Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland

Background: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional population. Prior research has identified 11 specific program components of FIT in Germany. In this paper we aim at assessing the applicability of these components to the Polish context and at comparatively analysing FIT implementation in Poland and Germany.Methods: Qualitative interviews about the applicability of the 11 FIT-specific components were conducted with the program managers of the Polish FIT models (n = 19). Semi-quantitative data on the FIT-specific components were then collected in 19 Polish and 10 German FIT models. We assessed the grading of each component, their overall degree of implementation and compared them between the two countries. In all study hospitals, structural and statistical parameters of service delivery were collected and compared.Results: The qualitative results showed that the German FIT-specific components are in principle applicable to the polish context. This allowed the comparative assessment of components grading and degree of implementation, which showed only subtle discrepancies between German and Polish FIT models. The little discrepancies point to specific aspects of care such as home treatment, peer support, and cooperation with non-clinical and social welfare institutions that should be further integrated in the components' definition.Conclusions: The specific program components of FIT as first defined from the German experience, serves as a powerful tool to measure, and evaluate implementation of integrated psychiatric care both within and between health systems.

Street Users in Drug Policy: On the Underestimated Role of Welfare Institutions

In Norway, the public and political debate is moving in the direction of treatment. This is in line with the tradition of the Nordic welfare state. However, it is argued, a treatment or welfare state approach to drugs can be as controlling as a policy based on legal punishments.

A SOCIOLOGICAL READING OF THE LEGAL ‎SYSTM OF SOCIAL WELFARE INSTITUTIONS‎

This research derives its importance from the scientific framework that Is rich in theoretical ‎approaches in the field of sociology, management systems and governance,and then from ‎the field framework related to the reality of managing social welfare institutions in Morocco, its ‎developments in legal and financial aspects and the current repercussions on the level of ‎social welfare. it also aims to raise the level of social welfare for the beneficiary groups, by ‎evaluations the efforts made in managing these institutions based on an exact scientific ‎approach, method and tools. As a result, we will try to answer in this scientific study, the ‎answer to the following problematic question. «To what extent is the sociological approach ‎adopted in the current legal system of social welfare institutions in Morocco and what is ‎impact on the profitability of these institutions»‎ It is efforts that Is divided into two parts, the first is theoretical and the second is ‎methodological and field, in which we focus on the sociological study of the current reality of ‎the legal and financial system for the management, and evaluations of social welfare ‎institutions in Morocco and the reflection of this evaluations on the profitability of these ‎institutions, especially for the elderly and the time allotted for completion‎‎‎. Keywords: Socıologıcal Reading, Socıal Welfare Instıtutıons‎, Management Systems.

Gender Perspectives of Male Immigrant Healthcare Assistants in Norwegian Elderly Care

Exploring gender and feminization in healthcare professions within welfare institutions is an important issue. This article explores the experiences of male immigrant healthcare assistants with racialized features in Norwegian elderly care. A key narrative theme was how notions such as gender and categories of class reinforce structural power relationships, positioning male immigrants in elderly care as “lacking” and/or vulnerable with respect to self-esteem. In the analysis, participants’ experiences were perceived, contested, and negotiated within the themes of: (a) Gender Identities: Negotiations among male immigrant healthcare assistants, and (b) The interwoven process of gender and class. Participatory parity (Fraser, 2008) and perspectives of intersectionality (Crenshaw, 1989) were applied to explore how notions of gender and categories of class limit and reinforce power relationships. The analysis sheds light on how such notions and categories reinforce structural power relationships. Furthermore, the article argues that understanding the impact of gender on the Norwegian care sector must address how specific categories of individuals are affected, in addition to the attendant labour market challenges.

Recommendations for ethnic equity in health: A Delphi study from Denmark

Aims A key issue in public health is how to approach ethnic inequities. Despite an increased focus on the health of people from ethnic minorities in the last 15 years, significant ethnic health inequities still exist in Denmark. These arise during pregnancy and are exacerbated by higher rates of exposure to health risks during the life course. This study aimed to formulate recommendations on both structural and organisational levels to reduce ethnic health inequities. Methods Nine decision-makers – representing municipalities, regions, the private sector and voluntary organisations in Denmark – participated in the formulation of recommendations inspired by the Delphi method. The consensus process was conducted in three rounds during spring 2020, resulting in eight overall recommendations, including suggestions for action. Results The recommendations address both structural and organisational levels. They aim to strengthen: 1) health policies and strategies related to the needs of people from ethnic minorities, including health literacy, linguistic, cultural and social differences; 2) health-promoting local initiatives developed in co-creation with people from ethnic minorities; 3) health promotion and prevention from a life course perspective with a focus on early intervention; 4) cross-sectoral and interdisciplinary collaborations that facilitate transitions and coordination; 5) competencies of professionals in terms of cultural knowledge, awareness, reflexivity and skills; 6) access to healthcare services by increasing information and resources; 7) interpreting assistance for, and linguistic accessibility to, healthcare services; 8) documentation and intervention research. Conclusions To reduce ethnic health inequities, it is crucial that Danish welfare institutions, including their strategies, approaches and skills of employees, are adapted to serve an increasingly heterogeneous population.