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An editorial is presented on the role of critical feminist leadership in social work academia and its impact. Topics include the practice of feminist leadership in academic settings, the challenges and rewards of navigating leadership roles as feminists, and the importance of self-care and community-building among feminist scholars.

Background: Over two decades of research about traumatic brain injury (TBI) rehabilitation emphasized the persistence of racial health disparities in functional outcomes that disproportionately impact Black populations without naming or addressing racism as the root problem. Further, the experiences of Black people with TBI have yet to be documented and accounted for in scientific scholarship from the perspectives of Black persons in Canada. Purpose: This study intended to examine the rehabilitation narratives of Black TBI survivors, family caregivers, and rehabilitation providers and use critical race theory as a conceptual framework to understand how anti-Black racism manifests in those experiences. Methods: Through critical narrative inquiry informed by a critical constructivist paradigm and a critical race theory lens, in-depth narrative interviewing were conducted with seven survivors, three family caregivers, and four rehabilitation providers. Data were analyzed using reflexive thematic analysis within and across groups of participants to conceptualize themes and sub-themes. Findings: Themes captured how racism becomes institutionalized in TBI rehabilitation: (1) the institutional construction of deficient Black bodies, (2) the institutional construction of rehabilitation access, (3) the institutional investment in resisting and approximating whiteness in rehabilitation practice, and (4) the institutional construction of deficient Black futures. Conclusion: Study findings point to the dire need to ensure rehabilitation programs, services, and the delivery of care are not determined based on inequitable practices, racial biases and assumptions about Black people, which determine who deserves to get into rehabilitation and have opportunities to be supported in working towards living a full and meaningful life. [ABSTRACT FROM AUTHOR]

Social work is a practice-based profession with social justice as a core value and ethical principle. Social work programs incorporate social justice into both the explicit and implicit curricula. However, there has been a longstanding divide in how to address social justice at systemic levels while fostering socially just and competent practice. The aim of this qualitative study was to examine how MSW students describe their learning about social justice and social work practice. To explore this area of inquiry, we conducted three focus groups (N = 16) with current MSW students or recent MSW graduates from Canadian social work programs. Participants described the following five themes that either facilitated or created barriers in their learning about social justice and social work practice: 1) reflection on practice, 2) negotiating discomfort, uncertainty, and safety, 3) learning from lived experiences, 4) learning how to embody social justice in practice, and 5) receiving support, supervision, and coaching. We discuss the implications for social work education and practice. [ABSTRACT FROM AUTHOR]

Background: Canada legalized recreational cannabis in 2018, and one of the primary objectives of the Cannabis Act was to protect youth by reducing their access to cannabis and providing public education. Canada has the highest prevalence of cannabis use worldwide, particularly among youth and young adults under the age of 25. Cannabis use is linked with many adverse effects for youth and young adults including psychosis, anxiety, depression, respiratory distress, cannabinoid hyperemesis syndrome, and impaired cognitive performance. Despite the high prevalence of cannabis use and the evolution of policies in Canada and globally, significant knowledge and research gaps remain regarding youth and young adult cannabis use. The aim of this scoping review is to map the extent, nature, and range of evidence available on youth and young adult cannabis use in Canada since its legalization, in order to strengthen policies, services, treatments, training, and public education strategies. Methods: Using a scoping review framework developed by Arksey and O'Malley, along with the PRISMA-ScR guidelines, we conducted a rigorous search in five academic databases: MEDLINE, Embase, APA PsycINFO, CINAHL and Web of Science Core Collection. We included empirical studies that collected data in Canada after the legalization of recreational cannabis (October 2018) and focused on youth or young adults < 30. Two reviewers independently screened articles in two stages and extracted relevant information from articles meeting the inclusion criteria. Results: Of the 47 articles meeting our inclusion criteria, 92% used quantitative methods, 6% were qualitative, and 2% used a mixed-methods approach. Over two-thirds (68%) used secondary data. These studies were categorized into six focus areas: (1) prevalence, patterns, and trends, (2) cannabis-related injuries and emergency department (ED) visits, (3) rates and patterns during the pandemic, (4) perceptions of cannabis use, (5) prevention tools, and (6) cannabis-related offenses. Key findings from the studies reviewed include an increase in cannabis use among 18-24-year-olds post-legalization, with mixed results for youth under 18. ED visits for intentional and unintentional cannabis-related injuries have increased in young children and teens. Perception studies show a mix of concern and normalization of cannabis use. Though limited, prevention studies are promising in raising awareness. A decline in cannabis-related offenses was noted by one study. The review highlights several research gaps, including the need for more qualitative data, disaggregation of demographic data, intervention research, and comprehensive studies on the physical and mental health impacts of cannabis use among youth and young adults. Conclusion: Maintaining a public health approach is critical, with a focus on reducing the high prevalence of cannabis use among youth and young adults. This involves implementing prevention strategies to minimize harms, enhancing public education, minimizing commercialization, reducing youth access to cannabis, promoting guidelines for lower-risk cannabis use and harm reduction strategies, and increasing training for healthcare providers. [ABSTRACT FROM AUTHOR]

