Lives Of Service Users Research Articles

Impact of Microfinance on the Social Performance of Local Households: Evidence from the Kassena Nankana East District of Ghana

This study examines the impact of microfinance on the social performance of local households in the Kassena Nankana East District of northern Ghana. The study’s primary objective was to measure the average effect of the common social performance framework’s core indicators (outreach and products and services) on beneficiaries. Because the social performance management framework is an institutional-based evaluation, it is silent on changes in the service users’ lives. This study modified the common social performance management framework to treat outreach and products and services as independent variables, with changes in the lives of service users as the only output or result. We narrowed these indicators to outreach and mobile banking, and under products and services, we concentrated on nonfinancial products and services because, in microfinance, nonfinancial services lack the needed attention. This study employed the propensity score matching (PSM) method to measure the average treatment effect of the independent variables (outreach, mobile banking, and training) by using data from 341 client households. In the absence of a random assignment of treatment conditions, we placed client households who received these three treatments in a treatment group and those who did not receive such treatments in a control group. We further used the PSM method to match observations of households in the treatment group (households who have access to mobile banks, MFI outreach, and training) with those in the control group (households without access to those) by creating the conditions of an experiment where the treatment elements are randomly assigned to avoid any possible bias. The results showed that outreach significantly decreased loan disbursement time. Conversely, outreach was not significant in relation to delayed loan disbursement time. Mobile banking was statistically significant for increased income, business expansion, timely loan disbursement, and high cost of loans. On the contrary, mobile banking was significantly negative in relation to delayed loan disbursement time. Training showed a significant correlation with women’s empowerment, household decision making, and political and community participation. Regarding the impact of training on the use of a loan, the value of loans for consumption was negative, whereas for production it was positive. Despite the general acceptance of the common framework to measure microfinance social performance, there is still little work to prove the relationship between the framework’s output variables and changes in the lives of the service users. This paper is the first to provide empirical evidence on the impact of outreach and training on change variables. The implication of this paper is that nonfinancial services are equally crucial to delivering change for microfinance service users. Therefore, policymakers must find ways to incorporate essential nonfinancial products and services as bundle packages with credit. Additionally, mobile banking has a high potential for addressing challenges with remote outreach and adverse selection, which is a primary obstacle preventing many poor people from accessing credit.

Care Pathways, Health Service Use Patterns and Opportunities for Justice Involvement Prevention Among Forensic Mental Health Clients.

The objective of the present study is to describe the patterns of health service use and of prescription claims in the year preceding an offense leading to a verdict of not criminally responsible on account of a mental disorder (NCRMD). Provincial health administrative databases were used to identify medical services, hospitalizations, and ambulatory prescription claims among 1,014 individuals found NCRMD in Québec. Contacts in the year preceding the offense were analyzed using descriptive analyses and latent class analysis. Overall, 71.4% of subjects were in contact with services for mental health reasons within a year of their NCRMD offense. Among those that received services and not hospitalized for psychiatric reasons at the time of the offense, 20.7% committed the NCRMD offense within a week of the most recent mental health contact. Among those that had at least one prescription claim for an antipsychotic, 45.8% were not taking any antipsychotic at the time of the offense. Latent class analysis provided a multidimensional representation of mental health service use and showed that 58.4% of subjects had no or very rare contact with services. Many forensic patients are likely to have experienced service disruption or discontinuity while in the community, for reasons that may relate to perceived need for care, to service organization, or to the acceptability, availability, and accessibility of services. Given the serious impact of the "forensic" label on the lives of service users, not to mention the increased pressure on resources, the considerable economic costs, and the impact on victims, there is reason to advocate for a greater involvement of mental and physical health service providers in early prevention of violence, which requires reorganizing resources to share the forensic knowledge upstream, before an offense is committed.

