Barriers to collaboration between health care, social services and schools

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Background: </span></strong><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">It is essential for professionals from different organizations to collaborate when handling matters concerning children, adolescents, and their families in order to enable society to provide holistic health care and social services. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 11pt; font-family: " lang="EN-US"> </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Objective: </span></strong><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">This paper reports perceptions of obstacles to collaboration among professionals in health care (county council), social services (municipality), and schools in an administrative district of the city of Stockholm, Sweden. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 11pt; font-family: " lang="EN-US"> </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; font-family: " lang="EN-US">Methods: </span></strong><span style="font-size: 11pt; font-family: " lang="EN-US">Data were collected in focus group interviews with unit managers and employees. </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-size: 11pt; font-family: " lang="EN-US"> </span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Results and discussion: </span></strong><span style="font-size: 11pt; line-height: 150%; font-family: " lang="EN-US">Our results show that the responsibility for collaboration fell largely on the professionals. Also, there was a <em style="mso-bidi-font-style: normal;">lack of clarity</em> regarding differences in mission and regulations, allocation of responsibilities, competence, explanatory models, and working approach. We conclude that a <em style="mso-bidi-font-style: normal;">holding environment</em> and a <em style="mso-bidi-font-style: normal;">committed management</em> would support these professionals in their efforts to collaborate.</span></p

Normalitetens gränser : En studie om 1900-talets mentalhygieniska diskurser

The comprehensive aim of the dissertation is to examine how ideas about mental hygiene have been elaborated and debated within the context of Swedish welfare. The dissertation is a compilation of four articles where issues of mental hygiene are examined in detail through an analysis of texts. In addition, a theoretical and methodological framework and a discussion of the concepts of mental health and normality are asserted to the dissertation. The subjects of research are (1) the launching of the movement in USA in the early twentieth, and the autobiographical narrative "A Mind That Found Itself" (Beers 1908), (2) the conception and the evolution of the movement in Sweden, (3) the psychosocial training within the education of social workers between the years 1939 –1989, and (4) the debate about the Mental health Campaign in 1969. The issues of mental hygiene and mental health discussed in the articles are elaborated in relation to the academic disciplines of Sociology of Health and Illness and the History of Public Health. The theoretical approach of these disciplines proceeds from a post-structural and social constructivist perspective of knowledge and language, a perspective also used in the interpretation of the textual materials. The section where the research methods are presented, consists of a description of how the textual materials have been selected and treated in relation to the theoretical and methodological standpoints. The outcome of the investigation of the autobiographical book "A Mind That Found Itself" (Beers 1908) in relation to the launching of the movement in the USA, is that the monomyth-character of the story supported an image of victory and hope, important for the movements aims to improve the reputation of psychiatry. Concerning the launching of the mental hygiene movement in Sweden two important conditions stands out as the course behind the rather hesitant start: the dominant position of custodial care and the antagonistic attitude towards psychoanalytical theories. The study of the psychosocial training of social workers showed how the skills of the clinical gaze were taught to the students by the technique of case-writing. The study of the Mental Health campaign in 1969 showed important divergences concerning the opinions of normality. Since the individual anatomy in the welfare system in Sweden is organised through the individuals position within the labour market, the issues of mental health and allied opinions of normality also contained the risks of exclusion. In conclusion, a comprehensive reflection concerning the results of the studies, is that the concept of mental hygiene, due to the mix of psychiatric and social knowledge, mediated shifting ideas about normality.At the time of the doctoral defence the following papers were unpublished and had s status as follows: Papar nr. 1: Manuscript; Paper nr. 3 Accepted Manuscript; Paper nr. 4: Manuscript.</p

Social Work and the Practice of Mental hygiene : The dispensary, the clinical gaze and the making of a case

