Does Mental Illness Affect Consumer Direction of Community-Based Care? Lessons From the Arkansas Cash and Counseling Program

Purpose: Previous research from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, New Jersey, and Florida suggests that giving consumers control over their personal care greatly increases their satisfaction and improves their outlook on life. Still, some argue that consumerdirected care may not be appropriate for consumers with intellectual disabilities or mental health diagnoses. This study examined how Cash and Counseling— a new option allowing consumers to manage an individualized budget equivalent to what agencies would have spent on their care—changes the way consumers with mental health diagnoses meet their personal care needs and how that affects their wellbeing. Design and Methods: Using the Arkansas CCDE baseline and the 9-month follow-up data for individuals in the treatment and control groups, we compared and contrasted the experience of elderly consumers with and without mental health diagnoses utilizing logit regression. Results: After examining several outcome measures, including satisfaction with care arrangements and the paid caregiver’s reliability and schedule, unmet needs, and satisfaction with the relationship with paid caregivers, this study found evidence that, from the perspective of consumers, the Cash and Counseling program works well for participants with mental health diagnoses. Implications: Considering the growing need for long-term-care services and the limited resources available, a consumer-directed option makes sense, and it can be a valuable alternative for persons with mental health needs.

Mental Health and Aging: Progress and Prospects

This volume originally appeared as an issue of the ASA journal, Generations. It contains contributions by prestigious writers in the field of gerontology, who present current concepts in research and clinical practice on mental health and aging. This book provides the latest perspectives on assessment and prevention techniques, depressive and anxiety disorders, the aging brain and neuroimaging, family therapy, and adult day care.

"She Was Not Even Normal": Unreliable Narratives of Female Insanity in Jane Eyre, Rebecca, and Wide Sargasso Sea

In my thesis, I interrogate narrative reliability related to depictions of female insanity in Jane Eyre, Rebecca, and Wide Sargasso Sea. By subjecting the trustworthiness of her storytelling to criticism, especially as regards the concealed madwoman, Bertha Mason, Jane's narration is revealed as unstable, offering problematic insight into a character long considered unflinchingly honest. In du Maurier's later literary adaptation of Jane Eyre, Bertha's parallel character, the eponymous Rebecca, comes to the fore, while the novel's unnamed narrator remains in the shadows, and bases much of her storytelling upon hearsay, rather than the "autobiography" of Jane Eyre. The most transparent narrative voice, however, is Antoinette, the main character of Wide Sargasso Sea, the 1966 prequel to Jane Eyre. Despite her madness, Antoinette's narration makes no attempt at dissemblance, speaking forthrightly about her marriage and experience, proving a truthful narrator and openly rejecting the marginal status the earlier narrators try desperately to hide.

"Enemigos de la virilidad": Sex, Masturbation, and Celibacy in Nineteenth-Century Spain

The discourse on sexuality in nineteenth-century Spain presents a fundamental difference between the masculine ideal of that period and our current definition of masculinity. According to today’s popular stereotype, the typical man seeks out sexual contact and takes any opportunities that arise. By contrast, within the hygiene texts of the nineteenth century one detects a sense of unease associated with sexual activity and its corresponding role in the construction of hegemonic masculinity. In particular, sexual excess, masturbation, and celibacy were viewed as antagonistic to middle-class masculinity, which was instead associated with venereal moderation, marriage, and fatherhood. Men who transgressed this model risked their health as well as their masculinity. This formula reveals an element of fragility with regard to notions of manhood, in contrast to the traditional image of Spanish masculinity that originated during the Reconquest and is based on bellicose heroism, bravado, and sexual prowess.