Gateways to human sex trafficking in the Central Valley

The purpose of this research study was to identify gateways to human sex trafficking\ud in the Central Valley of California. The three areas studied were the background of\ud the survivors, the events that took place prior to and during the survivor becoming\ud involved with sex trafficking and the relationship formed between the survivor and\ud volunteer, that was established at an undisclosed organization in the Central Valley.\ud The study is exploratory and qualitative in nature. The researcher used three sources\ud of instrumentation to gather data including, 3 survivor interviews, 15 volunteer\ud interviews and an analysis of 31 survivor case files. All data was analyzed using\ud Neuman???s 5-part plan. The study found that gateways to sex trafficking in the Central\ud Valley involve family dynamics of the survivor, specifically parental influence. Two\ud forms of sex trafficking are occurring in the Central Valley, teenagers and young\ud adults who are lured in and children as young as the age of five put into trafficking.\ud Traffickers varied from age 15 to 30 and many were involved with drugs, gangs, and\ud violence, while others were business and family men. More organizations need to be\ud established in the Central Valley where social workers, law enforcement and\ud volunteers all work together to fight against sex trafficking. Due to the association of\ud survivors in the system, social workers in Child Protective Services and law\ud enforcement in the Juvenile Justice System should continue be trained in awareness,\ud prevention, and how to work with survivors of sex trafficking

Whose story is it? Mental health consumer and carer views on carer participation in research

Abstract BACKGROUND: Mental health carers contribute a unique set of perspectives and lived experiences to research; however, national research ethics guidelines do not specifically address the issues that affect informal carers as participants. OBJECTIVE: This study sought to explore Australian mental health consumer and carer views on the ethical conduct of research involving mental health carers. DESIGN: A public forum (n = 14; consumer = 5, carer = 9) and a subsequent series of interviews (n = 10; consumer = 5, carer = 4, both = 1) were conducted to investigate consumer and carer views on mental health research ethics. Data collection and analysis drew strongly on methodological features of grounded theory. RESULTS: Conducting research involving carers and consumer-carer relationships raises potential concerns related to story ownership. Lived experience stories have shared and separate elements; thus, it is important to consider potential risks to the privacy of non-participants and of social harm to participants' relationships when conducting research in this space. These risks could be minimized and managed through communication between researchers and participants, and within relationships. CONCLUSIONS: When conducting research involving carers and consumer-carer relationships, researchers may need to facilitate the negotiation of information-sharing boundaries within relationships and the safe and confidential telling of shared stories.ACACIA is supported by ACT Health [contract numbers 2013.21920.590, 2015.27504.340]. At the time of the research, MB was supported by Australian Research Council Discovery Early Career Researcher Award [DE150100637]

Misdiagnosis, Mistreatment, and Harm - When Medical Care Ignores Social Forces.

The Case Studies in Social Medicine demonstrate that when physicians use only biologic or individual behavioral interventions to treat diseases that stem from or are exacerbated by social factors, we risk harming the patients we seek to serve

Burnout in Mental Health Services: A Review of the Problem and Its Remediation

Staff burnout is increasingly viewed as a concern in the mental health field. In this article we first examine the extent to which burnout is a problem for mental health services in terms of two critical issues: its prevalence and its association with a range of undesirable outcomes for staff, organizations, and consumers. We subsequently provide a comprehensive review of the limited research attempting to remediate burnout among mental health staff. We conclude with recommendations for the development and rigorous testing of intervention approaches to address this critical area

A Peer-Led Electronic Mental Health Recovery App in a Community-Based Public Mental Health Service: Pilot Trial

BACKGROUND: There is an increasing need for peer workers (people with lived experience of mental health problems who support others) to work alongside consumers to improve recovery and outcomes. In addition, new forms of technology (tablet or mobile apps) can deliver services in an engaging and innovative way. However, there is a need to evaluate interventions in real-world settings. OBJECTIVE: This exploratory proof-of-concept study aimed to determine if a peer worker-led electronic mental health (e-mental health) recovery program is a feasible, acceptable, and effective adjunct to usual care for people with moderate-to-severe mental illness. METHODS: Overall, 6 consumers and 5 health service staff participated in the evaluation of a peer-led recovery app delivered at a community-based public mental health service. The peer worker and other health professional staff invited attendees at the drop-in medication clinics to participate in the trial during June to August 2017. Following the intervention period, participants were also invited by the peer worker to complete the evaluation in a separate room with the researcher. Consumers were explicitly informed that participation in the research evaluation was entirely voluntary. Consumer evaluation measures at postintervention included recovery and views on the acceptability of the program and its delivery. Interviews with staff focused on the acceptability and feasibility of the app itself and integrating a peer worker into the health care service. RESULTS: Consumer recruitment in the research component of the study (n=6) fell substantially short of the target number of participants (n=30). However, from those who participated, both staff and consumers were highly satisfied with the peer worker and somewhat satisfied with the app. Health care staff overall believed that the addition of the peer worker was highly beneficial to both the consumers and staff. CONCLUSIONS: The preliminary findings from this proof-of-concept pilot study suggest that a peer-led program may be a feasible and acceptable method of working on recovery in this population. However, the e-mental health program did not appear feasible in this setting. In addition, recruitment was challenging in this particular group, and it is important to note that these study findings may not be generalizable. Despite this, ensuring familiarity of technology in the target population before implementing e-mental health interventions is likely to be of benefit.Funding for the Apple iPads to conduct the program was provided by the Canberra Hospital Foundation and funding to employ the peer worker was provided by ACT Health. This funding applied to the e-mental health program delivery only. The Menzies School of Health Research also provided the Stay Strong app for the current research cost-free. The research study was conducted using in-kind resources at the Centre for Mental Health Research. This includes funding provided by ACT Health for ACACIA: The ACT Consumer and Carer Mental Health Research Unit. The funding support for ACACIA is managed by a separate area from the one involved in program delivery, and the research was conducted independently of program implementation. MB is supported by Medical Research Future Fund fellowship 1150698

