The Ontario Disability Support Program Work Exit Process: Parallels to a Hostage Negotiation

2020 ◽  
pp. 104420732094460
Author(s):  
Pamela Lahey ◽  
Bonnie Kirsh ◽  
Emile Tompa ◽  
Joy MacDermid ◽  
Rebecca E. Gewurtz
Keyword(s):  
Mental Illness ◽  
Service Providers ◽  
Support Program ◽  
Theory Approach ◽  
Income Support ◽  
Welfare To Work ◽  
Structured Interviews ◽  
People With Mental Illness ◽  
Disability Support ◽  
Disability Income

There is a lack of empirical data on the experiences of people with mental illness (PMI) who transition from welfare to work, or how policy programs are designed to facilitate this outcome. We explore the factors that facilitate or hinder PMI from exiting disability income support programs in Ontario, Canada. Drawing on a grounded theory approach, we examine the process of exiting the Ontario Disability Support Program (ODSP). Data were collected from semi-structured interviews with current and former recipients with mental illness, service providers who support current and former recipients, and ministry staff. A metaphor for the work exit process emerged with four embedded themes: (a) picking yourself back up, (b) breaking the rules to get ahead, (c) stabilizing illness for employment success, and (d) displaying resiliency and resourcefulness for successful exits. The main finding is that system supports are not the determining factors in a successful transition. Rather, participants describe how recipients exit for employment by leveraging personal resources to successfully transition off income support benefits. A system redesign is needed to address the inherent tension between social and health programs if the policy intent is to promote successful welfare-to-work transitions for PMI.

What makes an optimal delivery for PrEP against HIV: A qualitative study in MSM

2022 ◽  
pp. 095646242110608
Author(s):  
Janice Y. C. Lau ◽  
Ngai-Sze Wong ◽  
Krystal C. K. Lee ◽  
Tsz-Ho Kwan ◽  
Grace C. Y. Lui ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Effective Means ◽  
Qualitative Assessment ◽  
Theory Approach ◽  
Service Model ◽  
Structured Interviews ◽  
Sexually Transmitted ◽  
Ethnic Chinese ◽  
Sex With Men

Background Pre-exposure prophylaxis (PrEP) is an effective means of HIV prevention for men who have sex with men (MSM), a key population whose engagement is crucial for achieving effective public health outcomes. An optimal service model would be important in planning the implementation of PrEP in places where such service has not been established. Methods A qualitative study was conducted to delineate the attributes of an optimal PrEP service model for MSM in Hong Kong, a city where no formal PrEP programs existed. Twenty purposively sampled MSM who were enrollees of two pilot PrEP projects participated in the semi-structured interviews promoting story-telling. The coded data were thematically analyzed following Grounded Theory approach, focusing on uncovering a typology of the essential attributes of an optimal PrEP service model, and the reasons for such preferences. Results Participating MSM were all ethnic Chinese and aged 26 to 52 years. All had received PrEP from pilot projects in conjunction with periodic screening of sexually transmitted infections (STI), HIV antibody, and plasma creatinine. Four major themes emerged as regards the attributes of a preferred PrEP service: (i) comprehensiveness of HIV/STI and safety monitoring; (ii) convenient unitary service; (iii) stigma-free PrEP access and protecting confidentiality; and (iv) affordable price. Whereas regular provision of PrEP was acceptable to MSM, unaffordability and related stigma were the anticipated challenges for potential service providers. Conclusions The qualitative assessment of MSM’s preference for PrEP service delivery has yielded important information on the many facets of a desirable service model.

Wellbeing and experiences of Chinese and Vietnamese carers of people with mental illness in Australia

2020 ◽  
pp. 136346152095262
Author(s):  
Abner Weng Cheong Poon ◽  
Maria Cassaniti ◽  
Michele Sapucci ◽  
Rosaleen Ow
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Support Groups ◽  
Negative Impact ◽  
Cultural Safety ◽  
Structured Interviews ◽  
People With Mental Illness ◽  
Qualitative Thematic Analysis

Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers’ wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers’ perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.

