Patients’ views of the quality of Danish forensic psychiatric inpatient care

The present study describes the quality of psychiatric care among forensic inpatients in Denmark who answered the Danish version of the Quality in Psychiatric Care–Forensic In-Patient (QPC–FIP) instrument. A sample of 143 patients (response rate 53%) from 25 of the 27 specialized forensic units in Denmark participated in the study. The patients’ ratings of the quality of care were generally high. The highest rating was found for the quality of the secluded environment and the lowest for patient participation in the care. The results showed that several factors influenced the patients’ ratings. Women rated the quality of care lower in comparison to men. Patients living together with someone before admission, patients with a lower level of education, and patients who were better informed regarding their diagnosis, who was the responsible physician, and where to complain rated the quality of care higher. We can recommend the use of the Danish version of the QPC–FIP instrument for measuring and improving the quality of care in forensic inpatient care.     

Kinship Family Relatedness,Nuclear Family Contact,and Social Support Among Foster Youth

Using a sample of 16-year-old youth placed with kinship foster families in California, the current study examines the relationship between kinship foster family structure and foster youth's biological family contact and support. Latent class analysis was used to examine differences in family structure based on the relatedness between foster youth and other members of the kinship family household. Subsequently, the respective relationships among household structure and foster youths' characteristics, experiences, and biological family contact and support were examined. We find that the kinship families serving foster youth are represented by four distinct household types, including sibling and grandparent households. Kinship family household type is found to be statistically significantly associated with youths' contact with siblings, closeness to caregivers, and perceived social support. Implications for kinship foster family scholarship are discussed.     

Indigenous Peoples in Commonwealth Countries: The Legacy of the Past and Present-day Struggles for Self-determination

Abstract

Although the UK has no indigenous peoples as understood by the UN, its earlier colonial policies in Africa, the Americas, Asia and the Caribbean have had consequences for today’s first peoples Colonial policies that deprived the native populations of their lands, resources and self-determination were generally pursued by the independent states that came in their wake. Today the world’s indigenous peoples are looking to bring to an end their colonial-type situations and re-establish control over their lands and futures. After more than 20 years, the United Nations adopted a Declaration setting out the rights of indigenous peoples, but several Commonwealth countries were unrelenting opponents. This article looks at the colonial heritage as it affects indigenous peoples in the Commonwealth countries, some of the contemporary struggles and situations that have marked the last years, and tries to understand why countries such as Australia, Canada and New Zealand were the last to accept that indigenous peoples had a right to self-determination.     

Health care and democratization in Indonesia

Analyses of Indonesian democracy often emphasize elite capture of democratic institutions, continuity in oligarchic power relations, and exclusion of popular interests. Defying such analyses, over the last decade, Indonesia has experienced a proliferation of social welfare programmes, some with a redistributive element. This article analyses the expansion of social welfare protection by focusing on health care. At the national level, Indonesia has introduced programmes providing free health care to the poor and approved a plan for universal social insurance. At the subnational level, in the context of far-reaching decentralization reforms, politicians have competed with each other to introduce generous local health care schemes. Taking its cue from analyses of social welfare expansion in other East Asian states, the article finds the origins of policy shift in the incentives that democracy creates for elites to design policies that appeal to broad social constituencies, and in the widening scope for engagement in policymaking that democracy allows. The article ends with a cautionary note, pointing to ways in which oligarchic power relations and the corruption they spawn still undermine health care quality, despite expansion of coverage.     

Prison Birthday: "It's All Good"

Due to an overreliance on arrests in the late 1990s, the incarceration of young women in the United States increased dramatically. On any given day in 2010, over 9000 girls were held in residential placement. Largely hidden from public view, little is known about the health requirements of female adolescent offenders in US secure custody. Less is known about how those needs are met while in detention. Curiously, while most theories regarding female juvenile delinquency draw upon non-criminogenic health-related factors – sexual abuse, family violence, and low self-esteem – their specific legal troubles are rarely, if ever, framed in public health terms. Drawing on original interviews with 100 court-involved girls, detainees’ perceptions of their medical, psychological, sexual, and social health concerns are highlighted. The data link court-involved girls’ prior health issues to their coming to the attention of juvenile authorities as well as demonstrating possible non-compliance with domestic and international standards for the health rights of juveniles deprived of their liberty.     

