Crisis intervention after the Tsunami in Phuket and Khao Lak

After the Tsunami disaster in Southeast Asia, India, Sri Lanka, and Africa, the German government set up a crisis task force that implemented crisis-intervention teams covering Thailand (Phuket and Khao Lak), Sri Lanka, and Sumatra. Two crisis teams were sent to Phuket; the first one on 28 December 2004, and the second one on 3 January 2005, each for an average of 1 week. This intervention was primarily for the benefit of German citizens and their expatriates and relatives caught up in a major catastrophe as well as the German helpers. This article describes the organizational structures of the German crisis intervention, protective factors for the helpers, psychiatric syndromes--often acute traumata, the problems of the identification process for relatives, and crisis intervention itself. Consequences for further crisis intervention after natural disasters are discussed.     

Indexing civil commitment in psychiatric emergency rooms.

A reliable prototype index, Three Ratings of Involuntary Admissibility (TRIAD), was developed to reflect the way psychiatric emergency room clinicians apply legal criteria for involuntary commitment. The interrater reliability coefficients--Pearson's r--of the TRIAD system for rating patients are 0.94, danger-to-self score; 0.89, danger-to-other score; 0.77, grave-disability score; and 0.89, total-admissibility score. TRIAD scores accounted for 82 percent of 89 disposition decisions in two metropolitan county hospital psychiatric emergency rooms. Study results indicate that (1) psychiatric emergency room clinicians shared constructs of danger to self, danger to others, and grave disability; (2) these constructs are reliably applied in actual cases; (3) TRIAD is a valid reflection of these constructs; and (4) case disposition is predictable from the severity of the patient's status with regard to these criteria.     

Crisis occurrence and resolution in patients with severe and persistent mental illness: the contribution of suicidality

Assertive community treatment appears to have limited impact on the risk of suicide in persons with severe and persistent mental illness (SPMI). This exploratory prospective study attempts to understand this observation by studying the contribution of suicidality to the occurrence of crisis events in patients with SPMI. Specifically, an observer-rated measure of the need for hospitalization, the Crisis Triage Rating Scale, was completed at baseline, crisis occurrence, and resolution to determine how much the level of suicidality contributed to the deemed level of crisis. Second, observer-ratings of suicidal ideation, the Modified Scale for Suicide Ideation, and psychopathology and suicidality, Brief Psychiatric Rating Scale, were measured at baseline, crisis occurrence, and resolution. A self-report measure of distress, the Symptom Distress Scale, was completed at baseline, crisis occurrence, and resolution. Finally, the patients' crisis experiences were recorded qualitatively to compare with quantitative measures of suicidality. Almost 40% of the subjects experienced crisis events and more than a quarter of these events were judged to be severe enough to warrant the need for hospitalization. Our findings suggest that elevation of psychiatric symptoms is a major contributor to the crisis occurrences of individuals with SPMI; although the risk of suicide may have to be conceived as somewhat separate from crisis occurrence.     

A mass-distributed CD-ROM for school-based suicide prevention

Recent violent events in schools in the United States have underscored the need for an examination of efforts aimed at mass education of school professionals on issues related to violence prevention and crisis intervention. A CD-ROM ("Team Up to Save Lives: What Your School Should Know About Preventing Youth Suicide") was mass mailed to schools throughout the United States in January 1997. We conducted an initial evaluation of this intervention in the Chicago area and found that the scope of the CD's impact was relatively narrow: Only 39% of all schools with informants that were contacted actually reviewed the CD-ROM and provided feed back for the evaluation. Insufficient time, computer equipment, and training were the major obstacles to CD-ROM use and to participation in the evaluation. Among those reviewing the CD-ROM, overall perceptions regarding its utility were extremely favorable. Multiple instances in which the CD had been used to address actual crisis situations were identified.     

Analysis of crisis intervention processes

The remediation processes in psychosocial crisis intervention were modeled focusing on cognitive orientation. Frequent observations and subsequent process modeling constitute a novel approach to process research and reveal process-outcome associations. A sample of 40 inpatients who were assigned to treatment in a crisis intervention unit was monitored in order to study the process of crisis intervention. The process data consisted of patients' self-ratings of the variables mood, tension, and cognitive orientation, which were assessed three times a day throughout hospitalization (M = 22.6 days). Linear time series models (vector autoregression) of the process data were computed to describe the prototypical dynamic patterns of the sample. Additionally, the outcome of crisis intervention was evaluated by pre-post questionnaires. Linear trends were found pointing to an improvement of mood, a reduction of tension, and an increase of outward cognitive orientation. Time series modeling showed that, on average, outward cognitive orientation preceded improved mood. The time series models partially predicted the treatment effect, notably the outcome domain "reduction of social anxiety," yet did not predict the domain of symptom reduction. In conclusion, crisis intervention should focus on having patients increasingly engage in outward cognitive orientation in order to stabilize mood, reduce anxiety, and activate their resources.     

