Search results

In the context of intense intercultural experience, the individual’s identity is often transformed by the forces of acculturation. Unexpectedly powerful demands, influences, and resistances buffet the values, beliefs, and behaviors of the sojourner, leading to confusion, and eventually resolution of profound identity issues. The resulting sense of being between two cultures or more, living at the edges of each, but rarely at the center, can be called cultural marginality. When these issues remain unresolved, the person is often confounded by the demands, and feels alienated in a state called encapsulated marginality. The constructive marginal resolves these questions by integrating choices from each culture of which the person is a part, choosing the appropriate frame of reference, and taking action appropriate for the context.

Global leaders need to recognize the characteristics of the marginal identity and leverage the skills the marginal brings to the organization. The mindset of hybrid professionals fosters increased creativity, culturally appropriate problem solving, and collaboration with other culture partners. Educators, trainers, and coaches can design developmental opportunities for sojourners to acculturate to new environments in a way that potentiates their intercultural competence and comfort with their bicultural mindset. By viewing a complex cultural identity as an asset to the organization, global leaders can avoid the common pitfall of overlooking cultural marginals and instead maximize their contribution to globalization.

The purpose of this paper is to focus on the findings of a review of the Learning Advice Service which provided mainstream learning opportunities and individual support to people using mental health services. The service was decommissioned after 15 years due to service reconfiguration and cost-cutting.

Semi-structured interviews were carried out with members of the Learning Advisor’s caseload by a researcher with no affiliation to the NHS or the Institute of Mental Health and no connection to the clients. The researcher also transcribed and analysed the interviews. This ensured that there could be no personal or positive bias. The clients faced significant mental health challenges and used the Learning Advice Service to facilitate and support their entry into mainstream learning.

The service enabled individuals facing significant mental health challenges to gain access to adult, community, distance and further and higher education facilitated by individual advice, guidance and support. They were able to broaden their sense of identity beyond that of someone using mental health services and to widen their social and educational base.

Lack of funding within mental health services to continue this type of work limits research which would further explore the value of mainstream education in the recovery of people with a mental health diagnosis. While this cohort was small because of funding and staffing constraints, it would be possible to generalise to a larger scale, using flexible person-centred ways of working if the will, staffing and funding were made available. Further research is certainly indicated as current practice has moved away from mainstream inclusion to discrete provision with associated limitations.

The practical implications include the development of autonomy and the development of a sense of identity that is separate from a mental health diagnosis and where appropriate to gain qualifications and further the student’s knowledge.

Social implications include broadening one’s experience, developing communication skills in a broad context, transferable skills, independence and strengthening one’s sense of identity separate from a mental health diagnosis.

Individuals from a variety of educational and other backgrounds who expressed an interest in pursuing education in mainstream facilities were encouraged and supported in doing so in flexible and individual ways. It appears to be more usual that people using mental health services are encouraged to learn in groups comprising other people using such services, frequently on mental health service premises with associated limitations.

This article explores some of the meanings and implications of learning for both the learner and the learning adviser in a mental health setting. It discusses the relationship of learning and employment, aspects of the lived reality of learning while experiencing fluctuating levels of distress and what kinds of support can help. It identifies barriers that need to be overcome on both individual and societal levels, and the benefits of supportive staff with an enthusiasm and awareness of learning needs.

The purpose of this paper is to provide a review of the current literature uncovering specific factors associated with self-harm and suicidality among young Asian-American women, as well as to present the Fractured Identity Model as a framework for understanding these factors. This paper offers concrete suggestions for the development of culturally competent interventions to target suicidality, substance abuse, and mental illness among young Asian-American women.

Empirical studies and theory-based papers featured in peer-reviewed journals between 1990 and 2014 were identified through scholarly databases, such as PubMed, MEDLINE, PsycINFO, JSTOR, and Google Scholar. Of an original 32 articles, 12 were chosen for in-depth empirical review due to relevance to the topics at hand, quality of research, and significance of findings.

The paper identified several factors associated with suicidality among young Asian-American women: family dynamics, or having lived in a household where parents practice “disempowering parenting styles,” substance use/abuse, and untreated mental illness(es), which are exacerbated by the stigma and shame attached to seeking out mental health services. The Fractured Identity Model by Hahm et al. (2014) is presented as a proposed causal pathway from disempowering parenting to suicidal and self-harm behaviors among this population, with substance abuse playing a significant mediating role.

