Kate Karban

Include me in: user involvement in research and evaluation

Purpose – This paper aims to discuss the experiences of a group of eight user and carer researchers from learning disability and mental health services who worked together in a research project. The research was to find out about the changes that took place as over 300 people moved from hostel accommodation into independent tenancies. These moves were part of a three year project involving a partnership between a local authority and a housing association.Design/methodology/approach – The evaluation was based on a model of user participation.Findings – User involvement in research can mean different things with different levels of involvement, from consultation through to user‐controlled research. In this paper the authors discuss some of the challenges in doing this kind of evaluation study, as well as the opportunities that came from involving users and carers in the research. This includes how the researchers got involved and some of the activities they did.Research limitations/implications – The author...

Towards a middle-range theory of mental health and well-being effects of employment transitions: Findings from a qualitative study on unemployment during the 2009–2010 economic recession

This article builds upon previous theoretical work on job loss as a status passage to help explain how people’s experiences of involuntary unemployment affected their mental well-being during the 2009–2010 economic recession. It proposes a middle-range theory that interprets employment transitions as status passages and suggests that their health and well-being effects depend on the personal and social meanings that people give to them, which are called properties of the transitions. The analyses, which used a thematic approach, are based on the findings of a qualitative study undertaken in Bradford (North England) consisting of 73 people interviewed in 16 focus groups. The study found that the participants experienced their job losses as divestment passages characterised by three main properties: experiences of reduced agency, disruption of role-based identities, for example, personal identity crises, and experiences of ‘spoiled identities’, for example, experiences of stigma. The proposed middle-range theory allows us to federate these findings together in a coherent framework which makes a contribution to illuminating not just the intra-personal consequences of unemployment, that is, its impact on subjective well-being and common mental health problems, but also its inter-personal consequences, that is, the hidden and often overlooked social processes that affect unemployed people’s social well-being. This article discusses how the study findings and the proposed middle-range theory can help to address the theoretical weaknesses and often contradictory empirical findings from studies that use alternative frameworks, for example, deprivation models and ‘incentive theory’ of unemployment.

Health Inequalities at the Heart of the Social Work Curriculum

Efforts to reduce the widening gap between the health and social well-being of people within and between countries have become an urgent priority for politicians and policymakers. The Rio Declaration called on governments worldwide to promote and strengthen universal access to social services and to work in partnership to promote health equity and foster more inclusive societies. This paper contributes to international debates about the role of social work in promoting social justice by reducing social and health inequalities. Despite clear commitments to promote good health, there is a notable absence of a social determinants of health perspective in international social work curricula standards. The current review of social work education in England presents a timely opportunity to integrate such a perspective in teaching and learning and to disseminate this more widely. Employing the concepts of downstream and upstream interventions, the first part of the paper examines the distinctiveness of the social work contribution to this global agenda. In the second part of the paper, we consider how the content of learning activities about health inequalities can be incorporated in international social work curricula, namely, human rights, using Gypsy and Traveller families as an exemplar, inter-professional education and international perspectives.

Towards support: evaluating a move to independent living

Purpose – The purpose of this paper is to present results from an evaluation of the experience of a move to independent living for people with mental health needs or a learning disability. The discussion focuses on the shift in organisational culture from providing care within a hostel setting to supporting people in their own tenancies.Design/methodology/approach – The evaluation was underpinned by a participatory action research design. A total of ten co‐researchers with experience of using services or as carers were recruited. Qualitative data was obtained from “before” and “after” interviews with residents, staff and relatives.Findings – Widespread satisfaction was expressed with peoples new homes. Many residents were found to be increasingly independent. There was some evidence of concerns regarding the pace and process of change and the introduction of new practices to promote independence.Research limitations/implications – The timing of the evaluation limited the opportunity for comprehensive “be...

Social Work and Global Health Inequalities—Practice and Policy Developments

Amidst increasing evidence regarding the social determinants of health (CSDH, 2008), this ambitious edited collection makes a strong and persuasive case for locating health inequalities at the heart of social work. The book is wide-ranging in its scope, incorporating global and national perspectives and addressing issues from across the life course, grounded in values of social justice, human rights and equality. Contributors to the book are primarily drawn from the Social Work and Health Inequalities Network which aims to promote discussion and action by social work practitioners, managers, educators and researchers to combat the causes and consequences of unjust and damaging socially created inequalities in health. It is also relevant to declare the reviewer’s interest as a current co-convenor of the network, although there was no involvement in either the writing or the development of this book. The book is structured into four main parts, beginning with an introduction that sets the scene for the subsequent chapters, recognising the wider social, political and economic context and the relevance of issues such as political conflict and climate change. Part two provides a number of chapters that provide the rationale for making the connection between social work, health and well-being. Nadkarni and Vikram argue in their chapter, that, despite many years of international and national declarations, there is still much to be done to overcome the barriers to health as a human right, emphasising the violations of health and human rights experienced by women and children and drawing on experiences in India, including the relevance of social work in working with community and grass roots organisations. Emphasising the connections between poverty and ill-health, Rose similarly advocates for social work involvement in the struggle for health and equity, proposing a social epidemiological perspective that addresses population health across the life course to answer the question, ‘how best to understand the inequitable distribution of health within the population served by social work?’. This discussion is also informed by the concept of ‘embodiment’, understood as the way in which physical bodies ‘contain the cumulative impact of their material existence’ (p. 41), and the impact of stress and deprivation on physical and emotional health and well-being. Other chapters in this section address both the macro and micro levels of health inequalities, including the impact of political conflict, violence and abuse, the relationship between long term illness, disability and inequalities, the global market in reproduction and the importance of establishing positive foundations for good health in childhood.

Exploring partnership: Reflections on an international collaboration.

This article explores some of the challenges involved in a collaborative mental health partnership, drawing on the reflections of two project members from the Chainama College of Health Sciences in Zambia and the Leeds Metropolitan University in England. The aim of the project was to support the education and training of the mental health workforce in Zambia as services shift from institutional to community-based care. The discussion is located within Gray’s ‘three-pronged dilemma’ and debates concerning the internationalisation agenda in social work and higher education. The conclusion emphasises the benefits and tensions of partnership working between ‘developed’ and ‘developing’ countries.

Building Capacity in the Zambian Mental Health Workforce through Engaging College Educators: Evaluation of a Development Partnership in Higher Education (DelPHe) project

Abstract Between 2008 and 2011 academic teaching staff from Leeds Beckett University (UK) and Chainama Hills College of Health Sciences (Zambia) worked together on a Development Partnership in Higher Education (DelPHe) project funded by the Department for International Development (DFID) via the British Council. The partnership focused on “up-scaling” the provision of mental health education which was intended to build capacity through the delivery of a range of workshops for health educators at Chainama College, Lusaka. The project was evaluated on completion using small focus group discussions (FGDs), so educators could feedback on their experience of the workshops and discuss the impact of learning into their teaching practice. This chapter discusses the challenges of scaling up the mental health workforce in Zambia; the rationale for the content and delivery style of workshops with the health educators and finally presents and critically discusses the evaluation findings.