Community Treatment Orders and mental health social work : issues for policy and practice in the UK and Ireland

This comparative scoping review charts and compares current and emerging issues for mental health social workers involved in the use of compulsory mental health legislation in the UK and Ireland. It acknowledges a dearth of research evidence in this key area of social work practice and an urgent need to critically examine the use of such compulsory intervention given the significant human rights implications of forced detention and medical treatment. A case study approach is used in the paper with specific focus on the role that mental health social workers play in the delivery of community based compulsory treatment orders (CTOs) in three UK jurisdictions (England, Wales and Scotland) and two where, at present they are not used, nor are planned to be used (Northern Ireland and the Republic of Ireland). The paper starts by offering an historical overview of the mandated and other roles of mental health social workers in the UK and Ireland with particular attention to the shifts in policy and law created by the processes of devolution that have occurred in the last few decades. This discussion draws out distinctions between jurisdictions, but notes the common policy and legal imperatives that involve social workers in decision-making in relation to CTOs, and the use of compulsory measures more broadly. Analysis is provided in terms of comparative themes, including the rationale for CTOs, legal thresholds, service user rights and trends in the use of CTOs and equivalent statutory measures. Attention is paid to the roles social workers undertake, both in terms of formal decision-making regarding applications for CTOs and post-hoc care and monitoring. This is compared with the social work role in the two jurisdictions without CTOs: Northern Ireland and the Republic of Ireland. A discussion then takes place about the ethical and practice dilemmas that social workers experience in these contexts, including inherent tensions between the potentially coercive nature of CTOs and social work’s espoused commitment to human rights and social justice, set against the paradigmatic shift in thinking about the legality of compulsion reflected in the United Nations Convention on the Rights of Persons with Disabilities. The paper considers the extent to which social workers can bring a social perspective to counter prevailing medical discourses in framing and responding to mental distress in statutory settings and to uphold citizens’ broader social and cultural needs in the context of welfare austerity. It concludes with an appeal for future critical analyses of the mental health role when such compulsory laws are being applied

A longitudinal study of tobacco use among American Indian and Alaska Native tribal college students

<p>Abstract</p> <p>Background</p> <p>American Indians (AI) have the highest smoking rates of any ethnic group in the US (40.8%), followed most closely by African Americans (24.3%) and European Americans (23.6%). AI smokers also have more difficulty quitting smoking compared to other ethnic groups, evidenced by their significantly lower quit ratios, and are among the least successful in maintaining long term abstinence. While health disparities like these have existed for years among AI, the epidemiology of smoking and nicotine dependence has not been optimally described among this underserved population.</p> <p>Our overarching hypothesis is that the susceptibility of AI to cigarette smoking and nicotine dependence and its consequences has both an underlying nicotine metabolism component as well as psychosocial, cultural, and environment causes. We are well-positioned to explore this issue for the first time in this population. Our objective is to establish a cohort of AI tribal college/university students to determine the predictors of smoking initiation (non-use to experimentation), progression (experimentation to established use), and cessation (established use to cessation). Much of what is known about the process of smoking initiation and progression comes from quantitative studies with non-Native populations. Information related to smoking use among AI tribal college/university (TCU) students is entirely unknown and critically needs further investigation. This study will be the first of its kind among AI college students who are at the highest risk among all ethnic groups for tobacco dependence.</p> <p>Methods/design</p> <p>First year students at Haskell Indian Nations University in Kansas will be recruited over four consecutive years and will be surveyed annually and repeatedly through year 5 of the study. We will use both longitudinal quantitative surveys and qualitative focus group methods to examine key measures and determinants of initiation and use among this high risk group.</p

'Open Data' and the Semantic Web Require a Rethink on Statistics Teaching

The concept of statistical literacy needs to be refreshed, regularly. Major changes in the ways that data can be accessed from government and non-government agencies allow everyone to access huge databases, to create new variables, and to explore new relationships. New ways of visualizing data provide further challenges and opportunities. The Open Data movement, and the rise of data driven journalism are increasing public access to large scale data via the media. Here, we map out some opportunities and potential pitfalls, and discuss the rebalancing of statistics curricula that is required. The most obvious challenge is the need to introduce students to the exploration and analysis of large scale multivariate data sets. The curriculum should also address issues of data provenance and quality. We present an example of our visualisations of complex multivariate data, used in classroom trials. General issues of pedagogy and curriculum innovation are discussed.