Mental illnesses are not an ‘ideal type’ of disability for disability income support: Perceptions of policymakers in Australia and Canada

2019 ◽  
Vol 48 (4) ◽  
pp. 452-459 ◽  
Author(s):  
Ashley Mcallister
Keyword(s):  
Grounded Theory ◽  
Ideal Type ◽  
Mental Illnesses ◽  
Constructivist Grounded Theory ◽  
Medical Illness ◽  
Theory Approach ◽  
Income Support ◽  
The Disabled ◽  
Disability Income ◽  
Grounded Theory Approach

Aim: This article aims to explore how policymakers conceptualise a person suitable for disability income support (DIS) and how this compares across two settings – Australia and Canada. Methods: A constructivist grounded theory approach was used; 45 policymakers in Australia and Canada were interviewed between March 2012 and September 2013. All policymakers are or were influential in the design or assessment of DIS. Results: Results found that the policymakers in both jurisdictions define a suitable person as having as an ‘ideal type’ of disability with five features – visibility, diagnostic proof, permanency, recognition as a medical illness and perceived as externally caused. Many of the policymakers described how mental illnesses are not an ‘ideal type’ of disability for DIS by juxtaposing the features of mental illnesses against physical illnesses. As such, mental illnesses were labelled imperfect disabilities and physical illnesses as ‘ideal type’ for DIS. Conclusions: The rise of DIS recipients has divided the once protected ‘deserving’ category of the disabled into more (‘ideal type’ of disability) and less deserving (imperfect disability). Such conceptualisations are important because these categories can influence the allocation of welfare resources.

“Hear me out”: Experiences of mothers suffering from severe mental illness with health care providers – A qualitative perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s899-s899 ◽  
Author(s):  
D. Banerjee ◽  
G. Desai ◽  
P.S. Chandra
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Seeking Help ◽  
Competing Interest

BackgroundContrary to popular myth, majority of mentally ill women are mothers with increasing number of them seeking help. Little is known about their own experiences in this regard and the extent to which their needs are met.ObjectivesTo assess the barriers and facilitators in seeking help from mental health care providers in matters of pregnancy and parenting.MethodsThe study used qualitative design with social constructivist paradigm. A purposive sample of 30 mothers with severe mental illness was obtained. Data was collected through one-to-one in-depth semi-structured interviews. After verbatim transcription, inductive thematic analysis was used to explore transcripts.ResultsMost women considered motherhood “central” to their lives and almost all of them experienced the burden of the “dual role”. Main barriers in seeking help were stigma, treatment side effects, wrong information and time constraints. Whereas self-advocacy, early engagement, education of women and involvement of the family with service providers were the facilitating factors. The prime expectations of the mothers as identified were early and direct communication, patient audience and basic guidance in regards to child health and parenting issues.ConclusionWomen who are mothers and also users of mental health services face special challenges in managing the contradictory aspects of their dual identity. Hearing their voices are essential for service provision and ensuring adequate mental health needs. Early and direct intervention along with understanding and addressing critical areas are necessary for proper care of both the mother and child.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Distrusting doctors’ evidence: a qualitative study of disability income support policy makers

2018 ◽  
Vol 42 (4) ◽  
pp. 475 ◽  
Author(s):  
Ashley McAllister ◽  
Stephen R. Leeder
Keyword(s):  
Diagnostic Tests ◽  
Mental Illnesses ◽  
Income Support ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Policy Makers ◽  
Data Collection And Analysis ◽  
Diagnostic Certainty ◽  
Support Policy ◽  
Disability Income

Objective The aim of the present study was to describe how policy makers (bureaucrats and politicians) in Australia and Ontario (Canada) perceive evidence provided by doctors to substantiate applications for disability income support (DIS) by their patients with mental illnesses. Because many mental illnesses (e.g. depression) lack diagnostic tests, their existence and effects are more difficult to demonstrate than most somatic illnesses. Methods Semi-structured interviews were conducted with 45 informants, all influential in the design of the assessment of DIS programs. The informants were subcategorised into advocates, legal representatives, doctors (general practitioners (GPs) and specialists (e.g. psychiatrists)), policy insiders and researchers. Informants were found through snowball sampling. Following the principles of grounded theory, data collection and analysis occurred in tandem. Results Informants expressed some scepticism about doctors’ evidence. Informants perceived that doctors could, due to lack of diagnostic certainty, ‘write these things [evidence] however [they] want to’. Psychiatrists, perceived as having more time and skills, were considered as providing more trustworthy evidence than GPs. Conclusion Doctors, providing evidence to support applications, play an important role in determining disability. However, policy makers perceive doctors’ evidence about mental illnesses as less trustworthy than evidence about somatic illnesses. This affects decisions by government adjudicators. What is known about the topic? Doctors (GPs and psychiatrists) are often asked to provide evidence to substantiate a DIS application for those with mental illnesses. We know little about the perception of this evidence by the policy makers who consider these applications. What does this paper add? Policy makers distrust doctors’ evidence in relation to mental illnesses. This is partly because many mental illnesses lack diagnostic proof, in contrast with evidence for somatic conditions, where the disability is often visible and proven through diagnostic tests. Furthermore, GPs’ evidence is considered less trustworthy than that of psychiatrists. What are the implications for practitioners? Although doctors’ evidence is often required, the utility of their evidence is limited by policy makers’ perceptions.