Purpose: Sexual and gender minority and racialized populations experienced heightened vulnerability during the Covid-19 pandemic. Marginalization due to structural homophobia, transphobia and racism, and resulting adverse social determinants of health that contribute to health disparities among these populations, were exacerbated by the Covid-19 pandemic and public health measures to control it. We developed and tested a tailored online intervention (#SafeHandsSafeHearts) to support racialized lesbian, gay, bisexual, transgender, queer, and other persons outside of heteronormative and cisgender identities (LGBTQ+) in Toronto, Canada during the pandemic. Methods: We used a quasi-experimental pre-test post-test design to evaluate the effectiveness of a 3-session, peer-delivered eHealth intervention in reducing psychological distress and increasing Covid-19 knowledge and protective behaviors. Individuals ≥18-years-old, resident in Toronto, and self-identified as sexual or gender minority were recruited online. Depressive and anxiety symptoms, and Covid-19 knowledge and protective behaviors were assessed at baseline, 2-weeks postintervention, and 2-months follow-up. We used generalized estimating equations and zero-truncated Poisson models to evaluate the effectiveness of the intervention on the four primary outcomes. Results: From March to November 2021, 202 participants (median age, 27 years [Interquartile range: 23–32]) were enrolled in #SafeHandsSafeHearts. Over half (54.5%, n = 110) identified as cisgender lesbian or bisexual women or women who have sex with women, 26.2% (n = 53) cisgender gay or bisexual men or men who have sex with men, and 19.3% (n = 39) transgender or nonbinary individuals. The majority (75.7%, n = 143) were Black and other racialized individuals. The intervention led to statistically significant reductions in the prevalence of clinically significant depressive (25.4% reduction, p <.01) and anxiety symptoms (16.6% reduction, p <.05), and increases in Covid-19 protective behaviors (4.9% increase, p <.05), from baseline to postintervention. Conclusion: We demonstrated the effectiveness of a brief, peer-delivered eHealth intervention for racialized LGBTQ+ communities in reducing psychological distress and increasing protective behaviors amid the Covid-19 pandemic. Implementation through community-based organizations by trained peer counselors supports feasibility, acceptability, and the importance of engaging racialized LGBTQ+ communities in pandemic response preparedness. This trial is registered with ClinicalTrials.gov, number NCT04870723. [ABSTRACT FROM AUTHOR]