Valuing informal carers\u2019 quality of life using best-worst scaling\u2014Finnish preference weights for the Adult \ufeffSocial Care Outcomes Toolkit for carers (ASCOT-Carer)

This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profiles describing different states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profile. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning effects were examined as scale heterogeneity. Several specifications of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position effect of the attributes on preferences associated with the best or second-best choices. A learning effect was found. The established preference weights can be used in evaluations of the effects of long-term care services and interventions on the quality of life of service users and caregivers. The learning effect implies a need to develop study designs that ensure equal consideration to all profiles (choice tasks) in a sequential choice experiment.

Domestic Violence and Whole Family Interventions: Charting Change in the Lives of Service Users

AbstractIn this article we report the results of the introduction of measures to ascertain the impact of therapeutic services for families where domestic violence has taken place. The setting is a specialist service for families located in Dublin, Ireland. The overall goal of the intervention was the ending of violence. To help achieve this, therapies sought to reduce conflict, promote better parental mental health and improve the quality of relationships between parents and children. Using validated instruments, measures were taken at Time 1 (entering service) from seventy-one mothers and forty fathers. At the time of data analysis for this article thirty-seven mothers and twenty-four fathers had completed the Time 2 (leaving service) surveys. Results indicate significant reduction in conflict between participating partners, and improvements in parental mental health and quality of parent–child relationships. These results add support to the view that whilst intervention goals must include the cessation of domestic violence, this can only be achieved with due attention to the complexity of the causes. The use of validated instruments is helpful in seeking to establish outcomes measures that may supplement more traditional measures of efficacy of interventions within specialist services.

M223. EXPLORING YOUR PERSONAL IDENTITY: USING USER-CENTRED-DESIGN FOR THE DEVELOPMENT OF A NEW INTERVENTION FOR SERVICE USERS WITH COMPLEX MENTAL HEALTH NEEDS

BackgroundIntroduction: As a human being we give meaning to our stories, in relation to the social and physical context. For people with severe and complex mental health needs, who have been dependent on (intensive) residential psychiatric support for a long time, it is possible that talents and qualities disappear because this part of their identity has been buried under a long psychiatric history. This can result in people’s identity becoming limited to ‘patient’, and the experience of life as meaningless.ObjectivesFor these service-users, few interventions aimed at personal recovery are available that match their cognitive and communicative skills. In this project, we developed a new psychosocial intervention to stimulate self-reflection and personal recovery.MethodsThe development of the intervention took place through a “user-centred-design process” (UCD). UCD is an iterative design process in which the needs and wishes of the user are the starting point, and they remain central in the product design circle. Throughout the whole design process, service users, significant others, mental health professionals, peer support workers, artists, and researchers collaborate in order to design a first testable prototype. For each step of design process, we organized focus group meetings and brainstorm sessions with all stakeholders as well as individual interviews with service users. Based on the input in these meetings and interviews, the design was adapted. This was done for each consecutive step, which made the whole design process iterative by nature.ResultsA new psychosocial intervention entitled “This Is Me” was developed as a “journey of discovery” through the lives of service users at both verbal and non-verbal levels. From the UCD process four basic principles underlying the intervention were disentangled that have been incorporated in the intervention: 1) “gaining new experiences”, 2) “attention for (self)stigma”, 3) “equal treatment as a person”, 4) “uniqueness of the individual”. This resulted in an intervention in which service-users, together with a teammate, engage in new experiences. Moreover, they are prompted to reflect on these experiences upon their return. With this process, we aim to support people in (re)discovering roles, talents and characteristics to broaden the identity from ‘patienthood’ to ‘personhood’.DiscussionConclusions: UCD was a useful method for the development of a new psychosocial intervention targeting identity for people with complex mental health needs. The process resulted into new knowledge about factors that are important in the (re)development of identity. In addition, we will present the first results of a pilot study in which we assessed the feasibility and effectiveness of the intervention.

