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Khan AA, Stirrup V, MacInnes D. An examination of service user satisfaction in forensic mental health settings. MEDICINE, SCIENCE, AND THE LAW 2024:258024241227719. [PMID: 38297506 DOI: 10.1177/00258024241227719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
High levels of service user satisfaction are viewed as a reliable indicator of a service providing good care and treatment. There has been limited research looking into levels of satisfaction in forensic mental health settings with most work focused on staff satisfaction in these settings. This study examined service users' levels of satisfaction with a forensic mental health service in the United Kingdom. The service covered two sites; one a purpose-built secure unit and the other based in an old cottage hospital. Thirty-nine in-patients completed a 60-item validated forensic satisfaction scale. The scale measured seven domains of satisfaction as well as reporting an overall satisfaction score. The results indicated the service users were reasonably satisfied with the care and treatment they received. The domains of rehabilitation, safety, staff interaction and overall care showed the highest level of satisfaction. The high rehabilitation satisfaction score demonstrated the importance of meaningful activities for users accessing forensic services and may have been influenced by the security measures on the wards. The high safety domain score indicated respondents felt safe and secure within the wards and were likely to be influenced by positive interpersonal interactions. Good staff interaction was also an important factor in helping service users feel safe on the wards. These interactions are likely to be associated with longer periods of admission in secure services allowing therapeutic relationships to develop. Financial advice/support was the one domain that recorded negative satisfaction levels. Financial literacy training may help develop money management skills.
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Affiliation(s)
- Al Adiya Khan
- Forensic and Offender Healthcare Services, Oxleas NHS Foundation Trust, Dartford, Kent, UK
| | - Victoria Stirrup
- Department of Research Development, Canterbury Christ Church University, Canterbury, UK
| | - Douglas MacInnes
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, UK
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Torbjørnsen A, Utne I, Løyland B. Long-term social assistance recipients' experiences with an increased monthly payment: a qualitative pilot study. Scand J Public Health 2023:14034948231209369. [PMID: 37953704 DOI: 10.1177/14034948231209369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
AIMS Ten long-term social assistance recipients in a Norwegian municipality received a greater-than-average fixed monthly payment for 12 months. This study aimed to explore whether these recipients with reduced administrative requirements and a fixed monthly payment that was greater than the average social assistance experienced reduced poverty, increased feelings of independence, better daily living, and an improved quality of life. METHODS The study's explorative design included 20 qualitative, in-depth, semi-structured interviews and a longitudinal electronic survey for 12 months. The 10 participants had been selected by the local labour and welfare agency based on stringent criteria and are therefore not representative of social assistance recipients in general. Individual interviews were conducted during autumn 2021 and spring 2022. The interview data were analysed using systematic text condensation, and the survey results are presented using descriptive statistics. RESULTS The participants included in the project described a reduced experience of poverty. They could buy additional items and set aside money, something they had not been able to do in the past, and meant a great deal to them. They expressed experiencing freedom, gaining a stronger sense of independence, and having lessened feelings of shame. Many of the participants described health issues that were incompatible with working. CONCLUSIONS Being given this opportunity led to a feeling of increased dignity and greater inclusion in society among this selected group of participants. They appreciated the simplified conditions and reduced requirements for administrative matters. All expressed that spending 8 months without contact with the social welfare office was a liberation.
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Affiliation(s)
- Astrid Torbjørnsen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Norway
| | - Inger Utne
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Norway
| | - Borghild Løyland
- Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, Norway
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Botha F, Butterworth P, Wilkins R. Protecting mental health during periods of financial stress: Evidence from the Australian Coronavirus Supplement income support payment. Soc Sci Med 2022; 306:115158. [PMID: 35751987 PMCID: PMC9212744 DOI: 10.1016/j.socscimed.2022.115158] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/30/2022]
Abstract
This paper investigates whether the Australian government's Coronavirus Supplement, a temporary income support payment for unemployed jobseekers during the height of the COVID-19 pandemic, protected mental health (frequency of feeling anxious or depressed during the past week) by lowering financial stress (how comfortable people are in paying for essential services). We use unique nationally representative repeated cross-sectional data on 3843 unemployed Australian adults over the period April 6, 2020 to May 10, 2021. We find that the Coronavirus Supplement payment significantly reduced reported financial stress, and lower financial stress was associated with lower mental distress. Though the Coronavirus Supplement was designed to reduce financial stress, we find the Supplement was also successful in protecting community mental health indirectly via its ability to reduce financial stress. The findings provide support for income support packages to protect mental health during economic shocks. However, transitory support measures also tend have short-lived positive effects on mental health, suggesting that more permanent income support reform may have longer-term mental health benefits.
