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This chapter explores the processes by which children framed as being ‘mentally ill’, and particularly here children who self-injure or hear voices, present us with a limit figure to current child rights discourse. In engaging with this limit figure, the chapter aims to examine the parochial frameworks drawn upon within legal decisions around children's rights to refuse ‘treatment’. In fact it aims to interrogate how psychiatric frameworks foreclose what can be understood to be ‘treatment’ in the first place. In contesting the frameworks by which the ‘child with mental health problems’ comes to be constituted, it engages with young people's own stories to enable dissonant and plural frames of recognition to come into view. Reading the stories that people who heard voices as children have told the author of this chapter, alongside the work of Giorgio Agamben and Judith Butler, particularly their theses around ‘bare’ and ‘precarious’ lives, enables further understanding of how dominant schemes of intelligibility may work to medicalize childhood experience; normalizing the absence of children with mental illness and pathologizing their presence within rights discourse. Thus we might conceptualize child rights as being a ‘violating enablement’ for children.

This chapter focuses on common mental health problems (primarily anxiety, depression and stress) and employment. An introduction outlines recent statistics and policy discussion in this area. Some key conceptual and theoretical questions are then introduced, including notions of mental health as a continuum and as a fluctuating state of being. Next, the chapter provides an overview of the current evidence base for ‘what works’ in promoting mental wellbeing at work and supporting employees who develop common mental health problems, including: flexibility and workplace adjustments; employer awareness and engagement; access to effective medical treatment; vocational rehabilitation services; and strategies for keeping well. A discussion section highlights the importance of context in managing mental health problems at work. Finally, some future research directions are suggested. The focus of the chapter is primarily on initiatives and interventions for supporting the job retention of those in employment (rather than returning to work from benefits).

This chapter examines the way in which those with long-term mental health problems can be voiceless. A limited ability to make their needs known contributes substantially to their ongoing suffering. Analysis of the interaction between mental health difficulties and palliative medicine should identify opportunities to improve the relationship and thereby give this group a greater voice and better care.

Chapter 1 offers an overview of the UK’s socio-demographic and policy context. The UK has an ageing population that is increasingly diverse and heterogenous. Whilst for many older people health outcomes have vastly improved since the introduction of the welfare state, prevalence of ill health does increase with advancing age. The number of older people living with dementia is 850,000, a figure expected to rise to over 2 million by 2051. Disability, pain, chronic physical illness and dementia are risk factors for both depression and suicide. It is estimated that 30 per cent of older people have ‘depressive symptoms’ and that 1 in 8 of all suicides relate to older people. 4 per cent of older people suffer from ‘anxiety disorder’. Although not mental health problems as such, a growth of the number of older people experiencing isolation and loneliness, problem alcohol issues and social exclusion are contributors. In terms of policy, all four UK nations, have specific policies relating to dementia, on the one hand, and policies relating to preventing and treating functional mental health problems on the other. The former tends to be older age focused whilst the latter extends across the whole adult lifespan.

This chapter examines young women's experiences of unemployment in Finland, Sweden, Germany and Spain. It describes how different predictors and buffers affect mental health in different countries. It starts by comparing the labour market context of women and cross-country differences regarding welfare arrangements. It then presents a short overview of research concerning unemployment and wellbeing among women. The empirical research is reported, which covers a comparison of mental health problems among young unemployed women and men, and further explores the influence of different buffers and predictors of mental health problems among women in countries with different breadwinner models. Financial dependency predicts mental health problems among unemployed young women in Finland, Sweden and Spain. In Germany, no substantial effects are found in relation to the predicting variables. The results demonstrate that the buffers and predictors of mental health problems among unemployed women vary between dual and male breadwinner model countries.

