Clinical and Medical Social Work Commons^™

Poverty, Family Support, And Well-Being Of Infants: Mexican Immigrant Women And Childbearing, Margaret Sherrard Sherraden, Rossana E. Barrera

The Journal of Sociology & Social Welfare

Data reveal that despite high levels of poverty, Mexican immigrants have relatively few low birth weight babies. This unusual pattern suggests that there are "protective" social factors mediating the effects of povertyperhaps especially family support. Our study, based on in-depth interviews with immigrant women in Chicago, finds that family support does protect some women from delivering a low birth weight infant but it does not protect women living in extreme poverty. Implications for services to Mexican immigrant women in childbearing years and their families are presented. These findings also speak to broad issues in social policy, especially the need for …

Speak Of The Devil: Rhetoric In Claims-Making About The Satanic Ritual Abuse Problem, Mary Deyoung

The Journal of Sociology & Social Welfare

This paper uses Toulmin's (1958) scheme to conduct a rhetorical analysis of claims being made in the construction of the satanic ritual abuse of children problem. The analysis reveals that the persistence of these claims over the last fifteen years is the product not of their compelling facts or their effective conclusions, but of their persuasive warrants. These implicit, "self-evident truths" resonate well with recent cultural concerns about the vulnerability of children to abuse, and the satanic menace.

Market Mechanisms And Consumer Involvement In The Delivery Of Mental Health Services: A Uk-Us Comparison, Wes Shera

The Journal of Sociology & Social Welfare

Both the United Kingdom and the United States Are in the midst of health care reform. By focusing on services for the severely mentally ill this paper compares recent developments in managed care in the U.S. and care management in the U.K. It particularly focuses on the use of market mechanisms and consumer involvement in these reforms.

Multicultural Clients: A Professional Handbook For Health Care Providers And Social Workers. Sybil M. Lassiter.

The Journal of Sociology & Social Welfare

Sybil M. Lassiter, Multicultural Clients: A Professional Handbook for Health Care Providers and Social Workers. Westport, CT: Greenwood Press, 1995. $65.00 hardcover.

Attention Deficit Disorder And Case Management: Infusing Macro Social Work Practice, Dennis D. Long

The Journal of Sociology & Social Welfare

Intervention with children with attention deficit disorders is complex and requires change at multiple system levels using a social work perspective. Case management, macro social work practice, time allocation issues, the structure of a professional self, constraints in expanding a narrow definition of the social worker, and specific macro level intervention areas for social workers are examined in this context.

Feminization Of The Aids Epidemic, Mark S. Kaplan

The Journal of Sociology & Social Welfare

Although males still constitute a substantial number of persons with AIDS, it is becoming clear that this is a disease affecting women and minority populations more adversely. Today women, while representing approximately 16 percent of all AIDS cases nationwide that are reported to the Centers for Disease Control, make up the fastest-growing segment of the population with AIDS. This article contends that AIDS is increasingly afflicting women who have little economic, political, or social power. Furthermore, misdirected public policy has been partly responsible for the greater incidence of the disease in certain regions and populations.

Women Who Hurt Themselves. Dusty Miller.

The Journal of Sociology & Social Welfare

Dusty Miller, Women Who Hurt Themselves. New York: Basic Books, 1994. $22 hardcover.

Defining Success: The Politics Of Evaluation In Alcohol And Drug Abuse Treatment Programs, James L. Wolk, David J. Hartmann, William P. Sullivan

The Journal of Sociology & Social Welfare

Alcohol and drug abuse treatment programs must respond to several important stakeholders or beneficiaries of services who have an investment in how success is defined. Utilizing data from recent statewide studies of treatment outcomes of alcohol and drug abuse services, this paper concludes that a strict adherence to an abstinence-only model of success, rigidly adopted by many in the treatment industry is counterproductive. Multiple measures of success are essential to fully understand and assess a changing model of intervention in the chemical dependency field.