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Affiliation(s)
- Ferdi Botha
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Australia.
| | - Peter Butterworth
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Australia; Research School of Population Health, Australian National University, Australia
| | - Roger Wilkins
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Australia; Institute of Labor Economics (IZA), Bonn, Germany
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Kino S, Nishioka D, Ueno K, Kondo N. Role of psychosocial factors in starting and leaving public assistance programs by older Japanese population: Longitudinal Japan Gerontological Evaluation Study. Arch Gerontol Geriatr 2021; 99:104615. [PMID: 34971872 DOI: 10.1016/j.archger.2021.104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Public assistance programs guarantee a minimum living standard, promoting independence for impoverished citizens. Although public assistance eligibility is mainly based on economic factors like poverty, psychosocial factors may be important in initiating and terminating participation. We explored factors governing commencement and termination of public assistance by the older Japanese population between 2013 and 2016. METHODS We used panel data from the Japan Gerontological Evaluation Study (JAGES), conducted in 2013 and 2016. Fixed-effects regression was used to examine variables in 2013 that were related to receiving public assistance in 2016. The Tokyo Metropolitan Institute of Gerontology -competence index (TMIG-CI) was used to assess higher-level activities of daily living (ADL, i.e., instrumental ADL, intellectual activity, and social role). The role of individual perceptions of community social cohesion (community trust, mutual help, and attachment), and sociodemographic factors were considered. RESULTS While 215 people (0.5%) started receiving public assistance between 2013 and 2016, almost 50% stopped participating. People with higher perceived mutual community help were 1.21 times (95% confidence interval [CI]: 1.02-1.46) more likely to commence public assistance three years later. Public assistance recipients who felt community attachment to their resident community, and had social roles were 1.16 (95% CI: 1.06-1.28) and 1.15 (95% CI: 1.01-1.30) times more likely to give up public assistance three years later, respectively, independent of socioeconomic statuses. CONCLUSION Psychosocial factors, including maintaining good relationships with community residents, could be important in accessing and terminating public assistance services.
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Affiliation(s)
- Shiho Kino
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Daisuke Nishioka
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan; Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Keiko Ueno
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan; Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan; Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for Future Initiatives, the University of Tokyo, Tokyo, Japan; Japan Agency for Gerontological Evaluation Study (JAGES Agency), Tokyo, Japan
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5
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Kino S, Nishioka D, Ueno K, Saito M, Kondo N. Changes in social relationships by the initiation and termination of public assistance in the older Japanese population: A JAGES panel study. Soc Sci Med 2021; 293:114661. [PMID: 34942580 DOI: 10.1016/j.socscimed.2021.114661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/25/2021] [Accepted: 12/14/2021] [Indexed: 10/19/2022]
Abstract
Public assistance recipients in Japan are financially empowered by social welfare but are also exposed to social stigma. Therefore, when their status of receiving public assistance changes, the conditions of their social life likely change. We examined whether the social relationships of older adults receiving public welfare are influenced by either starting or terminating their use of public assistance. This study used the Japan Gerontological Evaluation Study panel data from 2013 to 2016. To measure social relationships, we used four indicators: the frequency of meeting with friends, the number of friends whom the participants had met with in the past month, their frequency of participating in sports clubs, and their frequency of participating in hobby clubs. In the analyses, changes in social relationships between 2013 and 2016 were used as the study outcomes. Linear regression analyses were conducted to examine if their social relationships changed before and after starting or terminating public assistance while adjusting for confounders. We found that people who stopped receiving public assistance experienced an increase in their frequency of meeting with friends (coefficient: 0.56; 95% CI: 0.06, 1.07), the number of friends (coefficient: 0.60; 95% CI: 0.20, 0.99), participation in sports clubs (coefficient: 0.91; 95% CI: 0.46, 1.39), and participation in hobby clubs (coefficient: 0.70; 95% CI: 0.26, 1.13) compared to those who continued to receive public assistance. Contrarily, the measured social relationships did not change after the participants started receiving public assistance. Our main findings were that terminating one's reception of public assistance increases informal socializing and social participation while starting public assistance does not interrupt pre-existing relationships. These findings contribute to the literature by adding that social relationships are not negatively influenced by either terminating or starting public assistance. Targeted promotions of social connections would effectively maintain the health statuses of low-income older adults.