The experience of learning from mental health service users and carers

PurposeThe purpose of this paper is to explore student experiences of learning from mental health service users and carers.Design/methodology/approachIn total, 30 clinical psychology trainees and ex-trainees took part in an online survey (n=21) or focus group (n=9). Responses were analysed using interpretative thematic analysis.FindingsA number of themes were identified. There were two pre-conditions of learning: valuing the teaching and emotional arousal. Participants’ learning experiences were characterised by cognitive and meta-cognitive processes: active learning, reflection, increased attention and vivid memories. Furthermore, participants might have a meta-cognitive experience of having learned something, but being unsure what that something was. Participants reported learning about the lives of service users, about themselves and about the wider societal context for people with mental health difficulties.Practical implicationsIn order to facilitate learning students should value the input of service users. This allows them to contain and use the emotional arousal the teaching produces. Furthermore, leaving students with a feeling that something has been learned but not being exactly sure what that has been may facilitate students seeking out further opportunities for service user involvement.Originality/valueFew studies have explored the process of learning from mental health service users and carers. In the current study, the emotion aroused in participants was primary. Furthermore, a new meta-cognitive experience, namely, the experience of having learned something, but not being sure what has been learned, has been identified.

Social workers: a new precariat? Precarity conditions of mental health social workers working in the non-profit sector in Greece

ABSTRACTTraditionally, in western countries, the social work profession primarily has come into contact with issues of precarity through the lives of service users. This paper introduces precarity in the social work scholarly literature as a feature of social workers’ professional and personal lives. It draws from the findings of a qualitative small study of mental health social workers working in the non-profit sector in Greece. The findings reflect a picture of social workers experiencing precarious conditions as they have become part of the growing phenomenon of the working poor, surviving by loans, experiencing housing insecurity, reproductive insecurity, fuel poverty and unable to pay for their commuting expenses to and from work. Furthermore, the paper maintains that the expansion of the conditions of precarity to university-educated professionals, such as social workers, needs to be understood within an International Political Economy (IPE) perspective in order neoliberal capitalism which brings rising levels of inequalities to become a focus of intervention.

Care assistant experiences of dementia care in long-term nursing and residential care environments

Care assistants have a unique insight into the lives of service users and those factors which may impede or enhance the delivery of high quality dementia oriented care. To address the paucity of research in this area, the present study examined care assistant experiences of dementia care in British long-term residential and nursing environments. Semi-structured interviews were conducted with eight care assistants and transcripts were analysed using interpretive phenomenological analysis. Super-ordinate themes emerging from the data were psychological wellbeing of the care assistant, barriers to effective dementia care, the dementia reality and organisational issues within the care environment. The study revealed important deficiencies in understanding and varying levels of dementia training. Whilst person centred strategies were being implemented, task orientated care remained dominant. Furthermore, care assistants reported taking the perspectives of those with dementia into account, and actively using these to develop relationship centred care.

REFLECTIVE SOCIAL WORK EDUCATION IN SUPPORT OF SOCIALLY JUST SOCIAL WORK PRACTICE: THE EXPERIENCE OF SOCIAL WORK STUDENTS AT A UNIVERSITY IN SOUTH AFRICA

Social justice and human dignity are core components of social work principles and ethics; therefore social work education should lead to socially just practice. Social workers’ ability to practise in a socially just manner relies significantly on their ability to reflect on the influence of their personal and professional socialisation and the structural inequalities that influence the lives of service users. In order to achieve a deep sense of social justice, social workers should be educated to be critical, responsive practitioners who can observe, ask questions and fight against inequalities.

Quick and Dirty Research: Opportunities for People Who Are Too Busy to Do Research to Do Research

As a trainer and supervisor I have heard of many examples of the use of a solution-focused approach bringing about significant improvements in the lives of service users. Too often, from my point of view however, these wonderful stories of the possibilities of change stay known only to a few. As a practitioner I also recall my concerns over what might be required for my witnessing of this evidence to be presented to a wider audience. In this paper I reflect on my own journey into research whilst still being in practice, the ideas from professional culture that may have influenced my thinking, the possibilities of moving from evidence-based practice to practice-based evidence and the opportunities that were available to me in a busy Child & Adolescent Mental Health Service. The paper proposes the possibilities of a “quick and dirty” approach for others in practice who would like to do research. Two examples are given of studies that took advantage of available opportunities. I then offer a series of questions, in the hope that this paper will encourage more practitioners to carry out research.

