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Journal article

Care programming in mental health: assimilation and adaptation

Author:
SCHNEIDER Justine
Journal article citation:
British Journal of Social Work, 23(4), August 1993, pp.383-403.
Publisher:
Oxford University Press

Two years after the care programme approach in mental health was introduced there is still widespread confusion about its meaning and its relation to other changes in the arena of community care. Considers how care programmes are being implemented and at whom they are being targeted, and examines the relation between care management and care programming and raises some questions about future development in the light of community care reforms.

Journal article

Impact of supported employment on service costs and income of people with mental health needs

Authors:
SCHNEIDER Justine, et al
Journal article citation:
Journal of Mental Health, 18(6), December 2009, pp.533-542.
Publisher:
Informa Healthcare
Place of publication:
London

This paper examined the impact of supported employment on the cost of services used, benefits claimed, and earnings for 141 participants in the UK with mental health problems. Service use and frequency were measured at baseline and 12 months. Comparisons paid particular attention to the differences between people entering work and those who remained unemployed. Costs were analysed from a government perspective, excluding earnings, and a societal perspective excluding welfare benefits and taxes. Results revealed 77 of the participants in the study remained unemployed, 32 got jobs and 32 retained the jobs they held at the outset. Those who entered work reduced their consumption of mental health services. However, use of supported employment increased. The increase in earnings for those entering work was not offset by a similar reduction in benefits. In conclusion, the findings suggest that mental health services may make savings as a result of their clients engaging in paid work.

Journal article

Models of specialist employment for people with mental health problems

Author:
SCHNEIDER Justine
Journal article citation:
Health and Social Care in the Community, 6(2), March 1998, pp.120-129.
Publisher:
Wiley-Blackwell

There is a growing interest in work schemes for people with mental health problems. This article describes the characteristics of nine models of specialist employment, their similarities and differences are portrayed on three dimensions: productivity, integration, and permanence. Models discussed are sheltered settings, vocational rehabilitation and training, clubhouse, transitional employment, social firms, placement agencies, assertive community treatment and voluntary work.

Journal article

Campaign appears to influence subjective experience of stigma

Authors:
SCHNEIDER Justine, BEELEY Chris, REPPER Julie
Journal article citation:
Journal of Mental Health, 20(1), 2011, pp.89-97.
Publisher:
Informa Healthcare
Place of publication:
London

Between September 2007 and Mental Health Awareness Week in October 2009, Nottinghamshire Healthcare NHS Trust in England conducted an anti-stigma campaign. It hoped to reduce the general public’s stereotyped attitudes to mental health problems and mental health service users. The campaign's rationale was based on social contact theory, which holds that bringing together 2 groups can reduce inter-group hostility. This study evaluates the campaign's impact on removing barriers to service users’ employment, promoting recovery and social inclusion, reducing the incidence of discrimination, as well as dissipating stereotyped attitudes and self-stigma. Factor analysis of questionnaires returned by 243 service users revealed 3 key factors referring to service users’ perceptions of: public attitudes to mental health; service users’ relationships with staff; and other interpersonal relationships. Service users’ perceptions of public attitudes towards mental health were improved, suggesting a short term, successful outcome from the main thrust of the campaign. However, there was no significant effect on the other 2 factors. The authors conclude that certain aspects of stigma associated with mental health may be changed through targeted strategies and community-level interventions. But, there remains an intractable core of stigma experiences associated with interpersonal relationships with family and staff, discrimination and social interactions. Bullying, harassment and assault can occur. These hard core issues present the greatest challenge to future anti-stigma strategies.

Journal article

Community work - a cure for stigma and social exclusion?

Author:
SCHNEIDER Justine
Journal article citation:
Psychiatric Bulletin, 33(8), August 2009, pp.281-284.
Publisher:
Royal College of Psychiatrists

This editorial discusses how cultivating ‘social capital’ or interdependence between individuals and groups – as well as giving, each is entitled, but not compelled, to claim something in return can combat social exclusion. It is difficult, if not impossible, to sustain stigma and social exclusion when people are meeting mutual needs, building trust and helping each other. Mental health providers can foster social capital by creating community cohesion, namely interdependent relationships between individuals and organisations. This approach has been put into practice in the USA, where providers assert that small investments in building social capital return many times the cost. In the UK there is evidence that community development can make a contribution to mental health but it does not fit well with conventional approaches to mental health services – it calls for different skills and a vision that is collective rather than individualised.

