Analyses of black women's sex and sexuality in critical studies of gender and sexuality expose how the vocabularies of queer critique and black feminist thought-organized and driven by terms like normativity, nonnormativity, respectability, margin, and center-leave us faltering in our attempts to grasp the political, economic, and cultural shifts both occasioned and signaled by black women's incorporation into the u.s. imperial imaginary in the decades since World War II. This volume's invitation to rethink norms, as Robyn Wiegman and Elizabeth Wilson propose, "not in relation to a compulsory, uniform standard, but through an expansive relationality among and within individuals, across and within groups" (15), prompts me to revisit the terminologies that draw black feminism, women of color feminism, and queer of color critique together. In this essay I work at the intersection of queer critique and black feminism to elaborate the problem that the incorporation of minority difference into the institutions and imaginaries of contemporary global power poses for our habits of thought in feminist studies.1 Attending to representations of black women's sexuality in state narratives of black freedom and black freedom-to-secure against the differences
Background: Those with serious mental illness (SMI) experience poor health outcomes which may be addressed by the integration of mental health and primary care services. This integration could be enhanced by the inclusion of consumers in the planning process. Aims: This study sought to bring the voice of the consumer with SMI to assist with the integration of primary care and mental health services. Methods: Working with a community advisory board in the City of Philadelphia, we carried out a sequential explanatory mixed-methods study. The team conducted 12 focus groups ( n=149) and surveys ( n = 137) of consumers with SMI about their experiences of the health care system and perspectives on integrated health. Data from surveys and focus groups were analyzed and integrated. Results: Three relevant themes emerged: primary care experiences; health care stigma; and social determinants as barriers to health. Generally, individuals with SMI supported the integration of care, with careful consideration given to social determinants of health, patient privacy, and respect between providers and patients. Conclusions: Integration may reduce health disparities experienced by individuals with SMI, but the process must be informed by intended consumers. Policymakers and administrators will need to address barriers to care, healthcare stigma, and social determinants of health. Nurses are well placed to inform and lead healthcare integration and overcome the siloing of mental and physical healthcare systems.
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