Working With Lesbian, Gay, Bisexual, and Transgender People in Care Relationships

This chapter details some key considerations for health and human services professionals working with lesbian, gay, bisexual, and transgender (LGBT) people in care relationships. Reflecting on the impacts of stigma and discrimination as well as the social, cultural, and political contexts of LGBT communities and carers, this chapter will explore some of ways these factors (as well as heterosexist and cis-genderist assumptions about families and partners) impact the identification, support, and recognition of LGBT people in care relationships. Finally, this chapter will recommend strategies to reduce poor mental health and wellbeing outcomes among people in care relationships where one or all people involved are LGBT, and explore some key actions that may assist health and human services better support and include LGBT people in care relationships.

Access to Evidence-Based Services for Individuals With Borderline Personality Disorder

This chapter outlines the key features of the diagnosis of borderline personality disorder. This is a diagnosis that has attracted significant levels of stigma and has generally been viewed as difficult to treat. This has resulted in often inadequate service responses for people experiencing high levels of distress. Increased understanding is facilitated by exploring precipitating factors leading to this diagnosis, including invalidating and often traumatizing environments. Available evidence from Australian and international literature is considered, with main treatments identified to inform improved treatment outcomes. The need for attention to biological, psychological factors is highlighted and in particular acknowledgment of the high prevalence of trauma, particularly childhood sexual assault, amongst the mostly women who are given this diagnosis.

Individual Funding for People With Mental Health Issues

This chapter outlines the key features of individual funding programs and examines their suitability for people with mental illness. This is a contested area with some writers concerned that mental illness is different from other types of disability and unsuitable for individual funding. The recovery model and the episodic nature of mental illness are seen as conflicting with individual funding eligibility criteria for consistent and permanent disability. The counter view is that flexible individual funding is ideally suited to meeting the fluctuating needs of people with mental illness: its key principles of empowerment and self-direction being consistent with the recovery paradigm. Evidence from Australian and international studies is reviewed, suggesting that successful outcomes can be achieved if the necessary supports and resources are available to meet people's needs.

Encouraging Social Inclusion for Older Adults Through “Interest”-Led Technology Use

There are many misconceptions about older adults' capabilities and aspirations, and especially their attitudes and approach towards technology. They are often misunderstood and seen as uninterested and unmotivated to engage with use of technology. Due to an absence of an “interest” framework for older adults to learn mobile touch screen technologies, this chapter investigates the role that pre-existing interests play in older adults' adoption of technology. Can a curriculum guided only by pre-existing interests of older adults, rather than a structured curriculum have a positive influence on its adoption for mobile touch screen technologies? The results show that when older adults are taught according to requests based on their pre-existing interests, it encouraged long-term adoption of technology including building up their confidence in usage of mobile touch screen technologies.

Violence

This chapter explores the extent to which journalists draw on long-standing mental health narratives when telling their stories about the “mentally ill” and, in particular, their tendency to depict the mentally ill as violent and dangerous. The chapter is divided into three sub-categories based on the perpetrators of violent crime committed against members of their immediate family. These were “fathers,” of which 24 articles were dedicated to the stories of 11 men; “mothers,” where 22 articles documented the stories of 24 mothers who harmed their children; and finally, “progeny,” where 58 articles presented 17 cases of sons or daughters who killed, or planned to kill, one or both of their parents. Despite differences in the way Australian journalists explain the violence depicted in these stories, particularly when the perpetrator was a female, they continually drew on mental health as an explanatory device to account for how and why these crimes took place. This provides evidence for a continuation of the confinement narrative presented in Chapter 1.

Aboriginal Wellbeing

The aim of this chapter is to contribute to addressing the gap between policy and practice for the development and implementation of accessible health and wellbeing organizations and practices from a culturally safe, trauma-informed approach. The objective is to increase use of services early on by Aboriginal people and ultimately to improve health and wellbeing outcomes. A targeted literature search identifies the main features of cultural safety and trauma-informed approaches followed by the presentation of a culturally safe, trauma-informed framework, and implementation plan. The literature on organizations is predominantly from Australia with the work of Michael Yellow Bird in the United States relied upon for the discussion of decolonization. For improved health and wellbeing outcomes with Aboriginal people, historical and contemporary political, economic, and social contextual factors relating to colonization must be acknowledged, and in the Australian context, particular attention must be given to the stolen generations.

Inherent Requirements and Social Work Education

The aim of this chapter is to contribute to addressing issues of access and equity in social work education for people with mental health disabilities. The objective is to carefully consider the introduction of inherent requirements in universities, and particularly in relation to social work education, in Australia. A targeted review of relevant literature including legislation, policy, and practice standards frameworks identifies the parameters of inherent requirements and possible areas of discrimination. Consideration of the use of inherent requirements in social work education is from a human rights social justice perspective that acknowledges the strength and resources of people and communities and actively advocates for the protection of disability rights.

Healthcare Decision Making

The aim of this chapter is to explore the factors that health managers adopt when making decisions on how to allocate limited healthcare resources. The objective is to increase knowledge and understanding of decision making processes at the macro, meso, and micro levels and priority setting. An examination of current healthcare decision-making processes used for resource allocation around the world highlights the disparities in models and approaches and the often ad hoc nature of decisions made. A description of the allied health workforce highlights the size and significance of this workforce and why understanding decisions made in regards to allied health resources is of importance. Issues of access and equity are also considered in relation to notions of fairness and efficacy in relation to health outcomes.

Natural Environments, Ecosystems, Conflict, and Wellbeing

This chapter examines the correlation between environmental issues and wellbeing. A broad literature review illustrates that changing climate, increasing populations, and degrading natural environments have negative impacts on health and wellbeing. The focus of this chapter is on conflicts arising from the limited supply of natural resources and competing needs, interests, and demands. This can create high levels of tension and division within communities that erodes community spirit, support, and connectedness as people compete for limited resources. The conflict arising from such disputes has negative impacts on social cohesion and the high levels of stress experienced, without adequate supports, can trigger mental ill health. The example of basin level water conflict in Turkey is used to illustrate this.

Mental Health Access Issues by People of Refugee Backgrounds in Australia

This chapter presents a critical discussion on the understanding and access of mental health services by people from diverse refugee backgrounds delivered in a Western cultural setting. Mental health services are heavily influenced by a biomedical approach, but there is a growing understanding of the importance of culture and biopsychosocial approaches. This chapter highlights some of the institutional and cultural issues that need to be addressed for the services to be effective. Practical approaches that have worked in different places are explored and critically discussed. A recovery-oriented model that recognizes that the individual is part of the community and the importance of spirituality are canvassed.