The changing demographics of American society have received a great deal of attention in recent years. As the population ages, the overall number of elderly persons with mental disorders, particularly anxiety and mood disorders, will increase. Older adults with mental health problems are likely to have relatively longer life spans in the future due to expected advances in treatments and healthier aging lifestyles. Mental health problems will demand more attention from providers in order to minimize their effects on disability, the use of health care services, and the quality of life for older adults and caregivers. This chapter presents the current state of knowledge on mental disorders of late life (mental disorders, anxiety disorders, psychotic disorders), focusing on prevalence, consequences, and effective evidence-based treatments.

This chapter presents the perspective of parents who are living with mental health issues. It examines further the caring and filial relationships parents share with their children when parents have mental health problems and children are providing care. It also aims to understand the factors that can cause and perpetuate mental illness and thereby create impediments to effective parenting from the point of view of the parents themselves who face these obstructions on a daily basis. These factors include: genetic susceptibility to mental illness; expeditious factors such as bereavement, divorce, parental separation, and parent relationship problems; factors that are of an enduring nature such ongoing housing or financial problems, lack of effective support inputs, and chronicity of other health problems.

In the coastal town of Hastings in the southeast of England, a Befriending Scheme for people with mental health problems was established in 1989. It was a well-respected local service making a difference to the lives of vulnerable individuals with mental health problems, and received the local civic pride award for its work in 1997. However, the service was voluntarily decommissioned in January 2006 as it had failed to attract adequate funding for service delivery and development, and there were concerns regarding its ability to maintain the quality standards for which it was renowned. This chapter takes a critical look at the functions of the Befriending Scheme against a background of severe socioeconomic deprivation. It explores what we have learned about the scheme's potential role in challenging stigma and combating social exclusion within communities.

This chapter estimates the consequences of paternal incarceration for childhood well-being, broadly defined as children’s internalizing, externalizing, physically aggressive, and total behavioral problems. Especially at the extreme end of the continuum and for the most disadvantaged children, mental health and behavioral problems are strong predictors of crime and delinquency, educational and occupational attainment, and family formation later in the life course. By focusing on these types of problems, therefore, we provide indirect evidence concerning the long-term consequences of paternal incarceration for the children of the prison boom. The chapter also includes a lengthy discussion of the multiple ways to estimate incarceration effects, focusing on issues of selection bias and spuriousness. The estimates show that, even after substantial sample selectivity issues are accounted for, paternal incarceration increases all forms of children’s mental health and behavioral problems.

This chapter identifies appropriate resources needed in the research through a survey. The professionals participating in the survey tended to identify community-based services that were informal and flexible as being particularly appropriate for families where mothers had mental health problems. Although practitioners emphasised the need for appropriate residential settings, most of the resources they described were supportive or preventive. There were concerns that existing mental health services were targeted too high for mothers to be able to use them. Some of the suggestions for integrated services which might offer mental health interventions for parents, child care services and family support on one site came close to constituting a model for a family mental health service. Contemplating such alternative service configurations raises questions about the divides between both children's and adults' services and between health and social care.

This chapter draws together the key themes of the research and develops some recommendations for policy and practice. The study findings have relevance for transactions between practitioners and users as well as for the relationships between different groups of professionals and their organisations. The proposal for a dyad of keyworkers in cases where mothers have mental health problems and where there are child protection issues is designed to impact on each of these interfaces. However, some of the problems identified for mothers with mental health problems are not only confined to how professional roles are defined and played out, but also concern the availability and distribution of resources. The suggestions offered here are directed at policy makers at all levels as well as at the full range of practitioners in statutory and voluntary settings.

This chapter examines media values that influence how mental distress is represented in television drama. It is less concerned with the correlations between fiction and accuracy, instead focusing on the wider questions of how and why fictional characters with mental health problems are introduced to programme narratives and their role. In particular, the chapter explores the factors that influenced the production team from Coronation Street to construct a storyline about a young woman, Carmel, who suffers from the condition erotomania. The point in the chapter is not to argue that sexual abusers are ‘in reality’ motivated by mental health problems, but, as shall be seen, that there are interesting similarities in how the two portrayals of the characters of Carmel and Trevor of Brookside were constructed. The similarities of the portrayals of Carmel and Trevor identify shared production values across different programmes in relation to specific social issues, regardless of programme and production staff members. The chapter ends with reflections on producing social issue storylines in television fiction, and by comparing and contrasting all three case studies and the values and priorities of television drama personnel.

