Chapter 4. Concepts of Mental Health and Mental Illness in Older Hispanics

Abstract

The effect of cultural context in symptom expression and interpretation among older Hispanics, and how they experience psychological distress are not well-understood. We use the illness representation model to learn about older Puerto Ricans' and Dominicans' conceptions and causes of positive mental health, the causes of emotional problems, the conceptions and causes of depression and anxiety, the distinction between depression and anxiety, and the relationship between age and depression. Greater understanding of the meaning of symptoms and syndromes of depression and anxiety might help to define more culturally-sensitive mental health treatments and service delivery systems.     

Exploring the Relationship between Operational and Financial Indicators: The Case of Water and Sewer Utilities

ABSTRACT

There is debate in the literature on whether or not general management principles are applicable to the study and practice of public administration. This research responds by exploring how local officials manage the performance of public services with private good characteristics, where general management principles could be embraced for service delivery. The relationship between operational and financial indicators is explored within the functional areas of water and sewer, with the hypothesis that operational outcomes impact financial outcomes similar to private enterprises. Because the findings do not support this hypothesis, the authors conclude that general management principles may not be applicable to all forms of administration given that public cannot be removed from the management of public services even with private good characteristics.     

Financial Health in Australian Local Government: The Application of a Funding Assessment Model to Brisbane and Sydney City Councils

Local government financial viability measurement in an accrual budgeting environment poses complex challenges. Financial measures frequently generate conflicting results. A rating scale to assess financial management, constructed originally for South African municipalities (Dollery & Graves, 2009), represents a useful tool to analyze financial health trends. Applying a “Likert-like” scale to financial performance measures to assess “funding compliance”, the model in this article assists municipalities to avoid financial difficulties. To demonstrate the applicability of this model, we apply the model to the Brisbane City Council and the Sydney City Councils. Results show that the model represents a valuable aid to financial management decision-making.     

Chapter 10. Central American Survivors of Political Violence

Abstract

Despite compelling, well-documented findings on the levels of stress and trauma among Central American refugees, this group continues to be underserved. A host of issues contributes to this underservice, ranging from macro-level imposed obstacles, such as citizenship and health insurance as determining factors for accessing social and health services, to institutional factors that impede service utilization, such as an insufficient number of translators or a cumbersome and confusing bureaucracy. This chapter adopts a human rights framework as a strategy for working with groups of Central Americans who have experienced political violence. The ongoing effects of political violence on Central Americans, as they relate to mental and physical health problems, are reviewed and a case vignette is used to illustrate how political violence affects individuals and how macro-level forces and institutions create barriers to access and use of health care and social services. Treatment approaches for helping survivors of political violence in the context of a human rights framework are suggested.     

Financial Literacy and Retirement Planning among Government Officers in Malaysia

ABSTRACT

This study examines the level of financial literacy, financial behaviour and retirement planning behaviour and its dynamics among Malaysian government officers involving 320 employees working in the federal government administrative centre in Putrajaya and Kuala Lumpur using a questionnaire. Findings show high level of financial literacy, good financial behaviour but a mediocre in retirement planning behaviour, and only education and personal income positively influence financial literacy. Age and gender of officers do not influence financial literacy. Furthermore, financial literacy does not correlate with retirement planning and neither does it mediate the relationship between financial behaviour and retirement planning.     

Financial and Political Factors Motivating the Privatisation of Municipal Water Services

Financial and political factors are widely considered to be an explanatory factor of the privatisation of public services. However, the empirical evidence in this respect is not convincing. This paper considers elements of long-term financial condition and ideological and political strength, together with other socio-economic factors and the effects of the current global financial crisis, to address the financial stress–privatisation relationship, with respect to urban water services, observed during the period 2002–2012 in Spanish municipalities. A discrete time survival model is applied, and the results obtained show that certain elements of financial condition, together with political and ideological factors, are decisive influences in decisions to privatise urban water services. We also highlight the major impact of the Great Recession and its effect on the financial stress–privatisation relationship.     

Effects of Governance Practices and Investment Strategies on State and Local Government Pension Fund Financial Performance

Abstract

Recent statistical studies concerning state and local government pension funds’ boards of trustees have focused on two complementary issues. First is the influence governance practices have on administration of fund assets. Second is the impact of investment strategy choices on funds’ total rates of return. Reported results indicate that the primary effects of governance practices on pension outcomes are indirect via asset allocation decisions. This study re-examined these issues using abnormal return as an inherently valued measure of risk adjusted financial performance. An innovation of the investigation is that “process analysis” was used to decompose the direct and indirect effects of governance practices on financial performance. Results suggest that while both types of effects exist, direct impacts dominate relative to mediating processes.     

Refugees Who Have Experienced Extreme Cruelty: A Qualitative Study of Mental Health and Wellbeing after Being Granted Leave to Remain in the UK

Abstract

This study explores how vulnerable refugees’ experiences in the first year after being granted leave to remain in the UK impact on mental health and wellbeing. Nine semi-structured interviews were conducted with refugee survivors of extreme cruelty. Data were analyzed using thematic analysis with a narrative influence. Reported challenges included requirements to organize housing, finances and welfare benefits rapidly. Most respondents reported low mood, worry, exacerbated PTSD symptoms, physical ailments and isolation, but valued stable housing, meaningful activities, emotional support and service provider sensitivity in managing this transition. Policy and service recommendations are made, to assist integration and improve wellbeing.     

