Dan A. Lewis

Psychiatric Diagnoses and Racial Bias: An Empirical Investigation

Using data from a random sample of 313 severely mentally ill individuals, we assessed the relation between race and schizophrenic diagnoses among those hospitalized at four Chicago metropolitan state mental hospitals. After we controlled for psychiatric diagnosis with an independent SADS diagnosis and other relevant variables, the logistic regression analysis reveals that being Black is predictive of a diagnosis of schizophrenia. These results suggest that significant problems may exist with regard to the treatment and diagnosis of minority groups within the mental health system and the need for culturally appropriate services for minorities, especially within large urban areas. Recently, an association between race and hospitalization in state-operated mental institutions across the United States has emerged. Data collected by the National Institute of Mental Health (NIMH; 1980; Manderscheid & Barrett, 1987) suggest startling disparities in the types of diagnosis attributed to racial groups, indicating that the diagnosis of schizophrenia has increased among Blacks in comparison with Whites in state-operated facilities. Concurrently, literature that has accumulated over the last 20 years suggests that racial bias occurs within the institutions that treat the severely mentally ill. Given this context, we examined the issue of race and diagnosis in an urban mental health system. We asked, more specifically, to what extent being Black is predictive of a diagnosis of schizophrenia, independently of other clinical and social variables thought to influence clinical decision making.

Are Welfare Sanctions Working as Intended? Welfare Receipt, Work Activity, and Material Hardship among TANF‐Recipient Families

This analysis utilizes longitudinal survey and administrative data on 1998 welfare recipients in Illinois to assess whether different types of grant reductions are associated with subsequent work, welfare receipt, and hardships. Results show that imposed sanctions are inversely associated with formal work and earnings, as well as with increases in informal work, other work activities, and food hardships. Threats to sanction are unassociated with formal work and welfare outcomes but positively associated with informal work, other work activities, and rent hardship. Greater knowledge of welfare rules is associated with more formal work, less welfare receipt, and less hardship.

Studies in the Sociology of Social Problems.

This collection contributes data and analysis to the current sate of work in social problems sociology. The chapters are drawn together based on the social definitional or social constructionist view that social problems are not conditions but rather the definitional activities of people making claims and responses to such conditions. The emphasis is on social problems sociology as the distinct subfield of the discipline that addresses this kind of social conduct. The chapters seek to expand upon and elaborate various elements of this general theme.

Examining technology that supports community policing

This paper investigates how citizens use technology to support community policing efforts. To explore the types of conversations that are shared on the community web forum, we conducted a qualitative study. We analyzed 865 forum posts from a community crime web forum from April 2004 to June 2011. We found that residents use the forum to: 1) build relationships by strengthening social ties, 2) discuss ways to take collective action, 3) share information and advice, and 4) regulate the social norms of the neighborhood and the web forum. Results suggest that technologies intended for crime prevention should be designed to support communication and problem-solving discussions amongst residents, as opposed to simply providing information to citizens.

Quality of life of persons with severe mental illness living in an intermediate care facility

This study examined resident characteristics, clinical factors, and mental health service utilization associated with quality of life (QOL) for residents living in an Intermediate Care Facility (ICF). This study also utilized published literature to compare the QOL of ICF residents to persons with psychiatric disorders living in other residential settings. Chart review and interviews were used to study 100 randomly selected residents living in an ICF with a chart diagnosis of schizophrenia. Multivariate analyses suggest that higher levels of QOL are associated with reports that psychological problems did not interfere with work and activities and with lower levels of being a danger to others. Also, a comparison of the QOL scores reported by ICF residents to other published mentally ill populations suggests that residents of the ICF report somewhat higher QOL scores than state hospital patients, but lower scores as compared to other community samples. Data provide insight into the types of problems faced by residents of an intermediate care facility. These findings have implications for understanding the importance of mental health service utilization on QOL.

The negotiation of voluntary admission in Chicago's state mental hospitals

This study examines the admission of emergency certified patients to Chicagos state mental hospitals and the process by which patients decide to sign a voluntary admission form. Involuntary commitment is rarely used to admit Chicagos state mental patients. Patients, staff and court personnel negotiate with a common interest in avoiding commitment court. Hospital staff use three different strategies to convince emergency certified patients to admit themselves voluntarily and avoid involuntary commitment: persuasion/coercion, bartering and stalling. Similar strategies are employed to discourage voluntary patients’ requests for release. Hospital staff in Chicago are disinclined to commit patients because they feel pressured to discharge the majority of patients as quickly as possible to make room for a steady flow of new admissions. Workers manage their caseload by choosing the most expedient form of admission, which is to obtain their patients’ signatures on a voluntary admission form. In order to accomplish this task, however, hospital staff sometimes circumvent legal standards of voluntariness in the admission process.

Ironies of inclusion: Social class and deinstitutionalization

This paper discusses changes in the social organization of mental institutionalization as they relate to developments in the wider social and economic environment. Despite dramatic changes in the system of inpatient psychiatric care during the last three decades, the historic division of labor between the private and the public system (with the latter treating the poor, the unemployed, and the nonwhite) has not ceased to exist. At the same time, under the influence of the postwar trend towards greater political integration of disadvantaged and marginal groups into societys central value systems, treatment of the mentally ill has become less segregated and more voluntary. An important implication of these two interacting trends--the changed legal position of the patient vis-à-vis the provider and the deteriorating economic position of the user of public psychiatric facilities--has been the exceeding irrelevance of one of the basic tenets of psychiatric care: that clinical treatment precedes social functioning. With two vignettes of chronic patients the article illustrates how symptoms and survival are fused in the contemporary, inclusionary system of care.

The new political voice of young Americans: Online engagement and civic development among first- year college students

We present findings from the first wave of a longitudinal study of civic and political engagement among undergraduate students at a mid-sized university in the Midwestern United States. We find that high school experiences of civic learning are a significant predictor of three of our four measures of civic and political engagement, namely, the likelihood of contacting a public official, participating in a protest, and engaging in collective problem-solving. Online political engagement appears to partially mediate the relationship between high school civic learning and offline political engagement. In terms of the specific aspects of high school civic learning that may be most salient to adolescents, the classroom experience of ‘meeting people who make society better’ emerges as the strongest predictor of students’ civic engagement. These findings suggest that citizenship norms among young adults may be shifting to new forums of engagement rather than simply eroding, as some current literature suggests.

Moving up and moving out? Economic and residential mobility of low-income Chicago Families

This article examines the residential and income mobility of 403 low-income Chicago families within a context shaped by welfare and public-housing reforms implemented in the mid-1990s. We assess the extent to which sample members became less poor and less isolated in economically and racially segregated areas in the years following implementation of these reforms. Sample members experienced marked income gains between 1999 and 2002, but the average income reaches a plateau at less than

The Impact of Low-Level Lead Toxicity on School Performance among Hispanic Subgroups in the Chicago Public Schools

16,000 per year. Despite significant residential mobility, there was only a slight reduction in the economic segregation of sample members and no discernable change in racial segregation.