Reasons For Use Of Services Research Articles

Academic writing support through individual consultations: EAL doctoral student experiences and evaluation

Thesis and dissertation writing often presents significant challenges for many PhD candidates and it can be even more demanding for multilingual doctoral students who use English as an additional language (EAL). Second language writers who are unprepared to engage in disciplinary academic writing require institutional language support services. Among these services, individual (or one-on-one) consultations with learning advisers, who identify students’ specific writing issues and provide personalised advice, are resource-intensive but may have significant impacts on thesis and dissertation writing. This paper aims to evaluate the effectiveness of individual consultations through student learning experiences. It analyses the reasons for service use, evaluates students’ perceived impacts of consultations on thesis and dissertation writing, and explores their views on service improvement. Data were collected from semi-structured interviews with 13 EAL doctoral students enrolled in an Australian university. Results show that individual consultations were operated in four different formats and participants accessed consultation services because their learning needs were not met in group settings or they had identified writing issues. Participants reported pedagogical and psychological impacts, and provided practical suggestions for service improvement in terms of timing and adviser availability. This study provides important insights into the role of individual consultations on thesis and dissertation writing in a second language.

Stigma and other barriers to health and social care services among youth in Greater London

Background/Objectives : Despite the evidence supporting early intervention as a means of mitigating onset of more severe psychopathology, most children in the United Kingdom do not receive treatment for their mental illness. Delays to service use are common and often only occur once the youth has already experienced significant impairment, clinical symptoms and stigma, the effects of which can be difficult to reverse. Stigma may directly impact access to mental health care and indirectly influence mental health problems. Stigma, however, may influence access in different ways for youth with various presentations of clinical symptoms and socio-demographic characteristics and may be greater for those youth with the highest level of risk. This study describes the patterns of formal and informal care utilised by youth and identifies facilitators and barriers to receiving services and treatments among youth. Additionally, we examine the relationship between variations in patterns of care and barriers to mental health care, specifically stigma, by clinical profile, socio-demographic and community characteristics. Methods : This study used a retrospective longitudinal design, nested within an ongoing prospective study to recruit a community sample of youth from Greater London over-representing youth from deprived inner-London areas. Clinical profile was determined via psychotic like experiences (PLEs), internalising/externalising mental health problems and early developmental delays. The „Services Assessment for Children and Adolescents“ was used to ascertain type, nature, frequency and duration of services used, treatments received, setting in which the service occurred (including a range of informal and formal care), reasons for service use, and referrals via phone interview with the parent. The interview also inquired about social cohesion, social capital, parental awareness of symptoms, availability of services, and socio-demographic variables which might facilitate access to care or mediate or moderate the effects of stigma. Multivariable regression models were used to examine the independent effects of stigma and other barriers on pattern of care. Models tested for confounding, interaction and moderation effects. Results : Initial findings will be presented based on interviews with 100 parents. Specifically, we will describe findings on the prevalence of care patterns and reported barriers to care by clinical profile. Predictors of care patterns and impact of stigma will be presented. Discussion/Conclusions : This study sheds new light on the potential effects of stigma on access to mental health care and social support. This study overcomes limitations associated with previous ‘pathways to care’ studies by examining a wide range of service systems, assessing service use among a community sample in a naturalistic way (rather than recruiting from a service setting), and by incorporating a dimensional perspective rather than a categorical perspective by assessing risk of schizophrenia. Future research should continue to investigate and implement strategies which reduce stigma and other barriers which impede access to services and to work toward the development of a service system which better meets the needs of youth and their families.

Towards a psychology of service use in informal care: Social and psychological variables associated with service need and uptake amongst carers of learning disabled adults

A review and an empirical study were conducted to investigate social and psychological factors associated with reported service need and service uptake amongst carers of adults with a learning disability. Literature searches resulted in the identification of 150 hypothesis tests. distributed across 9 independent variables and 2 dependent measures of service use. Only three of the nine independent variables were consistently associated with use of services across the studies. Service use was higher amongst older carers. those caring for a younger client and amongst carers reporting more distress. Additionally. evidence was obtained to suggest a degree of unmet need. whilst carers of lower socioeconomic status expressed a greater need for services, there was no evidence that this need was translated into actual service receipt. An empirical study investigated Community Learning Disability Team members' views of carers' reasons for service use and non-use. Evidence was obtained to suggest that professionals perceived that service use by informal carers may be guided by both structural aspects of provision and a range of social psychological variables which influence carer motivations to use respite. The findings suggest that an understanding of service use amongst informal carers of the chronically disabled might be promoted by attention to carers' beliefs about respite.

Strategies for dealing with problems associated with use of services for HIV infection and AIDS out of region: views of providers and users.

To identify reasons why people with HIV infection and AIDS living within the former South West Thames Regional Health Authority use HIV and AIDS services outside the region, and to identify strategies for dealing with the problems associated with such use. Qualitative study consisting of interviews with individual subjects and focus groups. Providers of services for patients with HIV infection and AIDS in South West Thames, central London, and Brighton. Users of such services resident in South West Thames. Thirty four South West Thames residents with HIV infection and AIDS who use or used services outside the former region; and 70 providers of services within and beyond South West Thames. Principal reasons for use of services out of the region were accessibility (15) and negative appraisals of local services (14). Three main strategies for dealing with the problems of such use were suggested by providers. These entailed introducing users of services outside the region to services in their locality (16); sharing the responsibility for care between providers in specialist centres and in the person's locality (10); and involving the person's general practitioner in their care (12). These strategies were deemed acceptable by 29, 30, and 20 service users respectively. The reasons underlying use of services for patients with HIV infection and AIDS outside the region offer suggestions for developing services in areas with a high incidence of such use. The suggestions advanced by service providers offer an acceptable framework for dealing with the problems.