Social Infrastructure Services Research Articles

The Protest Psychosis: How Schizophrenia Became a Black Disease

Back to table of contents Previous article Next article Book ReviewsFull AccessThe Protest Psychosis: How Schizophrenia Became a Black DiseaseCarl C. Bell, M.D.Carl C. BellSearch for more papers by this author, M.D.Published Online:1 Aug 2011https://doi.org/10.1176/ps.62.8.pss6208_0979aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail The Protest Psychosis: How Schizophrenia Became a Black DiseaseMetzlJonathan M.; Boston, Beacon Press, 2009, 288 pages, $24.95This book takes a fascinating and unique approach to illustrating how psychiatry and the general public misused the diagnosis of schizophrenia as a label to portray African Americans who fought for civil rights as having severe psychopathology.Beginning with this absurd-sounding assertion, Dr. Metzl presents a retrospective, longitudinal study of the pattern of pre- and post-civil rights-era diagnoses at Ionia State Hospital in Michigan that clearly shows the changes in associations between race, schizophrenia, and violence over time. Using case histories collected before the civil rights movement, when psychiatry and the public assumed that patients with schizophrenia were white and harmless, the author shows how the diagnosis came to symbolize a disorder primarily of African-American men and characterized by paranoia and dangerousness. He makes compelling arguments that this shift in schizophrenia occurred as a result of research articles in leading psychiatric journals that provided “proof” that African-American men with schizophrenia were violent. His evidence is a review of 300 research articles from 1950 to 1980 revealing that “research articles in leading psychiatric journals preferentially applied language connoting aggression and hostility to African-Americans during the 1960's and 1970's”. He highlights Bromberg and Simon's (1) article on “protest psychosis,” which linked the Black Power movement to literally causing delusions, hallucinations, and violent projections among black men.In addition, he provides a review of mainstream journalism and illustrates that the frequency of association between the terms “Negro” and “schizophrenia” increased from the period 1930–1955 to 1956–1979 and that the media furthered the misapplication of the diagnosis of schizophrenia to black males in the civil rights struggle. His review also examines the misinterpreted “split personality” concept that dominated the American public's perception of the nature of schizophrenia, with the word “schizophrenia” often used to characterize the normal psychological functions of ambivalence or conflicts within life. Ergo, as African Americans had to live in two worlds—a black one and a white one—they were hypothesized to be prone to schizophrenia.African Americans were at least four times more likely than whites to receive a diagnosis of schizophrenia. Recounting the history of how, in 1977, Ionia State Hospital transformed from a mental hospital to a correctional facility, Metzl illustrates how fear of “psychotic” blacks shifted the social service infrastructure from hospitalizing schizophrenia patients to incarcerating them. Accordingly, people diagnosed as having schizophrenia reside more often in penal institutions than in psychiatric hospitals, and the rate of schizophrenia in prisons is five times higher than the rate in the general population. Psychiatry positioned itself as an authority that interpreted the crisis posed by angry, protesting black men during the civil rights era, resulting in a seemingly benevolent social institution's dominating, oppressing, and exploiting people of color.Metzl suggests that poorly taught cultural competence gives people the false notion that their professional training helps them be culturally sensitive. Unfortunately, race-based misdiagnosis distorts the objective use of diagnostic criteria, so psychiatry must teach doctors to assess people of color objectively. Finally, he recommends that psychiatry step away from economic dependence on pharmaceutical companies and be more thoughtful about how cultural forces influence diagnostic categorization.The reviewer reports no competing interests.Dr. Bell is president and chief executive officer of the Community Mental Health Council, Inc., Chicago.Reference1 Bromberg W , Simon F : “The protest psychosis”: a special type of reactive psychosis. Archives of General Psychiatry 19:155–160, 1968 Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 62Issue 8 August 2011Pages 979-980 Metrics PDF download History Published online 1 August 2011 Published in print 1 August 2011