Social Work, Social Science And The Disease Concept: New Directions For Addiction Treatment, Douglas Frans

The Journal of Sociology & Social Welfare

The perception of alcoholism and other substance abuse disorders as disease entities is a view ardently defended not only among chemical dependency professionals but, increasingly, by the general public as well. Over the past two decades, this perspective has also become so ensconced within the addiction treatment industry that alternative interventions are almost nonexistent even though evidence of their effectiveness is available (Miller & Hester, 1989). And yet, "no leading research authorities accept the classic disease concept" (Fingarette, 1988, p. 3). Competing views are generally characterized as irresponsible, and their sponsors summarily dismissed as dangerously uninformed by disease view proponents …

Client-Driven Advocacy And Psychiatric Disability: A Model For Social Work Practice, David P. Moxley, Paul P. Freddolino

The Journal of Sociology & Social Welfare

This paper presents an innovative advocacy model designed to assist people coping with psychiatric disabilities to fulfill their basic living needs. The model emphasizes the importance of clients defining their own needs for advocacy and then, with the support and assistance of an advocate, taking direct action to fulfill these needs. The model is elaborated in terms of its basic attributes, the interlocking roles of both clients and advocates, the importance of the advocacy relationship, and seven core processes of advocacy. The authors conclude with a discussion of possible effects of introducing the model into social work practice in mental …

Access To Prenatal Care And County Size: Implications For Service Delivery, Ellen E. Whipple

The Journal of Sociology & Social Welfare

The impact of population size across twenty-three west Michigan counties was examined to determine access to prenatal care, low birth weight, and infant mortality. Surveys were completed by forty-five managers of hospitals and county health departments. Service availability, sociodemographic, system-related and lifestyle factors were examined as contributors to perinatal support utilization. Low birth weight and infant mortality were highest in the small- and large-sized counties. Positive birth outcomes in medium-sized counties may have been due to greater availability of infant and child health services through health departments, and the targeting of resources to specific problem areas, such as smoking cessation. …

Families Of People With A Severe Mental Illness: Role Conflict, Ambiguity And Family Burden, James G. Hanson

The Journal of Sociology & Social Welfare

The perspective of families of people with a severe mental illness has become a focus of interest for mental health professionals. This paper reports the results of an ethnographic study of families' perceptions of dealing with a severe mental illness in their midst. The findings suggest that the families face continual role conflict and ambiguity as the illness moves through characteristic stages. Attention is given to the families' experience and needs and to social workers' responsibilities for involving and communicating with such families in order to reduce a portion of their burden.

Reformulation Of The Context Of Community Based Care, Phillip Fellin

The Journal of Sociology & Social Welfare

Community based care has traditionally been defined as residential location. An alternative is presented of including the patient's membership in multiple communities, both geographical and identificational. The literature on social supports is cited as a basis for social integration as a goal.

Structuring Support For Volunteer Commitment: An Aids Services Program Study, Taryn Lindhorst, Ronald Mancoske

The Journal of Sociology & Social Welfare

Since the AIDS epidemic began over a decade ago, the bulk of services for people living with HIV in the community setting have been provided by volunteers. Volunteers are confronted with the stigmatized status of people with HIV and must learn to manage multiple crisis issues. This paper describes research on volunteerism in a buddy program for people living with AIDS and the perceptions of volunteers about the structural supports of the volunteer program. Issues around perceptions of stress and the relationship between bereavement and volunteering are explored.

To Survive And To Thrive: Integrating Services For The Homeless Mentally Ill, Marie D. Hoff, Katherine H. Briar, Kristin Knighton, Angie Van Ry

The Journal of Sociology & Social Welfare

An intervention research project with homeless, chronically mentally ill persons demonstrated that linking rehabilitation services, such as employment skills and psycho-social stabilization, with survival services promotes success in serving this population. The project confirmed the central role of case managers in promoting engagement with mental health services and re-integration into stable community living.

Rediscovering The Asylum, Sharon M. Keigher

The Journal of Sociology & Social Welfare

Spending a night at a typical big city shelter for the homeless has reminded the author of the massive and regimented environment in institutions that she had mistakenly believed no longer existed after the much acclaimed "deinstitutionalization" of America. St. Mary's is run by a religious order attempting to provide charitable care in a nondemanding environment. Many demands are made, however. The lack of privacy and respect for individuality inherent in institutional life tends to erode the "inmate's" very conception of self. It controls their activities, time, and choices, and thus creates barriers to exit. Providing "shelter" for the homeless …

Assessing The Impact Of Serving The Long-Term Mentally Disabled Homeless, Laura E. Blankertz, Ram A. Cnaan, Marlene Saunders

The Journal of Sociology & Social Welfare

Homelessness has emerged as a major social problem. In an attempt to understand this problem, attention has been focused on postulating its causes, describing the individuals who hold this status, and estimating its magnitude. This study assesses the outcome of one social service program for long-term mentally disabled homeless individuals. It includes a synopsis of the state of the art in serving homeless individuals with severe mental health problems; a description of a program created to meet their needs; and an analysis of the outcome of this program.