The subject of this article is derives from my thesis Borders of Normality – discoursive practices of mental hygiene in the twentieth century. This comprehensive aim in this present text is to develop the ideas of the rise of modern knowledge and human science that Michel Foucault introduced in The Birth of the Clinic into the field of professional Social Work. During the midst of the twentieth century social workers created the concept of psychosocial work in close cooperation with the psychiatric profession. Mental hygiene was a public health- project which aimed to reach the “ordinary citizen” through practices of outward psychiatric care and social counselling. The issue addressed in the article is: -How did the medical professions influence the practice of psychosocial and mental hygiene social work? The analytical tools used in understanding the practices of mental hygiene are “the dispensary model”, “the clinical gaze” and “the construction of a case”. The “gaze” is an elaboration of the Foucaultian concept of the construction of medical knowledge and the dispensary practice relates to the new social perspectives of medicine in the twentieth century. The way of “seeing things” and the ways of organizing the clinical work, through “cases” construe a certain knowledge about the human kind. This technique was teached to social workers through The Mental hygiene Course and the course Training in Social Treatment between the years 1939 and 1989. The empirical materials consists of preserved materials of the course and the texts that are studied for the purpose of the article consists of pedagogic materials such as course books, papers, drafts and preparations for courses. A conclusion of the study is that the psychosocial training within the education of social workers was built on medical and psychological concepts and methods. The skills of the clinical gaze were trained through education in psychosocial theories. Theories, developed within medical and psychiatric practices, were applied to social work through the presentation of cases. The client, the ”owner” of the psychosocial problem, represented the case that confirmed the existence of psychosocial problems

The Case of Psychosocial Work : The Pedagogic Discourse of Psychosocial Work in Sweden 1938-1989

This article examines the pedagogic discourse of The Mental Hygiene Course (1939–1970) and the subsequent Training in Social Treatment (1971–1989), in Stockholm.The aim is to investigate the development of the psychosocial concept in Sweden; how it was expressed when adapted to the changing discourses of psychiatry and psychoanalysis and to the regulative discourses of social policy during the time. The interpretation is undertaken through the guidelines of critical discourse analysis and Bernstein’s structural model of the discourse of education. The outcome of the textual analysis showed that the psychiatric and regulative discourses were transmitted into the local context of social work by a technique of case writing, and the social worker/client relationship of the cases was, throughout the period, congruent with current scientific assumptions and predominant social policy. In conclusion, the concept of psychosocial work from the 1980s, which is still in use, is a mixture of psychiatric and psychoanalytic assumptions and political demands, certifying both the function of social work and the status of the client. Finally, the problems of psychosocial work attached to the dependency of social policy and psychiatric knowledge are discussed in relation to the outcome of the investigation

Review: Stastny, P. &amp; Lehmann, P. (2007) Alternatives beyond Psychiatry. berlin:Lehmann Publ.

Objectives: The purpose of this paper is to investigate possible reasons, based on economic and city characteristics, for the different usage of free-floating carsharing between a car-dependent city (Calgary) and one non-car-dependent city (Berlin). This paper identifies factors that help a free-floating carsharing system to be successful in a city that scores poorly on com-monly known success factors of carsharing. Methods: Various factors were evaluated, namely, geographic and demographic market char-acteristics, the available transport systems and the costs and household spending of both cities. A dataset which describes the usage of free-floating carsharing in Berlin and Calgary from Au-gust 2016 to November 2016 was analyzed in this study. Results: Calgary’s car2go system has fewer rentals and fewer members than Berlin. Possible reasons lie in the different city characteristics and different cost structures. Both 85th percentile of the travel distance is approximately as long as the radius of the respective home area in both cities. Thus, the median travel distance and the median reservation/rental duration is shorter in Calgary than in Berlin. The fact that more than 70 % of rentals in Calgary arrive in, depart from or travel within areas with active parking management could be due to the fact that free-floating carsharing users do not need to pay extra for parking fees. The carsharing bookings in Calgary peak at midnight when the public transportation service shuts down. The peak could also be the result of the high number of 3-minute long rentals at this time. Neither the high number of 3-minute bookings, the midnight peak, nor the public transport service close down during night, can be observed in Berlin. Given that employees in downtown Calgary may prefer to use free-floating carsharing to run errands during lunchbreak, the carsharing bookings do not plummet during midday, in contrast to Berlin, which only has a limited number of short distance rentals and where the free-floating carsharing bookings follow a similar pattern to the two-humped car traffic volume graph. Conclusion: Given the focus of the departures and arrivals in Calgary in areas where parking fees are charged, active parking management could be a success factor for free-floating car-sharing in car-dependent cities. However, it is not advisable to solely enforce parking fees within select parts of the home area as individuals generally prefer to use the less expensive mode of transport; which is free-floating carsharing to travel from and to areas with active parking man-agement and their own car for any other trip. As a result, the city would not gain the benefits free-floating carsharing could provide. Recommendations: Based on the results of this study, it is advisable to investigate whether home area wide or city wide parking management and surcharges for trips to downtown could encourage Calgary’s members in to use the car2go in a way that it provides the most benefits from a city perspective