Coercion in the Community: A Situated Approach to the Examination of Ethical Challenges for Mental Health Social Workers

Increasingly, mental health social workers in the United Kingdom and elsewhere in the world are employing coercive interventions with clients. This paper explores this trend in the context of community-based settings, using national and international research literature on this subject. It begins with a discussion about the complex, contested nature of ideas on coercion. The authors then explore debates about how coercion is perceived and applied in practice. They choose two forms of coercion*/informal types of leverage, and the legally mandated use of Community Treatment Orders*/to highlight the range of ethical problems and dilemmas that confront practitioners in this field. The authors conclude by developing a tentative, explanatory model to explain how and why mental health social workers should consider a more holistic, situated approach to help deal with ethical concerns about the use of coercion.

Associations between Mothers' Experiences with the Troubles in Northern Ireland and Mothers' and Childrens' Psychological Functioning: The Moderating Role of Social Identity.

Relatively little research has examined the relations between growing up in a community with a history of protracted violent political conflict and subsequent generations' well-being. The current article examines relations between mothers' self-report of the impact that the historical political violence in Northern Ireland (known, as the Troubles) has on her and her child's current mental health. These relations are framed within the social identity model of stress, which provides a framework for understanding coping responses within societies that have experienced intergroup conflict. Mother-child dyads (N = 695) living in Belfast completed interviews. Results suggest that the mother-reported impact of the Troubles continue to be associated with mothers' mental health, which, in, turn, is associated with her child's adjustment. The strength of mothers' social identity moderated pathways between the impact of the Troubles and her mental health, consistent with the social identity model of stress. (C) 2010 Wiley Periodicals, Inc.

'Securing' the past: Policing and the contest over truth in Northern Ireland

The question of whether Northern Ireland should have a formal truth recovery process has been amplified by the recent Report of the Consultative Group on the Past. Compared to the volume at which the truth recovery debate has been played out, relatively little is known about policing attitudes to this form of dealing with the past. This paper analyses the ways in which the history and context of policing in Northern Ireland have shaped attitudes towards truth recovery. It will be argued that differing opinions on the need for truth recovery are part of a debate over 'ownership of the past' between the ardent supporters of the Royal Ulster Constabulary and the new post-Patten managers and modernizers.

Coordination of palliative cancer care in the community: "unfinished business"

Goal: This study assessed the degree to which services in south-central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families. Participants and method: Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument. Main results: Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients' individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients' social/psychological status. Conclusions: The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care. © 2009 Springer-Verlag.

Victimhood and Attitudes towards Dealing with the Legacy of the Past: Northern Ireland as a Case Study

Research Highlights and Abstract: Using Northern Ireland as a case study, this article provides the first nationally representative and systematic study of victims' views on how to deal with the past; Focusing specifically on Northern Ireland, it both investigates and provides a comprehensive account of the marked divisions between the various religious groupings-Protestants, Catholics and the non-affiliated-in terms of a range of truth recovery mechanisms to deal with legacy of its violent past; It empirically investigates and validates two key predictors-perceptions of victimhood and general attitudes towards the past-in determining the source of these divisions It outlines the implications of our findings for other societies emerging from conflict. Truth recovery mechanisms have become a cornerstone of peacebuilding efforts in societies emerging from conflict. Yet, to date, the view of victims in post-conflict societies concerning such arrangements remains highly anecdotal and often second-hand in nature. Mindful of this omission and using Northern Ireland as a case study, this article investigates the views of victims towards a range of mechanisms to deal with the legacy of Northern Ireland's violent past. Based on the 2011 Northern Ireland Social and Political Attitudes Survey, the results suggest some marked divisions in relation to this issue, with victims within the Catholic community being significantly more supportive of such initiatives than either Protestants or those with no religion. Moreover, while perceptions of victimhood emerge as the key predictor of attitudes among Protestants and the non-affiliated, general opinions on how to deal with the past are the key determinant of views among members of the Catholic community