International Financial Crisis and Development Models of the Developing Countries

In the past one or two years most developing countries have implemented various types of anti-crisis measures. These measures are quite effective, but they should not be regarded as efforts to abandon the current models. Taking into consideration of today’s global financial crisis and also the past experience and lessons of the developing countries in pursuing economic and social progress, developing countries should pay more attention to the following points when they adjust and improve their development models in the post-crisis era: take a positive attitude towards globalization; deal properly the relationship between government intervention and market mechanism; adhere to outward orientation; encourage financial innovation; seek a "green recovery"; never neglect the imperative need of promoting social development.     

Changing Stalking Patterns and Prosecutorial Decisions: Bridging the Present to the Future

This article reviews sixty cases from prosecutor's files in two New Jersey counties. These cases are used to examine and help better define the phenomena of stalking. Selected sample case examples are presented and described in regard to the typology of stalking behavior originally proposed by Dziegielewski and Roberts (1995). Based on these cases, application, modification and refinement of the typology criteria are suggested. The critical need for crisis intervention protocols and specialized anti-stalking units and training are emphasized. It is hoped that this information will help the criminal justice and forensic professional to better understand, assess the dangerousness of, and intervene rapidly and effectively in the phenomena of stalking, and to provide technology to protect victims.     

Caring Letters Project: a military suicide-prevention pilot program

Background: The Caring Letters Project (CLP) is a suicide prevention program that involves sending brief caring letters to discharged inpatients following psychiatric hospitalization. Several studies suggest that repeatedly sending caring messages may reduce suicides and suicide attempts in high-risk populations. Aims: The aims of this study were to (1) evaluate feasibility of use in the military setting, (2) explore trends toward reduction of psychiatric rehospitalizations, (3) assess preference for and test e-mail correspondence, and (4) identify best practices and gather data to inform a randomized controlled study. Methods: A total of 110 psychiatric inpatients at a military treatment facility consented, were interviewed, and then received personalized handwritten letters or e-mails at regular intervals following discharge. Data collected included demographics, clinical characteristics, preference for e-mail versus postal mail, rates of undeliverable and return correspondence, rehospitalizations, and adverse events requiring safety procedures. Results: A total of 436 letters and e-mails have been sent to date. Most participants indicated preference for e-mail versus postal mail. Fifteen participants were readmitted for treatment compared to 20 patients in usual care. Twenty participants sent responses and all were positive statements about the program. There were no adverse events. Conclusions: This program is feasible for use at a military treatment facility. A randomized controlled trial is needed to determine whether the intervention can reduce suicide rates among military and veteran populations.     

From aid negotiation to aid effectiveness: the case of food and nutrition security in Ethiopia

This paper looks at aid ownership through the lens of negotiations that take place between a country and its development partners (DPs). Based on the case of Ethiopian food security policies, it combines a structural analysis of the negotiation capital of both parties with an actor-oriented analysis of the institutional setting through which negotiations take place. First, it shows that the growing influence donors have come to have in the shaping of Ethiopian public policies results from the relative loss of legitimacy the government has experienced after the 2005 political crisis and its greater need for external economic assistance. Second, the more recent creation of a negotiation platform between the Government of Ethiopia (GoE) and its DPs has allowed the GoE to enhance donor’s alignment with its development policies and regain some control over its development agenda, while giving them more room to contribute to several food and nutrition security policy reforms which have been positively evaluated. The paper stresses the need for donors to better recognise the centrality of politics in any aid intervention.     

Restoring Fiscal Balances Post the Global Economic Crisis in Botswana

This article discusses the restoration of fiscal balances in Botswana after prolonged deficit financing. Botswana is a diamond-export-dependent country; resultantly, it suffered revenue losses due to depressed demand for diamonds during the global economic crisis. Reduced revenues necessitated deficit financing between 2008/09 and 2011/12. Debt was financed through dissaving and borrowing. However, the government restored budget balances in April 2012. While this case study is Botswana-specific, there are general lessons. These are: using a crisis to introduce public finance reforms; eschewing populism aimed at short-term gains; and the need for politicians to take very bold decisions to guide fiscal policy.     

