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At the heart of health and social care services is the pursuit of safety and dignity. Legislation and organizational policies are the main way in which statutory and independent organizations’ are tasked with enabling adults with mental health services along the road to recovery. Safety is an intrinsic motivator and basic need.

There is increased political recognition that social policy including the Mental Health Act 2007, which is a cornerstone, is in need of reform. A Conservative Manifesto pledge to reform mental health legislation is based upon the need to mitigate discrimination.

The chapter will explore the interrelationship between “poor outcomes” within the black community and safety; consider the opportunities to move from organizational complacency as a result of new policy and legal frameworks; and promote the view that developing a new discourse around safety is an integral part of improving outcomes for service users, particularly those who are poorly served currently.

A literature review plus reference to case studies will form the basis of the chapter ent and modern racism?

In this article, we return to a piece of work we did with two NHS trusts in the mid 1990s that focused squarely on tackling institutional racism. We do this for two reasons. First, because we feel that the current context for equalities may be obscuring the need to continue to find ways to tackle institutional racism. Second, we brought together very achievable survey and group work techniques in a co‐produced process, which makes tackling institutional racism less laden with rhetoric and much more of a practical proposition. This article articulates a three‐staged approach to identifying racism operating inside the trusts, an appraisal of the experience of black patients and the development of learning groups. In these learning groups, black and white practitioners and managers engaged with each other on their impacts and relationships with black patients, thereby changing their practices with all patients. What achieves equality of health service response from this experience is the creation of an environment in which practitioners can become self‐motivated in re‐working ‘with and for themselves’ the way they work with patients based on a recognition of racial identities in service relationships.

In 2014, the Health Service Executive (HSE) in Ireland published its Safeguarding National Policy and Procedures (HSE, 2014). Under this policy, all agencies providing services through the social care directorate must ensure a robust culture of safeguarding is in place. Concurrent to this has been a move in social policy, practice and research to include the voice of the service user, both in terms of planning and reviewing services. (e.g. HIQA, 2012; Flanagan, 2020) This article examines whether service users with intellectual disabilities want to be involved in safeguarding plans and, if so, how that can be supported. Using focus groups service users demonstrated their knowledge of safeguarding as a concept, how they felt about the issues raised, and, crucially what they felt they would like to see happen next in addressing a safeguarding incident or concern. The focus groups took place in a large organisation providing residential services, day services, independent living supports and clinical supports. Engaging service users in planning and responding to safeguarding concerns is a fundamental principle of human rights legislation, both nationally and internationally. This study aims to highlight that it is both possible and desirable to engage fully with service users using a range of simple communication tools. For this to be implemented as routine practice in services providing support for people with intellectual disabilities, authentic leadership is required. Services will need to devote time, human resources and will need champions to get on board with the necessary culture shift.

Qualitative research examined peoples’ “lived experiences” and knowledge of safeguarding. Focus groups were used with thematic analysis highlighting common themes throughout, as guided by Braun and Clarke (2006). There were two objectives: Objective 1: measuring participant’s understanding of the safeguarding process. Objective 2: compare the potential differences between safeguarding plans devised by the participants in the focus groups, versus plans devised by trained designated officers responsible for safeguarding within the service.

Four principal themes emerged – 1. participants understanding of safeguarding; 2. restorative justice; 3. consent; and 4. high levels of emotional intelligence and compassion. Participants demonstrated that they could and did want to be involved in safeguarding planning and showed little variation in the plans compared to those completed by trained staff.

The study was completed with a small sample size in a single service in one area. It may not represent the lived experiences and knowledge of safeguarding in other services and indeed other countries. The video may have led to some priming; for instance, the Gardai in the footage being called may have resulted in the participants stating that contacting Gardai should be part of the plan. After the video was shown, there was a heightened awareness of safeguarding. This may indicate that participants are aware of safeguarding but unsure of the terminology or how to discuss it out of context.

For this to be implemented as routine practice in services providing support for people with intellectual disabilities, authentic leadership is required. Services will need to devote time and human resources and will need champions in the safeguarding arena to get on board with the shift in culture required.

While there did not appear to be many barriers to listening to participants, to progress this as a standard practice a very real shift in culture will be needed. It is important for practitioners to ask: Is the vulnerable person aware that this concern has been raised? What is known of the vulnerable person’s wishes in relation to the concern? To truly engage with service users in safeguarding plans these questions need to be more than a “tick box” exercise. This process needs to be fully embedded into a culture that promotes a person-centred, rights-based, inclusive approach as a standard rather than a one-off project. Some structural changes will be needed regarding the time given to designated officers, and what resources they can access (such as speech and language therapy). However, the real difference will be made by services operating authentic leadership that champions engagement on this scale, to fully answer the question posed by the researchers at the beginning of this report, “Whose safeguarding is it anyway?”

