Responsibility For Social Services Research Articles

Treatment seeking for gambling disorder in nationwide register data - observations around a major shift in legislation.

Treatment seeking for gambling disorder is known to be low and there has been a lack of longitudinal research regarding treatment opportunities. The present study aimed to assess possible changes in treatment uptake after a formal introduction of gambling disorder in social services and health care legislations, by using register data, including patient characteristics with respect to socio-demographics and comorbidities. Nationwide register data were collected for the years 2005-2019, describing diagnoses in specialized out-patient health care and in in-patient hospital care. Numbers and characteristics of patients with gambling disorder were followed longitudinally. Also, a new legislation for treatment by public institutions was introduced in 2018, and data were compared for the years before and after the shift in legislation, both nationally, for each of the three major urban regions, and for the rest of the country. Comparisons were made with respect to concurrent mental health comorbidities, age and gender. The number of out-patient gambling disorder diagnoses increased over time, but without any significant step changes around the shift in legislation. Over time, patients were younger, became more likely to have gambling disorder as their primary diagnosis, and less likely to have mental health comorbidities, whereas gender distribution did not change. Among the smaller group of patients diagnosed in in-patient settings, mental health comorbidity increased over time. Despite gradual changes over time, no changes in demographics were seen around the actual shift in legislation, although the psychiatric comorbidity appeared to increase after this change. After the introduction of gambling disorder in the responsibility of social services and health care settings in Sweden, the number of patients diagnosed with gambling disorder increased only modestly. Likely, further implementation of gambling disorder treatment is required in the health care services. Also, longer longitudinal studies are needed in order to understand to what extent patients not seeking health care treatment are received by municipal social services or remain outside the treatment system.

COVID-19 impact on familial relationships and mental health in a representative sample of adults

Abstract Background Benefits of the stay-at-home order imposed in Italy to prevent SARS-CoV-2 transmission need to be weighed against its impact on citizens’ health. In a country with a solid familial culture and where welfare relies on households, confinement drastically decreased support provided by elder relatives, which may have worsened mental health. Methods A web-based cross-sectional study (LOST in Italy) was conducted on a representative sample of Italian adults during lockdown (27th of April-3rd of May 2020). We asked 3156 subjects to report on reduced help in housework and childcare from retired parents to assess confinement impact on mental health through validated scales before and during the lockdown. Results Overall, 1484 (47.0%) subjects reported reduced housework help from parents, and 769 (64.0%, of the 1202 subjects with children) diminished babysitting support. Subjects reporting reduced housework help had worsened sleep quality (multivariate odds ratio, OR 1.74, 95% confidence interval, CI 1.49-2.03) and quantity (OR 1.50, 95%CI 1.28-1.76), depressive (OR 1.32, 95% CI 1.14-1.53) and anxiety symptoms (OR 1.53, 95%CI 1.32-1.78), compared to those reporting unreduced help. Worsening in sleep quality (OR 2.32, 95%CI 1.76-3.05) and quantity (OR 1.80, 95%CI 1.36-2.37), depressive (OR 1.79, 95%CI 1.39-2.31) and anxiety symptoms (OR 1.90, 95%CI 1.48-2.46) was also associated with reduced babysitting help. In subjects with poorer housing and teleworking, mental health outcomes were worse. Conclusions Confinement came along with reduced familial support from parents, negatively impacting mental health. Social networks and support within families provided by older relatives act as a resilience factor and a potential vulnerability that affects mental health outcomes. Health and social services response should be designed to address mental health needs and mitigate long-term health costs caused by the pandemic's unprecedented stressfulness and unknown duration. Key messages

Visualising Patterns in Women's Experiences of Intimate Partner Violence in the First 10years of Motherhood.