East Asian financial regionalism: why economic enhancements undermine political sustainability

East Asian financial regionalism was born in response to the Asian Financial Crisis of 1997–1998. The centrepiece of financial regionalism was the Chiang Mai Initiative (CMI), an emergency liquidity mechanism created by the ASEAN+3. It embodied both a clear interpretation of what had gone wrong in 1997–1998 and an understanding of the need for institutions that would be politically viable despite Sino-Japanese rivalry. Enforcement under CMI relied on the ‘IMF link’ – release of funds would be predicated on crisis countries' initiating negotiations with the International Monetary Fund (IMF), as a means of reducing moral hazard, enforcing conditionality and diverting blame from the leading creditors, Japan and China. The global financial crisis of 2008–2010 and the eurozone crisis that followed have inspired important changes meant to address CMI's economic gaps, including accelerated adoption of ‘CMI Multilateralization’ (CMIM), the creation of a new surveillance unit (ASEAN+3 Macroeconomic Research Organization, or AMRO), and the establishment of a new precautionary line. Many observers have remarked that these developments weaken the IMF link, which had effectively subordinated CMI to the IMF. While the moves appear to demonstrate a more confident, autonomous regionalism and a relative devaluation of the US-dominated global financial institutions, this paper argues that in fact, the ASEAN+3 states have again unearthed the underlying politics of divided leadership and mutual suspicion. CMIM is now threatened by the renewed potential for internal divisions. Further complicating the picture, both China and Japan have recently established large bilateral swap lines outside of the CMIM framework with several of their ASEAN+3 partners, raising the question of whether CMIM is moving towards political irrelevance even as it has arrived at a high water mark in its institutional development.     

Global South solidarity? China,regional organisations and intervention in the Libyan and Syrian civil wars

Why was China responsive to regional organisations’ call for intervention in the case of the Libya crisis, where it supported sanctions and an International Criminal Court referral, and acquiesced to a no-fly zone, but unresponsive to pressure from regional organisations for intervention in the Syria crisis, issuing repeated vetoes instead? Using interviews and other primary data, this article explains the variation by highlighting that China is most responsive to regional organisations when these groups remain cohesive, congregate around the same policy position and when they publicly criticise or isolate China.     

The Politics of Economic Crisis in Latin America

Researchers widely recognize that economic crises have important political consequences, yet there is little systematic research on the political factors that make nations more or less susceptible to economic crisis. Scholars have long debated the economic consequences of party systems, executive powers, and societal interest groups, but their relationships to crisis proclivity are poorly understood. We assess the political correlates of economic crisis using a cross-sectional time-series analysis of 17 Latin American countries over nearly three decades. Crises are measured along two dimensions—depth and duration—and disaggregated into three types: inflationary, GDP, and fiscal crises. Statistical results suggest that political institutions have a modest, and often unexpected, correlation with crises. More important than institutional attributes are social organization and the nature of party-society linkages, particularly the existence of a densely-organized trade union movement and/or a powerful leftist party. Strong unions and powerful parties of the left are associated with more severe economic crises, though there is some evidence that the combination of left-labor strength can alleviate inflationary crises. The results demonstrate the need to disaggregate the concept of economic crisis and incorporate the societal dimension when studying the political economy of crisis and reform.     

Perhaps this time it's different: ideas and interests in shaping international responses to financial crises

The experience of the recent two decades of financial crises shows that donor countries and international financial institutions (IFIs) can respond to a crisis in a peripheral open economy by either of two crisis management strategies: either they can impose harsh conditionality to fix the domestic economy and prevent future moral hazard problems, or they can provide last-resort credit to restore market confidence. In some cases, the crisis management strategy changes as the crisis evolves. What are the factors that determine the choice of key donor countries and IFIs? This article traces the processes by which the USA and the International Monetary Fund designed the crisis management strategy in respect to the Asian crisis, and how Germany and the European Central Bank designed the response to the eurozone crisis, in order to understand how ideas regarding the causes and solutions of a financial crisis interact with the interests of key donor countries. The article argues that in both cases ideas and interests are mutually constituted, but in each case the mechanism that linked ideas and interests was different: whereas in the Asian case US interests led to policy innovation and experimentation and to a change in the crisis management strategy, in the European case ideas played a greater role in shaping German interests. The article explains this difference on the basis of the lessons learned by IFIs from the Asian crisis, which were then implemented in the eurozone case.     

