Sue Gillieatt

Female sex work in Yangon, Myanmar

BACKGROUND Myanmar (Burma), with an upper estimate of 400,000 people living with HIV/AIDS, faces a dangerous and potentially devastating epidemic. Female sex workers in the country are one of the most affected populations, with high prevalence rates of both HIV and sexually transmitted infections (STIs). METHODS A qualitative study was undertaken in Yangon at the end of 2002 to investigate the social and demographic features contributing to the transmission of HIV among female sex workers in urban Myanmar. Twenty-seven key informants from the government, non-government organisations (NGOs), international non-government organisations (INGOs), private sector and the United Nations system agencies and 25 women currently working in the sex trade were interviewed. RESULTS The sex trade in Yangon is rapidly growing and is characterised by a high degree of complexity. The number of female sex workers is estimated to be between 5,000 and 10,000 and there are approximately 100 brothels operating in various townships around the city. Nearly one-third of the women in the study reported previous imprisonment for offences related to sex work as well as fear of harassment, sexual exploitation, violence and gang rape. Almost half reported using condoms with clients at all times. Contradicting views exist as to the level of awareness about STIs and HIV among Yangon sex workers, with the majority never having been tested for HIV. Only one-quarter of women were regular patients of the limited number of STI clinics operated by INGOs. CONCLUSIONS Female sex workers in Myanmar remain a highly marginalised group almost inaccessible due to a variety of legal, political, cultural and social factors and are particularly vulnerable to HIV and STIs. It is important to encourage partnerships between INGOs by promoting service coordination and information sharing to increase the availability of services for sex workers and to build political support for an unpopular cause.

Evaluation of an inter-professional training program for student clinical supervision in Australia

BackgroundAs a response to an Australian shortage of clinical health, nursing, and medical placements, Commonwealth Government funding has been directed to expand student training opportunities and increase the competence and number of available clinical supervisors. This paper evaluates the application of a particular supervision training model for this purpose. It considers the model’s suitability and relevance across professions and its impact on supervisory knowledge, skills, and values as well as the intention to supervise students.MethodsThe design, delivery, and evaluation of a series of one-day introductory student clinical supervision training workshops for allied health disciplines, nursing, and medicine are considered. Participants evaluated Proctor’s model of clinical supervision, which was expanded by the trainers to incorporate diversity and power relations in student supervision.ResultsEvaluation results suggest that adapting Proctor’s model for student clinical supervision is relevant across a broad range of health disciplines and clinical areas. Participants from 11 health professions reported that the training improved their knowledge, skills, and values and expanded their willingness to accept student clinical placements. The outcomes are suggestive of enhanced clinical supervision intent, capacity, and capability.ConclusionsThe student supervision training improved participants’ confidence in their clinical supervision skills. The findings suggest that the training has the potential to extend capacity and capability for student supervision across health professions and in Health Workforce Australia’s identified priority areas of mental health, community health, rehabilitation, private practice, and non-government organisations. Findings also indicate that these gains are reliant on health organizations developing and sustaining cultures of learning.

Family inclusion in mental health services: Reality or rhetoric?

Background: Contemporary mental health policies require family inclusion in the design, implementation and evaluation of services. Materials: This scoping review considers the factors in mental health practice which either mediate or promote family inclusion. A wide range of factors are reported to obstruct family inclusion, while a smaller number of studies report that meaningful family inclusion rests on a partnership approach which values the input of families and services users. Discussion: When it comes to family inclusion, there is a gap between policy and service delivery practice. Changes in service delivery attitudes, values and culture are necessary to meaningfully and systematically include families and service users.

Social Network Analysis and Social Work Inquiry

Abstract Understanding and positively impacting social networks is core to social work practice and research. As a research method, social network analysis provides an important mechanism for mapping various types of networks as well as the relationships and exchanges between network actors. This has relevance to Australian human and health services given the social policy context that currently emphasises and requires improvements in the integration of services. This paper describes the application of social network analysis to a consortium of mental health and related services to examine indicators of service integration such as the frequency, type, and direction of information exchanges including referral pathways. When combined with other research methods and information, social network analysis is shown to be a useful tool providing both visual and sociometric evidence of relational activities, thus creating a strong basis for advocacy and social change.

Transitional supported housing for mental health consumers enabling personal recovery: Allowing me to be me

ABSTRACT Objective: Safe, secure, affordable housing is recognised as pivotal to supporting mental health recovery. This article aims to evaluate an innovative West Australian transitional supported housing service for mental health consumers. The service offers 12-months accommodation and individually-tailored, recovery-oriented outreach support followed by six months of less intensive support. Method: Informed by the principles of personal recovery and co-production, the research team, consumers and service staff worked together to create a participatory evaluation process. Semi-structured interviews were conducted with consumers (n = 8), family members (n = 3), and staff (n = 5) which focused on the experience and impact of the service. Data were analysed using thematic analysis. Results: Consumers and family members were satisfied with the service, particularly its person-centred and co-produced approach, and the primacy of relationships characterised by power sharing, authenticity and transparency. Having stable accommodation enabled consumers to make positive changes, including engaging in new therapies, developing independence, and pursuing study and work opportunities. When re-interviewed at least three months after leaving the accommodation, consumers reflected that the service had a significant role in facilitating their recovery and were hopeful about their future. Discussion: Housing stability alongside flexible, tailored, recovery-oriented support were central to satisfaction with the service. Challenges in securing stable, affordable housing post-service highlight the broader issue of housing affordability and supply, and highlight the need for more low cost and social housing to promote mental health recovery. As recovery is a unique, individual process, a variety of flexible supported housing options are needed.

A Snapshot of Intellectual Disabilities in Lao PDR: Challenges for the Development of Services.

Lao People’s Democratic Republic (PDR) has experienced significant economic growth in the last two decades. While access to education, health, and employment for people with disabilities has also improved markedly, people with intellectual disabilities are still among the most vulnerable in society. This article presents findings from a screening survey of 2469 participants, a focus group discussion with key stakeholders in intellectual disabilities, and a case study of the Association for Autism. The screening survey suggests 1.9% of working age participants (18–59) and 0.7% of children (6–17) have intellectual disabilities. The qualitative data illustrate poor understanding and stigmatization of people with intellectual disabilities, lack of services, and development of a parent association to improve the life prospects for children with autism and intellectual disabilities. People with intellectual disabilities in Lao PDR remain particularly vulnerable. Parents and other disability advocates are raising awareness and demonstrating the effectiveness of specialized services.