scholarly journals Voting and mental illness: the silent constituency

2014 ◽  
Vol 31 (4) ◽  
pp. 225-227 ◽  
Author(s):  
B. D. Kelly
Keyword(s):  
Mental Illness ◽  
Social Services ◽  
Mentally Ill ◽  
Service Providers ◽  
Social Economic ◽  
Voting Rights ◽  
Voter Registration ◽  
The Political ◽  
People With Mental Illness ◽  
Political Spectrum

Mental illness has been long associated with denial of certain human rights, social exclusion and political disempowerment. Too often, the effects of adverse social, economic and political circumstances, along with stigma, constitute a form of ‘structural violence’, which impairs access to psychiatric and social services, and amplifies the effects of mental illness in the lives of sufferers and their families. Existing literature indicates that voting rates are low among people with mental illness and, whereas voting preferences in the mentally ill may tend towards the liberal end of the political spectrum, they do not differ dramatically from the overall population. Rates of voting could be improved by mental health service users, service providers, advocacy services and others through (a) improved awareness of voting rights; (b) provision of information, especially to inpatients; (c) assessments of voting capacity, where indicated, using standardised, well-proven tools; and (d) pro-active voter-registration programmes.

scholarly journals Uncertain Subjects: Shaping Disabled Women’s Lives Through Income Support Policy

2020 ◽  
Vol 9 (3) ◽  
pp. 78-103
Author(s):  
Sally A. Kimpson
Keyword(s):  
Chronic Conditions ◽  
Support Program ◽  
Income Support ◽  
Disabled People ◽  
Doctoral Research ◽  
The Everyday ◽  
Disabled Women ◽  
Women's Lives ◽  
Support Policy ◽  
Disability Income

This article provides a critical reading of one aspect of the “third mobilization of transinstitutionalization” (Haley & Jones, 2018), focused on how power is exercised through the B.C. government income support program (or the ambiguously-named B.C. Benefits), shaping the embodied lives of women living with chronic physical and mental impairments. I research and write as a woman living with a disabling chronic illness whose explicit focus is power: how it is enacted and what it produces in the everyday lives of women with disabling chronic conditions living on income support. I too have been the recipient of disability income support. Thus, my accounts are ‘interested.’ My writing seeks to create a disruptive reading that destabilizes common-sense notions about disabled women securing provincial income support benefits, in particular in British Columbia (B.C.), interviewed as part of my doctoral research. Despite public claims by the B.C. government to foster the independence, community participation, and citizenship of disabled people in B.C., the intersection of government policy and practices and how they are read and taken up by disabled women discipline them in ways that produce profound uncertainty in their lives, such that these women become uncertain subjects (Kimpson, 2015).

scholarly journals Erosion of Social Support for Disabled People in Ontario: An Appraisal of the Ontario Disability Support Program (ODSP) Using a Human Rights Framework

2020 ◽  
Vol 9 (1) ◽  
pp. 1-30
Author(s):  
Tracy Smith-Carrier ◽  
Phyllis Montgomery ◽  
Sharolyn Mossey ◽  
Tanya Shute ◽  
Cheryl Forchuk ◽  
...  
Keyword(s):  
Human Rights ◽  
Social Inclusion ◽  
Service Providers ◽  
Secondary Analysis ◽  
Support Program ◽  
International Human Rights Law ◽  
Disabled People ◽  
Assistance Program ◽  
Disability Support ◽  
Systemic Discrimination

The Ontario Disability Support Program (ODSP) is a social assistance program offering income and employment supports for disabled people in Ontario, Canada’s most populous province. Since its inception, the ODSP has been critiqued by policy analysts, service providers, and its recipients as flawed, principally in terms of the amount and the range of supports provided. The purpose of this paper is to assess whether the ODSP meets its stated objectives from the perspective of its recipients - an important issue for engendering substantive equality for disabled individuals. The design was a supplementary secondary analysis of data collected from seven focus groups (n=46) related to poverty and social inclusion. The overall theme, the ODSP falls short, was communicated through two types of assessments of inadequacies. The first, labelled “yes, but,” acknowledged the program’s positive intent despite its insufficiencies in services and supports. The second, labelled “no, and,” decisively assessed the ODSP as inadequate with supporting rationale. In exploring extant human rights jurisprudence, we conclude that substantive protection against systemic discrimination for disabled people will not be guaranteed unless human rights legislation truly has paramountcy over all other laws. Human rights tribunals have a mandate, reinforced in international human rights law, to provide remedial remedies to systemic discrimination. Our findings speak directly to the need for human rights tribunals and commissions to mitigate the erosion of rights and opportunities for disabled people.

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