Social Welfare Authorities Research Articles

Quality of care as perceived by caregivers and residents in aged care homes in Sri Lanka: a qualitative study

ObjectiveQuality of care determines the physical and psychological wellbeing of aged care residents. The study aims to explore barriers and facilitators of quality of care in aged care homes (ACHs) in Sri Lanka from the perspective of older adults and caregivers.MethodsThis qualitative descriptive exploratory study was conducted in selected five ACHs in Galle District, Sri Lanka, from May 2021 to January 2022. We recruited a purposive sample of residents and caregivers and conducted ten in-depth interviews with ten caregivers and nine focus group discussions with forty-five residents. The data were analysed using the thematic analysis.ResultsThe majority of caregivers and residents were females. Caregivers and residents were aged 25-35 years and 70-80 years, respectively. Two major themes emerged: (a) barriers of quality of care and (b) facilitators of quality of care. Both residents and caregivers reported a lack of referring system facilities; a lack of financial support on the infrastructure; a lack of financial support in supplying medication and employing human resources; insufficient knowledge of gerontological care and geriatric syndromes for both caregivers and residents; and lack of interest in being a caregiver at the ACHs as barriers in providing quality care. Moreover, caregivers and older people reported donations by philanthropists; supportive leadership; and welfare benefits from the government authorities as facilitators of quality care. Additionally, caregivers reported a lack of in-service programmes for caregivers as a barrier and positive institutional values as a facilitator for providing quality care.ConclusionThe available human and physical resources are insufficient to address the demanding needs of residents in ACHs, apart from the received donations. There is a simultaneous need for healthcare policymakers' and social welfare authorities' attention to implementing necessary measures to uplift the quality of care for residents in ACHs to enhance their quality of life.

Studies on Regress between Social Welfare Authorities and Private Debtors: Comparative Studies on the German Social Law Codes

Studies on Regress between Social Welfare Authorities and Private Debtors: Comparative Studies on the German Social Law Codes

ОЖИДАНИЯ ГРАЖДАН ОТ ЦИФРОВИЗАЦИИ В СФЕРЕ СОЦИАЛЬНОЙ ЗАЩИТЫ И СОЦИАЛЬНЫХ УСЛУГ

This paper discusses an issue of the prospects for increasing the information transparency of the system of social welfare and social services in the context of digital transformation through the prism of its perception by the population. We touch upon the issues of low informativeness and insufficient interactivity of official Internet resources on such topics, their unpopularity and, as a consequence — the low awareness of state social assistance and social services among the population. We conducted a survey of the population in the Perm region. The data of our survey show the expectations of citizens who are already receiving or applying to receive social benefits and social services in relation to the introduction of new digital technologies in this area in the near future. Citizens want to be able to independently select possible benefits and social services, choose an appropriate social agency, while doing that with the help of interactive services on the official websites of social welfare bodies and social agencies. They want to consult online, have an option to receive all social services in remote format, make appointments with the social welfare authorities and social agencies via the Internet, complain and evaluate the work of specialists serving them online. Citizens also hope to have terminals in public places with reference information on benefits and social services, to receive leaflets and brochures with such information, to take part in free training on thematic sites and mobile applications, to rent android robots for home-based services for the elderly and persons with disabilities, to enter information about themselves into the databases of social welfare bodies and social agencies on their own. The results obtained can be used for the development of information policy aimed at increasing the efficiency of digital transformation in the social sphere.