Consulting to residential programmes for sexually aggressive delinquents

Abstract

Delinquent adolescent boys, especially those looked after in residential settings, often have a long history of coercive antisocial behaviour. Many have a history of aggression and violence, including serious sexual offences such as rape and indecent assault. In light of the Criminal Justice Act 1991 the residential care sector will come under more pressure to accommodate sexually aggressive recidivistic delinquents. However, few staff who work in residential settings with delinquents have received training in the management and treatment of sexually aggressive behaviour. Time spent in residential care settings may therefore do little to reduce the risk of sexual aggression. This paper proposes that the assessment and management of risk is central to the effective rehabilitation of this group of young people. Based on work carried out at Glenthorne Centre a risk assessment strategy is presented consisting of several different strands: an analysis of organisational decision-making; identification of sources and types of information to inform decisions; the development and implementation of a risk assessment protocol; and staff training. A case example is used to illustrate the use of the protocol at Glenthorne.     

The need to improve the living conditions of women in Nuba Mountains,Southern Kordofan

ABSTRACT

The Comprehensive Peace Agreement (CPA) not only ended Africa's longest civil war, it aimed to transform Sudanese society. A critical element of this transformation is uplifting the status of women. This article surveys the conditions faced by women in two villages in Nuba Mountains/Southern Kordofan, principally their ability to access land for farming, credit facilities and barriers to education and health services, and whether the implementation of the CPA has resulted in any concrete changes.     

Toward Disorganized Governance in Public Service Provision? The Case of German Sickness Funds

Over many years now, the concept of “network” or “new governance” pervades the literature on public administration. It suggests a growing role for network-based governance downgrading both command-and-control bureaucracy and, if more implicitly, New Public Management (NPM). Challenging this reading, the article explores the relationship between network-based and (quasi-)market governance by investigating the policies of German health care insurance organizations, the so-called sickness funds, epitomizing the international movement towards focal agencies run at arm's length of Government. These policies reflect new forms of hybrid coordination in public service provision, leading into what can be coined disorganized governance and be characterized as a regime of hybrid coordination shaped by a nervous interplay of partnership-building and disruptive segregation, with important repercussions on the overall outcomes in the provision of health care.     

The Learning Orientation of Primary Health Care Teams in the English National Health Service: Is This a Myth That Should Be Perpetuated?

A qualitative study of primary health care teams in the UK provides insight into their co-ordination or learning-orientation and how this affects member commitment, conceptions of ‘core’ and periphery, group identification and willingness to integrate roles. Even if the ideal of a learning-oriented primary health care team is viewed as a myth, it can still perform useful functions despite an apparent withdrawal of its official authorization by the Cameron-led government. The perpetuation of this myth maintains a tension between reality and potentiality in the hopes that inspire its pursuit as an ideal of team formation.     

Assessing Performance in Shelters for Abused Women: Can “Caring Citizenship” Be Measured in “Value for Money” Accountability Regimes?

Results are reported from a study of shelters for abused women in Ontario, Canada, suggesting that what clients, managers, and frontline workers value most in shelter services is based on a care perspective in which ongoing relational support is seen as essential to effective service delivery. Presently, government-required metrics used to assess shelter services not only reflect a narrow, justice perspective where “fairness” is defined as equal access to publicly supported services, but reveal a New Public Management emphasis on efficiency in which the focus is more on the “what” than the “how” of practice. Findings are discussed in terms of their implications for the design of accountability systems for evaluating government-contracted social services.