Inter-Cloud Computing

This catchword article presents the concept of “Inter-Cloud Computing” which introduces an additional management layer on top of conventional Cloud Computing Systems. Its goal is to reach a higher level of sustainability by autonomously shifting resources among the participating Cloud systems when unexpected load levels occur or disasters strike. Cloud systems are widely seen as a promising paradigm for an IT infrastructure that is capable of creating an added value for business, society, and administration. If Cloud systems are to be applied to critical areas, such as enterprises’ core businesses, governmental systems, medical applications, and other social infrastructure services, it is crucial to guarantee end-to-end service quality that covers the involved external networks, and to meet a set of requirements regarding reliability (including security), compliance, governance, and power efficiency. However, if services are provided by a single Cloud system – which is the usual case today – unexpected levels of overload traffic from the Internet or natural disasters may affect the system’s reliable functioning. The ability of a single Cloud to request reserved resources is usually fixed by limited bounds. Therefore, unexpected loads and failures can easily overburden a single Cloud system and lead to unreliable and interrupted services. In order to enable a Cloud system to continue the delivery of guaranteed service levels even in such cases, it is indispensable to introduce a super-ordinate layer of Cloud organization which manages multiple Cloud systems so that they complement each other. Thus single Cloud systems, which are interconnected via broadband networks, can mutually request required resources from their peers, or provide available capacity to them, respectively. This flavor of Cloud Computing is called Inter-Cloud Computing.

Inter-Cloud-Computing

This catchword article presents the concept of “Inter-Cloud Computing” which introduces an additional management layer on top of conventional Cloud Computing Systems. Its goal is to reach a higher level of sustainability by autonomously shifting resources among the participating Cloud systems when unexpected load levels occur or disasters strike. Cloud systems are widely seen as a promising paradigm for an IT infrastructure that is capable of creating an added value for business, society, and administration. If Cloud systems are to be applied to critical areas, such as enterprises’ core businesses, governmental systems, medical applications, and other social infrastructure services, it is crucial to guarantee end-to-end service quality that covers the involved external networks, and to meet a set of requirements regarding reliability (including security), compliance, governance, and power efficiency. However, if services are provided by a single Cloud system – which is the usual case today – unexpected levels of overload traffic from the Internet or natural disasters may affect the system’s reliable functioning. The ability of a single Cloud to request reserved resources is usually fixed by limited bounds. Therefore, unexpected loads and failures can easily overburden a single Cloud system and lead to unreliable and interrupted services. In order to enable a Cloud system to continue the delivery of guaranteed service levels even in such cases, it is indispensable to introduce a super-ordinate layer of Cloud organization which manages multiple Cloud systems so that they complement each other. Thus single Cloud systems, which are interconnected via broadband networks, can mutually request required resources from their peers, or provide available capacity to them, respectively. This flavor of Cloud Computing is called Inter-Cloud Computing.

Para-social work to address most vulnerable children in sub-Sahara Africa: A case example in Tanzania

Addressing the needs of the most vulnerable children is a universal challenge, particularly in developing countries lacking infrastructure of social welfare services, adequately trained workforce and educational programs. This article describes training and utilization of para-social workers to the social service needs of children and families. These supervised para-professional community based staff and volunteers can fill gaps in serving the needs of children and families, particularly where social welfare systems are undeveloped or severely stretched. We present the development of one such program as a case study, the Social Work Partnership for Orphans and Vulnerable Children in Tanzania. A competency-based training model includes an introductory workshop, a six month-long supervised field component and subsequent training and technical assistance. The curriculum teaches practical skills to assist vulnerable children, especially those HIV affected, including assessing needs, implementing case management resource linkages, counseling, family support, and ongoing service coordination. Over 500 participants have begun the para-social work program in districts throughout the country. Participants report high satisfaction with the training, and knowledge scores consistently and significantly improve throughout the training. This partnership aims to create a sustainable para-professional workforce to address gaps of most vulnerable children in Tanzania and can serve as a model to apply social work principles and techniques in settings where professional and structural resources are highly limited.