Being a parent in Finland: a culturally-tailored psychoeducative parental support programme

Abstract Problem Migrant origin children are overrepresented in child protective services and among cases of suspected maltreatment against children. Language barriers, poor understanding of the child welfare system and differences in perceptions of child rearing and disciplinary practices create additional burden during the assessment process. Authorities struggle to meet the needs of migrant origin families. Description of the problem A variety of universal, selective and indicative parenting support programmes are available. While these have been shown to be effective also among persons of migrant origin, cultural adaptation has also been suggested to increase the benefits. Any adaptation to a trial-tested programme may, however, impact its integrity. To avoid this, a separate culturally sensitive Being a Parent in Finland programme was developed to complement other parenting interventions and supporting services offered by the health and social welfare authorities. Intervention was developed as part of the Barnahus project coordinated by the Finnish Institute for Health and Welfare. Results The aim of the Being a Parent in Finland psychoeducational group programme is to increase the wellbeing and safety of children through group-based parental support. The programme consists of three two-hour meetings offered to parents of children aged 3 to 12 years. The main themes include the Finnish service system, parenting practices that support the child's development and wellbeing and wellbeing of the family as well as children's rights. Psychoeducational videos were produced as supportive material. Groups of maximum 8-10 participants are led by trained instructors, assisted by professional interpreters. Lessons The programme will be piloted by the city of Helsinki, with the first two groups starting in May 2021. Experiences and lessons learned from these groups will be presented. Impact assessment of the programme and will be launched in autumn 2021. Key messages While culturally sensitive adaptations may increase positive outcomes of parental programmes, there is a risk for compromising programme integrity, leading to minimized or even adverse consequences. Being a parent in Finland aims at supporting the wellbeing and safety of families through culturally sensitive psychoeducative groups administered as complementary support measure to other services.

Creating and Maintaining Structural Hindrances to Criminal Justice Control – A Policy Analysis on the Normalisation of Parental Violence as a Crime in Finland

In the context of home, violence remains more accepted when committed against children than adults. Normalisation of parental violence has been documented in attitudinal surveys, professional practices, and legal regulation. For example, in many countries violent disciplining of children is the only legal form of interpersonal violence. This study explores the societal invisibility and normalisation of parental violence as a crime by analysing legislation and control policies regulating the division of labour and involvement between social welfare and criminal justice authorities. An empirical case study from Finland, where all forms of parental violence were legally prohibited in 1983, is used to elucidate the divergence between (criminal) law and control policies. The analysis demonstrates how normalisation operates at the policy-level where, within the same system of control that criminalised these acts, structural hindrances are built to prevent criminal justice interventions.

Features of emotion recognition in deviant adolescents

IntroductionSome researchers believe that an increased level of aggression and cruelty towards others in delinquent adolescents is due to impaired recognition of emotions and empathy.ObjectivesThe aim of our study was to study the recognition of emotions in deviant adolescents.MethodsAs a material, 156 juvenile offenders from 13 to 19 years old were selected who were in the camp for delinquent adolescents “Sibextrem”. All of them committed any offenses, they were registered with the social welfare authorities and the police. The adolescents were trained to reduce aggressiveness. During the training, several exercises were carried out. In the first exercise, the teenagers were asked to identify the emotions depicted in the photographs. In the second, determine what emotional state their peers portrayResultsDuring the training process, 78% of adolescents could not identify the emotions presented. This was typical not only for the recognition of standard images, but also for the presentation of emotions by peers. As a result of the training, most adolescents, 64.2%, learned to quite accurately recognize nonverbal emotions. As a result, the number of aggressive manifestations decreased by 31.6%. Mutual understanding and communication improved.ConclusionsThe results obtained indicate that deviant adolescents have impaired emotional perception of others. Difficulty in assessing emotions creates tension in interpersonal relationships and can contribute to the manifestation of various forms of aggressive behavior. The vector of research we have chosen shows the need for further study of the emotional sphere of adolescents and its relationship with deviant forms of behavior.