Adding rooms onto a house we love: Central banking after the global financial crisis

This article examines the extent to which central bankers have been willing and able to rethink their beliefs about monetary policy in the wake of the global financial crisis. We show that despite the upheaval, the core pre‐crisis monetary policy paradigm remains relatively intact: central bankers believe that they should primarily pursue price stability through targeting a low inflation rate in a transparent manner, and that they need operational independence in order to achieve this goal. In a bid to address post‐crisis conditions and maintain their credibility, however, central bankers have also layered new elements onto this paradigmatic core. We document both the resilience of pre‐crisis beliefs and the process of layering using computer‐assisted text analysis and qualitative analysis of 13,586 speeches given between 1997 and 2017 by central bankers from around the world.     

Going South: capitalist crisis,systemic crisis,civilisational crisis

This article argues that the current protracted and severe financial and economic crisis is only one aspect of a larger multidimensional set of simultaneous and interacting crises on a global scale. The article constructs an overarching framework of analysis of this unique conjecture of global crises. The three principal crisis aspects are: an economic crisis of (over) accumulation of capital; a world systemic crisis (which includes a global centre-shift in the locus of production, growth and capital accumulation), and a hegemonic transition (which implies long term changes in global governance structures and institutions); and a worldwide civilisational crisis, situated in the sociohistorical structure itself, encompassing a comprehensive environmental crisis and the consequences of a lack of correspondence and coherence in the material and ideational structures of world order. In these ways, the global system is now `going south'. All three main aspects of the global crisis provoke and require commensurate radical social and political responses and self-protective measures, not only to restore systemic stability but to transform the world system.     

Russia's Response to Crisis: The Paradox of Success

Russia's recovery from the deep economic crisis it experienced in 2008–2009 did not deliver clear political dividends for the Russian leadership. This is because of the context in which the crisis occurred and the way that the leadership, particularly President Medvedev, and many of its critics described the crisis. The oil-fuelled boom that preceded the crisis had the effect of deepening it. Economic recovery based on rising energy prices looks like a failure, rather than a success, and highlights the underlying structural problems of the Russian economy. Arguments about the need for modernisation from within government exacerbated this perception. This seems to have weakened the connection between approval for the leadership and economic growth, a staple of pre-crisis politics.     

NAZI GERMANY AND PUBLIC ADMINISTRATION 1933–42: THE MOST IMPORTANT LABORATORY FOR DEPRESSION AMERICA?

The inter‐war period saw a flowering of comparative research on emergency administration in response to the Great Depression. This article argues that Weimar and Nazi Germany was an important point of reference for scholars comparing different policy responses to the Great Depression. Centralization and administrative discretion were considered pivotal for effective crisis governance, irrespective of the political context. The resulting administrative ideology was ignorant of the polycratic realities of the Nazi state and frequently lauded its hierarchical features while condemning the Weimar Republic as anarchic. Faced with the challenge presented by Nazism, of squaring efficiency and accountability in the context of New Deal America, scholars of public administration developed ideas for training a new type of civil servant who was capable of acting beyond the control of legislative institutions. By exploring the ambiguous relationship between public administration and Nazism, this article highlights the complex issues confronting scholars of public administration in times of crisis.     

Deliberate self-harm patients with alcohol disorders: characteristics, treatment, and outcome

Deliberate self-harm (DSH) patients with alcohol problems present a considerable challenge for clinical services. In a study of a sample of 150 DSH patients who were representative of all such patients seen at a general hospital during the study period, 40 patients with an ICD-10 diagnosis of alcohol dependence or harmful use of alcohol were compared with the remainder of the sample. The treatment of the patients with alcohol disorders before and after the episode of DSH and the outcome 12-20 months later were also investigated. Compared with other DSH patients, those with an alcohol diagnosis were older and more often male, living alone, unemployed, sick, disabled, or with a past history of DSH. They also had higher scores on measures of anger, aggression, and impulsivity. Comorbid psychiatric disorder was present in 37 (92.5%) patients, this being depression in three-quarters of those cases. Fourteen (35.0%) patients were receiving treatment from the psychiatric services prior to DSH, and 33 (82.5%) were subsequently offered treatment. Of the patients who were followed up, 37.9% remained in contact with psychiatric services, 55.2% showed poor compliance with treatment and 44.8% reported a further episode of DSH. All patients presenting after DSH need to be carefully screened for alcohol disorders and for comorbid psychiatric diagnoses. Treatment of DSH patients with alcohol disorders should include the treatment of any comorbid depressive illness.