Journal article

Employment support agencies in the UK: current operation and future development needs

Authors:
WISTOW Richard, SCHNEIDER Justine
Journal article citation:
Health and Social Care in the Community, 15(2), March 2007, pp.128-135.
Publisher:
Wiley-Blackwell

Disabled people are amongst the most excluded in society, while people with learning disability have the lowest rates of employment. Supported employment promises to address the gaps, but it is a new approach, one whose development has been incremental. The present authors explore some of the features of agencies providing employment support to disabled people, together with their managers' views. This paper describes semi structured telephone interviews with the managers of 31 employment support agencies. The survey sought to understand the types of service provided, the staff and caseload numbers, the training offered, and the targets used. The authors also asked the managers what would help them in delivering employment opportunities to disabled people. The responses of the managers highlight gaps between current policy and practice. Particular attention is given to the use of targets, fragmented funding and what managers consider is required to improve employment opportunities for disabled people. Managers endorsed the vision expressed in current policy, and identified numerous obstacles to its implementation in employment support. Taken together, their views can be used to guide the development of supported employment.

Journal article

Impact of the national minimum wage on disabled people

Authors:
SCHNEIDER Justine, SIMONS Ken, EVERATT Greg
Journal article citation:
Disability and Society, 16(5), August 2001, pp.723-747.
Publisher:
Taylor and Francis,

The survey reported here found disparities in the impact of the introduction of the National Minimum Wage on disabled people. These were associated with age, gender, impairment and type of employment setting. The main determinant of whether individuals gained from the NMW was their status as claimants of welfare benefits. The authors also found evidence that paid hours had been reduced to implement the NMW with no net increase in earnings, possibly to enable people to enable people to retain benefits entitlements. They make recommendations about how the anomalies can be tackled. It may be unrealistic to expect the Act to have been implemented fully so soon after it became law and some of the anomalies found may eventually disappear. However, many of the inequalities uncovered by this survey are not addressed by the NMW, specifically those inequalities associated with impairment and gender.

Journal article

Work interventions in mental health care: some arguments and recent evidence

Author:
SCHNEIDER Justine
Journal article citation:
Journal of Mental Health, 7(1), February 1998, pp.81-94.
Publisher:
Informa Healthcare
Place of publication:
London

Evidence of the effectiveness of work in psychiatry in the UK is limited to studies conducted a generation ago, when mental health care was still hospital-based, and the level of unemployment in the general population was lower than today. Employment is scarcely considered directly in mental health policy, while purchasers have few guidelines on which to base their strategies. This article offers five perspectives on work in psychiatry, ideological principles; macro-economic considerations; demand on the part of service users themselves; the changing context of mental health care, with its effects on the public presentation of mental illness; and evidence of clinical benefits from constructive occupation. Each of these cases is presented, with particular attention paid to the clinical benefits which are relevant to evidence-based health care.

Journal article

Attitudes towards disabled staff and the effect of the National Minimum wage: a Delphi survey of employers and disability employment advisors

Authors:
SCHNEIDER Justine, DUTTON Jillian
Journal article citation:
Disability and Society, 17(3), May 2002, pp.283-306.
Publisher:
Taylor and Francis,

Reports on a Delphi study on a drawing on the expertise of a national sample of 100 employers of disabled people, and a similar number of Disability Employment Advisors (DEAs). It presents their existing attitudes towards disabled employees before analysing the effect of the NMW on these views. Differences between employers and DEAs were found in relation to the perceived costs and obstacles to employers of taking or retaining disabled staff, the problems presented by specific disabilities and the motivation shown by disabled staff. There was general agreement that the NMW has benefited disabled people by making low paid jobs better paid. Some disabled employees appear to have been adversely affected by the interaction of the interaction of the NMW with the Supported Placement Scheme (SPS, now Workstep) and the benefits system. Concludes that understanding employers' perspectives may facilitate the promotion of work opportunities for disabled people.

Book

Occupational outcomes: from evidence to implementation

Authors:
SCHNEIDER Justine, HEYMAN Anna, TURTON Neil
Publisher:
University of Durham. Centre for Applied Social Studies
Publication year:
2002
Pagination:
67p.,bibliog.
Place of publication:
Durham

This report outlines the methods used, and the rationale that informed the collection and sifting of evidence. The authors discuss the theoretical context for the paper, and the policy considerations that underpin the exercise, paying particular attention to social exclusion of people with mental health problems. This is followed by a discussion of the problems in extrapolating research findings from one context to another. Models of occupational interventions are then described, and their similarities and differences explored, together with what we call ‘delivery modes’, to ensure that the terms used in the paper are clear. Appendix 4 is devoted to investigating the impact on work incentives of the current benefits system in the UK, as compared to the USA, where most evidence comes from. The authors then assemble the evidence on what works, what is promising, and where further evidence is needed in relation to several themes. First, Predictors of Occupational Outcomes, relates to all three models of intervention. Then, there is a section devoted to each of these in turn: Sheltered Employment; Supported Education and Training; and Supported Employment. A section on Costs Evaluations again spans the three main models, and a further section explores the potential contribution of learning disability research to the theme of this paper. Each section is followed by a list of conclusions drawn from it.

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