Introduction: Although there is a growing body of evidence to suggest that persons who have been sex trafficked can suffer devastating health consequences and often face challenges accessing suitable care that addresses their health and overall well-being, little existing research has adopted a survivor-informed approach. Centering the voices of sex-trafficked women in this research will provide valuable insights into their health-related experiences and can help lay the foundation for survivor-centric healthcare responses. Methods and analysis: Using a semi-structured interview guide, we will interview women who have been domestically sex trafficked in Ontario; recruitment will continue until data saturation is reached. Interview questions and prompts will elicit information about women's experiences prior to, during, and after their trafficking ordeal, with particular attention paid to their encounters with healthcare providers. Intersectionality theory will inform strategies for recruitment, data collection, and data analysis. Data will be analyzed deductively as well as inductively using Braun and Clarke's six phases of reflexive thematic analysis. The study's design was informed by the consolidated criteria for reporting qualitative research (COREQ), which ensures a comprehensive and robust reporting of interview data. We will continue to adhere to the COREQ checklist throughout the data collection, analysis, and findings write-up phases, helping to ensure methodological accuracy and transparency. Discussion: To our knowledge, this will be the first Canada-specific investigation to apply intersectionality theory to explore the experiences of well-being, health, and healthcare from the perspectives of women who have been domestically sex trafficked. The results of this study hold the potential to improve responses to trafficking within the healthcare sector. Specifically, the findings could be used to inform the development of education materials and curricula for medical students and continuing professional education for health and allied healthcare providers. They could also inform the creation of patient experience surveys and intake forms for sex trafficked patients. [ABSTRACT FROM AUTHOR]

Hiring peer researchers – individuals with lived experience of the phenomenon under study – is an increasingly popular practice. However, little research has examined experiences of peer research from the perspectives of peer researchers themselves. In this paper, we report on data from a participatory, qualitative research project focused on four intersecting communities often engaged in peer research: mental health service user/consumer/survivor; people who use drugs; racialized; and trans/non-binary communities. In total, 34 individuals who had worked as peer researchers participated in semi-structured interviews. Transcripts and interviewer reflections were analyzed using a participatory approach. Many participants reported exposure to intersecting forms of systemic oppression (racism, transphobia, ableism, and classism, among others) and disparagement of their identities and lived experiences, both from other members of the research team and from the broader institutions in which they were working. Peer researchers described being required to perform academic professionalism, while simultaneously representing communities that were explicitly or implicitly denigrated in the course of their work. Practices of resistance to these harms were evident throughout the interviews, and participants often made strategic decisions to permit themselves to be tokenized, out of the expectation of promised benefits to their communities. However, additional harms were often experienced when these benefits were not realized. These findings point towards the need for a more reflexive and critical approach to the use of peer research. [ABSTRACT FROM AUTHOR]

This article explores structural mechanisms that are the context for violence and depression in the lives of sexual minority women and trans people in Ontario, Canada. The article draws on interviews with 14 people who reported experiences of depression in the previous year, foregrounding three representative narratives. Narrative and case study analysis reveal that violence is a repeated and cumulative experience over lifetimes, occurring across different interpersonal contexts and institutional encounters. A common theme across the narratives is that experiences of violence are connected to a broader context in which structural arrangements, cultural norms, and institutional processes create conditions where marginalized people are put in harm's way, perpetrators are empowered, and justice and access to help are elusive. As the violence experienced by these sexual minority women and trans people is rooted in structural and cultural oppression represented in poverty, racism, misogyny, homophobia, and transphobia, the prevention of violence and its consequences for these and other marginalized populations requires systemic transformation of the structures and systems that currently allow and perpetuate harm. [ABSTRACT FROM AUTHOR]