Representations of mental health disorders in print media

This article reviews research findings into the portrayal of mental health disorders in print media, with particular attention to research that uses content analysis. The findings indicate that there is diversity in the representations of mental health disorders, and that in the UK the proportion of ‘good news’ stories increased between 1992 and 2008. However, there remains an over-association of mental health disorders with dangerousness, and this is emphasised through the use of sensationalistic language and highlighting violence in newspaper headlines. These results are explored as part of the process of stigmatisation and the impact that it has on the knowledge, attitudes and behaviours of the general public; and on the lives of service users.

Underpinning reflective practice in social care and housing provision through collaborative knowledge exchange

Since 1988 Scotland has had a policy of providing care in the community for people with disability, through social housing. A number of specialised housing and social care providers are active in this area. In response to an emerging anecdotal understanding of how changes made in the built environment of housing had impacted on the quality of life of service users and care provision, one such provider in Scotland entered a collaborative knowledge exchange process with academic institutions, aiming to better understand the nature of this impact. Through a government and research council supported Kowledge Transfer Partnership (KTP) this collaboration verified the anecdotal experience of service staff across a structured sample of housing locations and types provided by the housing association, and reviewed this in the light of existing published knowledge. The outcome confirmed the experiential learning of the housing and service provider and has permitted knowledge exchange between academia and the housing provider. This paper describes the process of close collaboration that was established to enable this knowledge exchange. The KTP process underpinned a new approach to continuing reflective practice within the housing association, and provided this with a robust evidence base for marketing and policy activity, reinforcing its ongoing re-structuring in a changing policy and funding context for the housing and care service providers. In addition, it synthesises the findings from the research, benchmarked by the wider literature.

Personal narrative as a teaching tool.

Recovery-oriented service systems explicitly value including people with lived experiences of a mental and substance use diagnosis in the design, delivery, and evaluation of those services. Including first-person accounts as part of the education and training of service providers "demonstrates" recovery is possible, promotes empathy, offers insights into the lives of service users, and models a person-centered, person-first approach. More important, it serves as a visual and experiential example of the collegial relationships required for services that are truly recovery-oriented. This column provides recommendations for carefully planning in-person personal narratives as an effective teaching tool.

If a Holistic Approach to Social Work Requires Acknowledgement of Religion, What Does This Mean for Social Work Education?

There is growing recognition that promoting wellbeing requires a holistic approach to social work practice which includes understanding the role of religion in the lives of service users. This is reflected in a number of mentions of religion in the new code of ethics produced by the Australian Association of Social Workers. However, any consideration of whether religion has a place in social work should not only occur at the individual level, but also consider faith-based agencies. This paper considers the implications of this for social work education in respect of developing curriculum which acknowledges the religious dimension of the lives of many service users; skill development to enable social workers to broach issues of religion with service users; and working in or with faith-based agencies.

Aspectos relacionados à plasticidade de um centro de atenção psicossocial da região sul do Brasil

Identifying factors related to the plasticity of a Psychosocial Attention Center (CAPS) from southern Brazil. This is part of a research evaluation of CAPS in southern Brazil - Capsul. Being a qualitative study, using the evaluation of the fourth generation, constructivist, responsive and hermeneutic-dialectic. In this survey we evaluated the CAPS Alegrete / RS, based on interviews with 11 users, 14 family and 26 employees. The study was approved by the Ethics Committee of the School of Medicine, Federal University of Pelotas, as letter no. 014/07. Note that the team is committed to social change the lives of service users studied, demonstrating the plasticity of CAPS. However there are some complicating this process of rehabilitation such as lack of medication. Another facilitator is the fact of the users use of aluminum utensils and porcelain dish, thus promoting self-esteem. CAPS Alegrete, despite the present difficulties in the service, appears to be capable with respect to the care of individuals with mental suffering, committing themselves to biopsychosocial issues and seeking ways to care for free. Descriptors: mental health; personal autonomy; mental health services; mental health assistance.

