Snapshots of Sanctuary : Self-definitions of immigrant support in Eugene, Oregon

Summary: Since its inception in the 1980s, the US ‘Sanctuary Movement’ has been the source of contentious political debate and academic discussion. Although originally a clergy-based effort of transnational activism, ‘sanctuary’ has since diffused beyond the bounds of any one movement or social denomination. In this ethnography, ‘sanctuary’ is examined as a term inflected in diverse, instrumental, and meaningful ways by those participating in immigrant-support groups and non-profits in Eugene, Oregon. Research was conducted over a two-month period from August through September 2019 and funded by the London School of Economics’ Summer Ethnographic Project

Snapshots of Sanctuary : Self-definitions of immigrant support in Eugene, Oregon

Summary: Since its inception in the 1980s, the US ‘Sanctuary Movement’ has been the source of contentious political debate and academic discussion. Although originally a clergy-based effort of transnational activism, ‘sanctuary’ has since diffused beyond the bounds of any one movement or social denomination. In this ethnography, ‘sanctuary’ is examined as a term inflected in diverse, instrumental, and meaningful ways by those participating in immigrant-support groups and non-profits in Eugene, Oregon. Research was conducted over a two-month period from August through September 2019 and funded by the London School of Economics’ Summer Ethnographic Project

Stretched during COVID, Britain’s social infrastructure needs an urgent boost

Besides ‘the economy’ and ‘health’ lies a neglected area of human life during the pandemic: social infrastructures. These vital links, sustained by families and communities, now need to be a priority. The LSE COVID and Care Recovery Group call for both urgent and long term help for voluntary and community groups

How is city living associated with psychosis? Findings from a novel data linkage of 612,988 people from an urban and ethnically diverse area

Objectives UK cities show higher incidence of psychotic disorders, but the reasons remain unclear. This case-control study uses data from one of the first and largest person-level data linkages between mental health records and the UK census to explore associations previously only assessed using ecological or smaller studies in England. Methods The SocioEconomic Predictors of Mental Disorders (SEP-MD) project dataset comprises of data extracted from electronic health records (EHR) from the South London and Maudsley NHS Foundation trust (SLaM). These EHRs were linked to the 2011 UK census as a collaboration between SLaM, the ONS and King’s College London. Cases with clinical diagnoses of non-affective (schizophrenia-spectrum) and affective psychoses (bipolar disorder, depression with psychosis) were identified. Population controls were sampled from the locality. Logistic regression models were used to calculate weighted adjusted (age and sex) odds ratios (waOR) to assess associations. Robust standard errors were used to account for clustering. Results 16,863 linked cases with psychosis (affective n=5,694; non-affective n=11,169) were identified alongside 596,125 population controls. Cases with psychosis were more likely to live in areas with the highest population density (waOR 1.17 (1.05, 1.30)) when comparing the lowest quintile to the highest. Non-affective disorders showed the highest association with population density. Being born within the UK was associated with a higher risk of psychosis, and migrants living in the country for longer were at a significantly higher risk than those living in the UK for less time. Socioeconomic predictors, including education, occupation and tenure, were all associated with higher psychosis risk. Racialised minorities were at higher risk of specifically non-affective psychoses. Indicators of isolation (marital status and living alone) were highly associated with psychosis risk. Conclusions Our findings regarding urbanicity, ethnicity, migration socioeconomic position and social circumstances both confirm and provide further depth to previously identified associations. Novel findings relating to migration and interactions with ethnicity will require further investigation. These insights will provide valuable information for future public health and policy development

Social infrastructures for the post-Covid recovery in the UK

The central conflict facing policymakers, the voluntary sector, and communities during the Covid-19 pandemic has been keeping safe from a virus that is transmitted interpersonally while also providing vital support to those in need. The report presents the findings from 12 months of ethnographic, participatory, and quantitative research, which has revealed that people have fallen back on their families, neighbourhoods and communities in order to navigate new challenges and burden. We call these networks of kinship and care within and between families, friends, and communities “social infrastructures” and argue that economic life and pandemic recovery relies on the strength of these foundational relations. In the UK, local and rapid response initiatives saved lives as voluntary sector, religious organisations, and Community Champions built on these relations of care to encourage vaccine uptake. These innovative social projects also helped people to grieve and recover from losses of life and livelihoods. We argue that both short- and long-term investment in these integrated social infrastructures is crucial for the post-Covid recovery in the UK

The Contribution of Anthropology to the Study of Open Dialogue: Ethnographic Research Methods and Opportunities