Background: In 2018, Canada legalized recreational cannabis use with the purpose of protecting youth and restricting access. However, concerns have been raised that this objective has not been met as rates of cannabis use among youth aged 16–24 have not declined. Youth cannabis use is associated with various adverse effects including psychosis, anxiety, depression, suicidality, respiratory distress, cannabinoid hyperemesis syndrome, and intoxications. Service providers play a crucial role in addressing youth cannabis use. This study aimed to understand Ontario service providers' perceptions, practices, and recommendations on youth cannabis use. Methods: This mixed method study included a survey and two focus groups. The survey was distributed to mental health service providers serving youth aged 16–24 across Ontario who were given the option to participate in a focus group. The survey included closed and open-ended questions regarding perceptions, practices, and recommendations, while the focus groups explored these categories in greater depth. Descriptive statistics were used to analyze close-ended questions and interpretative content analysis was applied for open-ended questions. Focus group data were analyzed using thematic analysis. Results: The survey was completed by 160 service providers and 12 participated in two focus groups. Regarding perceptions, 60% of survey participants agreed with legalization, 26% had a strong understanding of medical versus recreational cannabis, 84% believed that cannabis has physical and mental health risks, and 49% perceived stigmatization. Less than half of the survey participants reported screening or assessing cannabis use, 16% stated they are highly familiar with treating cannabis use, and 67% reported that they rarely work with families. Subthemes identified in the focus groups under perceptions included normalization and stigmatization, harms for youth, and stigma, racism, and discrimination. Subthemes under practice included cannabis not being the primary focus, challenges with screening, assessment, and intervention, and referral to specialized services. Both the survey and focus group participants recommended increasing public education, enhancing service provider training, improving regulation and policies, reducing stigma and minimization, improving service access, and providing more culturally responsive services. Conclusion: Youth cannabis use in Canada remains a significant public health concern, necessitating a more comprehensive plan to protect Ontario youth and reduce associated harms. [ABSTRACT FROM AUTHOR]

Background: Canadian youth (aged 16–24) have the highest rates of mental health and addiction concerns across all age groups and the most unmet health care needs. There are many structural barriers that contribute to the unmet mental health care needs of youth including lack of available and appropriate services, high costs, long wait times, fragmented and siloed services, lack of smooth transition between child and adult services, stigma, racism, and discrimination, as well as lack of culturally appropriate treatments. Levesque et al. (2013) developed a framework to better understand health care access and this framework conceptualizes accessibility across five dimensions: (1) approachability, (2) availability, (3) affordability, (4) appropriateness, and (5) acceptability. The purpose of this study was to explore access to addiction and mental health services for youth in Ontario, Canada from the perspectives of youth, parents, and service providers. Methods: This qualitative study was a university-community partnership exploring the experiences of youth with mental health concerns and their families from the perspectives of youth, caregivers, and service providers. We conducted semi-structured interviews and used thematic analysis to analyze data. Results: The study involved 25 participants (n = 11 parents, n = 4 youth, n = 10 service providers). We identified six themes related to structural barriers impacting access to youth mental health and services: (1) "The biggest barrier in accessing mental health support is where to look," (2) "There's always going to be a waitlist," (3) "I have to have money to be healthy," (4) "They weren't really listening to my issues," (5) "Having more of a welcoming and inclusive system," and (6) "Health laws aren't doing what they need to do." Conclusion: Our study identified five structural barriers that map onto the Levesque et al. healthcare access conceptual framework and a sixth structural barrier that is not adequately captured by this model which focuses on policies, procedures, and laws. The findings have implications for policies and service provisions, and underline the urgent need for a mental health strategy that will increase access to care, improve mental health in youth, decrease burden on parents, and reduce inequities in mental health policies and services. [ABSTRACT FROM AUTHOR]

A recovery paradigm has been increasingly used recently to inform mental health and addiction policies with principles that promote autonomy, social capital, and inclusion. However, some policies such as coercive treatments conflict with recovery principles and social workers report challenges implementing recovery principles in practice. This scoping review explored the literature on recovery policies in mental health and addictions from a social work perspective (N = 29). Our results showed a need to strengthen training for social workers on recovery, increase the focus on policies for addiction recovery, reduce coercive treatment policies, support families, and reduce stigma and discrimination through equitable policies. [ABSTRACT FROM AUTHOR]