Intimate partner violence (IPV) can involve patterns of physical, sexual and emotional abuse. Women typically experience physical IPV in combination with emotional IPV, while emotional IPV is often experienced in the absence of other types of IPV. There is very little known about women's experiences of these different types of IPV over time. The primary aim of this paper is to describe patterns in women's individual experiences of physical and/or emotional IPV across the first 10years of motherhood. Data were drawn from a prospective pregnancy cohort of 1507 first-time mothers in Melbourne, Australia. Emotional, physical, and combined physical and emotional IPV were reported in the first, fourth and tenth year of motherhood using the Composite Abuse Scale. The overall prevalence of each type of IPV remained consistent across the three time-points, with emotional IPV alone being the most prevalent. There was substantial variability in women's experiences of IPV over time and there was no common progression from one type of IPV to another. Women were more likely to report IPV at more than one time-point if they experienced combined physical and emotional IPV, while for women who reported emotional or physical IPV alone this was more likely to be at a single time-point. A number of socio-demographic characteristics in early pregnancy were associated with a higher risk of reporting IPV at all three time-points, including being unemployed (RRR = 3.6; 95% CI: 2.1, 6.2) and being aged 18-24years (RRR = 3.1; 95% CI: 1.8, 5.4). Knowledge of the variability and persistence of IPV in the first 10years of motherhood, and factors associated with these experiences, can help tailor effective health and social service responses.

Parent abuse by dependent adult children living in the family home: a gap in the service?

ABSTRACT Research is beginning to examine the abuse of parents by their children but has tended to focus on adolescent-to-parent abuse where the child is aged between 10–17 years, or elder abuse where the victim is of post-retirement age. This article examines an under-recognized form of family violence that involves the abuse of parents by their dependent adult-aged children living in the family home. This article draws on data from an evaluation of a police-social services response to family violence in Australia, as well as de-identified case files involving child respondents aged 18-years-and-over to examine the nature of this type of family violence and the service responses to such cases. The data suggest that parent abuse by dependent adult children is a unique issue that currently lacks research and specialized responses within the family violence service system. We consider the changing dynamic of family structures and how this might impact parent abuse by dependent adult children living in the family home. We also discuss the potential effectiveness of varying criminal justice and social service responses and propose that a tailored response which acknowledges the complexity and dynamics of family relations involving dependent adult children is required.

A Systematic Review of Child Health and Developmental Outcomes Associated with Low Birthweight and/or Small for Gestational Age in Indigenous Children from Australia, Canada and New Zealand

While much is known about the health implications of low birthweight for infants and adults, there is limited information about the health implications in childhood, particularly for Indigenous children. The aim of this systematic review was to assess associations between low birthweight (LBW) and/or small for gestational age (SGA) and the developmental, physical or mental health outcomes for Australian, Canadian and New Zealand Indigenous children (5–12 years), including the potential mediating role of cultural connections. The review was guided by an Aboriginal Advisory Group established to guide the Aboriginal Families Study. Four databases were investigated with pre-determined inclusion/exclusion criteria. The search identified 417 articles after independent screening by two authors. Eight studies assessing six child outcomes were included. The review identified limited evidence, although the review suggested possible links between LBW and/or SGA and childhood asthma, lower body mass index (BMI) and poorer academic performance. Links between LBW, SGA and disability, global health and developmental vulnerability were inconclusive. One study identified cultural-based resilience as protective against perinatal adversity. In summary, research on the relationship between adverse birth outcomes and Indigenous children’s health and development is limited. Further investigation and collaboration with Indigenous communities is required to drive optimised health and social services responses and equitable system reform.

Response of Indonesian universities to the COVID-19 pandemic - between strategy and implementation.

Escalated by mid-January 2020, the Coronavirus Disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including the education activities in higher education. Colleges and universities globally are taking various actions to contain the COVID-19 outbreak. These efforts are mainly to secure the well-being of their students and staff, as well as members of their communities. Due to the increasing number of infections has prompted a number of universities in Indonesia to participate in the fight against the virus outbreak. This article provides an overview of the role played by Indonesian universities dealing with COVID-19 pandemic and how Indonesian universities serving the public good for COVID-19 breakthroughs. The research problem of this study focuses on how the strategies developed by the university in responding to COVID-19 and their implementation to reduce the potential consequences of the pandemic impacts. Subsequently, this paper presented the responses of universities in Indonesia in addressing the COVID-19 pandemic. The forms of responses presented in this paper are academic responses, research and development responses and social community services responses. Furthermore, a conceived information of the issues and challenging of involving of universities in collaborating on solutions to crises of the coronavirus pandemic in Indonesian context were portrayed. In conclusion, this paper summarizes the contribution of Indonesian universities and its impacts in fighting deadly virus disease COVID-19. Significance for public health To this day, the coronavirus disease 2019 (COVID-19) pandemic has not shown signs of abating. However, many experts have provided analysis and predictions that will begin to subside, provided that all parties are willing to continue to be ready to play a role, synergize, and work together to overcome it. Including the role of higher education in response of the outbreak of this pandemic. Universities in Indonesia has a strategic role to play in controlling COVID-19 with its various resources and have the potential to make various innovations as a contribution to prevent and to break chains of COVID-19 transmission both at the individual and campus community to the society. This paper provides the effort of higher education in Indonesia in response of the COVID-19 pandemic.

