Chapter 7. Mental Health Intervention with Dominican Immigrants

Abstract

Dominicans are a significant force in the changing composition of Hispanic immigration in the United States, and all indications are that they will continue to be in the years to come. A framework has been applied in which Dominican culture, psychosocial strengths and risks, and treatment implications are explored in the context of how Dominicans appear to be similar to and different from other Hispanic groups in the U.S. Much more needs to be done in terms of elaborating this combination of homogeneity and heterogeneity. Mental health practitioners who are open to such inquiry, and to keeping an open mind regarding the possibilities of modifications in therapeutic techniques and modality choices, will find Dominicans to be a clinically responsive, and an enjoyable population to work with.     

美国医疗保险照顾计划及其对我国的启示

在现代保险法制中,健康保险是一个新兴的领域。与欧洲、日本等以国家为主导的健康保险法制建设不同,美国采取的是一种公私混合的多元化模式,即以商业健康保险为主,以政府主办健康保险为辅,并为此制定了一系列的法律、法规,形成了一个比较完善的健康保险法律体系。而在政府主办的健康保险事业中,1965年推出的医疗保险照顾计划(Medicare)处在核心的地位。本文就医疗保险照顾计划的由来、主要内容、实施效果以及对中国的启示作了详细论述,对借鉴美国医疗保险照顾计划、克服我国在老年人和残疾人健康保险上的问题以及如何改进等,提出了思路。     

对《精神卫生法（草案）》的修改意见与建议

国务院法制办公布了《精神卫生法（草案）》征求社会意见，必要而及时。反复修改后的草案在结构和内容上基本合理，但也存在不足之处：对非自愿住院和强制住院产生异议的有关救济程序不完善；未涉及在监狱等特殊场所设立精神卫生医疗机构；“监护人”等名词使用欠周全；部分条款的结构及用语值得商榷。     

Physical restraint and the therapeutic relationship

The role of the forensic mental health nurse has led to many debates due to the conflicts between security and therapeutic aspects of their role. Physical restraint is a security element of the role which may have an impact on their ability to work therapeutically with patients. This study examined the impact of physical restraint on the nursing staff–patient therapeutic relationship. This was investigated in a secure unit in the North of England. Eight semi-structured interviews were conducted with patients across the service, and thematic analysis was undertaken. Five themes were identified from the data which highlighted the impact of the physical restraint as a power imbalance, the experience as traumatic, the importance of justification, the negative attributes and motives of some staff and the impact of coping with powerlessness. Clinical implications and research recommendations are discussed further in this article.     

The Rise of Statutory Wills and the Limits of Best Interests Decision‐Making in Inheritance

This article addresses ‘statutory wills’ executed under the Mental Capacity Act 2005 (MCA) for persons with impaired mental capacity. The article provides an overview of the historical development of statutory wills, before exploring their rising contemporary significance. It considers the shift from the previous ‘hypothetical substituted judgment’ test to the contemporary ‘best interests’ orientation of the MCA. The article assesses the problems that the best interests approach raises in this area, and its (in)compatibility with the right to equal recognition before the law under the UN Convention on the Rights of Persons with Disabilities, arguing that the pervasive reach of best interests in contemporary mental capacity law requires reconsideration. The paper concludes by suggesting that a more limited framing of the power to execute statutory wills is required in order to appropriately balance the rights of individuals with disabilities with practical considerations around the distribution of assets on death.     

Success and Failure in Public Policy: Twin Imposters or Avenues for Reform? Selected Evidence from 40 Years of Health‐care Reform in Australia*

In explaining policy reform, there is a tendency to assume that causes and outcomes are temporally contiguous and that the consequences of reform efforts unfold quickly. There is no obvious reason, theoretical or empirical, why this should be the case when considering the relationships between policy failure and policy success. This paper considers why and how policy failures may be causally linked to future policy events in sequences over extended periods of time. In particular, this paper focuses on the different mechanisms that might connect assessments of policy failure and subsequent reform success. Empirically, it draws on selected evidence from patterns of policy failures and successes in Australian health policy over a 40‐year time period.     

公共健康获益权的法理探源与权利建构

人内在的发展天性总希冀于更美好的发展与自由的获得,而现代国家的要义之一亦在于追求人民福祉与社会进步,一定社会经济条件下内外相生的发展动因将为人权的确立和发展提供物质基础,并通过进一步的法律权利构建,为其提供真实有效的保障。随着我国社会经济的发展,有必要将公民在公共健康领域的各种权利、特权、权力和豁免以霍菲尔德式的展开加以梳理,厘清现行主要公共卫生法律中公民法律利益的诸多形态,并对其中有关公民法律权利的规范和内容进行梳理、重构,以构建法律权利意义上的公共健康获益权,最终促进公民健康水平的提高和全面发展的实现。     

规则、关系与地区安全治理——以大湄公河次区域公共卫生协作治理为例

在地区安全治理研究中,规则或国际规则是主导话语和主导研究范式。然而,规则本身并不能自动构建治理实践和产生预期的治理效果。文章通过借鉴世界政治关系理论的最新研究成果,尝试建立“规则-关系”治理模型。其基本假设是,国际规则需经由地方关系过程激活和运化,才更有可能产生协作机制和务实政策,从而实现有效的地区安全治理。具象的地方关系过程由地区安全利益攸关方的互动关系构成,是各方参与协商的过程,同时也是给国际规则和治理实践赋能的过程。整体和抽象的地方关系过程就是治理实践本身,是所有治理要素联动应对安全威胁的过程,并以大湄公河次区域跨境传染病联防联控协作治理为案例对模型进行了验证。实践证明,关系过程活力越大,越能够激活和运化规则,就越有可能形成有效的地区安全治理,这项研究有望推动和深化地区安全治理的学理思考,并为公共卫生治理研究作出累积性知识贡献。     

山东省老年妇女健康与医疗保障问题研究

对2683位60岁以上老年妇女的入户问卷调查数据显示,当代老年妇女的健康状况较好.有配偶和老有所医对于老年妇女健康水平的维护有显著性保护作用;老年妇女生活自理能力差,年龄、慢性病是重要危险因素.