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Talking past each other: towards HIV/AIDS prevention in Nigeria
- Authors:
- IYIANI Christian, BINNS Tony, SHANNON Pat
- Journal article citation:
- International Social Work, 54(2), March 2011, pp.258-271.
- Publisher:
- Sage
HIV/AIDS is extensive in Nigeria, with a prevalence rate of 5.8%. This study investigates the relationship between HIV/AIDS prevention programmes and the lived realities of people most at risk in the poor urban community of Ajegunle in Nigeria’s Lagos State. The research compared the formal approach of the HIV/AIDS prevention organisations, with the felt realities of those on the receiving end of such responses: sex workers, street youths and low-income families. The results demonstrate a significant difference between the medical model of health espoused by agencies and the broader social model of the lay respondents. While providers, international non-governmental organisations (NGOs) and their client NGOs, emphasise Western medical models for HIV/AIDS intervention and prevention, at-risk groups expressed strong feelings of powerlessness over socio-cultural and political conditions affecting them. The article suggests that multi-sectoral responses with full community participation are necessary in order to engage in more effective preventive action. This requires a major power shift, whereby local people are fully involved in decision-making about policies and their implementation.
From mental illness to a social model of madness and distress
- Authors:
- BERESFORD Peter, et al
- Publisher:
- Shaping Our Lives
- Publication year:
- 2016
- Pagination:
- 76
- Place of publication:
- London
This report draws on the views and experiences of mental health service users/survivors, regarding mental health policy, models and services. It aims to update findings of an earlier 2010 report, ‘Towards a social model of madness and distress?’, which found that mental health service users/survivors felt that a medical model dominated both public and professional thinking and that further discussions about more social approaches to mental health were needed. A total of 82 people took part in this second stage project through discussion groups, individual interviews, and an on-line survey. Participants included a diverse range of service users including, people from rural and urban areas, older women and people from black and minority ethnic backgrounds. Organised in six main sections, the report draws heavily on the comments of service users and includes quotations throughout. The six sections explore mental health service users’/survivors’ views on: a medical model of mental health; reclaiming the term ‘madness’; the social model of disability as applied to mental health; the idea and policy of recovery; social approaches to mental health; and taking forward social approaches to mental health. A final section brings together the findings from the project and offers a set of possible ways of taking them forward. (Edited publisher abstract)
Agency in institutionalised youth: a critical inquiry
- Author:
- POLVERE Lauren
- Journal article citation:
- Children and Society, 28(3), 2014, pp.182-193.
- Publisher:
- Wiley
This qualitative study examined the perspectives of formerly institutionalised youth labelled with psychiatric disabilities through the lens of agency. Rooted in the medical model, much research on institutionalised youth describes clinical symptoms and behaviour problems, locating the source of these problems within the individual. To address the lack of critical inquiry regarding the transactions between youth and institutions, this article examines youth perspectives on institutional practices. Semi-structured interviews were conducted with formerly institutionalised youth and young adults. The findings suggest that youth draw from agentic strategies to negotiate oppressive institutional practices. Implications for research and practice are discussed. (Publisher abstract)
Rethinking a framework for dementia 1: a journey
- Authors:
- MINGHELLA Edana, SCHNEIDER Kate
- Journal article citation:
- Working with Older People, 16(3), 2012, pp.122-131.
- Publisher:
- Emerald
This is the first of 2 papers that aim to propose a revised model of care for dementia aimed at improving experiences and outcomes, and informing service redesign and commissioning. It draws conclusions from the combined findings of a number of independent, local and regional projects commissioned across southern England. The key methodologies in all the studies included listening to people with dementia and carers, non-participant observation of services, and reviews of good practice, policy and literature. The paper proposes a revised values-base for service development, identifying a 6-phase dementia journey from the perspective of those living with dementia. The framework moves away from the medical model towards understanding dementia as a long term condition that affects a number of dimensions. Through understanding the dementia journey from the perspective of people living with dementia, it is possible to design and implement a range of services that help people plan for and manage their own journeys, provide interventions proactively and help prevent crises. The second paper will describe a full service model demonstrating how the model could be applied.