COVID-19: articulação das políticas de saúde e sociais para promoção de cuidados seguros aos idosos

Objetivou compreender o processo de articulação das políticas de saúde e sociais dirigidas aos idosos durante estado de emergência por COVID-19 e implicações para a enfermagem. Estudo qualitativo, documental que utiliza como fonte de dados discursos de órgãos governamentais e dirigentes sociais, veiculados em 20 jornais portugueses, de acesso online, entre 2 de março a 2 de maio de 2020. Da análise dos dados emergiram três macrocategorias: dever de proteção dos idosos como grupo vulnerável, medidas promotoras da segurança dos idosos e consciencialização das lacunas de supervisão e apoio nos cuidados aos idosos em instituições sociais. De fato, apesar dos esforços na articulação das políticas de saúde e sociais e reorganização dos serviços durante a pandemia, observaram-se algumas lacunas nos cuidados aos idosos. Ficou evidente que é necessário aproximar cuidados de saúde comunitários às instituições sociais, através da capacitação dos seus profissionais e supervisão dos cuidados.

VIOLENCE AGAINST CHILDREN AND INTEGRATED CHILD PROTECTION SYSTEMS IN THE EUROPEAN UNION

In line with international and European human rights instruments and standards, the EU Member States are under obligation to protect children from all forms of violence. The establishment of a holistic child protection system is the primary obligation of each EU Member State and a prerequisite for the effective protection of children. An integrated child protection system covers a wide range of comprehensive and integrated measures, and includes multi-disciplinary, crosssectorial and inter-agency cooperation of all duty-bearers. Due to migration to the EU and mobility within the EU, the number of cross-border and transnational child protection situations has been increasing. These situations require cooperation between social welfare, judicial, investigative and other authorities in different EU Member States. This paper gives an overview of the EU legislation and policies relevant to child protection, and examines the EU’s role in reinforcing the protection of children against violence.

Evaluation of the Availability of Safe Water and Sanitation Facilities in IDP Camps In Kahda District in Mogadishu, Somalia


 
 
 
 
 
 Water, Sanitation and Hygiene (WASH) is generally a challenge in Somalia particularly in IDP settlements where access to water and sanitation facilities is limited. Children particularly the ones under the age of 5 years mostly fall victim to diseases caused by poor sanitation and hygiene practices. The objective of this study was to evaluate the availability of safe water and sanitation facilities in IDP camps Kahda district Mogadishu Somalia. The study was descriptive cross-sectional baseline assessment. The study area was selected purposively 4 IDPs camps in Kahda district and the sample size was 166 households, draw from 270 households from selected 4 IDPs using Cochran’s formula for calculating sample size when population size is finite. Administrated closed-ended questionnaire and observational checklist was used as data collection tools and the study employed statistical package for social science SPSS version (20.0) for data analyzing and data was present descriptive statistics graphs and frequencies tables. Majority of the households 84 (51.5%); their source of water were hand dug well with pump as well as Most of the households 100 (61.3%); it takes 3km walk to get a water from their nearest point source while the guide to WASH cluster strategy and stander states that the maximum distance from any household to the nearest water point should be 500 meters. Which means it is longer than the stander and 61 (37.4%) households they bring 1 dollar per day to get water, 52 (31.9%) they bring less than $0.5 per day so that it is one factor that may affect the availability of safe water and sanitation, whereas A very large number of households 105 (64.4%) don’t treat their drinking water to improve the quality of water and The study also founded that 21 (12.9 %) of the households do not have latrine and 153 (93.9%) of the households share latrine with their neighbor and most of these households 57 (35%) they share latrine with 5 households and above, 37 (22.7%) they share latrine with 4 households, while the highly average 117 (71.8%) of the households do not wash their hands after using toilet. The study was done and it proves that the water source is far from and longer three times more than the standard, the quality of drinking water is not good and the knowledge of the dwellers for the treatment of drinking water needs to improve. Some of the households don’t have latrine and they share with their neighbor. the study recommends Federal Ministry of health and social welfare, local and international nongovernmental organization and authorities concerned with constructing water source near IDPs, conducting health promotion campaign for drinking water treatment and hygiene and constructing toilets.
 