The review focussed on Asian-American women, substance use among Asian-Americans, and mental health among Asian-Americans. Literature that focused on Asians living in Asia or elsewhere outside of the USA was excluded from this review; the review was limited to research conducted in the USA and written in the English language.

The complex interplay among Asian-American culture, family dynamics, gender roles/expectations, and mental health justifies the development of a suicide and substance abuse intervention that is tailored to the culture- and gender-specific needs of Asian Pacific Islander young women. It is imperative for professionals in the fields of public health, mental health, medicine, and substance abuse to proactively combat the “model minority” myth and to design and implement interventions targeting family dynamics, coping with immigration/acculturative stresses, mental illnesses, suicidal behaviors, and substance abuse among Asian-American populations across the developmental lifespan.

This paper provides specific suggestions for interventions to adequately respond to the mental health needs of young Asian-American women. These include addressing the cultural stigma and shame of seeking help, underlying family origin issues, and excessive alcohol and drug use as unsafe coping, as well as incorporating empowerment-based and mind-body components to foster an intervention targeting suicidality among Asian-American women in early adulthood.

The race concordance hypothesis suggests that matching patients and health providers on the basis of race improves communication and patients’ perceptions of health care, and by extension, encourages patients to seek and utilize health care, which may reduce health disparities. However, relatively few studies have examined the impact of race concordance on the utilization of health services. This chapter is grounded on Andersen’s Emerging Model of Health Services Utilization (Phase 4) and extends that model to include race concordance.

The data were collected from a stratified random sample of adult beneficiaries enrolled in North Carolina Medicaid’s primary care case management delivery system in 2006–2007. Propensity score matching techniques were used to sort respondents on their propensity for race concordance and indices were constructed to generate key control variables. Poisson regression was used to examine the impact of race concordance on the utilization of primary care and emergency room care, under the assumption that race concordance would increase the use of primary care and decrease the use of emergency care for minority patients.

While blacks (compared to whites) used less primary care and had more emergency care visits, race concordance was not a statistically significant predictor of either primary care or emergency room use. However, patients’ satisfaction with their primary care providers was associated with significantly fewer primary care and emergency care visits while trust in one’s provider was associated with more primary care visits.

The study findings suggest that the central premises of the race concordance hypothesis require further study to confirm the assumption that better patient – primary care provider relationships result in less utilization of more costly and resource-intensive forms of health care.

The study makes a valuable contribution by expanding the relatively small body of literature dedicated to exploring the impact of race concordance on health services utilization. Additionally, by virtue of researching the experience of Medicaid enrollees, the study controls for health insurance status.

Olga Snell reviews a new handbook for tutors and managers in adult education offering information and guidance on supporting people with mental health difficulties.

College classrooms are an important socializing site, preparing students to critically reflect upon their viewpoints and engage in democratic citizenship and civic leadership. Yet this very notion of educational environment can serve to produce racial inequality and ethnically and culturally blind pedagogical space. In this chapter, the author describes how students articulate their internalized social position and racism in a given college classroom and understands the process by which students’ sense of self is internalized and (re)constructed through the practice of reflective journaling.

This paper aims to explore the well-being impacts of social enterprise, beyond a social enterprise per se, in everyday community life.

An exploratory case study was used. The study’s underpinning theory is from relational geography, including Spaces of Wellbeing Theory and therapeutic assemblage. These theories underpin data collection methods. Nine social enterprise participants were engaged in mental mapping and walking interviews. Four other informants with “boundary-spanning” roles involving knowledge of the social enterprise and the community were interviewed. Data were managed using NVivo, and analysed thematically.

Well-being realised from “being inside” a social enterprise organisation was further developed for participants, in the community, through positive interactions with people, material objects, stories and performances of well-being that occurred in everyday community life. Boundary spanning community members had roles in referring participants to social enterprise, mediating between participants and structures of community life and normalising social enterprise in the community. They also gained benefit from social enterprise involvement.

This paper uses relational geography and aligned methods to reveal the intricate connections between social enterprise and well-being realisation in community life. There is potential to pursue this research on a larger scale to provide needed evidence about how well-being is realised in social enterprises and then extends into communities.