Patrick Callaghan and Andrew Grundy
The purpose of this paper is to examine empirical, epistemological and conceptual challenges and clinical narratives in the application of risk assessment and management in mental…
Abstract
Purpose
The purpose of this paper is to examine empirical, epistemological and conceptual challenges and clinical narratives in the application of risk assessment and management in mental health.
Design/methodology/approach
The authors used a narrative review of empirical, conceptual and clinical literature.
Findings
The worldwide prevalence of violence in mental health settings remains high. Risk assessment and management approaches, while well intentioned as an attempt to reduce harm and increase people’s safety, have negligible effect on both. They are invariably individual centric, ignore wider environmental, societal and behavioural influences that foment violence and have a stigmatising effect on people using mental health services. They also reinforce the myth that people who are mentally unwell threaten society and that through current risk assessment and management approaches, we can minimise this threat.
Research limitations/implications
There is a need to reconsider the study and application of violence risk assessment in mental health.
Practical implications
The practice of risk assessment and management in mental health is marred by an overuse of risk assessment measures that are limited in their predictive efficacy. As a result, they have little value in preventing, reducing and/or managing harm. The language of risk punishes and stigmatises service users and reinforces the image of menace. An alternative language of safety may nourish and protect. A collaborative approach to safety assessment based upon recovery-focussed principles and practices may fuse professionals and service users’ horizons. Combining service users’ self-perception, professionals’ sound clinical judgement, assisted by electronically derived risk algorithms and followed by evidence-based risk management interventions, may lessen the threat to service users, reduce harm and transform the practice of violence risk assessment and management.
Social implications
Risk appraisals discriminate against the small number of people who have a mental illness and are risky, an example of preventive detention that is ethically questionable. On the basis of the limitations of the predictive efficacy of actuarial measures, it is ethically dubious to subject people to interventions with limited benefits. Risk assessment processes tend to reinforce stigma by classifying individuals as risky, sanctioning society’s prejudices and fear through scientific authority.
Originality/value
The increasing focus on risk assessment and management to tackle violence in mental health is fraught with empirical, conceptual and practical concerns; the authors have suggested ways in which these concerns can be addressed without compromising people’s safety.
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Social Work education has seen some changes since my first paper on how The Archers could be used to enhance a student's understanding of service user experiences (Burrows, 2016)…
Abstract
Social Work education has seen some changes since my first paper on how The Archers could be used to enhance a student's understanding of service user experiences (Burrows, 2016). Social Work students still, however, need to understand the difficulties that their future service users may experience; learning is developed through lectures, seminars and workshops, and most of all through practice experience, but a real challenge for educators is how to show students the constant lived reality of families and communities who have complex difficulties. A visit to a household only gives a snapshot of their life, and service users may be guarded in their behaviour during a professional visit. My original paper considered the educational value of the ‘fly-on-the-wall’ perspective of The Archers, in catching unguarded moments and drawing attention to issues in the community. From the impact of rural poverty and unaffordable housing, through issues of mental health, hospital discharge, to adult survivors of child sexual abuse and the tangled webs of modern slavery, these issues will resonate with any social worker, in Adult, Children and Families or Mental Health fields. These are not just issues in a rural setting; professionals in more urban settings will recognise these as things the families and individuals they work with must deal with from time to time.
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John M. Violanti, Claudia C. Ma, Ja K. Gu, Desta Fekedulegn, Anna Mnatsakanova and Michael E. Andrew
The purpose of this paper is to examine the association of social avoidance among police, cardiovascular disease (CVD) (metabolic syndrome (MetSyn)), and social support.
Abstract
Purpose
The purpose of this paper is to examine the association of social avoidance among police, cardiovascular disease (CVD) (metabolic syndrome (MetSyn)), and social support.
Design/methodology/approach
Participants were officers from the Buffalo Cardio-Metabolic Occupational Police Stress study (n=289). Social avoidance (defined as the tendency to avoid social contact) and other subscales from the Cook-Medley Hostility Scale were analyzed. The mean number of MetSyn components across tertiles of the Cook-Medley scales was computed using analysis of variance and analysis of covariance. Social support was measured with the Social Provisions Scale, categorized as high or low based on the median.
Findings
The mean number of MetSyn components increased significantly across tertiles of social avoidance (1.51±0.18, 1.52±0.12, and 1.81±0.12); the only Cook-Medley subscale that remained significantly associated with MetSyn following adjustment for age and gender. Participants high in social avoidance reported significantly lower social support (79.9±8.5 vs 85.8±8.6; p=0.001).
Research limitations/implications
The study is cross-sectional and therefore precludes causality. The authors were unable to determine the direction of associations between social avoidance and MetSyn. The measure of social support was unidimensional, including only perceived support; additional types of social support measures would be helpful.
Practical implications
This study suggests that occupational-based police social isolation is associated with health outcomes and lower support. Several suggestions are made which will help to improve communication between the police and public. Examples are the use of social media, training in communication techniques, and changing the police role to one of public guardians.
Originality/value
Social avoidance is the least studied the Cook-Medley subscale associated with CVD. It is important for the health of officers to maintain a social connection with others.
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Nekehia T. Quashie, Julian G. McKoy Davis, Douladel Willie-Tyndale, Kenneth James and Denise Eldemire-Shearer
Purpose: Grandparents are common providers of childcare within the Caribbean region. Yet research on the implications of grandparent caregiving for older adults’ well-being is…
Abstract
Purpose: Grandparents are common providers of childcare within the Caribbean region. Yet research on the implications of grandparent caregiving for older adults’ well-being is limited. This study examined gender differences in the relationship between grandparent caregiving and the life satisfaction of older adults in Jamaica.
Methodology: Using a sample of 1,622 grandparents 60 years and older drawn from the 2012 study “The Health and Social Status of Older Jamaicans,” we estimated binary logistic regression models to examine the association between the frequency of grandparent caregiving and the life satisfaction of grandparents.
Findings: Grandmothers were more likely than grandfathers to provide care. We did not find a statistically significant gender difference in the life satisfaction of caregiving grandparents. Yet, gender differences in the patterns of association between grandparent caregiving and life satisfaction were evident. Among grandmothers, both occasional and regular caregiving was associated with higher life satisfaction relative to non-caregivers. Among grandfathers, however, only regular caregiving was positively associated with life satisfaction.
Originality: This is the first population-based study within the Caribbean to examine gendered patterns of grandparent caregiving and the association with grandparents’ well-being. The findings of this study suggest that grandparent caregiving is beneficial to the well-being of older Jamaican men and women. This study challenges assumptions of gender norms that typically do not position men to be involved in caregiving roles, and to derive satisfaction from such roles, within Caribbean households. The authors suggest more attention should be given to interventions to encourage men to be actively involved in family caregiving.
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Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18;…
Abstract
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management…
Abstract
Index by subjects, compiled by K.G.B. Bakewell covering the following journals: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18;…
Abstract
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18;…
Abstract
Compiled by K.G.B. Bakewell covering the following journals published by MCB University Press: Facilities Volumes 8‐18; Journal of Property Investment & Finance Volumes 8‐18; Property Management Volumes 8‐18; Structural Survey Volumes 8‐18.