 
 
 
 

Children’s maintenance obligations to parents versus the right to social welfare benefits

If they suffer privation, which means that they are unable to meet their basic needs on their own, parents are entitled to claim maintenance from their children. On the other hand, the difficult life situation caused by privation, linked with lack of self-sufficiency, is one of the reasons to claim social welfare benefits. Therefore, the same circumstances constitute the basis for financial support from both the family and the public social system. Because the laws do not explicitly define the order in which maintenance ought to be paid, this study attempts to establish the relation between the family’s and the State’s financial obligations. Based on the legal-dogmatic and analytical methods, this article presents: the essence of the right to maintenance and its forms in the Polish Social Welfare Act, the duties of the administrative bodies in bringing actions for maintenance, the consequences of failure in fulfilling maintenance obligations and of unjustified relinquishment of maintenance claims from family members. In the conclusion, the authors stress the primacy of family obligations over the State’s ones, and formulate recommendations for social welfare authorities as regards enforcing the fulfilment of family financial obligations.

Hospitalization of Migrants without Health Insurance: An Explorative Study of Hospital Healthcare in Lower Saxony, Berlin and Hamburg

Different reasons prevent migrants from obtaining health insurance resulting in their exclusion from regular medical care in Germany. In case of medical emergency, hospitals are obliged by law to provide treatment. In addition, hospitals might get reimbursed for treatment expenses by social welfare authorities. This includes undocumented migrants who should not be reported to the police. However, actual legislation regarding the level of medical intervention, the principles of medical confidentiality and the conditions of reimbursement by the authorities is unclear. Thus, migrants without health insurance may be precluded from receiving urgent medical treatment. A first assessment of hospital health care for migrants without health insurance in three federal states with the intention to identify obstacles in access to in- and out-patient emergency treatment. Electronic mail survey of all non-specialized general hospitals located in the federal states of Niedersachsen (Lower Saxony, n=129), Berlin (n=46) and Hamburg (n=24). Data was anonymized and descriptively analyzed using SPSS statistical software. Rate of questionnaire return was 31.2% (n=62). Almost all hospitals had already encountered migrants without health insurance in their emergency wards (82.3%) including 72.5% undocumented migrants. 76.7% of all hospitals had submitted a subsequent emergency aid proposal to the social welfare authorities. 17.1% of them confirmed that they were reimbursed in most cases. 8.5% of all participating hospitals mostly consult the police in case migrants are not able to provide any means of identification, whereas 43.6% consult the police only in rare cases. 64.5% of all hospitals reported non-reimbursed expenses for 2011 - 2014 ranging from € 4 000 - €1.01 million. RESULTS indicate that the provision of care for people without health care insurance represents an important issue for a majority of the assessed hospitals since they have to take the responsibility for treatment costs in many cases. Moreover, the term "medical emergency" can be differently interpreted. Due to the inconsistent processing of cases and confusing legislation, a low-threshold health care access for (undocumented) migrants is not available. The actual legal system may result in disease progression because of uncertainty on the part of hospitals and migrants; it is also inadequate in case of emergency.

Cinderella's lifetime abuse.