Towards a social model of madness and distress?: exploring what service users say
- Authors:
- BERESFORD Peter, NETTLE Mary, PERRING Rebecca
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 4p.
- Place of publication:
- York
There has been more emphasis on social approaches to mental health in recent years, reflected, for example, in the establishment of the Social Perspectives Network. There have been some initial discussions about a social model relating to mental health among mental health service users/survivors. However, as yet, this has not been widely explored or developed. This report provides a summary of a national study which explores with mental health service users what models they feel underpin current thinking in mental health policy and practice. It asks what effects these models may have, and looks at what models service users think might be helpful. Key findings suggest that most service users believe that a medical model based on deficit and pathology still dominates public and professional understanding of mental health issues, shaping attitudes and policy. The idea of a social model of madness and distress, following the format of the social model of disability, met mixed views. The labelling and stigma following from a medical model of mental illness are major barriers for mental health service users. Service users see social approaches to mental health issues as much more helpful.
Towards a social model of madness and distress?: exploring what service users say
- Authors:
- BERESFORD Peter, NETTLE Mary, PERRING Rebecca
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2010
- Pagination:
- 45p.
- Place of publication:
- York
There has been more emphasis on social approaches to mental health in recent years, reflected, for example, in the establishment of the Social Perspectives Network. There have been some initial discussions about a social model relating to mental health among mental health service users/survivors. However, as yet, this has not been widely explored or developed. This national study explores with mental health service users what models they feel underpin current thinking in mental health policy and practice. It asks what effects these models may have, and looks at what models service users think might be helpful. Four key issues were explored with service users; how mental health issues are understood in society; their personal understandings of mental health issues; the social model of disability in relation to mental health; and their personal understandings of madness and distress within a social model of disability. Key findings suggest that most service users believe that a medical model based on deficit and pathology still dominates public and professional understanding of mental health issues, shaping attitudes and policy. The idea of a social model of madness and distress, following the format of the social model of disability, met mixed views. The labelling and stigma following from a medical model of mental illness are major barriers for mental health service users. Service users see social approaches to mental health issues as much more helpful.
Patients' involvement in medical audit in general practice
- Author:
- NEWTON John
- Journal article citation:
- Health and Social Care in the Community, 4(3), May 1996, pp.142-149.
- Publisher:
- Wiley
Considers how patients might be involved in medical audit. It argues that there are ethical, political, and clinical justifications for widening the current 'medical model' to include patients' views of mainly sociopsychological matters, and that these are intrinsic to the delivery of health care and evaluations of its quality. The potential barriers to such involvement are doctor-patient relationships; the cultural of general practice; the existing pattern of audit; and the lack of organization amongst patients. None of these barriers is seen as insurmountable and the paper concludes that audit could be extended to include practice-based initiatives within medically defined communities of interest.
Seniors' experiences of client-centered residential care
- Authors:
- EALES Jacquie, KEATING Norah, DAMSMA Annita
- Journal article citation:
- Ageing and Society, 21(3), May 2001, pp.279-296.
- Publisher:
- Cambridge University Press
The philosophy concerning long-term care for frail seniors has shifted from a provider-driven, medical model toward a more client-centered, social model. Reports on qualitative in-depth interviews conducted with residents of adult family living and assisted living programmes in western Canada to better understand the elements that residents themselves felt were integral to client-centred care. Three main themes emerged for the data analysis: the physical setting, people within the setting, and the community were important areas of expression of residents' values and preferences; the decision about where to live influenced whether the residential care environment was congruent with residents' values and preferences; contentment resulted when there was a good fit between preferences and experiences, reflecting the essence of residents' perspective of client-centred care. Concludes that choices among models of care, appropriates staffing levels and training, and recognition of family contributions may improve the practice of client-centred care.