Measuring horizontal integration among health care providers in the community: An examination of a collaborative process within a palliative care network

In many countries formal or informal palliative care networks (PCNs) have evolved to better integrate community-based services for individuals with a life-limiting illness. We conducted a cross-sectional survey using a customized tool to determine the perceptions of the processes of palliative care delivery reflective of horizontal integration from the perspective of nurses, physicians and allied health professionals working in a PCN, as well as to assess the utility of this tool. The process elements examined were part of a conceptual framework for evaluating integration of a system of care and centred on interprofessional collaboration. We used the Index of Interdisciplinary Collaboration (IIC) as a basis of measurement. The 86 respondents (85% response rate) placed high value on working collaboratively and most reported being part of an interprofessional team. The survey tool showed utility in identifying strengths and gaps in integration across the network and in detecting variability in some factors according to respondent agency affiliation and profession. Specifically, support for interprofessional communication and evaluative activities were viewed as insufficient. Impediments to these aspects of horizontal integration may be reflective of workload constraints, differences in agency operations or an absence of key structural features.

Evaluation of a partnership between primary and secondary care providing an accessible Level 1 sexual health service in the community

Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.

Composition and temporal variation of the algal assemblage associated with the haplosclerid sponge Haliclona indistincta (Bowerbank)

Although interactions between seaweeds and sponges have been studied in detail, general information concerning the whole epibiontic algal assemblage associated with a sponge species is virtually non-existent. We present here the first study in which the macroalgal community associated with a sponge, Haliclona indistincta (Bowerbank), was examined in detail. In the period October 2009-September 2010, the seaweed assemblage epibiontic on H. indistincta at a site of the Irish West coast was composed of 66 algal taxa (48 red algae, 7 green algae, 11 brown algae). The red algae Gelidium spinosum and Rhodothamniella floridula were the only epibionts associated with H. indistincta for the whole annual cycle. Most of the algal epibionts were filamentous species, which colonized the surface of the sponge and did not penetrate deeply into it. The algal assemblage was most abundant and species-diverse in the period late winter-spring; multivariate analyses revealed a significant variation of the community on the temporal scale of season and sampling date (weeks to months). The results indicate that the algal communities associated with sponges may be very diverse, showing that this type of assemblage deserves further detailed studies. © 2012 Elsevier B.V.

Collectively coping with contact: The role of intragroup support in dealing with the challenges of intergroup mixing in residential contexts

The social identity approach to stress has shown how intragroup support processes shape individuals' responses to stress across health care, workplace, and community settings. However, the issue of how these 'social cure' processes can help cope with the stress of intergroup contact has yet to be explored. This is particularly important given the pivotal role of intergroup threat and anxiety in the experience of contact as well as the effect of contact on extending the boundaries of group inclusion. This study applies this perspective to a real-life instance of residential contact in a divided society. Semi-structured interviews with 14 Catholic and 13 Protestant new residents of increasingly mixed areas of Belfast city, Northern Ireland, were thematically analysed. Results highlight that transitioning to mixed communities was fraught with intergroup anxiety, especially for those coming from 'single identity' areas. Help from existing residents, especially when offered by members of other religious denominations, signalled a 'mixed community ethos' to new residents, which facilitated adopting and sharing this identity. This shared identity then enabled them to deal with unexpected intergroup threats and provided resilience to future sectarian division. New residents who did not adopt this shared identity remained isolated, fearful, and prone to negative contact.

Physical characterization of TNOs with the James Webb Space Telescope

Studies of the physical properties of trans-Neptunian objects (TNOs) are a powerful probe into the processes of planetesimal formation and solar system evolution. James Webb Space Telescope (JWST) will provide unique new capabilities for such studies. Here, we outline where the capabilities of JWST open new avenues of investigation, potentially valuable observations and surveys, and conclude with a discussion of community actions that may serve to enhance the eventual science return of JWST's TNO observations.