Resource allocation across the dementia continuum: a mixed methods study examining decision making on optimal dementia care among health and social care professionals

BackgroundThe understanding of appropriate or optimal care is particularly important for dementia, characterised by multiple, long-term, changing needs and the increasing expectations of people using services. However, the response of health and social care services is limited by resource constraints in most countries. This study sought to determine the optimal level, mix and cost of services for different dementia case types across the dementia continuum, and to better understand the resource allocation decision making process among health and social care professionals (HSCPs).MethodsA balance of care framework was applied to the study questions and developed in three ways; firstly by considering optimality across the course of dementia and not just at the margin with residential care; secondly, through the introduction of a fixed budget to reveal constrained optimisation strategies; and thirdly through the use of a mixed methods design whereby qualitative data was collected at workshops using nominal group technique and analysed to obtain a more detailed understanding of the decision-making process. Twenty four HSCPs from a variety of disciplines participated in the resource allocation decision-making exercise.ResultsHSCPs differentiated between case type severity; providing 2.6 times more resources to case types with higher level needs than those with lower level needs. When a resource constraint was introduced there was no evidence of any disproportionate rationing of services on the basis of need, i.e. more severe case types were not favoured over less severe case types. However, the fiscal constraint led to a much greater focus on meeting physical and clinical dependency needs through conventional social care provision. There was less emphasis on day care and psychosocial provision when resources were scarcer following the introduction of a fixed budget constraint.ConclusionsHSCPs completed complex resource allocation exercises for people with dementia, including expected differentiation across case type severity. When rationing was introduced, HSCPs did not discriminate in favour of case types with high levels of need. They did, however, support conventional home care provision over psychosocial care, although participants were still keen to provide some residual cover for the latter, especially for case types that might benefit.

Social service responses to human trafficking: the making of a public health problem

Human trafficking has received considerable attention from policymakers, researchers and service providers globally, with resulting interventions often positioning trafficking as something that simply exists. Drawing on Bacchi’s ‘What’s the Problem Represented to be?’ approach, this article proposes that trafficking is continually made through efforts designed to eradicate it. We conducted 22 interviews with representatives from social service organisations funded by the government of Ontario, Canada, for anti-trafficking programming. These interviews provide insight into how trafficking is being represented and with what effects. Our findings suggest that organisational initiatives often rely on individualised health-related interventions, such as trauma-informed counselling and other mental health support, to address trafficking. In the process, various sex work activities are deemed ‘symptoms’ of trafficking, and perceived pathways to engaging in sex work (such as drug use/dependence, a history of trauma and low self-esteem) are produced as ‘causes’ or ‘risk factors’. We contend that by pathologising sex work and sex workers, organisations are employing a contradictory neoliberal paternalism to advance a public health representation of human trafficking that simultaneously responsibilises and disenfranchises purported victims.

Psychosocial adaptation to climate change in High River, Alberta: implications for policy and practice.

Psychosocial adaptation to climate change-related events remains understudied. We sought to assess how the psychosocial consequences of a major event were addressed via public health responses (e.g., programs, policies, and practices) that aimed to enhance, protect, and promote mental health. We report on a study of health and social service responses to the long-term mental health impacts of the 2013 Southern Alberta flood, in High River, Alberta. Qualitative research methods included (i) telephone interviews (n = 14) with key informant health and social services leaders, (ii) four focus group sessions with front-line health and social services workers (n = 14), and (iii) semi-structured interviews with a sample of community members (n = 18) who experienced the flood. We conducted a descriptive thematic analysis, with a focus on participants' perceptions and experiences. Findings of this study suggest (1) the long-term psychosocial impacts of extreme weather and climate change require sustained recovery interventions rooted in local knowledge and interdisciplinary action; (2) there are unintended consequences related to psychosocial interventions that can incite complex emotions and impact psychosocial recovery; and (3) perceptions of mental health care, among people exposed to climate-related trauma, can guide climate change and mental health response and recovery interventions. Based on this initial exploration, policy and practice opportunities for public health to enhance psychosocial adaptation to our changing climate are highlighted.

