Anti-oppressive Approach to Assessment

Veltman, Albina; Rose, Tara La

doi:10.1007/978-3-319-30346-8_5

Cited by 6 publications

(2 citation statements)

References 6 publications

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“…Trust and safety and the negative impacts of structural violence resonated across the studies. As the paradigm of safety expands to all settings within the healthcare continuum,[88] there is a need for anti-oppressive approaches (critically reflecting on the power structures such as systemic racism, sexism, homophobia, transphobia, ableism that impact patients’ lives) [89,90] that address structural violence. Primary care providers are uniquely positioned to provide, refer to, or advocate for health and structural interventions using the principles of trauma-informed care [91]…”

Section: Discussionmentioning

confidence: 99%

Common trust and personal safety issues: A systematic review on the acceptability of health and social interventions for persons with lived experience of homelessness

Magwood¹,

Leki²,

Kpadé³

et al. 2019

PLoS ONE

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BackgroundPersons experiencing homelessness and vulnerable housing or those with lived experience of homelessness have worse health outcomes than individuals who are stably housed. Structural violence can dramatically affect their acceptance of interventions. We carried out a systematic review to understand the factors that influence the acceptability of social and health interventions among persons with lived experience of homelessness.MethodsWe searched through eight bibliographic databases and selected grey literature sources for articles that were published between 1994 and 2019. We selected primary studies that reported on the experiences of homeless populations interacting with practitioners and service providers working in permanent supportive housing, case management, interventions for substance use, income assistance, and women- and youth-specific interventions. Each study was independently assessed for its methodological quality. We used a framework analysis to identify key findings and used the GRADE-CERQual approach to assess confidence in the key findings.FindingsOur search identified 11,017 citations of which 35 primary studies met our inclusion criteria. Our synthesis highlighted that individuals were marginalized, dehumanized and excluded by their lived homelessness experience. As a result, trust and personal safety were highly valued within human interactions. Lived experience of homelessness influenced attitudes toward health and social service professionals and sometimes led to reluctance to accept interventions. Physical and structural violence intersected with low self-esteem, depression and homeless-related stigma. Positive self-identity facilitated links to long-term and integrated services, peer support, and patient-centred engagement.ConclusionsIndividuals with lived experience of homelessness face considerable marginalization, dehumanization and structural violence. Practitioners and social service providers should consider anti-oppressive approaches and provide, refer to, or advocate for health and structural interventions using the principles of trauma-informed care. Accepting and respecting others as they are, without judgment, may help practitioners navigate barriers to inclusiveness, equitability, and effectiveness for primary care that targets this marginalized population.

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Section: Discussionmentioning

confidence: 99%

Common trust and personal safety issues: A systematic review on the acceptability of health and social interventions for persons with lived experience of homelessness

Magwood¹,

Leki²,

Kpadé³

et al. 2019

PLoS ONE

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“…The consideration of antioppressive assessment in psychiatry is a key to psychiatric care being more liberating than oppressive in a population. Veltman and La Rose (2016) suggest that adopting an anti-oppressive approach involves a commitment to social justice, including minimizing power imbalances, promoting equity and empowerment for patients, and self-reflection on one's own social location to enhance a clinician's understanding of the predisposing, precipitating, and perpetuating factors in a patient presentation.…”

Section: Discussionmentioning

confidence: 99%

Rural and Remote Psychiatry

Mehl‐Madrona¹,

McFarlane²

2020

Handbook of Rural, Remote, and Very Remote Mental Health

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The pronounced differences between rural and urban areas relate to access to care and psychiatric resources with nearly every rural county (96%) having a shortage of psychiatrists. Studies on urban-rural differences in psychiatric disorders have shown that urban environments are associated with increased risk for mental illness generally and with a greater range of psychiatric disorders. Urban-rural differences lie in social networks. Barriers to care include having an ideal of selfreliance and believing that mental illness is a weakness. The maturing field of rural health research supports the robust impact of the "neighborhood effect" on health, which includes community and social networks, and finds, in rural areas, that immersion in traditional cultures and networks are health-enhancing. Moving from rural to urban areas is often found to be a risk factor for mental illness, though the odds ratio for substance abuse disorders has been found to be the same. Providers and organizations in rural areas struggle with issues of access, recruitment, and professional burnout or exhaustion in traditional models. Systems of training must be considered for rural psychiatry that tap traditional and community-based systems of healing and health care; assess and intervene with "neighborhood" community, family, and social networks; and are less enamored with psychopharmacology. Primary care teams have an essential role in the treatment of rural mental illness and are most effective when inserted into a collaborative care model for disease management. Affiliating and understanding the natural helpers and social networks in any location is a key aspect to being in rural and remote psychiatry. Open Dialogue was developed in a rural and remote part of northwestern Finland. The implementation of Open Dialogue style approaches which are highly compatible with most indigenous cultures (Western Lappland in Finland is the traditional home of the Lapp people) puts psychiatry in a new perspective for rural and remote mental healthpsychiatrists are considered to be just another team member and not necessarily the leader or the most important team member. The difficulty inherent in telemedicine approaches is the lack of community engagement. Psychiatry, like anthropology, has garnered distrust in rural and remote communities related to its "helicopter" approach of coming to a community with little knowledge of the traditions, beliefs, customs, and ideas about mind and mental health, applying a biomedical model of diagnosis and treatment, prescribing medications, and leaving. Effective rural psychiatry will recruit well-trained psychiatrists akin to rural primary care providers who enjoy and value a broader scope of practice and who, while they are experts in pharmacotherapy, also desire to practice psychotherapy and systems development that advantage already existing community social networks and helpers.

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Equity, Diversity, and Inclusion in the Care of Older Adults

Veltman,

La Rose

2024

Geriatric Psychiatry

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Anti-oppressive Approach to Assessment

Cited by 6 publications

References 6 publications

Common trust and personal safety issues: A systematic review on the acceptability of health and social interventions for persons with lived experience of homelessness

Common trust and personal safety issues: A systematic review on the acceptability of health and social interventions for persons with lived experience of homelessness

Rural and Remote Psychiatry

Equity, Diversity, and Inclusion in the Care of Older Adults

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