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One size fits all? The social construction of dis-employ-abled women
- Authors:
- VANDEKINDEREN Caroline, et al
- Journal article citation:
- Disability and Society, 27(5), August 2012, pp.703-716.
- Publisher:
- Taylor and Francis
In Europe, welfare states attempt to increase efforts to employ economically inactive citizens, such as disabled people, according to the norm of economic productivity. This article is based on an evaluation of a labour-market training programme for 17 women with mental health problem in a social workplace in Belgium. The study explored the retrospective insider perspectives on the work aspirations of the women involved in the programme to identify critical dynamics in their high drop-out from the social workplace. The central findings provide evidence of a prevalent one-size-fits-all discourse in these practices wherein complex and interrelated processes of discrimination take place that are based on both disability and gender. The findings demonstrate that the social workplace functions as a male bastion, in which the oversized overalls that women are forced to wear are symbolically relevant. In conclusion, the authors discuss and challenge the dominance of the neo-liberal norm of economic productivity and employability.
Key dimensions of collaboration quality in mental health care service networks
- Authors:
- NICAISE Pablo, et al
- Journal article citation:
- Journal of Interprofessional Care, 35(1), 2021, pp.28-36.
- Publisher:
- Taylor and Francis
Appropriate care delivery for patients with severe mental illness (SMI) requires a high level of collaboration quality between primary, mental health, and social care services. Few studies have addressed the interpersonal and inter-organizational components of collaboration within one unique study setting and it is unclear how these components contribute to overall collaboration quality. Using a comprehensive model that includes ten key indicators of collaboration in relation to both components, we evaluated how interpersonal and inter-organizational collaboration quality were associated in 19 networks that included 994 services across Belgium. Interpersonal collaboration was significantly higher than inter-organizational collaboration. Despite the internal consistency of the model, analysis showed that respondents perceived a conflict between client-centered care and leadership in the network. Our results reveal two approaches to collaborative service networks, one relying on interpersonal interactions and driven by client needs and another based on formalization and driven by governance procedures. The results reflect a lack of strategy on the part of network leaders for supporting client-centered care and hence, the persistence of the high level of fragmentation that networks were expected to address. Policy-makers should pay more attention to network formalization and governance mechanisms with a view to achieving effective client-centered outcomes. (Edited publisher abstract)
Psychosocial and psychiatric factors associated with adolescent suicide: a case-control psychological autopsy study
- Authors:
- PORTZKY Gwendolyn, AUDENAERT Kurt, van HEERINGEN Kees
- Journal article citation:
- Journal of Adolescence, 32(4), August 2009, pp.849-862.
- Publisher:
- Academic Press
Relatives and other informants of 19 suicide adolescent victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Results showed that suicide victims had been exposed more frequently to suicidal behaviour by friends and through media and experienced more relational problems in the past year. Suicidal communication was less frequently reported in suicide victims than in controls and when communication did occur, it was less often directed towards parents. Treatment of psychiatric disorders was significantly less found in suicide victims. Psychiatric control patients were more likely to have comorbidity of psychiatric disorder, conduct disorder, delinquency or academic difficulties. This study showed significant differences between young suicide victims and psychiatric controls for life events, exposure, communication and treatment. These results also suggest that more symptoms and more externalizing behaviour can be observed in psychiatric control patients which could indicate more warning signals of possible psychiatric problems for the environment, which could result in more help-seeking behaviour and treatment.
Neuropsychiatric symptoms of dementia: cross-sectional analysis from a prospective, longitudinal Belgian study
- Authors:
- ENGELBORGHS Sebastiaan, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(11), November 2005, pp.1028-1037.
- Publisher:
- Wiley
Given the rather limited knowledge on profiles of neuropsychiatric symptoms (behavioural and psychological signs and symptoms of dementia, BPSD) in several degenerative dementias, we designed a prospective study of which we here present the baseline data. Diagnosed according to strictly applied clinical diagnostic criteria, 205 patients with probable Alzheimer's disease (AD) , 29 with frontotemporal dementia (FTD) , 39 with mixed dementia (MXD) and dementia 23 with Lewy bodies (DLB) were included. All patients underwent a neuropsychological examination and behavioural assessment by means of a battery of scales (Middelheim Frontality Score (MFS), Behave-AD, Cohen-Mansfield Agitation Inventory, Cornell Scale for Depression in Dementia). In AD and MXD, activity disturbances and aggressiveness occurred in more than 80% of the patients. With a prevalence of 70%, apathy was very common whereas delusions and hallucinations were rare in FTD patients. Frequently used behavioural assessment scales like the Behave-AD systematically underestimated BPSD in FTD whereas the MFS displayed high sensitivity for frontal lobe symptoms. Hallucinations discriminated DLB patients from other dementias. A high prevalence of disinhibition (65%) in DLB pointed to frontal lobe involvement. Behavioural assessment may help differentiating between different forms of dementia, further stressing the need for the development of new and more sensitive behavioural assessment scales. By means of the MFS, frontal lobe involvement was frequently observed in DLB. As 70% of FTD patients displayed apathy, prevalence was about two times higher compared to the other disease groups, meanwhile indicating that apathy is frequently observed in dementia, irrespective of its etiology.
Applicability of the DUNDRUM-1 in a forensic Belgium setting
- Authors:
- HABETS Petra, DARME Inge Jean, KENNEDY Harry G.