Global vaccine equity demands reparative justice-not charity

By late April, more than 80% of the world’s COVID-19 vaccines had gone to people in wealthy countries, with just 0.3% to people in low-income countries.1 This reprehensible imbalance is no accident. High-income countries have used neocolonial negotiating power, global policy leverage and capital to procure enough doses to cover 245% of their citizens while leaving few doses for poorer countries.2 As a result, lower-income countries may not be able to vaccinate their populations until 2023.3 Such inequity is yet another example of how the interests of racial capitalism run roughshod over the golden rule of global solidarity—attend to the highest risk first.4 Currently, older and medically vulnerable individuals are dying from COVID-19 disproportionately in poor countries, while young, healthy individuals are getting vaccinated in wealthy ones.5 Vaccine apartheid is a not novel phenomenon. The notion that only certain corners of the world get to benefit from life-saving treatments is an everyday reality of a global health system driven by a capitalist, philanthropic model.6 7 But in times of crises—and as new variants threaten the vaccination plans of wealthy countries—these inequities and their solutions come to the forefront of global debate.8 Policy-makers in rich nations are aware of these issues. But the solutions they have proposed so far do nothing to address the underlying structural problems. They offer charitable donations and partial, temporary fixes that are designed to deflect the substantive demands for reform that global South countries are fighting for, including challenges to unethical intellectual property (IP) regimes.9 This approach will not work, because it is not designed to ‘work.’ If we want to end vaccine apartheid, we need to target the root causes of global health inequities. We need reparative justice. There are currently three approaches to reduce inequity in

Working overtime in community mental health: Associations with clinician burnout and perceived quality of care

OBJECTIVE: Funding cuts have increased job demands and threatened clinicians' ability to provide high-quality, person-centered care. One response to increased job demands is for clinicians to work more than their official scheduled work hours (i.e., overtime). We sought to examine the frequency of working overtime and its relationships with job characteristics, work-related outcomes, and quality of care in community health clinicians. METHOD: One hundred eighty-two clinicians completed demographic and job characteristics questions and measures of burnout, job satisfaction, turnover intention, work-life conflict, and perceived quality of care. Clinicians also reported the importance of reducing stress and their confidence in reducing their stress. Clinicians who reported working overtime were compared to clinicians that did not on demographic and job characteristics and work-related outcomes. RESULTS: Ninety-four clinicians (52%) reported working overtime in a typical week. Controlling for exempt status and group differences in time spent supervising others, those working overtime reported significantly increased burnout and work-life conflict and significantly lower job satisfaction and quality of care than those not working overtime. Clinicians working overtime also reported significantly greater importance in reducing stress but less confidence in their ability to reduce stress than those not working overtime. There were no significant group differences for turnover intention. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Working overtime is associated with negative consequences for clinician-related work outcomes and perceived quality of care. Policies and interventions aimed at reducing overtime and work-related stress and burnout may be warranted in order to improve quality of care

BREATHE: A Pilot Study of a One-Day Retreat to Reduce Burnout Among Mental Health Professionals

OBJECTIVE: Staff burnout is a frequent problem for mental health providers and may be associated with negative outcomes for providers, consumers, and organizations. This study tested an intervention to reduce staff burnout. METHODS: Community mental health providers were invited to participate in a day-long training session to learn methods to reduce burnout. A Web-based survey was given at time of registration, before the intervention, and again six weeks later. RESULTS: Eighty-four providers participated in the training, and follow-up data were available for 74. Six weeks after the day-long training, staff reported significant decreases in emotional exhaustion and depersonalization and significant increases in positive views toward consumers. There were no significant changes in providers' sense of personal accomplishment, job satisfaction, or intention to leave their position. Ninety-one percent of the staff reported the training to be helpful. CONCLUSIONS: This brief intervention is feasible, is acceptable to staff, and may improve burnout and staff attitudes

Where We Fall Down: Tensions in Teaching Social Medicine and Global Health

Background: As global health interest has risen, so too has the relevance of education on the social determinants of health and health equity. Social medicine offers a particularly salient framework for educating on the social determinants of health, health disparities, and health equity. SocMed and EqualHealth, 2 unique but related organizations, offer annual global health courses in Uganda, Haiti, and the United States, which train students to understand and respond to the social determinants of health through praxis, self-reflection and self-awareness, and building collaborative partnerships across difference. Objectives: The aim of this paper is to describe an innovative pedagogical approach to teaching social medicine 'and' global health. We draw on the notion of praxis, which illuminates the value of iterative reflection and action, to critically examine our points of weakness as educators in order to derive lessons with broad applicability for those engaged in global health work. Methods: The data for this paper were collected through an autoethnography of teaching 10 global health social medicine courses in Uganda and Haiti since 2010. It draws on revealing descriptions from participant observation, student feedback collected in anonymous course evaluations, and ongoing relationships with alumni. Findings: Critical analysis reveals 3 significant and complicated tensions raised by our courses. The first point of weakness pertains to issues of course ownership by North American outsiders. The second tension emerges from explicit acknowledgment of social and economic inequities among our students and faculty. Finally, there are ongoing challenges of sustaining positive momentum toward social change after transformative course experiences. Conclusions: Although successful in generating transformative learning experiences, these courses expose significant fracture points worth interrogating as educators, activists, and global health practitioners. Ultimately, we have identified a need for building equitable partnerships and intentional community, embracing discomfort, and moving beyond reflection to praxis in global health education