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The use of detention as a defence against intolerable social anxiety towards asylum seekers
No full textThe movements of peoples across the world are causing grave concern for politicians, government agencies, humanitarian organisations and individual citizens. The immigrants fleeing poverty, war and tyrannical regimes are seen every day on our televisions. We see immigrants crossing the Mediterranean in broken-down boats. In South East Asia Thailand, Malaysia and Indonesia are turning back boatloads of refugees fleeing Burma, leaving 6,000 people stranded at sea. At Calais thousands of people are living in destitute conditions whilst risking their lives to stow away in lorries. In London a man fell to his death onto a roof being stowed away in an aircraft from South Africa. These scenes of human desperation are now every day occurrences. At the same time more overt political conflict is emerging from the European countries that take in the immigrants. Italy and Greece want a sharing out of the migrants known as 'compulsory burden sharing' but other European countries are not willing to participate. This paper focuses on an aspect of the immigration crisis namely the asylum seeking and detention centers of the UK. The Tavistock Institute of Human Relations was commissioned to review the mental health care of detainees in Immigration Removal Centers. This paper makes use of the concepts of system psychodynamics, open systems and boundary management, and social systems as a defence against anxiety. We examine the organisational culture of IRCs where people are detained. Our paper focuses on how asylum seekers are treated in removal centres, particularly in relation to their mental health needs. We suggest that there is confusion in the conscious and unconscious understanding of the primary task. We propose that there is a task conflict that manifests in the socio-technical system itself in the organisation of the centres. At the same time we examine the casework system that is engaged in processing asylum applications
"It turns your whole world upside down...but still brings immense pleasure": Perspectives on kinship care
No full textImproving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications
No full textPhysical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service
Young people's reflections on engaging with youth offending services. A psycho-social exploration
No full textThis exploratory, psycho-social study examined young people’s reflections on their experiences of engaging with a youth offending service (YOS). There is a paucity of research that explores this. Five participants were recruited from a YOS in the UK. Free association techniques were used; five participants were interviewed using the Grid Elaboration Method, four were interviewed again using the Free-Association Narrative Interview. Interview transcripts were analysed using thematic analysis, a psycho-social lens was then applied and ‘scenic understandings’ composed for each participant. The thematic analysis illuminated four themes: transformative relationship with YOT worker: identity transformation: engaging: then’s presence in now. Themes and ‘scenic understandings’ were drawn upon in discussion of links to literature, navigated as: trust in relationships; past and present, developing an identity distanced from a past self, engagement in personalised intervention, the function and structure of YOS, YOS engagement; a window of opportunity, developing a psycho-social understanding of what participants talked about. Strengths of the study lie in the psycho-social approach and free association method of data collection, enabling rich descriptions and interpretations that considered the interrelatedness of psychological and social experiences. Potential implications for practice were highlighted; 1. consideration of what participants talked about by professionals working in YOS and with similar populations, 2. consideration of the development of the EP role, such as providing supervisory support to reflect on the psycho-social needs of young people engaging with YOS, 3. maintenance and development of the focus of YOS procedures such as emphasising the importance of building meaningful relationships and providing structure for young people engaging with YOS. Recommendations for future research are; 1. undertaking similar studies with young people having difficulty with engagement, 2. investigating both young people’s and their YOT worker’s experiences of working together to develop understanding of the intersubjective nature of the engagement process
Growing crisis in children and young people's mental health demands action. Young people face unprecedented social pressures, leading to serious psychological distress. Society’s response has been inadequate
No full textSelf-harm among young people, particularly girls, has rocketed in the last decade. The number of girls admitted to hospital after cutting themselves has quadrupled, incidents of poisoning have risen by more than 40%, and demand for university counselling services has mushroomed. Behind these figures are young people and families struggling to cope with toxic levels of mental distress.
In part these numbers reflect a greater awareness of mental health and willingness to seek help but more is going on than that. These figures are also evidence that the today’s generation of young people are facing unprecedented levels of social pressure leading to serious psychological distress. Our response, as a society, has not, as yet, been anywhere near sufficient to answer this cry for help.
At the Tavistock and Portman specialist mental health trust, we have been engaged for nearly 100 years in understanding the causes of psychological distress among young people and, in particular, the impact of childhood experience, relationships and trauma, on mental health. It is why we feel strongly that it was the right thing to do to let the cameras in and help tell the story of young people, their families and clinicians working with them.