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Affiliation(s)
- Shiho Kino
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Daisuke Nishioka
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan; Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan.
| | - Keiko Ueno
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan; Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Masashige Saito
- Faculty of Social Welfare, Nihon Fukushi University, Chita-gun, Aichi, Japan; Center for Well-being and Society, Nihon Fukushi University, Nagoya, Aichi, Japan.
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan; Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan; Japan Agency for Gerontological Evaluation Study (JAGES Agency), Tokyo, Japan.
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6
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Collie A, Sheehan L, McAllister A. Health service use of Australian unemployment and disability benefit recipients: a national, cross-sectional study. BMC Health Serv Res 2021; 21:249. [PMID: 33740960 PMCID: PMC7977490 DOI: 10.1186/s12913-021-06255-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background Healthcare is funded and delivered separately from income support programs such as unemployment and disability benefits. Greater understanding of the health service use (HSU) of benefit recipients would support more effective design and delivery of health and income support programs. This study aimed to characterise the HSU of disability and unemployment benefit recipients relative to people earning wages, while controlling for personal, household and health-related factors associated with HSU in benefit recipients. Methods A cross-sectional national survey of 9110 working age Australian adults in three groups: (1) 566 receiving the disability support pension (DSP); (2) 410 receiving unemployment benefits; and (3) 8134 earning wages. Outcomes included prevalence and frequency of health professional consultations, hospital attendance and admission in the past 12 months, as well as medication and supplement use in the past 2 weeks. Analyses compared DSP and unemployment benefit recipients to wage earners using prevalence ratios and incident rate ratios, adjusted for predisposing, enabling and need factors that may affect HSU. Results In adjusted regression models, both DSP and unemployment benefit recipients were significantly more likely than wage earners to have consulted psychologists and social workers. DSP recipients also reported a significantly higher prevalence of consultations with General Practitioners (GPs), specialist physicians and podiatrists.. Both groups reported significantly more frequent consultations with GPs and DSP recipients with specialists. No differences were observed between groups for hospital attendance or admission, or supplement use in fully adjusted models, though the DSP group reported more prevalent medication use than wage earners. Inclusion of confounders including self-assessed health, disability severity, health insurance status, and financial resources attenuated the relationship between benefit receipt and HSU, however significant associations were still observed. Conclusions People receiving unemployment and disability insurance benefits use significantly more health services than wage earners. A range of personal and clinical characteristics explained much, but not all, of the association between greater HSU and benefit receipt. Greater coordination between health and income support systems may improve health, reduce HSU and improve work ability in unemployed and working age people. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06255-0.