When Open Dialogue diversifies internationally as an approach to mental healthcare, so too do the research methodologies used to describe, explain and evaluate this alternative to existing psychiatric services. This article considers the contribution of anthropology and its core method of ethnography among these approaches. It reviews the methodological opportunities in mental health research opened up by anthropology, and specifically the detailed knowledge about clinical processes and institutional contexts. Such knowledge is important in order to generalize innovations in practice by identifying contextual factors necessary to implementation that are unknowable in advance. The article explains the ethnographic mode of investigation, exploring this in more detail with an account of the method of one anthropological study under way in the UK focused on Peer-Supported Open Dialogue (POD) in the National Health Service (NHS). It sets out the objectives, design and scope of this research study, the varied roles of researchers, the sites of field research and the specific interaction between ethnography and Open Dialogue. This study is original in its design, context, conduct and the kind of data produced, and presents both opportunities and challenges. These are explained in order to raise issues of method that are of wider relevance to Open Dialogue research and anthropology

A right to care: the social foundations of recovery from Covid-19

This report presents key findings from a 6-month ethnographic study on the impact of the Covid-19 pandemic on disadvantaged households and communities across the UK conducted by anthropologists from the London School of Economics, and associates. This research involved in-depth interviews and multiple surveys with people across communities in the UK, with particular focus on a number of case studies of intersecting disadvantage. Crucially, our research has found that Government policy can improve adherence to restrictions and reduce the negative impacts of the pandemic on disadvantaged communities by placing central importance on communities, social networks and households to the economy and social life. This would be the most effective way to increase public trust and adherence to Covid-19 measures, because it would recognise the suffering that communities have experienced and would build policy on the basis of what is most important to people - the thriving of their families and communities

Mutuality as a method: advancing a social paradigm for global mental health through mutual learning

Purpose: Calls for “mutuality” in global mental health (GMH) aim to produce knowledge more equitably across epistemic and power differences. With funding, convening, and publishing power still concentrated in institutions in the global North, efforts to decolonize GMH emphasize the need for mutual learning instead of unidirectional knowledge transfers. This article reflects on mutuality as a concept and practice that engenders sustainable relations, conceptual innovation, and queries how epistemic power can be shared. // Methods: We draw on insights from an online mutual learning process over 8 months between 39 community-based and academic collaborators working in 24 countries. They came together to advance the shift towards a social paradigm in GMH. // Results: Our theorization of mutuality emphasizes that the processes and outcomes of knowledge production are inextricable. Mutual learning required an open-ended, iterative, and slower paced process that prioritized trust and remained responsive to all collaborators’ needs and critiques. This resulted in a social paradigm that calls for GMH to (1) move from a deficit to a strength-based view of community mental health, (2) include local and experiential knowledge in scaling processes, (3) direct funding to community organizations, and (4) challenge concepts, such as trauma and resilience, through the lens of lived experience of communities in the global South. // Conclusion: Under the current institutional arrangements in GMH, mutuality can only be imperfectly achieved. We present key ingredients of our partial success at mutual learning and conclude that challenging existing structural constraints is crucial to prevent a tokenistic use of the concept

Improving our understanding of the social determinants of mental health: a data linkage study of mental health records and the 2011 UK census

Objectives To address the lack of individual-level socioeconomic information in electronic healthcare records, we linked the 2011 census of England and Wales to patient records from a large mental healthcare provider. This paper describes the linkage process and methods for mitigating bias due to non-matching.Setting South London and Maudsley NHS Foundation Trust (SLaM), a mental healthcare provider in Southeast London.Design Clinical records from SLaM were supplied to the Office of National Statistics for linkage to the census through a deterministic matching algorithm. We examined clinical (International Classification of Disease-10 diagnosis, history of hospitalisation, frequency of service contact) and socio-demographic (age, gender, ethnicity, deprivation) information recorded in Clinical Record Interactive Search (CRIS) as predictors of linkage success with the 2011 census. To assess and adjust for potential biases caused by non-matching, we evaluated inverse probability weighting for mortality associations.Participants Individuals of all ages in contact with SLaM up until December 2019 (N=459 374).Outcome measures Likelihood of mental health records’ linkage to census.Results 220 864 (50.4%) records from CRIS linked to the 2011 census. Young adults (prevalence ratio (PR) 0.80, 95% CI 0.80 to 0.81), individuals living in more deprived areas (PR 0.78, 95% CI 0.78 to 0.79) and minority ethnic groups (eg, Black African, PR 0.67, 0.66 to 0.68) were less likely to match to census. After implementing inverse probability weighting, we observed little change in the strength of association between clinical/demographic characteristics and mortality (eg, presence of any psychiatric disorder: unweighted PR 2.66, 95% CI 2.52 to 2.80; weighted PR 2.70, 95% CI 2.56 to 2.84).Conclusions Lower response rates to the 2011 census among people with psychiatric disorders may have contributed to lower match rates, a potential concern as the census informs service planning and allocation of resources. Due to its size and unique characteristics, the linked data set will enable novel investigations into the relationship between socioeconomic factors and psychiatric disorders