The need for a comprehensive response to HIV/AIDS in north-western Somalia: evidence from a seroprevalence survey

The prolonged civil strife in the North-West Zone of Somalia (Somaliland) has hampered the development of social infrastructure and public health services. There are limited data on HIV/AIDS. In 2004, a sentinel HIV seroprevalence survey was conducted. Blood samples were collected from 1561 women attending antenatal care clinics, 249 tuberculosis (TB) patients and 243 people attending sexually transmitted disease (STD) clinics. Samples were tested for syphilis and HIV. Overall HIV prevalence was 1.4%, significantly higher than that observed in many other countries in the Region. Prevalence was 1.2% among pregnant women 15-24 years, 12.3% among patients with STD and 5.6% among TB patients. The prevalence of syphilis was 1.3% in the pregnant women.

Analysis of Farmers’ Access to and Perception of Extension Service Delivery in Borno State, Nigeria

This study analysed access to and perception of private extension delivery by farmers in Borno state. Primary data were collected from 128 farmers selected using multi-stage sampling technique. A five point Likert type scale was developed and used to elicit information on respondents’ attitude toward private extension service delivery. The collected data were analysed using descriptive statistical techniques such as frequency counts and percentages. Result indicated that majority (63.3%) of the respondents were between the ages 36 and 50 years with high proportion (70%) cultivating not more than 4 hectares of land. The study further revealed that majority (84%) had access to public extension service with only 43% having access to private extension. Most of the respondents expressed positive attitude towards privatization of extension services. Based on the findings of the study, it was recommended that rural areas should be provided with social and economic infrastructure and private extension services be encouraged in rural areas.

Contrasting Children and Women's Health and the Determinants of Health in a Small-Sized City

Contrasts that exist in urban infrastructure and accessibility of public health and social services between suburban and urban districts of mega-cities have been well defined. There has been less research in small-sized cities (population under 500,000). This cross-sectional study was done on 1,728 ever-married reproductive-aged women living in Manisa, Turkey, in the year 2000. The probability proportion to size cluster sampling approach was used in the sample selection. Data were collected for women and 7,016 inhabitants of the interviewed households. The data were collected from the women by face to face interviews. Suburban areas (illegally occupied public land called "Gecekondu" dwellings) in Manisa differ from other urban regions (legal settlements of the city) on socioeconomic factors including household occupancy, adult literacy, social class, rates of religious marriages, unemployment, health insurance coverage, migration, cultural segregation, and social status of women. Some traditional practices were also highly prevalent in gecekondu families, where poverty is more common. Although gross fertility rate (GFR), total fertility rate (TFR), and percent decrease of the TFR were higher for gecekondu women than urban women, total wanted fertility rate (TWFR) was lower. In urban neighborhoods, prevalence of contraceptive use was higher, and the infant and child mortality rates were lower; however, when rates were adjusted for mother's age, education and number of births, the differences turned out to be nonsignificant. Women living in urban areas receive better antenatal care, child immunization services, and professional health delivery assistance and services in a health facility; these services are very scarce in gecekondu districts. Health status of gecekondu populations can be improved by social and economic support and by making health services more available and accessible, especially maternity and child health services.

Civil Conflicts in Four African Countries: A Five-Year Review of Trends in Nutrition and Mortality

Armed conflicts are defined as political conflicts in which armed combat involves the armed forces of at least one state or one or more armed factions seeking to gain control of all or part of the state, and in which at least 1,000 people have been killed by the fighting during the course of the conflict. Globally, the number of armed conflicts has been decreasing since 1995, when it peaked at 44 recorded civil wars (1). By 2003, seven of these conflicts had ended, and in 2003 there were 37 active conflicts in the world. More than 80 percent of these conflicts were in Asia and Africa. The latter continent harbored 42 percent of all conflicts in 2003, involving 28 states and their neighboring countries (2). Many governmental and nongovernmental organizations, as well as research scholars, evaluate the human impact of civil conflict for operational and policy purposes (3). These evaluations typically measure not only direct casualties due to violence but often indirect casualties among persons affected by the breakdown of the health and social-service infrastructure and its consequences (4, 5). A World Health Organization report (6) underlined the use of mortality and nutrition as indicators for assessing the severity of a complex emergency; for identifying needs, prioritizing interventions, and monitoring impacts; and for advocacy purposes. While these factors serve as broad indications of the severity and nature of a conflict, an understanding of the process and therefore planning of the response depends on many external variables and constraints that are unique to each emergency situation (6, 7).