Refugees,idps and Citizenship Rights: the perils of humanitarianism in the African Great Lakes region

Persistent civil warfare has created a crisis of protection for vulnerable refugees/returnees and internally displaced people ( idps ) in the African Great Lakes region. This is in the context of increasing state hostility towards refugees, intensified inter-group competition among citizens, and rising xenophobia towards African ‘foreigners’. Humanitarian solutions are often de-contextualised from struggles over entitlements, citizenship and exclusionary practices based on social hierarchies, ethnicity and indigeneity. Hence, they tend to contribute to rather than alleviate the marginality experienced by the displaced. This article argues for further exploration of the processes of identity construction that accompany displacement and humanitarianism and their problematic relationship with sovereignty and citizenship. It suggests that transcending marginality requires greater emphasis on political agency within refugee and idp communities—for their voices to be part of negotiations and conversations on repatriation and integration—in order for them to rejoin the political community.     

Chapter 6. Psychosocial Stressors,Psychiatric Diagnoses and Utilization of Mental Health Services Among Undocumented Immigrant Latinos

Abstract

The combined effects of minority status, specific ethnic group experiences (political, economic, trauma and immigration history), poverty, and illegal status pose a set of unique psychiatric risks for undocumented Latinos in the United States. Restrictive legislation and policy measures have limited access to health care, and other basic human services to undocumented immigrants and their children throughout the nation. However, little is known about the patterns of mental health care use, psychiatric diagnoses and psychosocial problems prevalent among the undocumented who do succeed in presenting to clinical settings and to the mental health sector. To begin to address the need for further understanding in this area, we completed a clinical chart review of 197 outpatient adult psychiatric charts in a Latino mental health outpatient treatment program located in an urban hospital system.

We compared the diagnoses and mental health care use of undocumented Latino immigrants (15%) with that of documented (73%) and US born Latinos (12%) treated in this clinical setting. The undocumented Latinos in our study were more likely to have a diagnosis of anxiety, adjustment and alcohol abuse disorders. The undocumented also had a significantly greater mean number of concurrent psychosocial stressors (mean number = 5, p < .001) ascompared to documented immigrants and US born groups, which both had a mean number of 3 stressors identified at evaluation. The undocumented were more likely to have psychosocial problems related to occupation, access to healthcare and the legal system. However, the undocumented had a lower mean number of total mental health appointments attended (mean visits = 4.3, p < .001) in which to address these stressors as compared to documented immigrants (mean visits = 7.9) and US born (mean visits = 13.3). In terms of other previous mental health service use, the undocumented group had lower rates of lifetime inpatient and outpatient treatment use.

The results of this study suggest the importance of early assessment of psychosocial stressors, substance use and barriers to care when treating undocumented immigrants. Although all Latino groups included in this investigation demonstrated numerable concurrent stressors, our investigation highlights the particular importance of accessible social services and supports for addressing psychosocial stressors in the lives of undocumented patients. Our results stress the importance of reexamining policies, that restrict access to social services and healthcare for the undocumented. Our results also suggest the importance of culturally appropriate evaluation and treatment of substance abuse disorders as well as addressing other psychological and behavioral responses to multiple stressors among undocumented individuals.     

On Being Black,Muslim, and a Refugee: Stories of Somalis in Chicago

Abstract

Somali refugees are considered one of the largest African refugee populations in the United States and the fourth largest refugee population globally. Yet, there is limited scholarship on their overall migration paths and the ways in which their intersectional identities may impact their resettlement and integration in the United States. Study findings are from a qualitative study on the migration and integration experiences of 15 Somali Americans in Chicago. Findings illustrate the complexities associated with the Somali refugee narrative and how this population is often positioned at the intersections of anti-Black, anti-Muslim, and anti-refugee racism and discrimination in the United States.     

A New Predictor of Local Financial Distress

The development of predictive models for financial distress is a recurring topic in both private and public contexts, although currently its repercussions are greater in the public sphere, where efforts are being made to define new warning systems for fiscal crises. The present study thus aims first to show the similarities and differences between the absolute and relative models based on a 10-point scale, in order to subsequently combine the positive aspects of both proposals to find a system that can determine local fiscal distress in a more robust way.

The results obtained show that the optimum predictive system is a slight variant of the model proposed by Kloha et al. (2005) Kloha, P., Weissert, C. S. and Kleine, R. 2005. Developing and testing a composite model to predict local fiscal distress. Public Administration Review, 65(3): 313–323. [Crossref], [Web of Science ®] , [Google Scholar]. This variant consists of the inclusion of two indicators of financial independence proposed by Zafra-Gómez et al. (2009a) Zafra-Gomez, J. S., López-Hernández, A. M. and Hernández-Bastida, A. 2009a. Developing an alert system for local governments in financial crisis. Public Money &; Management, 29(3): 175–82. [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar] for which an alert threshold has been empirically determined.     