Introduction: Despite the development of safe and highly efficacious COVID-19 vaccines, extensive barriers to vaccine deployment and uptake threaten the effectiveness of vaccines in controlling the pandemic. Notably, marginalization produces structural and social inequalities that render certain populations disproportionately vulnerable to COVID-19 incidence, morbidity, and mortality, and less likely to be vaccinated. The purpose of this scoping review is to provide a comprehensive overview of definitions/conceptualizations, elements, and determinants of COVID-19 vaccine hesitancy among marginalized populations in the U.S. and Canada. Materials and methods: The proposed scoping review follows the framework outlined by Arksey and O'Malley, and further developed by the Joanna Briggs Institute. It will comply with reporting guidelines from the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The overall research question is: What are the definitions/conceptualizations and factors associated with vaccine hesitancy in the context of COVID-19 vaccines among adults from marginalized populations in the U.S. and Canada. Search strategies will be developed using controlled vocabulary and selected keywords, and customized for relevant databases, in collaboration with a research librarian. The results will be analyzed and synthesized quantitatively (i.e., frequencies) and qualitatively (i.e., thematic analysis) in relation to the research questions, guided by a revised WHO Vaccine Hesitancy Matrix. Discussion: This scoping review will contribute to honing and advancing the conceptualization of COVID-19 vaccine hesitancy and broader elements and determinants of underutilization of COVID-19 vaccination among marginalized populations, identify evidence gaps, and support recommendations for research and practice moving forward. [ABSTRACT FROM AUTHOR]

Participatory research, or the practice of involving 'peers' with lived experience, has become popular in social work. Peer engagement is lauded for: 'democratising' the research process; providing 'capacity building' and facilitating opportunities to co-produce knowledge. Yet, these claims are rarely evaluated by empirical investigations into the socio-material work conditions of peer researchers. Here we present findings of a study that examined the experiences of peer researchers, focusing on payment inequities and social workers' roles in advocating for economic justice. Together with peer research assistants, we conducted a participatory constructivist grounded theory study, interviewing peers (total n  = 34) who were compensated to work on studies focused on the following: racialised communities, communities of people who use drugs, consumer/psychiatric survivor/ex-patient and mad communities and trans/non-binary communities. Our findings highlight divergent compensation practices in peer research work. Whilst some peers were satisfied with their treatment on research teams and payment received, others discussed challenges associated with precarious short-term casual work and managing formal income alongside state social assistance such as disability support. We conclude that in some cases, the peer role is characterised by precarious working conditions which compound rather than challenge injustice within the research enterprise, and we discuss implications for social work. [ABSTRACT FROM AUTHOR]

Introduction: This article explores how religion and religious institutions affect the lives of lesbian, gay, and bisexual (LGB) people living in Saint Lucia. Methods: Drawing on thirty-three interviews conducted as part of an international human rights project, we explore the role that religion can play in both reinforcing marginalization and promoting human rights for sexual minority people. Results: Thematic analysis of interview data reveals ways in which religion is the foundation for life in Saint Lucia and both marginalizes and sustains sexual minority lives. Conclusions: Although churches are often viewed as major opponents to LGBT human rights, participants discussed hopes and strategies for churches to become allies in advocating for inclusion. Policy Implications: We conclude that Saint Lucia is a context in which work toward human rights for sexual minority people must include attention to religion as a powerful and meaningful component of peoples' lives. [ABSTRACT FROM AUTHOR]

Introduction Social work is a key profession in the field of mental health worldwide and the profession has values that are aligned with a recovery paradigm. However, there are gaps in understanding how social workers are applying the recovery paradigm in practice. This study will scope and synthesise the literature related to recovery and social work practice in mental health and addictions. There will also be an exploration of best practices and gaps in recovery-oriented social work practice. Methods and analysis Using a scoping review framework developed by Arksey and O’Malley, we will conduct our search in five academic databases: PsycINFO, Medline, CINAHL Plus, Sociological Abstracts and Social Services Abstracts. Articles meeting inclusion criteria will be charted to extract relevant themes and analysed using a qualitative thematic analysis approach. Ethics and dissemination This review will provide relevant information about best practices and gaps in recovery-oriented social work practice in mental health and addictions. The study will inform the development of mental health curricula in social work programmes and clinical settings. Results will be disseminated through a peer-reviewed journal and at conferences focusing on mental health, addictions, and social work education. Ethics approval is not required for this scoping review. [ABSTRACT FROM AUTHOR]