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Affiliation(s)
- Alex Collie
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Luke Sheehan
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Ashley McAllister
- School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC, 3053, Australia
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Løyland B, Hermansen Å, Dahl E, Wahl AK. Differences in income trajectories according to psychological distress and pain: A longitudinal study among Norwegian social assistance recipients. Scand J Public Health 2020; 49:865-874. [PMID: 32706301 DOI: 10.1177/1403494820939812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: Mental diseases and pain are serious public health problems and are a leading cause of disability worldwide. The aim of this study is to describe how pain and psychological distress separately and in combination are associated with four income trajectories over nine years in a cohort of long-term social assistance recipients (LTRs). Methods: A cohort of 456 LTRs from 14 municipalities in Norway were divided into four groups based on the presence or absence of pain and/or psychological distress. These were surveyed in 2005, and later linked by personal identification numbers to high-quality longitudinal administrative data covering the period 2005-2013. Methods include calculation of income statuses based on main sources of income, and multinomial logistic regression analysis. Results: In the group without pain and psychological distress, earnings from work as main source of income (14.6-38.0%) and disability benefits (2.9-16.1%) increased over the period. In the 'double burden' group the proportions who had social assistance as main income decreased (68.2-21.5%) and the proportions with disability benefits increased over time (5.6-36.6%). Only 27.2% of the total sample had earnings from work as their main income in 2013. Conclusion: LTRs are extra burdened by pain and psychological distress, and this has consequences for their life opportunities and income trajectories. This study indicates that the primary goal of the social assistance system, to make the clients self-sufficient, is hard to achieve. A better co-operation between health services and work-related services is needed.
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Affiliation(s)
- Borghild Løyland
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway
| | - Åsmund Hermansen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Norway
| | - Espen Dahl
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Norway
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Ogbo FA, Kingsley Ezeh O, Dhami MV, Naz S, Khanlari S, McKenzie A, Agho K, Page A, Ussher J, Perz J, Eastwood J. Perinatal Distress and Depression in Culturally and Linguistically Diverse (CALD) Australian Women: The Role of Psychosocial and Obstetric Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2945. [PMID: 31426304 PMCID: PMC6720521 DOI: 10.3390/ijerph16162945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 01/24/2023]
Abstract
Perinatal distress and depression can have significant impacts on both the mother and baby. The present study investigated psychosocial and obstetric factors associated with perinatal distress and depressive symptoms among culturally and linguistically diverse (CALD) Australian women in Sydney, New South Wales. The study used retrospectively linked maternal and child health data from two Local Health Districts in Australia (N = 25,407). Perinatal distress was measured using the Edinburgh Postnatal Depression Scale (EPDS, scores of 10-12) and depressive symptoms, with EPDS scores of 13 or more. Multivariate multinomial logistic regression models were used to investigate the association between psychosocial and obstetric factors with perinatal distress and depressive symptoms. The prevalence of perinatal distress and depressive symptoms among CALD Australian women was 10.1% for antenatal distress; 7.3% for antenatal depressive symptoms; 6.2% for postnatal distress and 3.7% for postnatal depressive symptoms. Antenatal distress and depressive symptoms were associated with a lack of partner support, intimate partner violence, maternal history of childhood abuse and being known to child protection services. Antenatal distress and depressive symptoms were strongly associated with postnatal distress and depressive symptoms. Higher socioeconomic status had a protective effect on antenatal and postnatal depressive symptoms. Our study suggests that current perinatal mental health screening and referral for clinical assessment is essential, and also supports a re-examination of perinatal mental health policy to ensure access to culturally responsive mental health care that meets patients' needs.
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Affiliation(s)
- Felix Akpojene Ogbo
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia.
- General Practice Unit, Prescot Specialist Medical Centre, Welfare Quarters, Makurdi, Benue State 972261, Nigeria.
