Kynnyskysymyksiä : Huono-osaisimmat huumeiden käyttäjät ja matala kynnys

The study examines the term "low threshold" from the point of view of the most marginalized drug users. While using illicit drugs is criminalised and morally judged in Finland, users have special barriers to seek for care. Low threshold services aim at reaching drug users who themselves don t seek for help. "Low threshold" is a metaphor describing easy access to services. The theoretical frame of reference of the study consists of processing the term analytically and critically. The research work sets out to test the rhetoric of low threshold by making use of a qualitative multi-case study to find out, if the threshold of so called low threshold services always appears low for the most marginalized drug users. The cases are: the mobile unite offering health counselling, the day service centre for marginalized substance abusers and the low threshold project of the outpatient clinic for drug users in Helsinki and the health counselling service trial in Vyborg, Russia. The case study answer following questions: 1) How do the method of low threshold work out in the studied cases from the point of view of the most marginalized drug users? 2) How do potential thresholds appear and how did they develop? 3) How do the most marginalized drug users get into the care system through low threshold? The data consists of interviews of drug users, workers and other specialists having been accomplished in the years 2001 - 2006, patient documents and customer registers. The dissertation includes four articles published in the years 2006 - 2008 and the summary article. The study manifests that even low threshold is not always low enough for the most marginalized drug users. That expresses a highly multiproblematised and underpriviledged group of drug users, whose life and utilization of services are framed by deep marginalisation, homelessness, multi-substance use, mental and somatic illnesses and being repeatedly imprisoned. Using services is rendered difficult by many factors arising from the care system, drug users themselves and the action environment. In Finland thresholds are generally due to the execution of practical services and procedures not considering the fear of control and labelling as a drug user. When striving for further rehabilitating substance abuse care by means of low threshold services the marginalized drug users meet the biggest difficulties. They are due to inelastic structures, procedures and division of labour in the established care system and also to poor chances of drug users to be in action in the way expected by the care system. Multiproblematic multisubstance users become "wrong" customers by high expectations of care motivation and specializing in the care system. In Russia the thresholds are primarily caused by rigid control politics directed to drug users by the society and by the scantiness of care system. The ideology of reducing drug related harm is not approved and the care system is unwilling to commit to it. Low threshold turnes out to be relative as a term. The rhetoric of the care system is not enough to unilaterally define lowness of the threshold. The experiences of drug users and the actual activity to search for care determine the threshold. It does not appear the same for everybody either. Access of certain customer group to a service unit may even raise the threshold for some other group. The low threshold system also is surprisingly realized: you could not always tell in advance, what kind of customers and how many of them could be reached. Keywords: low threshold, marginalized drug users, harm reduction, barriers to services, outreach

Women and Marital Breakdown in South India : Reconstructing Homes, Bonds and Persons

Women and Marital Breakdown in South India: Reconstructing Homes, Bonds and Persons is an ethnographic analysis of the situation of divorced and separated women and their families in the South Indian city of Bangalore. The study is based on 16 months of anthropological fieldwork, i.e., participant observation and life history interviews among 50 divorced and separated women from different socio-religious backgrounds in their homes, in the women s organisations and in the Family Court. The study follows the divorced and separated women from their natal homes to their affinal homes through homelessness and legal battles to their reconstructed natal, affinal or single homes in order to find out what it means to be a person within hierarchical gender and kinship relations in South India. Marital breakdown impacts on kin relations and discloses the existing gender relations and power structure through its consequences. It makes the transformability of relational personhood as well as the transformability of relational society and culture visible. Although the study reveals the painful history of women s ill-treatment in marriage, family and kinship systems, it also demonstrates the women s rejection of the domination; and shows their ability to re-negotiate and promote changes not only to their own positions but to the whole hierarchical system as well. The study explores the divorced and separated women s manifold dilemmas, complicated legal battles, and endless arrangements when they have to struggle with the very practical problems of supporting themselves financially, finding and making a new home for themselves, and re-arranging relationships with their kin and friends. As marital breakdown fundamentally transforms the women s relational field, it forces them to recreate substitutive relations in a flexible way and, simultaneously, to re-construct themselves and their lives without a ready or positive cultural or behavioural template. This process reveals the agency of the divorced and separated women as well as shedding light on issues of gender and the cultural construction of the person in South India. This topical study explores the previously neglected subject of marital breakdown in India and shows the new meaning of kinship in South India.

Monietnisten ihmisten etninen identiteetti suomalaisessa viitekehyksessä : kosmopoliittisuutta, monikulttuurisuutta ja itsensä etsimistä

The purpose of this thesis was to understand the experiences of the multiethnic people in Finland. This study explored the different aspects of the ethnic identity development process. Thesis was done in two phases. First phase studied the question of how is the ethnic identity developed in Finnish context and what aspects had affected their ethnic identity process. The second phase explored questions as what kind of ethnic identity form the multiethnic people have in Finland and do they have developed cosmopolitan global identities. The aim of this qualitative study was not to empirically measure or define the multiethnic identity, but to open new perspectives of the life and experiences through narrative research. Intention of this thesis was to give voice to small stories of the minority people that are so often shadowed by the big stories of the male of the majority. The first phase of this study included narratives from four multiethnic women. The narratives answered to questions who am I and where do I come from. The second phase data collection was made with narrative forms to 12 self-identified multiethnic persons. The multiethnic people were from three backgrounds: ones with parents from different ethnic backgrounds, Finnish who had lived long time abroad and people from non-Finnish backgraound who had lived in Finland for a long time. The analyzing was made by analyzing the narratives with content analysis that based on the theory of the multiethnic people and by narrative analyzing where short narratives were created of each person. In conclusion the multiethnic identity was found to be a continuous process that lasted through lifetime. Different aspects affected the identification process, including family dynamics, social mirroring and belonging. The variety of different ethnic options in multiethnic person identity process, lacking family support for the both ethnic identities and the feeling of otherness experienced by the multiethnic people in Finland cause additional challenges to the ethnic identity process and results in some cases cultural homelessness. On the other hand the variety of cultural contexts brings flexibility to negotiate between different cultures and languages resulting to positive hybrid identity for some of the multiethnic people. Hybrid identity was sub grouped to cosmopolitan identity and multicultural identity.