This paper presents my reflections on the use of critical oral history method for a participatory, community-based international LGBT human rights research project. Although critical oral history method has been promoted as an empowering research method particularly suited to advocacy work, I describe emerging dilemmas around naming the work, assuming risks and understanding the method as a medium with potential for reifying existing power imbalances. I advocate for more complicated understandings of how critical research is not defined by the method, but instead, by the processes surrounding it. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, trans, and/or queer (LGBTQ) people face barriers to accessing mental health care; however, we know little about service experiences of low income LGBTQ people. In this qualitatively-driven mixed methods study, over 700 women and/or trans people completed an internet survey, of whom 12 LGBTQ individuals living in poverty participated in interviews. Low income LGBTQ respondents saw more mental health professionals and had more unmet need for care than all other LGBTQ/income groups. Narrative analysis illustrated the work required to take care of oneself in the context of extreme financial constraints. These findings highlight the mechanisms through which inadequate public sector mental health services can serve to reproduce and sustain both poverty and health inequities. [ABSTRACT FROM AUTHOR]

This article uses an intersectionality lens to explore how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental healthcare in a population of 704 women and transgender/gender liminal people from Ontario, Canada. A survey collecting demographic information, information about mental health and use of mental healthcare services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression was completed by 704 people via Internet or pen-and-paper between June 2011 and June 2012. Bivariate and regression analyses were conducted to assess group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental healthcare services. Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental healthcare. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables. Everyday discrimination was the strongest predictor of both depression and unmet need for mental healthcare. The results suggest lower income and intersections of race with other marginalised identities are associated with more depression and unmet need for mental healthcare; however, discrimination is the factor that contributes the most to those vulnerabilities. Future research can build on intersectionality theory by foregrounding the role of structural inequities and discrimination in promoting poor mental health and barriers to healthcare. [ABSTRACT FROM AUTHOR]

Background: Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender ( i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. Materials and Methods: This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. Results: Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p < 0.01) and bisexual people 1.8 times (95% CI = 1.1-2.9, p = 0.02) as likely to report an unmet need for mental healthcare as cisgender heterosexual women. Trans participants were also 1.6 times (95% CI = 1.0-27, p = 0.04) more likely to report untreated depression. These differences were not seen after adjustment for social context factors such as discrimination and social support. Conclusion: We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people. [ABSTRACT FROM AUTHOR]

Internationally, mental health care systems have identified recovery as the underlying philosophy for practice and policy in mental health care, although establishing a specific definition of recovery is still work in progress. This mixed-methods study explored the meaning and scope of recovery from the perspective of people diagnosed with mental illnesses. Sixty-five individuals self-identifying as diagnosed with schizophrenia completed measures of recovery, symptom level, insight into illness, hopelessness and internalised stigma. In addition, twenty people participated in a semi-structured interview focused on how diagnosis affected their personal and social experiences. Regression analyses based on the quantitative data and thematic analysis of the qualitative data indicated stigma is a major barrier to recovery. However, recovery can be promoted by integrated biomedical, psychological, social and political processes. Qualitative findings suggested that an important component of recovery is feeling empowered and entitled to full participation in social environments. This study suggests that recovery-oriented social work interventions should be directed at promoting social citizenship for people diagnosed with mental illness, combating stigma, and creating the psychological and social environments for finding meaning and hope after receiving a diagnosis. [ABSTRACT FROM AUTHOR]