- Journal article citation:
- Journal of Forensic Practice, 21(1), 2019, pp.85-94.
- Publisher:
- Emerald
Purpose: Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Research regarding the assessment of security level is minimal and few instruments are available. The DUNDRUM toolkit is a structured clinical judgement instrument that can be used to provide support when determining security level. The purpose of this paper is to investigate the applicability and validity of the DUNDRUM-1 in Flanders. Design/methodology/approach: The DUNDRUM-1 was scored for 50 male patients admitted at the forensic units in the public psychiatric hospital Rekem. Some files were rated by three researchers who were blind to participants’ security status, resulting in 33 double measurements. Findings: Almost all files (96 per cent) contained enough information to score the DUNDRUM-1. Average DUNDRUM-1 final judgement scores were concordant with a medium security profile. No difference was found between the current security levels and the DUNDRUM-1 final judgement scores. Inter-rater reliability was excellent for the DUNDRUM-1 final judgement scores. On item level, all items had excellent to good inter-rater reliability with the exception of one item institutional behaviour which had an average inter-rater reliability. Practical implications: The DUNDRUM-1 can be a useful tool in Flemish forensic settings. It has good psychometric properties. More research is needed to investigate the relationship between DUNDRUM-1 scores and security level decisions by the courts. Originality/value: This is the first study that investigated the applicability of the DUNDRUM-1 in a Belgian setting, also a relative large number of repeated measurements were available to investigate the inter-rater reliability of the DUNDRUM-1.
Severe interpersonal violence against children in sport: associated mental health problems and quality of life in adulthood
- Authors:
- VERTOMMEN Tine, et al
- Journal article citation:
- Child Abuse and Neglect, 76, 2018, pp.459-468.
- Publisher:
- Elsevier
In a recent large-scale prevalence study of interpersonal violence (IV) against child athletes in the Netherlands and Belgium we found that 9% of adult respondents who participated in organised sports before the age of 18 had experienced severe psychological violence, 8% severe physical violence, and 6% severe sexual violence in various sport settings. While the general literature has repeatedly shown that exposure to IV during childhood is associated with mental health problems in adulthood and to a lesser extent with reduced quality of life (QOL), these relationships have not been demonstrated in (former) athletes. Thus, the current study aims to assess the association of severe childhood IV in sport and adult wellbeing. Depression, anxiety, and somatisation were assessed in the same general population sample (N = 4043) using the Brief Symptom Inventory (BSI-18) and QOL with the World Health Organization Quality of Life questionnaire (WHOQOL-Brèf). The association between severe IV in sport and adult wellbeing was investigated using multiple linear regression while controlling for demographics, recent life events, and relatives’ psychological problems. The authors found severe sexual, physical, and psychological childhood IV in sport to be associated with more adult psychological distress and reduced QOL. Polyvictimisation shows the strongest correlation with poorer wellbeing and QOL. Recent life events, relatives’ psychological problems, marital status, and level of education were significant covariates in the psychological symptoms and QOL assessed. The authors hope that these new insights prompt sport administrators to implement broad spectrum child protection measures and raise the awareness of mental health professionals about the necessity to also screen for adverse childhood experiences in the sport context. (Edited publisher abstract)
Behavioral symptoms in mild cognitive impairment as compared with Alzheimer's disease and healthy older adults
- Authors:
- VAN DER MUSSELE Stefan, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 28(3), 2013, pp.265-275.
- Publisher:
- Wiley
Mild cognitive impairment (MCI) is a clinical concept that describes patients who are in an intermediate state between normal aging and dementia. It does not generally affect their activities of daily living but complex instrumental functions may be minimally impaired. Although behavioural symptoms are common in MCI they are not included in the concept. The aim of this study was to characterise behaviour in MCI compared with Alzheimer's disease (AD) and healthy older patients. The data were drawn from the baseline of a longitudinal study of behavioural symptoms of dementia and MCI. The study population, consisting of 270 MCI, 402 AD patients, and 108 healthy controls from Antwerp, underwent a battery of tests and assessments. Moderate-to-severe behavioural symptoms were present in 13% of MCI patients, compared with 39% in AD patients and 3% in controls. The general severity of behavioural symptoms was intermediate between controls and AD patients. The three most common symptoms in MCI patients were aggressiveness (49%), affective disturbance (45%), and anxiety (38%); in AD patients, they were aggressiveness (60%), activity disturbances (54%), and psychosis (40%). Overall the prevalence and severity of frontal lobe symptoms, aggressiveness, activity disturbances, and delusions was intermediate between normal aging and AD and the severity of physically non-aggressive, verbally agitated behaviour and the severity of depressive symptoms were also intermediate.
Organizational and individual level determinants of stigmatization in mental health services
- Authors:
- VERHAEGHE Mieke, BRACKE Piet
- Journal article citation:
- Community Mental Health Journal, 43(4), August 2007, pp.375-400.
- Publisher:
- Springer
Despite the large amount of research on the existence and the negative consequences of stigmatization of clients of mental health services, little is known about the differences between services. Using data from 520 clients of 47 rehabilitation centres in Belgium in a multilevel design, the authors studied organisational and individual characteristics explaining variation in social rejection and self-rejection. The results reveal that only a very small percentage of variance in stigmatization is explained by organizational features, such as size, composition of the client population and the kind of supplied activities. Client level characteristics affecting stigmatization are current mental health status, former mental hospitalization, and participation in psychotherapeutic activities.