allocating scare resources in health care and current controversies in mental health.

SATISFACTION WITH LIVING ARRANGEMENTS OF OLDER ADULTS WITH INTELLECTUAL DISABILITY: SERVICE USERS' AND CARERS' VIEWS

A. O Rourke

Journal of Learning Disabilities, Vol. 8, 2004, p.12-29

Researchers interviewed 92 Irish people with learning difficulties aged over 40 living in residential homes or with parents or guardians. A questionnaire addressing service users' living arrangements was completed by 103 carers or guardians. Service users identified physical features of living arrangements, the provision of activities and staff as primary contributors to satisfaction. Dissatisfaction arose from staff issues such as hindering personal independence, impatience and personnel shortages. Service users living with family were more likely to report being happy but also to report loneliness than those resident in group homes.

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