COVID-19-Related School Closings and Risk of Weight Gain Among Children.

The COVID-19 pandemic is causing substantial morbidity and mortality, straining health care systems, shutting down economies, and closing school districts. While it is a priority to mitigate its immediate impact, we want to call attention to the pandemic's longer-term effect on children's health: COVID-19, via these school closures, may exacerbate the epidemic of childhood obesity and increase disparities in obesity risk. In many areas of the U.S., the COVID-19 pandemic has closed schools and some of these school systems are not expected to re-open this school year. The experiences in Hong Kong, Taiwan and Singapore suggest that social distancing orders, if lifted after short periods, will have to be periodically re-instated to control COVID-19 flare ups. In short, we anticipate that the COVID-19 pandemic will likely double out-of-school time this year for many children in the U.S. and will exacerbate the risk factors for weight gain associated with summer recess.

Changes in commissioning home care: an English survey

PurposeThe purpose of this study is to examine changes in the nature, form and range of commissioning arrangements for home care.Design/methodology/approachData from two discrete national surveys of English local authorities with social service responsibilities were used. In the first, undertaken in 2007, responses from 111 of the 151 local authorities (74%) were received; in the second, undertaken in 2017, responses from 109 local authorities (72%) were received. A combined data set of 79 complete cases, 52% of local authorities, was created. Percentage point differences across the two time periods were calculated and tested to identify significant changes and a systematic analysis of the free-text responses regarding intended changes to the commissioning process in each data set was undertaken.FindingsFindings identified substantial changes in some aspects of the commissioning of home care in the 2007-2017 decade. Collaboration between stakeholders had increased, particularly regarding the identification of future needs. Improved conditions of service and remuneration for home care workers were evident within the commissioning process. Standardised charges for home care (regardless of time and day) had also become more widespread. Initiatives to prompt providers to deliver more personalised care were more evident.Originality/valueThis paper describes the evolution of commissioning arrangements for home care in localities in response to national policy initiatives. It provides guidance to commissioners in meeting the needs of current service users and emphasises the importance of collaboration with stakeholders, particularly providers, in securing future capacity.

Addressing elder abuse in rural and remote communities: social policy, prevention and responses

ABSTRACT This article reports the findings of an international scoping literature review focussed on social policy, prevention, and service responses to elder abuse in rural and remote communities. Forty-seven articles were included in the review, and fourteen types of prevention or service responses were identified in the literature, including several Indigenous-specific initiatives. The review highlighted the need for meaningful inclusion of rural and remote communities in elder abuse policy, as well as the importance of community consultation and consideration of the local context in developing prevention and response initiatives for these communities.

Social care for adults with learning disabilities in England: trends over time

Purpose The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England. Design/methodology/approach Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities. Findings In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing. Social implications While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care. Originality/value This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

Innovation of College Education Management from the Perspective of New Public Service Theory

The new public service theory provides a rich theoretical perspective and scientific methodology for the education management innovation of colleges and universities in China. The meaning of “humanity”, “responsibility” and “service” can help to change many problems in the education management of colleges and universities in China. To build a service-oriented education management model for colleges and universities, we need to:(1) Establish a public service concept and change the administrative management style of higher education;(2) Build a common value base and promote the participation of multiple entities in higher education management;(3) Deepen the responsibility of social services and realize the “legal management” of higher education.

History and Relevance of Patronage, the Civil Service Reform and the Pendleton Act: The Rationale for Congressional Intervention

The ownership of land determined ones importance. However, the church was one of the largest single property holders in Italy. By the 11th century, Bishops were competing with wealthy rural families to become patrons” of local land – owners. To combat the political problems in 1867 The Tenure of Office Act was passed during Andrew Jackson term; Congress passed the Act in an effort to secure a greater role in the appointive process. The act specific that those appointed with the advice and consent of the Senate could only be removed from office with the Senate’s approval. Hence, the goal of this research is to examine the implications of political pressure on the evolutionary process with new emergent paradigm characterized by three anti-government values: personal accountability limited and decentralized government, and community responsibility for delivery or social services.

Equity in social care for people with intellectual disabilities? A cross-sectional study examining the distribution of social care funding across local authorities in England.

