Barriers and enablers to health and social services for older prisoners transitioning to community

Purpose When properly designed and implemented, prison-to-community transition programs targeting older prisoners could potentially save resources, reduce reoffending rates and contribute to improved public protection and safety. However, older prisoners transitioning to community are often neglected and overlooked, and thus, interventions targeted to address their needs are limited. The purpose of this study was to identify barriers and enablers to health and social services for older prisoners transitioning to community. Design/methodology/approach A qualitative study was conducted using focus group discussions with corrections officers, community corrections officers and parole officers (n = 32) in four correctional centres, two community corrections offices (CCOs) and one parole unit in New South Wales (NSW) in 2019. The authors used thematic analysis to analyse the findings. Findings The study identified three main themes relating to barriers and enablers: organisational, social and economic and individual and family and seven sub-themes: planning the transition, communication, assisting prisoners, transition programs, officers’ knowledge and scope of work, social and economic issues and offenders’ conditions Research limitations/implications The processes required to ensure effective prison-to-community transition of older prisoners are not well-developed suggesting the need for more systemic and organised mechanisms. Implications of the barriers and enablers for policy, research and practice are discussed. Originality/value This study identified a composite of barriers and enablers to health and social services for older prisoners in NSW prisons and CCOs.

Youth Perspectives on Integrated Youth Services: A Discrete Choice Conjoint Experiment

Objective Integrated youth services (IYS) are an emerging model of care offering a broad range of mental health and social services for youth in one location. This study aimed to determine the IYS service characteristics most important to youth, as well as to determine whether different classes of youth have different service preferences, and if so, what defines these classes. Methods Ontario youth aged 14–29 years with mental health challenges were recruited to participate in a discrete choice experiment (DCE) survey. The DCE contained 12 attributes, each represented by 4 levels representing core characteristics of IYS models. To supplement the DCE questions, demographic information was collected and a mental health screener was administered. Preferences were examined, latent class analyses were conducted, and latent classes were compared. Results As a whole, participants endorsed the IYS model of service delivery. Among 274 youth, there were three latent classes: 1) the Focused Service (37.6%) latent class prioritized efficient delivery of mental health services. 2) The Holistic Services (30.3%) latent class prioritized a diverse array of mental health and social services delivered in a timely fashion. 3) The Responsive Services (32.1%) latent class prioritized services that matched the individual needs of the youth being served. Differences between classes were observed based on sociodemographic and clinical variables. Conclusions IYS is an acceptable model of care, in that it prioritizes components that reflect youth preferences. The differences in preference profiles of different groups of youth point to the need for flexible models of service delivery. Service design initiatives should take these preferences into account, designing services that meet the needs and preferences of a broad range of youth. Working locally to co-design services with the youth in the target population who wish to be engaged will help meet the needs of youth.

Harm reduction must be recognised an essential public health intervention during crises

The COVID-19 had a substantial impact on the provision of harm reduction services for people who use drugs globally. These front-line public health interventions serve a population that due to stigma, discrimination and criminalisation, faces barriers to accessing health and social services and are particularly vulnerable to public health crises. Despite this, the pandemic has seen many harm reduction services close, reduce operations or have their funding reduced. Simultaneously, around the world, harm reduction services have been forced to adapt, and in doing so have demonstrated resilience, flexibility and innovation. Governments must recognise the unique abilities of harm reduction services, particularly those led by the community, and identify them as essential health services that must be protected and strengthened in times of crisis.

Access and Barriers to Use of Long Term Services: Contextual Issues

The challenges that some older adults face in accessing both health and social services is a topic of continuing concern. This panel will focus on contextual issues that often shape specific challenges. These contextual issues usually emerge either from issues of diversity among the older persons themselves (for example, minority status or foreign born) and diversity between the ways in which services are offered (usually established at the national or in the case of the United States, at the state level). The intersection of these two forms of diversity often define the specific challenges faced by older persons in accessing health and social services. Further, unexpected events, such as the COVID pandemic, can affect both types of diversity (greater challenges for persons who do not speak the dominant language; inability of services to quickly adapt to radically changed environment). Our panel will address these issues through four presentations, each taking a different look at the ways in which diversity affects access. Our first paper, by Torres, will place this discussion in wider context by presenting results from a scoping review. Our second paper, by Diederich looks at access to services by immigrant generation (that being another source of diversity) in Germany. The third paper, by Thiamwong looks at how the COVID crisis affected older Hispanic women. Finally, Ring will examine how a national policy, here the definition of poverty, affects outcome and access for older person in the United States.