The role of telecare in overcoming social exclusion in older people

It is generally accepted that assistive technologies such as telecare will play an increasingly important role in managing the problems of supporting older people's independence. Some feel that this could increase social exclusion, resulting in many more people becoming lonely and depressed. This paper describes a number of ways that the technology can be used to help improve the quality of life of service users through increased interaction opportunities. Many of these initiatives will rely on the use of the TV as the interface for services and on a 24‐hour monitoring centre for facilitating the services.

The Potentiality of Bodies

Theorizing embodiment has proved a major stumbling block in social psychology in recent times. Attempts have been made, such as the “discursive body” or the “regulated body,” but less attention has been placed upon incorporating a sense of movement and change within theories of the body. This paper seeks to conceptualize a potentialized body, utilizing Deleuzian theory, along with Massumi’s focus on potentiality. This is empirically driven through focus on the various ways in which mental health service users manage the somatic challenges presented by adhering to medication regimens, which involves a detailed empirical and conceptual engagement with accounts of medication taking. This culminates in the presentation of a move towards innovating social psychological engagement with embodiment theory and reveals greater insight into the difficulties presented in everyday life for service users drawn into complex medication regimen practices.

The Initial Evaluation of the Scottish Telecare Development Program

In 2006 the Scottish Government provided just over £8 million to help 32 health and social care partnerships to develop telecare services. This paper presents a summary of the 2007–2008 evaluation of the Scottish Telecare Development. This evaluation focused on measuring overall program progress toward eight predefined Scottish Telecare Development objectives. Results indicate that the initial investment has resulted in significant savings to the health and social care sectors. Additionally, telecare provides opportunities to promote independence and improve the quality of life of service users and their informal carers. However, some caution needs to be taken in interpreting the findings as results are based on self-reported performance from partnerships, and many of the reported monetary “savings” are actually efficiency savings and are unlikely, in practice, to be cash-releasing.

Towards Social Inclusion Through Lifelong Learning in Mental Health: Analysis of Change in the Lives of the Emilia Project Service Users

The application of formal lifelong learning to enhance social inclusion in mental health is rarely investigated in terms of change in the lives of service users on a cross-country comparative scale. This study was aimed at examining changes in key areas of the lives of mental health service users across eight European mental health sites. A before and after case study design was applied. Users of mental health services who participated in the lifelong leaning interventions reviewed the changes in key areas of their lives at baseline and 10 months later, through the thematic analysis of qualitative data collected in semi-structured interviews (27 and 21, respectively) and self-reports (138 and 99, respectively). In-depth examples from one site are provided. Most users reported positive changes in the areas of training and social networks, with a sizeable minority moving onto unpaid and paid employment. In addition most users reported active planning for job search and other goals. Obstacles that were highlighted included the negative effects of having a mental illness, difficulties in close relationships and economic disadvantages. The lifelong learning intervention offered within an EU Framework 6 project to mental health service users in eight demonstration sites had a largely positive impact on key areas of their lives at 10 months, though obstacles remained which may be less amenable to change by social interventions.

Reflections on Welsh substance misuse services in a global context

Following the inspiration of attending the International Harm Reduction Association Conference 2009, a number of questions arise relating to substance misuse services in Wales. The debates of criminal justice and harm reduction approaches continue in everyday practice, from policy level to frontline interventions, and sight is often lost of what is really being achieved. The following paper sets out a number of observations relating to areas of international best practice and considers what lessons can be learned and translated into Welsh services. Innovative practices within Wales and the rest of the UK can be witnessed in criminal justice and health services, often with a harm reduction agenda bridging both, yet the impact on the lives of service users and communities needs greater recognition.