Social isolation: A conceptual and measurement proposal

Social isolation is a deprivation of social connectedness. It is a crucial aspect that continues to be named by people as a core impediment for achieving well-being and as a relevant factor for understanding poverty. The notion of social isolation has been discussed within a diversity of theories that have provided rich insights into particular aspects of social isolation. However, there is no agreement on the core components of this social malady or on how to measure it. Although the challenge of conceptualising and measuring social connectedness is daunting, this paper argues that existing research in several fields provides solid ground for a common concept and for the construction of basic internationally comparable indicators that measure specific aspects of social isolation. In particular, this paper aims to contribute to the debate on social connectedness and its measurement in three ways: (1) presenting a working definition that, while doing justice to the rich insights advanced by different theories, stresses relational features in the life experience of people; (2) emphasising the relevance of isolation for poverty analysis; and (3) proposing some indicators to measure social connectedness that could be feasibly incorporated into a multi-topic household survey

Shame, Humiliation and Social Isolation: Missing Dimensions of Poverty and Suffering Analysis

While people living in poverty talk about isolation, shame, and humiliation as being key aspects of their lived experiences of suffering, until recently, there has been no international data on these aspects – making them “missing dimensions” within poverty analysis and within research into suffering. Drawing upon international fieldwork and datasets from Chile and Chad, this chapter examines the relevance of social isolation, shame and humiliation in contexts of poverty, to research on suffering. The chapter suggests that the use of particular indicators of shame, humiliation, and social isolation can better recognize distributions of suffering. It can also help identify individuals and sub-groups within those living in multidimensional poverty – or of the general population at large – that are affected by concrete and particularly hurtful situations. Consequently, they can help to identify levels of suffering which are higher within a specific population. We argue that these types of indicators could form the basis of more refined measures that help generate more concise data on suffering

Globalising disorders: encounters with psychiatry in India

Amid calls from the World Health Organization (WHO) and Global Mental Health to ‘scale up’ psychiatric treatments, globally, there are other calls (sometimes from those who have received those treatments), to abolish psychiatric diagnostic systems and to acknowledge the harm caused by some medications. This thesis elaborates a space for these arguments to encounter and to be encountered by each other. This is a thesis about encounters; about psychiatry’s encounters with the global South; about research encounters in India with mental health Non-Governmental Organisations (NGOs); and about colonial encounters more generally. Drawing on analysis of interviews and visits to a range of mental health support provision in India, this thesis traces some conceptual and material mechanisms by which psychiatry travels - across borders - into increasing domains of everyday experience, and across geographical borders, into low and middle-income countries. It explores the claims of Global Mental Health, ‘to make mental health for all a reality’, as being particular mechanisms of psychiatrization - ones that may employ similar codifications to those of colonial discourse. Global Mental Health and WHO mental health policy often mobilise psychiatric interventions in response to a ‘crisis’ or an ‘emergency’ in mental health, globally. Yet while this current incitement suggests an abnormal deviation from a normal order, mental illness may also be read as a ‘normal’ reaction to the (dis)order of globalisation. Nevertheless, in making the claim that mental health problems, such as Depression, are a ‘normal’ response to inequitable market relations in the global South, may also be normative, as it glosses over a simultaneous globalisation; that of bio-psychiatric explanations of distress. Thus, while Global Mental Health marks an explicit making political of psychiatry through its conceptualisation of mental health as key to an agenda of international development, it simultaneously disavows psychiatry as political through its universal application of psychiatric technologies. To claim the universality of psychiatric diagnoses is different from making the claim that distress, manifest in myriad forms, is universal. This is because psychiatric frameworks are mediators of that distress, they provide but one way of understanding yet they are often framed as being the ‘truth’, globally. 4 Reading Global Mental Health psychopolitically, then, enables an engagement with the double process through which conditions of inequality and alienation may become internalised –how inequality may come to play on the body, to be made flesh. This move occurs alongside another process that reads the mechanisms by which socio-economic crisis comes to be rearticulated and reconfigured as individual crisis, as mental illness. To read Global Mental Health as a colonial discourse is to trace how particular knowledge is mobilised in the creation of a space for psychiatric ‘subject peoples’, a global space. This research traces some of these ‘on the ground’, often powerful, techniques of recruiting subjects and fixing them. It also interrogates the knowledge base of Global Mental Health to create a space to read this alongside alternative ways of knowing; specifically psychiatric user/survivor and critical psychiatry critiques. This works to explore how psychiatry encounters difference (both within the global North and South), and to (re)think how Global Mental Health might be encountered differently. This thesis thus explores how the colonial relation is mobilised within psychiatric treatment in order to think through how the violence of colonialism may enable a re-thinking of contemporary forms of psychiatric treatment as being violent, the violence of psychiatrization - violence in the name of ‘treatment’. Using the post-colonial theory of Frantz Fanon, Ashis Nandy and Homi Bhabha, as conceptual tools, alongside research encounters (interviews, ethnographic field work, policy documents) in India, enables exploration of how psychiatrization may allow relationships of domination and resistance to continue after formal colonialism has ended. It also enables engagement with how strategies of resistance to colonialism may be read alongside and used to illuminate resistance to psychiatry – resistance that may be secret, sly, covered up. This research concludes by attending to emerging counter-hegemonic ways of knowing distress, epistemologies of the South, in order to creatively re-think the work of Global Mental Health and psychiatry in countries of the global South. To imagine a global mental health that attends to the heterogeneity and complexity of local, indigenous ways of knowing distress, that rethinks issues of consent – specifically around the use of psychiatric terminology and the provision of non-medical (and non-‘western’) spaces 5 of healing, and that recognises psychiatry as one of many approaches, questioning whether it can, or should, be global