Cultural Differences in Older Immigrants' Health and Social Services Use

Even though Germany has a mandatory health and long-term care insurance with no or only very low co-payments, immigrants and the native population differ in their health and social services use. Differences in cultural traits and a lack of knowledge about the institutional setting are frequently mentioned as contributing factors. Relying on the epidemiological approach in the economic literature, this empirical study shows that both cultural traits that prevail in older immigrants’ country of origin and older immigrants’ knowledge about the host country’s institutional setting affect their health and social services use in Germany. We distinguish foreign-born immigrants and their descendants as both groups differ in their connection to the home and the host country. The results will be used to discuss immigrants’ access and potential barriers to the use of health and social services in comparison to the native population.

Community-based support for children who are next-of-kin for a parent experiencing illness or disability – a scoping review

Introduction Children who are next-of-kin, for a parent who experience illness or disability, need support. In Norway, guidelines, routines and structured approaches in the community health services are lacking regarding involving children in the care of a parent and for services when supporting children as next-of-kin. Additionally, no existing international review has focused on support from community health and social services for children who are next-of-kin to a parent regardless of the specific illness or disability. Aims This scoping review examined the current knowledge regarding the types of community health and social services support to children 0 to 17 years old living with a parent experiencing illness or disability. The review also identified children’s support preferences and needs. Methods The scoping review involved five stages; identifying research question; identifying relevant articles; selecting articles; charting the data and finally, collating, summarizing and reporting the results. Results Articles which included community health and social services interventions and children’s preferences or needs for support were included. The foci of interventions included preventive education, peer support, psychosocial support, and interventions focusing on family communication and recovery planning. Articles focusing on children’s preferences or need for support described their wish to be recognized as a next-of-kin, having someone to talk to and professional and peer support. Conclusion The review highlighted the importance of children receiving support according to their preferences. It is important to elicit children’s voices, to ensure community health and social services are developed for and tailored to this population.

Effective Consumer Consultation in the Planning and Delivery of Health and Social Services: A New Zealand Case Study: A Comparative Study of the Theory and Practice of Government Organisations in Engaging Consumers in Consultation

<p>About 600 million people in the world live with disabilities (World Health Organisation, 2007). Over the past ten years there has been increasing calls for government organisations in the health and disability sector to involve consumers in their decision-making, service design and general governance. This has led government health and disability organisations in different countries to try and find ways to ensure consumers are consulted with and involved in decision-making processes (Coney, 2004). The potential benefits of effective consumer consultation are better quality services, policy and planning decisions that a more consumer focused, improved communications and greater ownership of the local health services. For consumers effective consultation can mean they get better outcomes of treatment and support, a more accessible and responsive service and improved health. For the community consultation can help bring about a reduction in health inequalities and provide a health service better able to meet the needs of its constituents (Anderson et al., 2002). There are a number of real and perceived barriers to consumer consultation. Consumers may be anxious that their views will not be taken seriously, that they will look foolish or that they won’t understand what’s being talked about. Staff and organisations might be anxious that their work will be criticised, that there will be unrealistic demands to change services or that their role and authority might be undermined (Fletcher & Bradburn, 2001). For consultation to work there needs to be commitment from the organisation to plan and provide adequate resources. Developing a strategy is critical before organisations start down this path. The UK Audit Commission (2003) believe developing a strategy will help organisations to define exactly what the purpose of the consultation is, what they want to achieve, help them identify the relevant stakeholders and assess what level of engagement to undertake. Consultation is an important part of designing, delivering and managing effective health and social services. There are many different ways of engaging consumers and finding the right way for each organisation takes planning, commitment, time and energy.</p>