Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required.
Theorising psychological activity as a spatial product appears a logical extension of moves in social theory to emphasise the role of space and place in the consideration of experience. Catalysed by turns in social and human geographies to highlight the role of space and location in constituting psychological activity, various forms of the ‘spatialisation of experience’ have emerged. In this paper I will follow this theoretical direction in relation to the underlying destabilisation of everyday life that emerges as a product of theoretical formations that emphasise the fluidity of space. More specifically, I will take the example of the home as a central space in the ongoing activity of people with enduring mental distress. Forging a theoretical line that takes in geographies of mental health, the home, and finally, Gilles Deleuze's work on ‘repetition’ and ‘habit’, I will analyse the role of home spaces in everyday life. Key here is a concern regarding the impact of theoretical emphases on continuity, mobility, and instability on understandings of the everyday lives of mental health service users. This includes addressing conceptualisations of the home space alongside the activities of the people who occupy, and hence co-make, such spaces. The article concludes by framing ‘spatial habituation’ of the everyday as central to creating a perceivable stability, analysis of which can aid understanding of the challenges facing people suffering with mental distress.
The spaces that surveillance produces can be thought of as ambiguous, entailing elements that are ethereal yet material, geographical yet trans-geographical. Contemporary surveillance systems form numerous connections that involve multiple times, spaces, and bodies. Due to their ubiquity, normalisation, and yet clandestine characteristics, they seem to produce an almost unnoticed aspect of everyday life. The impacts then, of contemporary surveillance systems, appear to be particularly experienced on the margins of consciousness. Thus we find that an empirical analysis of this realm of experience is possible but requires one to look for such things as disruption, disfluency, and hesitation in the text of speech acts rather than clear representation. Through empirical analysis of narratives concerning everyday experiences of living with contemporary surveillance systems, this paper focuses on their possible affective impacts. In turn, we find it more fitting to think about the so called "surveillance society" in terms of producing "atmospheres" rather than "cultures or assemblages," and "affects" rather than "emotions." Keywords Affect, Atmosphere, Assemblage, Emotion, Surveillance Affecting Atmospheres through SurveillanceThere is an overarching perception between academics, politicians, media, and the general public that surveillance systems are now almost ubiquitous in the UK (particularly in the cities). A report by
This paper develops the concept of digital atmosphere to analyse the affective power of social media to shape practices of care and support for people living with mental distress. Using contemporary accounts of affective atmospheres, the paper focuses on the impact/s on feelings of distress, support and care that unfold through digital atmospheres. The power of social media intersects with people's support and care seeking practices in multiple ways and not in a straightforward 'accessing/providing support' model. Indeed, we find that the caring relations that develop through social media often need caring for themselves (Schillmeier, 2014). The paper draws on online and interview data from a larger project investigating how practices of care and support are (re)configured in the mental health-related social media site Elefriends.
This study sought to analyse how knowledge of the controversial illness, known among other names as Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME), is rhetorically constructed in the accounts of four sufferers. A discursive psychological approach was adopted, to analyse how sufferers of CFS use their discourse to actively represent notions of blame and accountability and their stake and interest, in situated illness narratives. The themes identi ed all serve to construct CFS as a legitimate organic illness. By constructing CFS in this way, the sufferers are able to position themselves as legitimately ill, and thus avoid the stigma and threats to their identities that being diagnosed as suffering from a psychological disorder could bring. Qualitative Research in Psychology 2004; 1: 153 /167
This article develops a conceptualization of 'space' that enables in-depth analysis of mental health service user 'territories'. Driven by the aim to understand how spaces within the framework of 'community care' are produced, an approach that draws upon Deleuze and Guattari's notion of 'territoriality' is developed. Through this we see how important it can be for service users to produce 'safe spaces' that enable forms of 'normalized' activities to be produced, but, crucially, in settings that exist outside completely mainstream settings. Analysing drop-in day centres and home environments (two key sites in community care), the article demonstrates the value of a micro-analysis of the production of space to understanding some of the ways service user experience operates in a spatially distributed sense. This helps to illuminate the impact on identity of existing within 'community care'.
Medium secure forensic psychiatric units are unique environments within the broader 'post asylum' landscape of mental health services. Length of stay is much greater, a recovery-focused care system is much more difficult to implement, and there is a paucity of suitable "step-down" services. The aim of this study was to examine how forensic psychiatric environments contribute to the shaping of recovery, by examining key features such as social interactions and agency. Here, we report on the findings from patients participating in a qualitative-visual study. This analysis forms part of larger study on staff and patient experiences of secure hospital space. In this paper, the analytical focus is directed towards two key elements of recovery -agency and relationality, using the concept of 'topology' and 'life-space', developed by the social psychologist Kurt Lewin. First, we explore how patients have relative freedom to move within institutional spaces, yet lack relational space. Secondly, we explore how life-space is expanded or compressed by the manner in which the patient's present life in hospital is connected or disconnected from their past or pending future. Finally, we discuss the implications of these findings for a recovery model within secure forensic settings, focussed on personalisation and expanded life-space.2
Child abuse and neglect are strongly associated with many subsequent mental health problems. This review summarizes the research on how adult mental health services respond when child abuse or neglect become known. MEDLINE, PsycINFO, and Scopus were searched for studies with rates of responding in various ways to child abuse and neglect by mental health professionals. Thirteen studies were identified: seven case note reviews, three surveys of staff, and three sets of interviews with service users. Rates of inclusion of abuse or neglect in treatment plans ranged from 12% to 44%. Rates of referral to abuse-related therapy ranged from 8% to 23%. Rates were lower for neglect than for abuse and were also lower for men and people with a diagnosis of psychosis. Two per cent or less of all cases were referred to legal authorities. The studies varied in focus and methodology, but all indicated inadequate clinical practice. The rates of abused or neglected people referred for therapy are actually lower than indicated by this review because most users of adult mental health services are not asked about abuse or neglect in the first place. The barriers to good practice, and the need for trauma-informed services, are discussed.
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