Why community compulsion became the solution - Reforming mental health law in Sweden

The aim of this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State.In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, there was agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framed within an ideology of integrating the disabled. The new legislation allowed for a broad range of measures to control patients at the same time as it was presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community.The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.     

外伤性癫痫法医学评定100例分析

目的探讨颅脑外伤后癫痫的法医学评定要点,提出外伤性癫痫的法医学评定依据。方法对100例颅脑损伤后癫痫患者门诊及住院病历,结合临床脑电图（EEG）结果、CT片、MRI片等影像学资料,进行了回顾性分析。结果依据GBl8667-2002《道路交通事故受伤人员伤残评定》标准有关颅脑损伤后癫痫发作类型、发作频率的相关条款规定,Ⅲ级伤残8人,Ⅴ级伤残10人,Ⅶ级伤残22人,Ⅸ级伤残40人,Ⅹ级伤残20人。误工期限、营养期限和护理期限评定结论时间长短差异较大,具有个体化特征。结论外伤后癫痫常继发于严重的颅脑损伤,其发作特点决定于颅脑外伤的部位和程度,外伤性癫痫法医学鉴定必须以外伤史及既往史为基础,结合电生理及影像学检查,综合癫痫发作类型、频率及药物控制情况作出正确的伤残等级及误工期限、护理期限、营养期限的鉴定结论。     

监狱环境与罪犯改造研究

“监狱环境”是指罪犯在监狱内接受惩罚和改造的客观条件和诸多因素的综合,具有安全性、封闭性、多重性、关联性和渗透性等特征。监狱应从监管设施、公正执法、生产劳动、教育改造、人际关系、生活卫生等方面综合分析监狱环境对罪犯改造的各种影响,力求从提高思想认识、加大财政保障力度、加快布局调整、创新改造手段、倡导人文关怀、营造健康和谐人际关系等环节入手,大力加强监狱环境建设,不断提高教育改造质量。     

吉林省新型农村合作医疗现状与应对策略

农民的健康问题关系到保护农村生产力、振兴农村经济、维护农村社会和谐发展和稳定的大局,对提高全民族素质具有重大意义。吉林省新型农村合作医疗（简称新农合）基本解决了农村居民因病致贫、因病返贫问题,广大农民主动就诊意识明显提高,＂小病拖,大病扛＂的现象得到了缓解,但还存在一些问题需要尽快采取措施加以解决。一是要加大宣传力度,让广大农民充分了解新农合的好处;二是要加强对新农合基金的管理;三是要科学调整补偿方案,提高补偿比例;四是要加快信息化建设,提高管理效率和水平;五是要大力加强农村卫生服务体系建设;六是要健全农村医疗保险制度。     

A SECOND CHANCE FOR CHILDREN AND FAMILIES: A MODEL STATUTE TO REINSTATE PARENTAL RIGHTS AFTER TERMINATION

There are more than half a million children in foster care in the United States. Some of these children are adopted into loving families, but many are considered hard to adopt and never find a permanent family. Research suggests that the outlook for the teens who exit or age out of foster care without a permanent home or a meaningful adult relationship is bleak. They are more likely to face homelessness, joblessness, drug addiction, early pregnancy, mental health problems, and prison time. With such grim statistics, states should explore every possible permanent family resource for youth in foster care. This Note proposes that, in limited circumstances, it is in the best interest of the child to vacate a final order of termination and reinstate parental rights. It calls for states to adopt a model state statute based on the five state statutes currently in place that already allow for the reinstatement of parental rights.     