The Centre Decides and the Local Pays: Mandates and Politics in Local Government Financial Management in China

Abstract

In China, ‘the centre decides and the local pays’ means the central government decides on policies but requires its local subordinates to provide the financial resources. The politics of this practice implies that local government has to take different strategies to cope with the unfunded mandates with various consequences. As an empirical study framed by Niskanen’s rational choice theory and Dunleavy’s ‘bureau-shaping’ model, this paper examines how the unfunded mandates impact local government behaviour. Its main focus is the question of how the local officials respond, the extent to which they comply or resist and the techniques they use to adapt to these mandates. This paper finds when deciding how to pay the bill for the centre, local officials have to take a number of principles into consideration. They need to stick to the people-orientated principle and to finance money for salaries and operation to the extent that they can; they also have to see if the mandates are strictly implemented or popular among local people.     

Chapter 2. Mental Health in the Hispanic Immigrant Community

Abstract

This chapter addresses the mental health status of Hispanics in the United States. The prevalence and incidence of mental health disorders among different Hispanic ethnic subgroups is examined. Patterns of mental health services utilization and barriers to mental health care are also reviewed. Research specific to best mental health practices with Hispanics is stressed.     

Understanding Immigration and Psychological Development

Abstract

Approximately one in five children in the U.S. are born to immigrant families in which at least one parent is foreign-born. Existing theoretical frameworks suggest that immigration experiences can increase acculturative stress and lead to developmental psycholopathology in immigrant children. These models, however, do not account for levels in the environment that trigger this stress and/or serve as forms of resilience. Drawing from Bronfenbrenner's multilevel, bioecological model of development, this paper presents a framework that charts environmental processes which generate or buffer acculturative stress and, therefore, mediate the impact of immigration on psychological well-being. Empirical research shows that Mexican immigrants, on the whole, fare better than U.S.-born groups in terms of mental health outcomes. These results are explained in the context of the presented theoretical model. Though further research is needed, preliminary evidence suggests that encouraging “enculturation,” as opposed to “acculturation,” has positive mental health repercussions for Mexican American children. Further research using the presented theoretical framework as well as policies and practices that incorporate and leverage the cultural strengths of Mexican immigrant children should be pursued.     

International Pressure and Domestic Precedent: Japan's Resettlement of Indochinese Refugees

Abstract

Why did Japan decide to admit more than 11,000 refugees from Vietnam, Laos, and Cambodia between 1975 and 2005? The conventional explanation is that Japan admitted these refugees because of pressure from foreign countries, and particularly from the United States. In this article, I argue that, in addition to foreign pressure, there was another factor that was important in causing Japan to admit these refugee populations. Japanese leaders agreed to admit Indochinese refugees because they came to believe that this would not set a precedent that would make Japan into a major destination for refugee resettlement.     

Chapter 11. The Future of Culturally Competent Mental Health Care for Latino Immigrants

Abstract

This chapter underscores the importance of cultural competence in the provision of effective mental health services to Latino immigrants. Culturally competent mental health care must be understood within the context of a social-political-economic framework that is changing on a continual basis. Health and mental health care reform for Latino immigrants must be linked to both practice-based research efforts and timely diffusion of best practice innovations. Cultural competence must be integrated as a valued component of the organizational structure of mental health systems of care.     

Mental Health Intervention with Hispanic Immigrants

Abstract

The underutilization of mental health services by Hispanic immigrants has been well documented in the literature. Hispanic immigrants encounter numerous obstacles which prevent them from successfully navigating through the mental health system. This reality is further compounded by the fact that research appears to suggest an increased rate of mental health disorders among Hispanics. This article underscores the importance of understanding the influence of a Hispanic client's worldview, language, and religion on the provision of mental health services. A case vignette is presented as a means of illustrating key conceptual points. Practice principles or conclusions drawn from this article should be used as a general guide by mental health practitioners.     

When ‘brothers and sisters’ become ‘foreigners’: Syrian refugees and the politics of healthcare in Jordan

Abstract

Does overseas development aid necessarily translate into more generous national policies for refugees? Evidence from Jordan suggests that this is not always the case. Since the arrival of an estimated 756,000 Syrian refugees, international funding has made Jordan one of the top seven recipients of foreign aid in the world. Despite sustained international financing, however, national policies towards refugees have become increasingly restrictive, especially when it comes to healthcare. Based on fieldwork conducted between 2017 and 2019, this paper argues that Jordan’s healthcare policies towards Syrian refugees are not necessarily correlated to international financing, but are rather the product of political considerations aimed at maintaining domestic stability, increasing bargaining power in the global policymaking arena and resisting international pressures to integrate Syrian refugees. This paper contributes to filling a gap in the literature on the complex and interdependent factors which influence the evolution of national healthcare policies towards refugees in a country not only highly dependent on foreign aid, but also at the geopolitical crossroads of international interests in the Middle East.