| | - Osita Kingsley Ezeh
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - Mansi Vijaybhai Dhami
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - Sabrina Naz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - Sarah Khanlari
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, 24 Liverpool Street, Croydon, NSW 2132, Australia
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Anne McKenzie
- Primary & Community Health, Child and Family, South Western Sydney Local Health District, Narellan CHC, NSW 2567, Australia
| | - Kingsley Agho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - Andrew Page
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - Jane Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571, Australia
| | - John Eastwood
- Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, 24 Liverpool Street, Croydon, NSW 2132, Australia
- Ingham Institute for Applied Medical Research, 1 Campbell Street, Liverpool, NSW 2170, Australia
- School of Women's and Children's Health, The University of New South Wales, Kensington, Sydney, NSW 2052, Australia
- Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney, NSW 2006, Australia
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Camperdown, NSW 2050, Australia
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Schofield TP, Haslam N, Butterworth P. The persistence of welfare stigma: Does the passing of time and subsequent employment moderate the negative perceptions associated with unemployment benefit receipt? JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2019. [DOI: 10.1111/jasp.12616] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Timothy P. Schofield
- Centre for Mental Health, Melbourne School of Population and Global Health The University of Melbourne Victoria Australia
| | - Nick Haslam
- School of Psychological Sciences The University of Melbourne Victoria Australia
| | - Peter Butterworth
- Centre for Mental Health, Melbourne School of Population and Global Health The University of Melbourne Victoria Australia
- Melbourne Institute of Applied Economic and Social Research The University of Melbourne Victoria Australia
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10
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Jovanovski N, Cook K. How Australian welfare reforms shape low-income single mothers’ food provisioning practices and their children’s nutritional health. CRITICAL PUBLIC HEALTH 2019. [DOI: 10.1080/09581596.2019.1577951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Natalie Jovanovski
- Faculty of Business & Law, Swinburne University of Technology, Hawthorn, Australia
| | - Kay Cook
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
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Shahidi FV, Ramraj C, Sod-Erdene O, Hildebrand V, Siddiqi A. The impact of social assistance programs on population health: a systematic review of research in high-income countries. BMC Public Health 2019; 19:2. [PMID: 30606263 PMCID: PMC6318923 DOI: 10.1186/s12889-018-6337-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/17/2018] [Indexed: 01/23/2023] Open
Abstract
Background Socioeconomic disadvantage is a fundamental cause of morbidity and mortality. One of the most important ways that governments buffer the adverse consequences of socioeconomic disadvantage is through the provision of social assistance. We conducted a systematic review of research examining the health impact of social assistance programs in high-income countries. Methods We systematically searched Embase, Medline, ProQuest, Scopus, and Web of Science from inception to December 2017 for peer-reviewed studies published in English-language journals. We identified empirical patterns through a qualitative synthesis of the evidence. We also evaluated the empirical rigour of the selected literature. Results Seventeen studies met our inclusion criteria. Thirteen descriptive studies rated as weak (n = 7), moderate (n = 4), and strong (n = 2) found that social assistance is associated with adverse health outcomes and that social assistance recipients exhibit worse health outcomes relative to non-recipients. Four experimental and quasi-experimental studies, all rated as strong (n = 4), found that efforts to limit the receipt of social assistance or reduce its generosity (also known as welfare reform) were associated with adverse health trends. Conclusions Evidence from the existing literature suggests that social assistance programs in high-income countries are failing to maintain the health of socioeconomically disadvantaged populations. These findings may in part reflect the influence of residual confounding due to unobserved characteristics that distinguish recipients from non-recipients. They may also indicate that the scope and generosity of existing programs are insufficient to offset the negative health consequences of severe socioeconomic disadvantage. Electronic supplementary material The online version of this article (10.1186/s12889-018-6337-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Faraz V Shahidi
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.
| | - Chantel Ramraj
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Odmaa Sod-Erdene
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada
| | - Vincent Hildebrand
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.,Department of Economics, Glendon College, York University, 2275 Bayview Abe, North York, ON, M4N 3M6, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.,Gillings School of Public Health, University of North Carolina, 135 Dauer Dr, Chapel Hill, North Carolina, 27599, USA
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12
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Schofield TP, Butterworth P. Are Negative Community Attitudes Toward Welfare Recipients Associated With Unemployment? Evidence From an Australian Cross-Sectional Sample and Longitudinal Cohort. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2017. [DOI: 10.1177/1948550617712031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Negative stereotyping and stigmatization of welfare recipients may account for the negative outcomes they experience. Much is known about the impact of stigma on welfare take-up, whereas much is hypothesized about the stigma–unemployment association. In two representative Australian samples, we show that individuals previously exposed to unemployment benefits held negative attitudes to welfare recipients only when these reflected those of their community. Temporal patterns in the data suggest this could reflect an internalization of negative community attitudes. These stigmatizing negative attitudes were not associated with prior unemployment but were linked with current employment, future employment, and a return to employment among the previously unemployed. Community attitudes had no direct effect on employment outcomes. Thus, the effects observed may have an indirect path through the internalization of negative community attitudes. These findings underscore the importance of multilevel analyses of social stigma and highlight that welfare stigma may promote recovery from the underlying characteristic.