Life is not always a fairy tale, especially for frail isolated elderly adults living far from family. I was reminded of this sad fact during the course of conducting a survey on elder abuse and neglect among rural community-dwelling elderly adults in Malaysia, when I came across Mrs. ST, who willingly shared the story of her life with us. When I called upon Mrs. ST in her house one hot, sunny afternoon, in the village she has lived in most of her life, she came across as warm and personable, despite being bedridden. She is a 76-year-old widow, having grown children who live away and visit periodically, and lives with a dedicated maid who assists with her daily needs. Before her husband died, he had inflicted frequent psychological, physical, and even sexual abuse on her. Her family, whom she confides in, were unable to protect her from this situation. At the most, her children would warn her that her husband was irritable and to avoid him at times, but he would invariably find her and beat, kick, or punch her, even locking her up, in addition to demeaning her, slighting her, and being suspicious and jealous of any contact she may have had with men, even the handyman or mailman. According to her, her once-loving husband turned into a jealous and abusive person in the last 4 years of his life. From her account, we can only wonder whether he had dementia or some other untreated condition. If we had not visited her in this remote area, her story might not have come to be known. Local health and social welfare authorities followed up with elderly adults found to be abused in the recent survey and hence had some form of monitoring or even closure to their unhappy situation. This is an attempt to share her experiences, to bring her story out of the shadows. Mrs. ST was brought up practically an orphan. Her mother died when she was an infant, her father left the family shortly after, and her older siblings raised her, treating her much like Cinderella, forcing her to perform household chores, besides being beaten and starved by her older sister. When she was older, she ran away and was later taken in by her older brother, in exchange for assisting with his growing family. This was a welcome refuge from the abusive situation that she escaped from, living with little or no shelter for a time. At 14, she married for the first time but soon separated because of pressure from her mother-in-law. She remarried at 19 and lived happily until her twilight years, when this husband began mistreating her in his last few years of life. Mrs. ST has a wistful look on her face when she speaks about him, choosing to remember the better parts of a lifetime shared with him, showing us jewelry and keepsakes she still has from him, and not the harsh reminders of abuse encountered toward the end. If only all of us were that forgiving. Although she is no longer at risk of abuse and has forgiven the perpetrator of her abuse, the effects may still be upon her, as she feels lonely and a little depressed. One wonders, with proper elder protective measures in place, if Mrs. ST would have had a happy ending, just like Cinderella. Rajini Sooryanarayana's work on this study was supported by the Public Service Department of Malaysia and University of Malaya and Ministry of Higher Education High Impact Research Grant E000010–20001. Ethical approval was received from the University of Malaya Medical Centre institutional review board (902.2, February 21, 2012). Conflict of Interest: The author has no conflicts of interest. Author Contributions: Rajini Sooryanarayana was responsible for the literature search, study design, data collection, writing, and submission. Sponsor's Role: None.

Physical rehabilitation in post-conflict settings: analysis of public policy and stakeholder networks

Physical rehabilitation plays a determinant role in post-conflict contexts to restore disabled citizens’ mobility and independence. While the main objectives of any physical rehabilitation programme are to ensure that the services provided are accessible and of good quality to meet existing needs, it is intended that the services need to be supported over the long term by public health and social welfare authorities. This article presents the results of a study conducted in three post-conflict countries on the relationships between the level of commitment of national governments to rehabilitation services and the influence of social networks on national policy related to physical rehabilitation. From a policy and resource standpoint, the environment in Nepal is the most favourable for creating leverage at the national level to influence the commitment of ministries in the rehabilitation sector, compared with Cambodia and Somaliland. Stakeholder network analysis in Nepal, furthermore, reveals a dominant civil society and private sector supporting rehabilitation services, including intense involvement of local organisations and user groups.Implications for RehabilitationPhysical rehabilitation is not on the top of the agenda of governments in fragile states.The commitment and involvement of national authorities in the rehabilitation sector is positively influenced by civil society and international organisations.The denser the social network of the rehabilitation sector is, the more influence the actors can exert influence over national authorities.

Mental Health Law of the People's Republic of China: inviting dialogue.

Mental Health Law of the People's Republic of China: inviting dialogue.