Foster children＇s right to family： A description and analysis of the legislative approach in Sweden

This paper emphasizes the foster children＇s right to family life and investigates whether change of custody and guardianship to foster parents is a successful option to achieve this right. Using CRC as the base for my definition of the right to family I will include the right to continuity, well-being and a family environment in the understanding of the term ＂right to family＂ in this article. These rights may, primarily, be fulfilled by the child＇s parents, and, if necessary for the best interest of the child, be complemented or substituted by foster or adoption parents. The analysis of different solutions concerning state interventions will base on Swedish law. In Sweden, a child in need of help or assistance as a result of abuse, neglect, or other inappropriate behavior in the home setting may be helped by the Social Welfare Committee-voluntarily or by a court order-in the child＇s home or a foster home. Other alternatives contain judicial involvement by changing custody and guardianship or making a decision for adoption. Since many years ago, the most commonly used alternative for children needing long term placements outside their homes in Sweden has become foster care. This development of many long-term placements has been criticized for not fulfilling the needs of the children, especially their needs for family continuity, stability and well-being. As a consequence, an amendment to the Social Services Act 200l was enacted in 2003 which states that the Social Services Committee shall consider the ＂permanence＂ of foster care by changing custody and guardianship to the foster parents three years later since a child starts in foster care, and every six months thereafter, as long as the child remains in the foster parents＇ care. Assuming that the foster parents are fit and willing to become custodians and guardians, and the child views the foster home as his or her home, the District Court can decide to change the custody and the guardianship to the foster parents. The assessment is to be based solely on the best interest of the child, and not on the fitness or wishes of the original custodian. However, can changing the custody and guardianship assist foster children＇s right to family？ This paper elaborates on this question by describing a legal reform in Sweden.     

Parents’ Perspectives on Family‐centered Care in Juvenile Justice Institutions

Family‐centered care during adolescent detention aims to increase parental participation in an attempt to optimize treatment outcomes. However, little is known about parents’ needs in family‐centered care. To fill this gap, we interviewed 19 purposefully selected parents of detained adolescents using a semi‐structured topic list. Although needs differed between parents, they were generally interested in activities that included spending time with their child. It is important for parents to receive timely information about their child's condition and treatment, detention procedures, and activities in the facility. The outcomes demonstrated that parents expected a two‐way communication based on respect and reliability.     

Older Youth in Extended Out-of-home Care

The purpose of this study is to examine the permanency experiences of older youth, age 18–21 in out-of-home placements and placement characteristics that influence age of exit from child welfare. Findings suggest a difference between age groups with more 18-year old youth exiting to emancipation than youth who exit at age 21. A higher number of spells in care and a higher number of placement changes during the last spell were associated with exit to emancipation. Additional study findings suggests that youth who leave care before the age of 21 may be more vulnerable than youth who stay through age 21. Implications for practice are discussed.     

Evaluating integrative services in edge-of-care work

Children living on ‘the edge-of-care’ are typically known to local safeguarding authorities and are considered likely to face risks to their safety. Many are subject to a child protection plan and/or involved in ‘pre-proceedings’ processes. A growing number of their parents face (un)diagnosed mental health difficulties as well as economic and social precarity. This article draws on a mixed methods evaluation of a pilot service in the East of England offering a therapeutically led attachment-based intervention for families. The service cross-cuts health and social care, allowing psychologists and psychotherapists to work alongside social workers and other practitioners. The evaluation examined psychological and safeguarding outcomes and explored practitioner perspectives. A key outcome was that 85.4% of families were enabled to remain, or reunite with their child, compared with an estimated 50% of ‘edge-of-care’ cases nationally. This supports the need for similarly oriented interventions that could help lower the incidence of child removals.     

Transferring custody from birth parents to foster parents – an ambiguous matter

In this study, we analyse 32 district court decisions regarding custody transfers from the birth parents to the foster parents in Sweden. When a child has been in foster care for three years, in order to enhance stability for child, the local social welfare committee considers a transferral of custody to the foster parents following an application to the district court. Although all but one of the decisions in our study favoured a custody transfer, the courts acknowledge different reasons for this. Specifically, there is vagueness about whether or not functioning contact between the child and birth parents is a hindrance in custody transfer. Our findings stress the need for clarification in the law regarding the criteria for custody transfer in order to reach a more unified judgment. Furthermore, the district courts do not sufficiently acknowledge children’s views, and we suggest that children and young people should be made more visible in the decision-making process.