Neoliberalism and Suburban Employment: Western Sydney in the 1990s

During the past 15 years metropolitan planning strategies of the NSW state government have done little to address the spatial distribution of either employment or labour market equity within the metropolis. In the fast-growing outer western suburbs, the government has focused on attracting business investment to increase the stock of local jobs and to improve employment ‘self-sufficiency’— a dominantly neoliberal policy framework. This paper explores a widening gulf between the reality of outer urban change and this policy framework by considering changes in the location of jobs and in the employment experiences of residents in Greater Western Sydney (GWS). Evidence is drawn from census journey-to-work data (1991–2001). While holding a majority of manufacturing jobs in Sydney, GWS also experienced continued growth of jobs in service industries during the 1990s. Yet the relative importance of employment in the city's fast-growth finance and business services sector still lags well behind that of inner and northern parts of the city. The focus on growing the regional stock of jobs has not addressed problems of labour market access faced by residents of particular localities and the goal of employment self-sufficiency has not delivered greater equity to outer suburban labour markets. A focus on sufficiency of access to employment for residents of GWS draws attention not only to regional stocks of jobs but also to the provision of social infrastructure and state-provided services to outer suburban populations as they continue to expand.

The Family Study

Summary The Caribbean, although classified as a developing country has been experiencing an ageing of its population over the past two decades. Faced with the lack of a well-developed social service infrastructure for seniors and economic challenges, care of the elderly is predominantly by families and in the community. Training institutions have had to develop new programs and new approaches to aid those caring for seniors. A course for community based social workers of varying backgrounds has been developed to enhance their skills in promoting good health as well as maximum independence in all aspects of life among seniors. Health as defined by the World Health Organization is all embracing including physical, mental, social and spiritual aspects. The course uses several innovative approaches one of which the paper discusses. A key component of the course is the use of the “Family Study” which exposes teams of students to a family, which includes a senior for the du-ration of the 20-week course. Seniors are chosen for study based on their social, physical complaints and desire for assistance. Using a modified version of the social compass and other quality of life assessment tools, students are required to not only identify the problems but how the problem affects the senior and the family and to plan and implement an intervention based on the strengths and weaknesses of the senior and the support system. The paper describes the process and the evolution of the use of the family study since 1992 and the students' evaluation of it. The family study also exposes the students to other aspects of theories and practices associated with ageing, including the importance of effective communication and how to work in teams. The inclusion of a practical approach involving seniors and their families has strengthened the academic program while benefiting the client SO satisfying the needs of both.

Sustainability and public choice: a theoretical essay on urban performance indicators

Livable, endurable, and governable cities are sustained by a delicate balance of laws and policies that protect the interests individuals, households, and firms at the same time as meeting th collective consumption needs of existing and future citizens. A general equilibrium model is developed in order to articulate som the important theoretical features of this problem of urban management. Central to the model is the idea that sustainable policies and actions have themselves to be sustainable and that t is possible only if they reflect the preferences of citizens. Starting from a household utility-maximisation problem the model yields an equilibrium urban public goods matrix, which may be vie as a socially efficient urban management objective function. It contains quantities of environmental goods, social infrastructure and regulative services that are socially optimal in the sense th any deviation from them will make some citizens worse off. These used to derive a set of urban system performance indicators that represent a realistic specification of a sustainable city from th current perspective of citizens. The degree of environmental sustainability implicit in the indicators depends on the preferen of existing citizens for prudent collective action. The indicato represent the optimal prescription of sustainable-city policies f present application. If pro-sustainability education and propaga are successful in changing preferences over time, then a comparat static use of the model charts a socially and politically sustain path towards longer term environmental sustainability. The essay a theoretical one intended to explore the nature of collective an individual consumption trade-offs in a sustainable city. (A)

Japan's aging population. Implications for healthcare.