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Affiliation(s)
- Timothy P. Schofield
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Butterworth
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Melbourne, Victoria, Australia
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13
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Lau JTF, Kim Y, Wu AMS, Wang Z, Huang B, Mo PKH. The Occupy Central (Umbrella) movement and mental health distress in the Hong Kong general public: political movements and concerns as potential structural risk factors of population mental health. Soc Psychiatry Psychiatr Epidemiol 2017; 52:525-536. [PMID: 28258334 DOI: 10.1007/s00127-017-1340-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/07/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE Political tension, as expressed by mass movements such as the Occupy Central movement (2014) in Hong Kong, is a potential but understudied structural factor of population mental health. METHODS A random population-based telephone survey anonymously interviewed 344 Hong Kong Chinese adults aged 18-65 years during the 2 weeks since the termination date of the 2-month-long Occupy Central movement (15/12/2014). Linear regression models were fit using mental distress (depression, anxiety and negative mood) and self-perceived changes in mood/sleeping quality as dependent variables. RESULTS Prevalence of participation in the movement was 10.5% (self), 17.7% (family members/relatives), and 34.0% (peers); 8.5% had participated for ≥2 days. Young age, but not participation, was associated with mental distress. In adjusted analysis, three types of responses to the movement (worry about safety, negative emotional responses to media reports, and conflicts with peers about the movement) and emotional responses to local political situations were significantly associated with all/some of the dependent variables related to mental distress. The variable on emotions toward local political situations was correlated with the three responses to the movement; it fully mediated the associations between such responses and mental distress. CONCLUSION Many citizens participated in the movement, which was led by youths and might have increased the general public's mental distress. Negative personal responses to the movement and emotions toward political situations were potential risk factors. As the political tension would last and political pessimism is globally found, politics may have become a regular and persistent structural risk factor negatively affecting population mental health.
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Affiliation(s)
- Joseph T F Lau
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary, Prince Wales Hospital Care, The Chinese University of Hong Kong, 5/F, Shatin, Hong Kong, China. .,The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China.
| | - Yoona Kim
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary, Prince Wales Hospital Care, The Chinese University of Hong Kong, 5/F, Shatin, Hong Kong, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macau, China
| | - Zixin Wang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary, Prince Wales Hospital Care, The Chinese University of Hong Kong, 5/F, Shatin, Hong Kong, China
| | - Bishan Huang
- Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary, Prince Wales Hospital Care, The Chinese University of Hong Kong, 5/F, Shatin, Hong Kong, China
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14
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Enticott JC, Meadows GN, Shawyer F, Inder B, Patten S. Mental disorders and distress: Associations with demographics, remoteness and socioeconomic deprivation of area of residence across Australia. Aust N Z J Psychiatry 2016; 50:1169-1179. [PMID: 26560843 DOI: 10.1177/0004867415615948] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Australian policy-making needs better information on socio-geographical associations with needs for mental health care. We explored two national surveys for information on disparities in rates of mental disorders and psychological distress. METHODS Secondary data analysis using the 2011/2012 National Health Survey and 2007 National Survey of Mental Health and Wellbeing. Key data were the Kessler 10 scores in adults in the National Health Survey (n = 12,332) and the National Survey of Mental Health and Wellbeing (n = 6558) and interview-assessed disorder rates in the National Survey of Mental Health and Wellbeing. Estimation of prevalence of distress and disorders for sub-populations defined by geographic and socioeconomic status of area was followed by investigation of area effects adjusting for age and gender. RESULTS Overall, approximately one person in 10 reported recent psychological distress at high/very-high level, this finding varying more than twofold depending on socioeconomic status of area with 16.1%, 13.3%, 12.0%, 8.4% and 6.9% affected in the most to least disadvantaged quintiles, respectively, across Australia in 2011/2012. In the most disadvantaged quintile, the percentage (24.4%) with mental disorders was 50% higher than that in the least disadvantaged quintile (16.9%) in 2007, so this trend was less strong than for Kessler10 distress. CONCLUSION These results suggest that disparities in mental health status in Australia based on socioeconomic characteristics of area are substantial and persisting. Whether considering 1-year mental disorders or 30-day psychological distress, these occur more commonly in areas with socioeconomic disadvantage. The association is stronger for Kessler10 scores suggesting that Kessler10 scores behaved more like a complex composite indicator of the presence of mental and subthreshold disorders, inadequate treatment and other responses to stressors linked to socioeconomic disadvantage. To reduce the observed disparities, what might be characterised as a 'Whole of Government' approach is needed, addressing elements of socioeconomic disadvantage and the demonstrable and significant inequities in treatment provision.