This study explored professional caregiving from the perspective of people diagnosed with schizophrenia to develop proposed professional competencies for promoting recovery. We conducted semi-structured qualitative interviews with 40 people diagnosed with schizophrenia to explore their experiences of caregiving. Interview segments related to professional caregiving were analyzed to derive categories and themes that described aspects of caregiving that clients believed contributed to their recovery. The proposed competencies derived from the interviews overlap with hypothesized competencies identified in the literature, but also suggest other areas of skill and attitude that relate to promoting recovery, including use of time, talk, and teamwork. The significance participants attach to time and talk suggests that services play an important role in recovery by creating the space for service users and service providers to engage in recovery-promoting practices. [ABSTRACT FROM AUTHOR]

This paper examines insight into mental illness, particularly as it applies to people diagnosed with schizophrenia. The paper argues that insight should be reconceptualized as a component of post-diagnosis identities that are defined in relation to other social identities, and under conditions of stigma against mental illness. The proposed conceptualization suggests there are at least four possibilities for post-diagnosis identities in schizophrenia: engulfed, resistant, detached, and empowered. Revising the insight concept to integrate the influence of social context and the potential for multiple post-diagnosis identities could be the basis for therapeutic dialogues with individuals about the implications that diagnosis has for their lives. [ABSTRACT FROM AUTHOR]

This qualitative study used the long interview method with Canadian mothers of African and Caribbean descent to understand the underresearched experience of raising a child with sickle cell disease (SCD). Mothers' realities were explored through three levels of social organization: daily caregiver coping (micro level); community views of SCD, such as stigma (meso level); and systemic SCD health care provision (macro level) . Through the use of population health and structural social work perspectives, mothers' experiences were examined in the context of perceived gender and racial oppression. Saturation was achieved after initial interviews with 10 participants and a four-month postinterview with half of the participants. Mothers commonly reported several daily coping challenges: fear of their children's death, separation anxiety, loss of control over life, helplessness, and loneliness/isolation. SCD stigma interacted with racism, contributed to social isolation, and prevented families from organizing as a group. All mothers perceived racism as a salient factor behind inadequate mainstream SCD health care. Recommendations to improve SCD health care and implications for social work practice and research are discussed. This is the first known Canadian psychosocial study of SCD and investigation into SCD stigma outside of rural Nigeria. [ABSTRACT FROM AUTHOR]

Understanding the dynamics of caregiving is essential to providing effective support to individuals and families living with serious mental illnesses. Yet, research in this area has typically explored caregiving without consulting mentally ill people. This paper adds this overlooked viewpoint by exploring the experience of care relationships by people diagnosed with schizophrenia. A secondary analysis of interview data from 21 individuals reveals that relevant dimensions of care relationships include: providers of care; types of care received; self-care; contested practices in care; negotiating practices; recipients of care; and types of care provided to other people. Addressing care within this broader conceptualization can contribute to developing interventions for individuals and families that more fully recognize the potential for people with mental illnesses to be active participants in care relationships. [ABSTRACT FROM AUTHOR]

This paper reviews the experience of evaluating a cultural competence workshop series for social workers practicing in a mental health care setting. The study used a pretest-posttest nonequivalent comparison group design, and evaluation was based on both quantitative and qualitative data collections. Between subjects analyses suggested that there were no differences between the intervention and comparison group after the intervention was completed, hut within-subjects analyses revealed that the intervention group had made superior gains in their scores on the Awareness subscale of the Multicultural Counseling Inventory. Qualitative data contributed additional information about important individual and group processes that affected the experience of training and contributed to self-reported outcomes from training. The study suggests that evaluating process and outcomes of training at both the individual and group levels may be particularly important to understanding how cultural competence develops for social work practitioners in interdisciplinary settings. [ABSTRACT FROM AUTHOR]