Many people with intellectual disabilities rely on social care provision, though little research has looked at how access to such provision is distributed nationally. Evidence from children's services suggests that there are large discrepancies between local authorities (LAs) in terms of the resources expended on interventions with children and families, which can be explained by variations linked to geographical location, namely the level of socioeconomic deprivation between LAs, constituting 'child welfare inequalities'. This study explored relationships between resources allocated to community services for people with intellectual disabilities in England and geographical factors, including deprivation, rurality and political leadership in the LAs where these individuals reside. Data were sourced from publicly available reports of spending of 151 English councils with adult social services responsibilities (CASSRs) for 2013-2014 and from CASSR index of multiple deprivation (IMD) scores and rurality for the same period. We found that more deprived LAs supported more people with intellectual disabilities, per 100,000 of population. We did not find effects for rurality or political party. However, it was not the case that more deprived LAs allocated more funds for expenditure on this group. These findings point to inequities in the distribution of social care resources for people with intellectual disabilities in England, as although more deprived LAs support more people with intellectual disabilities, they do not spend proportionally larger sums of money on this group. We discuss possible explanations for these findings and highlight the need for more research, particularly investigations about allocation of resources within LAs and more detailed explorations of how structural factors such as socioeconomic status of service users effects service access at the local level.

Connecting Socially Isolated Older Rural Adults with Older Volunteers through Expressive Arts.

Employing a participatory arts-based research approach, we examined an innovative program from rural Ontario, Canada, designed to address social isolation among older people. Older socially isolated adults were matched to trained volunteers, where in dyads, the eight pairs created expressive art in their home setting over the course of 10 home visits. With thematic and narrative inquiry, we analysed the experiences and perceptions of the program leader, older participants, and older volunteers via their artistic creations, weekly logs, evaluations, and field notes. The findings reveal a successful intervention that positively influenced the well-being of older adult participants and older volunteers, especially in regards to relationships, personal development, and creating meaning as well as extending the intervention's impact beyond the program's duration. We also discuss opportunities for similar programs to inform policy and enable positive community-based health and social service responses to rural social isolation.

Responding to Child Maltreatment: a Framework for Mapping Child Protection Agencies

While there is a growing number of international population surveys about rates of child maltreatment there is much less data on legal, health and social services responses to maltreatment. Agency surveys are a cost effective method for assessing this response in countries where there is limited administrative data available about child maltreatment reports, investigations and services. The first step in conducting such survey is to map out the network of agencies and organizations tasked with responding to child maltreatment, as part of a multi-stage sampling strategy to identify a representative sample of child maltreatment reports and investigations. This endeavor can be complex as a diverse universe of agencies are involved in protecting victimized children and supporting their families—government-run child protective services, child protection teams at hospitals, not-for-profit helplines, psychotherapists at private practices, and community-based child welfare organizations, to name a few examples. This paper offers a framework for mapping child protection along the dimensions of levels of authority, functions and processes. Beyond high-income countries with well-established child protection systems, it gives special consideration to informal structures such as councils of community leaders and non-governmental organizations’ consortiums in low-income countries.

Gendered violence and victim blame: subject perceptions of blame and the appropriateness of services for survivors of domestic sex trafficking, sexual assault, and intimate partner violence

The last decade has seen advances in both scholarship and advocacy efforts regarding the domestic sex trafficking (DST) of women and children, culminating in federal and state legislation addressing this human rights issue. Despite these advances, prostituted women and girls continue to face stigma and blame for victimization, similar to female survivors of other forms of gendered violence, specifically intimate partner violence (IPV) and sexual assault. Studies have yet to fully explore perceptions of DST as it intersects with these forms of gendered violence, particularly with regard to victim and perpetrator culpability. The current study uses a student sample of survey questionnaires to examine subject perceptions of gendered violence, with a focus on victim and perpetrator blame and appropriate social service responses for victims of DST, sexual assault, and IPV. Future research directions and policy implications are discussed.

Health at the Intersections of Precarious Documentation Status and Gender-Based Partner Violence.

This article is based on qualitative research investigating Spanish-speaking immigrant women's experiences of gender-based intimate partner violence (GBPV) and help seeking in New Jersey (2006-2008). Methods included interviews with these women, health care and social service providers, and community members. This article reveals that as many immigrant women live at the intersections of structural, normalized, and gender-based partner violence, integrated social service responses emerge as key health care responses to GBPV. The health impacts of undocumented and precariously documented migration and GBPV demand policy interventions and dedication of resources to address the multi-faceted needs of this population.