Evaluation der Traumaambulanzen nach dem Opferentschädigungsgesetz in Nordrhein-Westfalen

Over the past years, 35 trauma outpatient units have been established in accordance with the Crime Victims' Compensation Act in the federal state of North Rhine-Westphalia (Germany) for both children and adolescents as well as for adults. They are operated by the social welfare authorities and, since 2008, by the regional authorities of Westphalia-Lippe and Rhineland. They enable victims to receive qualified psychotraumatological help within the first few days after suffering violence. Since trauma units have now been set up across most parts of this federal state, the time has come to assess the effectiveness of their acute care provision to victims of violence. In 2007, on the order of the Ministry of Labour, Health and Social Affairs of the federal state of North Rhine-Westphalia, trauma outpatient units were subjected to scientific evaluation. In 17 trauma outpatient units, a data assessment protocol was officially implemented that included repeat measurements (immediately before the initial contact, after completion of intervention, at follow-up six months after intervention) of traumatized subjects aged 14 and older. Socio-demographic data were gathered, and the scores of the Impact of Event Scale - Revised (IES-R), the Symptom Checkliste-27 (SCL-27), the simplified Beck Depressions Inventory (BDI-V), the Global Assessment of Functioning Scale (GAF) as well as the Cologne Risk Index (CRI) (expert rating) were collected. Nearly three-fourths (65.9 %) of the traumatic experiences of the 211 patients investigated can be characterized as type-1 traumatisation. 31.8 % of patients were victims of crimes involving violations of the right to sexual self-determination (94.0 % of sexual offences being committed against girls and women). Crimes against physical integrity, which according to crime statistics are the most frequent of crimes against individuals (88.8 %, 34.8 % females), were suffered by 36.0 % of all patients of the trauma outpatient units (63.2 % being females). In 57.1 % of the victims, the interval between the traumatic event and initial intervention was less than a month. In 51.7 % (n = 109), suspicion of PTBS (F43.1) was raised at the initial presentation. The average of all instruments yielded an effect size of d = 1.04 (SD = 0.28) in a pre-post comparison. Pair-wise comparison showed highly significant differences in averages between pre and post (that is, between initial and follow-up measurements) in the sense of marked symptom reduction for all scales. The services of the trauma outpatient units are utilized in a timely and targeted fashion. The calculated effects show that the trauma outpatient units offer highly effective services to crime victims seeking help there.

Towards Empowering Practice of Social Work: Activation and Support of Employment as a Practice of Social Work in the Municipalities

The aim of the study was to analyse how the development of activation and employment sup­ port services for long term unemployed and for persons with disabilities has affected social work practices in the municipalities in Finland. The data consists of interviews and training materials collected in 2003-2004 in the Helsinki region. The theoretical framework of the study relies on the conceptual discussion on empowerment, social work, and rehabilitation in Finland in the beginning of the 2000's. The social work practice descriptions and evaluations of the interviewed are compared to the good practices of activation and social work described in the literature and in the relevant research and development projects. The implications and stipulations on customer-oriented practices in the municipalities of the new workfare paradigm of social policy are being evaluated, as well. As a member of a multidisciplinary team, social worker brings comprehensiveness and larger societal views to the problems of employment and disability. Social worker's views and practices concentrate on the barriers of employment and aim at overcoming them. Assessment of the life situations of the clients, case management, counselling of long processes, and securing the rights of the clients is the core content of empowering social work practices. Empowering social work practices in the municipality social welfare services were previ­ ously coincidental. The change has been rapid and thorough in the beginning of 2000's, and it has brought new perspectives to the aims and practices of the client work, and the network of cooperation has broadened and become closer. The multisectoral cooperation in activation, em­ ployment and vocational rehabilitation services is considered to be primarily well functioning and effective. However, the encounter of varying work cultures, practices, values, and service models has brought about contradictions, as well. At the present moment there is a continuous re-organizing process of client work and work organizations in the municipalities. During the last two years numerous joint employment service centres have been established, primarily in urban areas, in co-operation with employment, social welfare, health care, and social insurance authorities. This development is changing the local service cultures from sectoral approach towards close partnership and comprehensiveness in cli­ ent work. Various stipulations and mechanisms are endangering the establishment of empowering social work practices in the municipal social welfare services. The high turnover of workers, recruit­ ment problems, case load, and introduction of new tasks and responsibilities also hamper the establishment of the new practices. The conditions of social work have become unstable.