In the summer of 2001, the Canadian media devoted attention to two court cases that resulted in mothers losing custody of their children. Kimberly Van de Perre and Nadia Hama might have been overlooked if the presentation of their cases had not evoked discussion regarding the relevance of claims of racism in custody decisions. Analysis of the media narrative reveals that the narrow focus on race distorted perceptions of these family situations, and contributed to the marginalization of the two single mothers involved. This paper examines this process to explore how an analysis based on multiple identities, and simultaneous existence of oppression and privilege, may have led to different outcomes for these two families. [ABSTRACT FROM AUTHOR]

This study investigates the discharge-planning process and short-term outcomes for 100 patients discharged from a general psychiatry unit. The contributions of functional/illness factors, personal factors, and family factors to communication of the plan, length of stay, and satisfaction with discharge-planning process were investigated. Findings indicate that both the process and short-term outcomes of discharge planning are affected by factors that can be addressed in interventions with patients, families and the social environment. This research suggests that discharge planning without attention to psychosocial factors will fail to address issues relevant to patient well-being. [ABSTRACT FROM PUBLISHER]

Chronicity and disability can accompany a diagnosis of schizophrenia, but long-term followup studies are demonstrating that these outcomes are not inevitable. There is g owing awareness that characteristics of long-term illness previously understood to be part of the disorder can be partially constructed through a convergence of physical, psychological, and social processes. In this study, the potential for social construction of disability was explored through secondary analysis of qualitative data. Findings suggest that family, consumers, professionals, and society each have a role in shaping a person with schizophrenia's perceptions of his or her worth, competence, and place in society but that the individuals are not passive recipients of this input. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the predictors of psychiatrists' perceived success and personal satisfaction with their careers. The present study examines self-reported success and personal satisfaction with their careers in a cohort of psychiatrists followed for more than 20 years.Methods: A total of 29 psychiatrists, all of whom had participated in a study during their residency 21 to 24 years earlier, completed a self-report questionnaire. The first set of questions addressed the type and characteristics of their professional practice; the second set assessed aspects of their nonprofessional practice; and the third set assessed aspects of their nonprofessional, personal lifestyles. The personality traits of neuroticism and extraversion were assessed during the residency years and were used as predictors. Composite measures of self-perceived external success and personal satisfaction were computed. Regression models were constructed to determine the best predictors of these composite measures.Results: Neuroticism proved to be a significant predictor of external success but not of personal satisfaction, with higher scores predicting a lower rating of perceived external success. There were 2 practice characteristics--involvement with research and practising from an orientation other than psychoanalytic--that predicted perception of success. One personal lifestyle characteristic--the perception that one's nonprofessional life sustained professional life--also predicted perception of success. The best predictor of personal satisfaction was overall satisfaction with nonprofessional aspects of life.Conclusions: Personality, nonprofessional social support, and engaging in research are associated with greater perceived success and personal satisfaction with a career in psychiatry. [ABSTRACT FROM AUTHOR]

Relates the experiences of the author as an academic women of color who attempt activism. Place of people of color in academia; Risk inherent in trying to address racial politics from within institutions; Lack of solidarity and intellectual community among black women; Attitude of professors towards women of color.

Presents life-history interviews with 15 individuals diagnosed with schizophrenia and describes the explanatory models they use to give coherence to their experiences of psychosis. Struggle for control; Respondents' statements about the possibility of recovery from illness; Advocacy for recovery-based models of care including therapeutic discourse with clients.

This study examined the relationships between insight, severity of symptoms, diagnosis, locus of control, quality of life, and engulfment among 25 patients with a DSM-IIIR diagnosis of schizophrenia and 33 patients with a diagnosis of bipolar disorder. Engulfment is the extent to which a person identifies with the patient role. Severity of symptoms and engulfment were significantly associated with insight. These results are consistent with the notion that poor insight is associated with severe illness. The association between development of deviant or sick roles and awareness of illness warrants further attention. [ABSTRACT FROM AUTHOR]