There appears to be little evidence of service user engagement in terms of planning and processing safeguarding responses, either in research or anecdotally.

My early life was punctuated by turning points and transformations that gradually led to a surprising and late-blooming academic career – my first “real” sociology position began when I was 44. Here I trace six different trajectories of scholarly work which have compelled me: feminist women's health and technoscience studies; social worlds/arenas and the disciplinary emergence of reproductive sciences; the sociology of work and scientific practices; biomedicalization studies; grounded theory and situational analysis as qualitative research methods; and symbolic interaction-ists and -isms. I have circled back across them multiple times. Instead of seeing a beautifully folded origami of a life, it feels more like a crumpled wad of newspapers from various times. Upon opening and holding them up to the light in different ways, stories may be slowly discerned. I try to capture here some of the sweetness and fragility of these moments toward the end of an initially stuttering but later wondrously gratifying career.

In this chapter, I analyze how the intersection of geographic and social locations shapes ethnographic relationships in urban areas. While early urban ethnographers were acutely aware of the importance of geographic location, I argue that researchers’ social locations were ignored, obscuring how their bodies and social identities lead to different forms of knowledge about the metropolis. I use data from a two-year ethnographic research project conducted in Caracas, Venezuela as well as interviews conducted with women qualitative researchers to consider gendered dynamics of fieldwork experiences and data collection. Using a framework of embodied ethnography, which posits that all ethnographic knowledge is shaped by researchers’ bodies, I argue that men and women confront similar but distinct challenges while conducting fieldwork, and discuss what this means for data collection in cities. Specifically, I focus on how social control mechanisms, the gendered meanings attached to researchers’ bodies, and geographic barriers in urban areas can facilitate and restrict fieldwork. Critiquing hegemonic standards within ethnography that encourage researchers to leave their bodies out of their tales of the field, I advocate for the incorporation of gendered research experiences in our ethnographic writing with the aim of producing more complete narratives, but also to better prepare future ethnographers for fieldwork.

The USA outpaces most other countries in the world in the rates at which it incarcerates its citizens. The one million women held in US jails and prisons on any day in the USA face many physical health challenges, yet interventional work to address physical health in carceral settings is rare. This study’s purpose was to summarize the literature on programs and interventions implemented with women in US carceral settings (jail or prison) that primarily addressed a physical health issue or need.

A scoping review was conducted. The authors searched databases, reference lists, individual journals and websites for physical health program descriptions/evaluations and research studies, 2000–2020, that included women and were set in the USA.

The authors identified 19 articles and a range of problem areas, designs, settings and samples, interventions/programs, outcomes and uses of theory. The authors identified two cross-cutting themes: the carceral setting as opportunity and challenges of ethics and logistics.

Much potential remains for researchers to have an impact on health disparities by addressing physical health needs of women during incarceration.

Interventional and programmatic work to address physical health needs of women during incarceration is sparse and diversely focused. This review uniquely summarizes the existing work in a small and overlooked but important area of research and usefully highlights gaps in that literature.

Perinatal depression is common and increases the risk of adverse outcomes for both the mother and child. Despite regular contact with midwives and GPs during the perinatal period less than 50 per cent of women with depression are identified and treated. A number of reasons for this have been proposed; however, failure of health professionals to recognise the symptoms women present with may contribute. The purpose of this paper is twofold: to explore women’s self-report symptoms of perinatal depression and understand how the symptoms women present with might impact on identification.

Women were invited to post their experiences of perinatal depression on one of two online discussion forums over a nine-month period. Data were analysed using a process of deductive thematic analysis informed by cognitive behavioural therapy.

Women’s symptoms were presented using five headings: triggers (for perinatal depression), thoughts, moods, physical reactions and behaviours. Women believed having a previous mental health problem contributed to their depression. Women’s self-report symptoms included intrusive and violent thoughts; emotional responses including fear, worry and anger; and somatic symptoms including insomnia and weight changes. Women also reported aggressive behaviour and social withdrawal as part of their depressive symptomatology. Symptoms women present with may negatively impact on identification as they often overlap with those of pregnancy; may not be included in the criteria for mental health assessment and may involve undesirable and socially unacceptable behaviour, making disclosure difficult.

A more inclusive understanding of women’s self-report symptoms of perinatal depression is called for, if identification is to improve.

This paper offers an analysis of women’s self-report symptoms of depression, in the context of identification of perinatal mental health problems.