This chapter examines the historical context, contrasting it with the research evidence regarding the work aspirations of people with enduring mental-health problems and their potential to become valued employees. It argues that what is required to enable people to fulfil their potential is a shift from a clinical model of recovery, from mental ill health towards a model more akin to a social model of disability. The chapter presents the results of a study exploring approaches to employment support for this group to back up that argument. It looks at the progress being made in developing appropriate supported employment in the UK and at the challenges ahead.

This chapter focuses on mental health in schools. There is a clear-cut case for investment in campus mental health services: 30% of depressed students eventually drop out, and research suggests that one fifth of this drop-out rate can be averted by early intervention and treatment. This means that for every 500 incoming students, a robust mental health system would help 30 more complete college, adding about $1 million in tuition to that school. Based on the cost of providing mental health services, for every $1 spent on such services, there is a $2 increase in school revenue. This calculation presents only a narrow perspective. Since lifetime earnings follow from successful graduation, there is even greater value to an at-risk student if he or she is not derailed by a mental health problem during college. Ultimately, screening and intervention programs are investments in academic achievement and will have downstream effects on the public’s health.

This chapter offers some conceptual frameworks that could contribute to facilitating the increased reflexivity on the part of service users and their movements advocated by Beresford. It considers the principles that (should) inform participatory approaches to governance and service delivery, and specifically, the principles underpinning the issue of who precisely is to participate. It explores the tensions between the principles of ‘local representation’ and ‘local knowledge’ — principles frequently and simultaneously in evidence in participatory processes of governance and service delivery. It examines the question of the consequences of participation and user involvement for social justice. It offers a framework for assessing the social justice outcomes of user involvement, drawing on a conceptualisation of social justice as both recognition and redistribution, and a distinction between ‘affirmative’ and ‘transformative’ recognition and redistributive policy strategies. It applies this framework to assessing whether and how the situation of people with mental health problems and carers has benefited from user involvement initiatives.

This introductory chapter first sets out the focus of the book, namely advocacy, particularly, but not only, for people who have learning disabilities or mental-health difficulties. It draws on practical experience coming mainly from Scotland, where new and important things have been happening in this field. The chapter presents two stories that illustrate the important changes now at work in our society – changes in which advocacy plays a part. These stories also pose some of the dilemmas of advocacy. An overview of the subsequent chapters is presented.

This chapter outlines the methodology used for the research and reports on the pilot study completed in 1997. Funding for the project came from a number of sources, including the University of Hull, a NHS trust and a health authority. The study was fuelled by a desire to understand the response of a range of health and social care agencies to two contrasting sets of needs in families. The study explored the nature of serious mental health problems in mothers whose children were on the child protection register, and examined the extent to which different professionals worked together to meet the family's needs.

This chapter brings together the demographic estimates on the cumulative risk of paternal imprisonment and the individual-level results on the effects of paternal incarceration on mental health and behavioral problems, infant mortality, and child homelessness to estimate the impact of paternal incarceration on black-white inequality in childhood well-being. The results are striking and often larger than those estimated for adult men in other studies. Our analyses suggest fairly small effects on some outcomes, such as total behavioral problems, where mass incarceration is associated with a five to ten percent increase in black-white inequality. For other outcomes, such as child homelessness, we see much more pronounced effects, as mass incarceration is associated with about a sixty-five percent increase in the already large black-white disparities in the risk of child homelessness. Effects on inequalities on infant mortality, internalizing, externalizing, and aggression fall somewhere in between. In each case, paternal incarceration harms children and results in measurable differences in the childhood circumstances of black and white children in the United States.