Homeless Persons' Interest In Basic And Health Services: The Role Of Absolute, Relative, And Repressed Needs, Russell K. Schutt

The Journal of Sociology & Social Welfare

This study describes and explains the interest of homeless persons in housing, economic, and health-related services with intake interview data collected by a large urban shelter for single adults. Shelter guests were most interested in assistance with housing, job, and economic benefits, rather than health services. Three explanations of variation in service interests are identified: the "absolute needs" explanation expects service interests to vary directly with service needs, the "repressed needs" explanation expects service interests to vary inversely with alcoholism and mental illness, while the "relative needs" explanation expects interest in health-related services to be related to health needs, but …

The Withering Of Community Life And The Growth Of Emotional Disorders, Thomas F. Maher

The Journal of Sociology & Social Welfare

The architecture of this essay is as follows: I begin by assaying the communitarian crisis of the modern western world. Second, I offer a brief narrative of the social and cultural variables that foster rootlessness and social disintegration in much of urban industrial life. Third, I state a strong case for how this same process may be systematically undermining the nuclear family as a life-long community, threatening the dependence of children on care-giving adults, and, thereafter, the psychological development of children.

Mental Health Services In Egypt, A. Okasha

The Journal of Sociology & Social Welfare

This paper begins with a historical perspective on mental health care from ancient Egypt to modern times. Current mental health services are described including epidemiological information, the structure of services, and methods of service delivery. Contrasts are made between urban and rural community care systems. The changing demographics of institutional care are analyzed in detail and future plans for psychiatric services are discussed. The recent development of comprehensive interdisciplinary model of service and the founding of a training center for this model is described.

Mental Health Services In Mexico, Teresa Lartigue, Juan Vives

The Journal of Sociology & Social Welfare

The history of mental health services in Mexico is traced from the time of the Spanish conquest to modern times. The present structure of mental health services is outlined as it relates to the overall social services and health\care system in Mexico. Inpatient, aftercare, partial hospitalization, and outpatient service are outlined and described. Levels of service and distribution of facilities and staff by region are given. Methods of intervention are described from traditional healers, to highly specialized modern psychiatry, to innovative community self-management programs. Key issues in the future are financial resources, distribution of services and staff, and ways to …

Mental Health Services: An International Perspective, Thomas R. Holmes, Merl C. Hokenstad

The Journal of Sociology & Social Welfare

This paper provides an introduction to this special edition on international mental health perspectives. The importance of an international perspective is discussed and key questions are raised to provide the reader with a frame of reference for examining the mental health systems in the countries presented. An orientation to some of the current mental health issues in Europe, the United States, and developing countries is given as point of comparison for the reader. Questions discussed relate to the status of institutional care, outpatient services, the composition of mental health staff, the role of community interventions and prevention, and the availability …

Journal Of Sociology & Social Welfare Vol. 18, No. 2 (June 1991)

The Journal of Sociology & Social Welfare

SPECIAL ISSUE ON MENTAL HEALTH SERVICES: AN INTERNATIONAL PERSPECTIVE

• FOREWORD
• MENTAL HEALTH SERVICES: AN INTERNATIONAL PERSPECTIVE - Thomas R. Holmes and Merl C. Hokenstad
• THE DEVELOPMENT OF MENTAL HEALTH SERVICES IN SUB-SAHARAN AFRICA: THE CASE OF RWANDA - Froduald Gatarayiha, Franz Baro, Morton 0. Wagenfeld,
• & Rene Stockman
• MENTAL HEALTH SERVICES IN INDIA - S. Rajkumar
• MENTAL HEALTH SERVICES IN MEXICO - Teresa Lartigue and Juan Vives
• MENTAL HEALTH SERVICES IN EGYPT - A. Okasha
• MENTAL HEALTH POLICY AND PROGRAMS IN ISRAEL: TRENDS AND PROBLEMS OF A DEVELOPING SYSTEM - Uri Aviram
• MENTAL HEALTH SERVICES IN HONG KONG: HISTORY, MODERN …