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Affiliation(s)
- Joanne C Enticott
- Southern Synergy, Department of Psychiatry and School of Primary Health Care, Monash University, Melbourne, VIC, Australia
| | - Graham N Meadows
- Monash Health, Melbourne, VIC, Australia .,School of Population Health, University of Melbourne, Melbourne, VIC, Australia.,Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Frances Shawyer
- Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia
| | - Brett Inder
- Department of Econometrics and Business Statistics, Faculty of Business and Economics, Monash University, Melbourne, VIC, Australia
| | - Scott Patten
- Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, AB, Canada
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Abstract
Although many Western studies examining the mental health of welfare recipients exist, Japanese welfare recipients have been overlooked. This study investigated mental health among welfare recipients in Japan and relations with a sense of deprivation of life's necessities and social support. Participants ( n = 305) completed the General Health Questionnaire-12 (GHQ-12), Proportional Deprivation Index, and a social support scale. Participants' GHQ-12 scores exceeded those of the general public, as 54.9% scored above the cut-off, suggesting poorer mental health among welfare recipients than the general population. Proportional Deprivation Index and emotional support from relatives and friends were associated with GHQ-12 scores. These results suggest that while chronic deprivation is associated with poorer mental health among welfare recipients, receiving emotional support may help cope with distress and maintain mental health.
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16
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Patterns of Welfare Attitudes in the Australian Population. PLoS One 2015; 10:e0142792. [PMID: 26554361 PMCID: PMC4640565 DOI: 10.1371/journal.pone.0142792] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/27/2015] [Indexed: 11/19/2022] Open
Abstract
The study of community attitudes toward welfare and welfare recipients is an area of increasing interest. This is not only because negative attitudes can lead to stigmatization and discrimination, but because of the relevance of social attitudes to policy decisions. We quantify the attitudes toward welfare in the Australian population using attitude data from a nationally representative survey (N = 3243). Although there was broad support for the social welfare system, negative attitudes are held toward those who receive welfare benefits. Using canonical correlation analysis we identify multivariate associations between welfare attitudes and respondent demographic characteristics. A primary attitudinal dimension of welfare positivity was found amongst those with higher levels of education, life instability, and personal exposure to the welfare system. Other patterns of negative welfare attitudes appeared to be motivated by beliefs that the respondent's personal circumstances indicate their deservingness. Moreover, a previously unidentified and unconsidered subset of respondents was identified. This group had positive attitudes toward receiving government benefits despite having no recent experience of welfare. They did, however, possess many of the characteristics that frequently lead to welfare receipt. These results provide insights into not only how attitudinal patterns segment across the population, but are of relevance to policy makers considering how to align welfare reform with community attitudes.
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Kiely KM, Butterworth P. The contribution of financial hardship, socioeconomic position and physical health to mental health problems among welfare recipients. Aust N Z J Public Health 2015; 37:589-90. [PMID: 24892161 DOI: 10.1111/1753-6405.12121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Kiely KM, Butterworth P. How has Welfare to Work reform affected the mental health of single parents in Australia? Aust N Z J Public Health 2014; 38:594-5. [PMID: 25440466 DOI: 10.1111/1753-6405.12304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kim M Kiely
- Centre for Research on Ageing Health and Wellbeing, Australian National University, ACT
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19
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Kiely KM, Butterworth P. Mental health selection and income support dynamics: multiple spell discrete-time survival analyses of welfare receipt. J Epidemiol Community Health 2013; 68:349-55. [DOI: 10.1136/jech-2013-203179] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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