Efficacy of Dog Training With and Without Remote Electronic Collars vs. A Focus on Positive Reinforcement

We assessed the efficacy of dog training with and without remote electronic collars compared to training with positive reinforcement. A total of 63 dogs with known off-lead behavioral problems such as poor recall were allocated to one of three training groups (each n = 21), receiving up to 150min of training over 5 days to improve recall and general obedience. The 3 groups were: E-collar—manufacturer-nominated trainers who used electronic stimuli as part of their training program; Control 1—the same trainers following practices they would apply when not using electronic stimuli; and Control 2—independent, professional trainers who focused primarily on positive reinforcement for their training. Data collection focused on dogs’ response to two commands: “Come” (recall to trainer) and “Sit” (place hindquarters on ground). These were the two most common commands used during training, with improving recall being the target behavior for the subject dogs. Measures of training efficacy included number of commands given to elicit the response and response latency. Control 2 achieved significantly better responses to both “Sit” and “Come” commands after a single instruction in the allocated time. These dogs also had shorter response latencies than the E-collar group. There was no significant difference in the proportion of command disobeyed between the three groups, although significantly fewer commands were given to the dogs in Control 2. There was no difference in the number of verbal cues used in each group, but Control 2 used fewer hand and lead signals, and Control 1 made more use of these signals than E-collar group. These findings refute the suggestion that training with an E-collar is either more efficient or results in less disobedience, even in the hands of experienced trainers. In many ways, training with positive reinforcement was found to be more effective at addressing the target behavior as well as general obedience training. This method of training also poses fewer risks to dog welfare and quality of the human-dog relationship. Given these results we suggest that there is no evidence to indicate that E-collar training is necessary, even for its most widely cited indication

Response: Commentary: Remote Electronic Training Aids; Efficacy at Deterring Predatory Behavior in Dogs and Implications for Training and Policy.

A Commentary on Commentary: Efficacy of Dog Training With and Without Remote Electronic Collars vs. a Focus on Positive Reinforcemen

Remote electronic training aids; efficacy at deterring predatory behaviour in dogs and implications for training and policy. Response: "Commentary: Efficacy of dog training with and without remote electronic collars versus a focus on positive reinforcement"

In their commentary, Sargisson and McLean (2021) object to our conclusion that the use of e-collars are unnecessary in dog training (China et al 2020). Their criticisms make 4 broad claims: firstly that the training approaches were not the most effective means of training with e-collars; secondly that the paper focussed on measures of efficacy and did not present data on welfare; thirdly that the study did not include long term measures of efficacy; and fourthly our statistical approaches were not appropriate. Sargisson and McLean (2021) also question whether the research should be used to inform policy decisions with regard to use of e-collars in dog training, although we were cautious not to make any specific recommendations regarding legislation in our paper. We shall deal with each of these objections in turn, placing the first three in the context of the research project as well as related published work, clarifying the statistical approaches as there appear to be misunderstandings by Sargisson and McLean (2021) and finally relating the research to policy implications

Madness after the war. Experiences and life stories of people who experienced distress before, during and after the war in Bosnia and Herzegovina

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The construction of mental health as a technological problem in India

This paper points to an underexplored relationship of reinforcement between processes of quantification and digitization in the construction of mental health as amenable to technological intervention, in India. Increasingly, technology is used to collect mental health data, to diagnose mental health problems, and as a route of mental health intervention and clinical management. At the same time, mental health has become recognized as a new public health priority in India, and within national and global public health agendas. We explore two sites of the technological problematisation of mental health in India: a large-scale survey calculating prevalence, and a smartphone app to manage stress. We show how digital technology is deployed both to frame a ‘need’ for, and to implement, mental health interventions. We then trace the epistemologies and colonial histories of ‘psy’ technologies, which question assumptions of digital empowerment and of top-down ‘western’ imposition. Our findings show that in India such technologies work both to discipline and liberate users. The paper aims to encourage global debate inclusive of those positioned inside and outside of the ‘black box’ of mental health technology and data production, and to contribute to shaping a future research agenda that analyzes quantification and digitization as key drivers in global advocacy to make mental health count

Focus on vulnerable populations and promoting equity in health service utilization ––an analysis of visitor characteristics and service utilization of the Chinese community health service

Background Community health service in China is designed to provide a convenient and affordable primary health service for the city residents, and to promote health equity. Based on data from a large national study of 35 cities across China, we examined the characteristics of the patients and the utilization of community health institutions (CHIs), and assessed the role of community health service in promoting equity in health service utilization for community residents. Methods Multistage sampling method was applied to select 35 cities in China. Four CHIs were randomly chosen in every district of the 35 cities. A total of 88,482 visitors to the selected CHIs were investigated by using intercept survey method at the exit of the CHIs in 2008, 2009, 2010, and 2011. Descriptive analyses were used to analyze the main characteristics (gender, age, and income) of the CHI visitors, and the results were compared with that from the National Health Services Survey (NHSS, including CHIs and higher levels of hospitals). We also analyzed the service utilization and the satisfactions of the CHI visitors. Results The proportions of the children (2.4%) and the elderly (about 22.7%) were lower in our survey than those in NHSS (9.8% and 38.8% respectively). The proportion of the low-income group (26.4%) was apparently higher than that in NHSS (12.5%). The children group had the lowest satisfaction with the CHIs than other age groups. The satisfaction of the low-income visitors was slightly higher than that of the higher-income visitors. The utilization rate of public health services was low in CHIs. Conclusions The CHIs in China appears to fulfill the public health target of uptake by vulnerable populations, and may play an important role in promoting equity in health service utilization. However, services for children and the elderly should be strengthened