Mental Health Services In India, S. Rajkumar

The Journal of Sociology & Social Welfare

India has a population of over 800 million of which about 20 million are suffering from a mental illness. In terms of numbers of patients alone, mental health planners are presented with quite a challenge. How the challenge is being met is the topic of this article. Governmental efforts need to be augmented by voluntary agencies and private practitioners for optimal mental health care. Despite deficiencies, India is a pace setter for many developing countries. It has the political will to initiate needed changes. Aftercare services for the mentally ill should be a top future priority.

Mental Health Services In Japan, Kunihiko Asai

The Journal of Sociology & Social Welfare

Modern Japanese mental health services have their beginning with the conclusion of World War II. The system of services has since changed at all levels. New laws affording fundamental rights to mental patients were initiated in 1950, but reforms are in process even today that continue down the path toward more enlightened and specialized care. Demographic data are presented including the number of patients and their characteristics, and the number and kinds of service providers. An outline of the administration of mental health services is provided with special emphasis on institutional care. Future trends are highlighted.

The Development Of Mental Health Services In Sub-Saharan Africa: The Case Of Rwanda, Froduald Gatarayiha, Franz Baro, Morton O. Wagenfeld, Rene Stockman

The Journal of Sociology & Social Welfare

This paper considers several aspects of the evolution, organization and current status of the mental health system of Rwanda. The centerpiece of the Rwandan mental health system is the neuropsychiatric hospital in Ndera. Resource constraints preclude development of an extensive system of specialty mental health care. The World Health Organization has proposed that mental health services can best be delivered in developing countries through decentralization and integration with primary health care services. The accomplishments and problems encountered in implementing this model in Rwanda are described and, based on this experience, some recommendations are offered for other developing countries.

Mental Health Policy And Programs In Israel: Trends And Problems Of A Developing System, Uri Aviram

The Journal of Sociology & Social Welfare

Israel has an ancient history blended together with a relatively brief independent identity. An introductory section provides a backdrop for understanding mental health policies and programs in the context of the cultural and historical background of Israel's people. The second section portrays the nature of the mental health delivery system. The final section focuses on three interrelated issues: the limited development of community mental health services, the dominance of the mental hospital in the provision of mental health services, and the medicalization of mental health services.

Mental Health Services In Hong Kong: History, Modern Development, And Issues, Wai-Kwong Mak

The Journal of Sociology & Social Welfare

This paper provides a comprehensive account of the history, current mental health services, and related-issues in Hong Kong. Psychiatric services provided by the Government such as inpatient, outpatient, and daypatient treatments are highlighted. Community mental health services rendered by the voluntary sector such as the counseling and casework, care in half-way houses, and psychiatric nursing are also discussed. Recent statistical information provides a detailed picture of psychiatric institutions and characteristics of patients. Mental health issues typical of developed countries are discussed.

A Cross-Cultural Perspective On Selected Mental Health Systems, Gary Mathews, Morton O. Wagenfeld

The Journal of Sociology & Social Welfare

The information provided from authors around the world on their respective mental health systems is analyzed and compared. Several key dimensions are utilized, including the relationship of mental health services to other services, institutional care, community care, staffing, prevention and mental health promotion services, and accessibility. Resources and governmental priorities are identified as being essential to the provision of effective services. It is clear that the general trends identified by the experts for mental health in both developing and developed countries are by no means universal in applicability.

Self-Empowerment Among Adults With Severe Physical Disability: A Case Study, Nancy A. Brooks

The Journal of Sociology & Social Welfare

An independent living residential setting for severely physically disabled adults was studied through overt observation methods for twenty-two months. The purpose was observation of residents' council actions and expressions of group interests. The council displayed several phases of political structure and behavior. These phases were related to staff and administrative considerations as well as the residents emerging demonstrations of self-empowerment at the group level. The capacity for selfadvocacy emerges as a dynamic enterprise which is clearly related to the structure and interests of the service agency.