In the early years of the next century, the Japanese population may well become the oldest in the world. The Japanese government's concentration on post-World War II economic expansion meant that the government only fully woke up to the financial implications of having a large elderly population when oil prices were raised in the 1970s, highlighting Japan's economic dependence on global markets. This article explains the process by which policy regarding Japan's elderly developed both before and after these oil price increases. The measures of healthcare cost containment that the government introduced in response to the increased financial pressure are described, with a particular focus on pharmaceuticals. This article shows that the government has achieved a degree of success in terms of containing pharmaceutical costs, but that future effects on the quality of healthcare are uncertain. Ultimately, a wider application of a per diem fee in place of the prevalent fee-for-service system, and the realisation of plans to improve the social service infrastructure, would be the best path for policy to follow.

Restitution of Victims by the Offenders

It is with great pleasure that I address you today at this Conference in Jerusalem. I believe that there is a profound symbolic meaning in putting the subject of victims of crime on the agenda of a conference in Israel, the homeland and the state of a people who, throughout history, have experienced much victimization.Unfortunately, it seems that the historical collective experience of victimization does not necessarily enhance the understanding of the phenomenon of victims of crime — neither that of secondary victimization by the criminal justice system itself nor the responsibility of society to address victims’ needs and problems.It seems that the criminal justice system in Israel, to a certain extent, is still detached from the victims rights movement which has been developing with growing impact during the last decade in the Western world. It is true that in recent years specific issues concerning victims of crime, such as violence in the family and child abuse, have been a topic of growing interest and action in Israel. As a result, legislation has been passed by the Knesset to deal with these issues and the groundwork for an infrastructure of social services is being laid. However, this does not appear to be a result of a genuine or widespread recognition of the social and legal importance of the commitment which a society should have towards the plight of crime victims. Rather, it seems to be more of a reaction to various political pressure groups.

Enhancing Primary Services for Youth through an Infrastructure of Social Services

This article considers how the strengths of primary social services can be integrated more purposefully into a cohesive, community-based infrastructure of youth andfamily services. The term primary services refers to the wide range of programs and activities that are embedded within the familiar social world of children and their families, and addresses broad developmental outcomes rather than specialized problems. The article first highlights five features of practice and participation that research indicates may distinguish primary social services as a sector and suggests some implications of those features for youth development. The features discussed include a youth development outlook, voluntariness, intentionality, flexibility, and connectedness. It then considers how the benefits of primary services could be amplified by integrating them into a comprehensive, community-based infrastructure of social services. A particular model of infrastructure is reviewed, which poses the primary service sector as both a key ingredient and a beneficiary of this approach to social service reform. The article concludes by suggesting key outcomesfor youth associated with infrastructure reform and highlights research issues involving primary services and infrastructure development.

Debt crisis, health and health services in Africa

In the early 1960s when most of Africa became independent, the hope for the resolution of the related problems of poverty, illiteracy and disease became the primary agenda of its sovereign states. There were indeed initial gains in various aspects of social infrastructure, especially education and medical services. Beginning from the mid 1970s, but particularly since 1980, this initial progress is, however, being reversed as Africa totters under an excruciating debt burden and accompanying austerity programmes. This essay provides a kaleidoscope of this ominous decay with particular reference to health and health services. Several proposals for the way forward are discussed.

Infrastructure And Economic-Geographic Situation (a search for mutual enrichment of concepts)

AbstractThere has been little attempt to adopt a spatial approach to the study of infrastructure, which is said to include both productive infrastructure (transportation, water, power, etc.) and social infrastructure (housing and services). A useful approach is to combine the analysis of infrastructure with the concept of economic-geographic situation, which involves the economically significant linkages of a place or area. Formulas similar to those used in the potential of population may be used to measure the combined effect of infrastructure and economic-geographic situation on the prospects of development of a particular territory. Computation of these measures for a number of years may suggest trends of development of economic regions, including changes in economic-geographic situation. This type of information may have a significant bearing on economic-geographic prediction.