Addressing entrenched disadvantage in Australia

An estimated four to six per cent of Australia\u27s population experiences chronic or persistent poverty or deprivation. Executive Summary Entrenched disadvantage is a wicked problem for any society. Disadvantage of one form or another will always be with us, but when disadvantage is entrenched, some Australians are not able to play their full part in our economy and society. An estimated four to six per cent of our society experiences chronic or persistent poverty or deprivation. This represents both a tragedy for the individuals concerned and a loss of economic potential for the nation. While we have policies in place or in development to address disadvantage, it is not clear that we have recognised the need to address the deeper problem of long-term, persistent and chronic disadvantage. As a rich and successful society, we can clearly do better – others do. Two aspects of entrenched disadvantage are clear: The problem is both significant and complex; and Current policies to remove entrenchment are not working. The people who find it hardest to escape from disadvantage appear to fall into six main categories: 1. Older people; 2. Less-educated people; 3. Households with no employed members; 4. Particular geographic areas; 5. Indigenous Australians; and 6. Those with chronic health problems. Current policies are mainly designed to get people into, or back into, the labour market. While this is an appropriate objective, there are people in our society who need targeted and/or additional help to prepare themselves for ongoing employment. It is difficult to get or hold a job if you do not have anywhere to sleep or have ongoing health problems. It is hardly surprising then that disadvantage is cumulative: The longer a person spends with significant disadvantage, the more likely he or she is to be stuck there. Children who grow up in a home with entrenched disadvantage are also more likely to face the same problem. Related identifier: ISBN 0 85801 299

Investigating the lived experience of recovery in people who hear voices: a narrative inquiry

There is evidence of both clinical and personal recovery from distressing voices. However, the process of recovery over time is unclear. The overall aims of this thesis were 1) to produce a systematic review and synthesis of existing studies employing narrative inquiry to examine the process of recovery, across disorders and 2) to investigate recovery from distressing voices using narrative inquiry and to use this to critically appraise Romme et al.’s (2009) notion of recovery. Results of the systematic review indicated the following processes were implicated in recovery process across studies: rebuilding a positive sense of self and identity (including agency, self-worth), hope, occupation and activity, acceptance and support, contributing / helping others and making sense of or reframing experiences. Participants emphasised that the recovery process was not linear, and involved integrating their experiences and a transformation of self. Narrative inquiry contributed uniquely to understanding recovery processes and was subsequently employed to investigate the lived experience of recovered voice-hearers. Results revealed two divergent recovery typologies emerging after a period of despair/exhaustion: 1) turning toward/empowerment, which involved developing a normalised account of voices, building voice-specific skills, integration of voices into daily life and a transformation of identity and 2) turning away/protective hibernation, which involved harnessing all available resources to survive the experience and wherein participants emphasised the importance of medication in recovery. Results indicate the importance of services being sensitive and responsive to a person’s recovery style at any given time and their readiness for change. Coming to hold a normalised account of voice-hearing and the self, and witnessing of preferred narratives by others, were essential in the more robust turning toward recovery typology

Seeing the wood for the trees. Carer related research and knowledge: A scoping review

This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference

Schizophrenia and the Self: Rebuilding and Maintaining Identity After a Diagnosis of Schizophrenia

Schizophrenia is a debilitating mental illness that strikes approximately 1 in 100 people in the population during their lifetimes. It is an illness that can have a severe impact on the sense of self of people affected. It is the purpose of this thesis to examine the processes by which such a sense of self is disrupted, rebuilt and maintained in people diagnosed with schizophrenia. Twelve people diagnosed with schizophrenia were interviewed with regards to the ongoing impact of their illness. In particular, interviews focused on processes relevant to their sense of identity before, during and after the diagnosis of schizophrenia. The thesis also thematises issues of power and social structure surrounding the person diagnosed with schizophrenia. It was found that, after medication, a number of social processes were important to rebuilding a sense of identity. These included the development of illness narratives, interaction with family and friends, illness management, life management, the setting of life goals and, in some cases, participation in organised religion. Identity was typically maintained through processes of stigma concealment and passing. The influence of psychiatrists, psychopharmaceutical companies and a deinstitutionalised environment in which severe mental illness is treated all emerged as significant factors in the process of rebuilding a sense of identity. The thesis seeks to make contributions to the sociology of schizophrenia and severe mental health concerns more widely. In particular, it deploys concepts of biographical crisis to make sense of the intensity of identity disruption people diagnosed with schizophrenia may experience. It also seeks to revise the perspectives of symbolic interactionism and phenomenology to better understand the emotive and embodied nature of identity processes in schizophrenia. Beyond this, the thesis explores the relationship between language, power and agency and its significance in shaping the experience of the patient diagnosed with schizophrenia. The concept of negotiated power networks is put forward to help make sense of these power relationships in a deinstitutionalised environment. Finally, the thesis proposes the concept of identity work as a way of understanding the operations of agency and relevant processes affecting identity

Living with schizophrenia in a rural community

While a great deal of research has been developed that addresses the phenomenon of schizophrenia, much less is known about the lived experience of schizophrenia, and no research could be found, which highlighted the experience of schizophrenia, for people who live in rural communities in Canada. Five phenomenological interviews were conducted to explore the lived experiences of persons with schizophrenia in a rural community. Five themes were identified: transportation, relationships, meaningful activities, illness experience, and home. Themes, which arose in the study, underscored the essential role of the determinants of health, and the determinants of mental health, for persons, who lived with schizophrenia in rural communities. Findings from this study may be used to enhance practice, education, and research through the application of a health promotion and health equity lens in psychiatric nursing.Includes bibliographical references (pages 87-99)."In partial fulfillment of the requirements for the degree of Master of Psychiatric Nursing.

Mental Health and Work: Impact, Issues and Good Practices

[From Introduction] There is growing evidence of the global impact of mental illness. Mental health problems are among the most important contributors to the burden of disease and disability worldwide. Five of the 10 leading causes of disability worldwide are mental health problems. They are as relevant in low-income countries as they are in rich ones, cutting across age, gender and social strata. Furthermore, all predictions indicate that the future will see a dramatic increase in mental health problems

Psychology and poverty reduction: a global special Issue

A “global special issue” on poverty brought together 9 international psychology journals during 2010 through 2013. The purpose was to highlight psychology’s contribution toward the Millennium Development Goals (MDGs). These goals are rooted in the “capabilities approach” and highlight the importance of fostering environments that support 3 core domains: health, basic education, and income. Here, we analyze what the global special issue contributed. As a whole the global special issue provided an account of “how” psychology engages with poverty and poverty reduction. First, the global special issue, more than other research on poverty, was focused on lower- and middle-income settings. Second, while the content of the articles could be coded into 3 specific domains (health/well-being, education/development, and society/work), the vast majority of the articles straddled more than 1 category. Third, the contents of the global special issue could be organized in terms of the type of contribution: that is, practicality, theory, description, and advocacy. We highlight the importance of addressing wider situational and sociopolitical structures that constrain capability and potential, without losing sight of the person. Psychology might (a) concentrate resources on finding out what actually works to enable poverty reduction; and (b) apply what we know to ensure that research on poverty reduction is more informative and compelling to community stakeholders, organizations, and policymakers. Such an “implementation science” could advance poverty reduction and human development. (PsycINFO Database Record (c) 2014 APA, all rights reserved

Mental Disorders

This book brings together an international array of stars of the mental health professions to create a cutting edge volume that sheds light on many important and heretofore poorly understood issues in psychopathology. Mental Disorders-Theoretical and Empirical perspectives will be an important addition to the libraries of scholars and clinicians