Youth Justice in Denmark

Denmark, strictly speaking, does not have a juvenile justice system. The age of criminal responsibility is fifteen. Offenders younger than that are dealt with by social welfare authorities. Offenders aged fifteen and older are dealt with in regular criminal courts under the same laws, procedures (with a few exceptions), and circumstances as adults. In practice, the divide is not so sharp. Social welfare authorities can place children in secure institutions, though they seldom do so. Offenders under age eighteen benefit from a number of sentencing policies and options not available for adults. These include shorter sentences, diversion to the welfare authorities, and special sentencing options. Crime rates generally and for young offenders were stable or declining throughout the 1990s. Criminal justice policy generally and concerning young offenders has become increasingly politicized, and tougher laws and policies have been enacted. Owing, however, to the influence of international standards, renewing confidence in rehabilitative programs, and Danish skepticism about incarceration of young offenders, punishments for young offenders in the 1990s did not become markedly harsher, as enforcement of prison sentences declined.

Integration of Students with Severe and Profound Intellectual Disabilities into the Comprehensive School System: Teachers' perceptions of the education reform in Finland

In Finland compulsory education has been organised within the comprehensive school system since 1970. However, until August 1997, the students with the most severe intellectual disabilities were educated by social welfare authorities outside the school system. This study evaluates the transition from the social service system into the comprehensive school system one year after the reform. Nationally representative data was gathered in 1998 from 125 teachers who taught 591 (65%) of all school age children with severe and profound intellectual disabilities in Finland. The results of the study indicated that while physical integration had increased, individual integration into the full-time mainstream classroom occurred only seldom. Further, only a few teachers thought that the best placement for children with severe and profound intellectual disabilities was in full-time general education classes. About 80% of the respondents thought that the best placement was in full- or part-time special classes located in mainstream schools.

Child and young adolescent suicide in New Zealand.

To describe the epidemiology and characteristics of all suicide deaths among under 15-year-olds in New Zealand over a 10-year period. In a 10-year retrospective study the features of all 61 children and young adolescents aged less than 15 years who died by suicide in New Zealand from 1989 to 1998 were examined by review of coronial files. Suicide among under 15-year-olds is very rare but increasing. Suicide risk increases with age: the majority of those who die are aged 14 years (57.4% of the total) or 13 years (26.2%). Boys (72.1%) and Maori (57.4%) predominate. Most suicides occurred in children not living in intact biological families (67.2%). Hanging was the predominant method (78.7%). One in three children left suicide notes. One in four had a history of contact with social welfare authorities. There was a family history of suicide in 10% of cases. A minority had a documented history of prior suicide attempts (13.1%) or mental health problems (23%). One in four (23%) was reported to have made threats of suicide within the year prior to their death. A majority of deaths appeared to have been precipitated by relatively minor family arguments or disciplinary events, which, however, occurred in the context of actual or anticipated disruptions or transitions in family living arrangements or school circumstances, or severe family problems. In general, the impression of young adolescent suicide was of a disadvantaged, vulnerable and distressed group of adolescents growing up in extremely difficult circumstances. Maori children predominate in this group. There is clearly a need to verify these impressions with an in-depth investigation of the familial and social circumstances of children who die by suicide. Such investigations might best be conducted by annual mortality review and monitoring of all young adolescent suicides.

People with Disabilities in China: Changing outlook— new solutions— growing problems

One new child is born with a serious disability every 40 seconds in China. With the number of people with a disability already exceeding 50,000,000 (approaching the size of the whole population of the UK) it can be seen that this rapidly developing third world country is facing a monumental task in rehabilitation and education. This paper does not attempt to offer solutions, but describes the variety and complexities of the problems facing the People’s Republic of China at the present time and makes estimates of its future needs. It also describes some of the ways China is trying to deal with the problems and gives a realistic appraisal of the difficulties faced by academic, clinical, and social welfare authorities.