Channel 4’s documentary Kids on the Edge, screened over the last month, is the result. For us it has captured, with great sensitivity, the challenges faced by young people and their families, and which our services are working through on a daily basis. Some of what is shown is shocking but not in a sensationalist way. Only by better understanding, both intellectually and emotionally, the level of distress that can drive a young person to self-harm or to think of taking their own life can we begin to move forward.
There is a growing crisis in children and young people’s mental health. It demands a response, it requires urgent action. We would highlight three priorities.
First, demand for help is outstripping supply. A target has been set that 70,000 more young people are able to access help by 2020. That is welcome. However, the treatment gap is enormous. It is estimated that only 25-35% of young people who need help for mental health difficulties receive it. If this was true for cancer there would be a public outrage. Furthermore many services are seeing year-on-year increases in demand of more than 10%, often combined with a rise in case complexity. If the goal is to get good quality and timely help to the young people who need it, the new money promised by the government for children’s mental health must reach the frontline. So far the story on this has been mixed.
Second, dealing with emotional and mental distress is part of the day-to-day business of teachers, social workers and other professionals. This workforce need the right skills, recognition and support to help build resilience in children and keep them engaged with education...
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A baby mouse in a tiny boat. In psychotherapy treatment can the experience of premature birth be considered significant in understanding the internal world of a child?
No full textThis thesis discusses the potential impact a premature birth can have on a childʼs internal world. This was explored using a single case study of a girl who was born at 25 weeks gestation. There are ten sampled individual psychotherapy sessions and one initial meeting in order to research this question using grounded theory and thematic analysis. Themes that arose from this material, in connection with infant prematurity, include babies and growing up; incubators and hospitals; psychotherapy and play; animals, insect and reptiles; and finally the importance of the beginnings, endings and holiday breaks in the psychotherapy. The implications of the possible trauma of a premature birth for both the parents and the young girl are thought about in detail. My analysis of the material indicated that this had a profound effect on Poppy and her family. The question of whether Poppyʼs memory of her premature birth and early experiences were internalized by her at birth, or whether this was projected into her by her parents, concluded that it was likely to have been a combination of these two factor
“Canvassing the Context”: An exploration of the context of the Holding Hands Parenting Programme using principles of realist evaluation
No full textPrinciples of Realist Evaluation (Pawson & Tilley, 1997) were used alongside a framework based on Realist Social Theory (Archer, 1995; De Souza, 2013) in order to explore and explain the nature of the local parenting context in which the Holding Hands Parenting Programme (HHPP) was both embedded and functioned. The research identified particular mechanisms that were pre-existing in the local context in its structural, cultural, agential and relational aspects which were activated by the introduction of a parenting programme. It was carried out in a large shire county where the researcher worked as a Trainee Educational Psychologist. Stakeholders in the HHPP from various system levels, ranging from those with service and commissioning responsibilities to recipients of parenting support, participated in the study, providing a rich insight into the multi-layered local context.
Thematic analysis (Braun & Clarke, 2006) was used as a grounding framework for the analysis of data which followed a realist analytical process culminating in retroduction (Crinson, 2001) and six overarching themes were developed: (i) forward thinking; (ii) one size fits; (iii) collaboration; (iv) involvement; (v) barriers and (vi) perceptions and expectations. Network patterns (or configurations) were created which mapped out the relationship between aspects of the context, pre-existing mechanisms and the outcomes potentially generated as a result of a parenting programme.
Existing literature was explored and findings formed a key part of the theorisation and retroductive phases of data analysis. Two overarching theories were constructed in order to summarise the concluding thoughts in this study on the relationship between the HHPP and its context. These were presented and can form the basis of future realist evaluation research.
This research contributes to the further development of the HHPP as it seeks to use innovative and creative ways to support a wider range of parents within a complex and changing local context. Implications for future research and links to the practice of educational psychologists are discussed and the potential value principles of realist evaluation may have for an educational psychology service is outlined
How can we understand the demise of Kids Company?
No full textThe sudden closure of the charity Kids Company was headline news in the UK on 6 August 2015. In this piece the author shares her feeling of shock, her questions and her concerns arising from the BBC interviews with the charity's founder Camila Batmanghelidjh who had been at the helm for 19 years. While alluding to the vision of charismatic leaders and their extraordinary ability to bring about social transformations, the author refers to Weber and others highlighting that charismatic leadership must be transitional if the enterprise is to survive. However, charisma can lead to idealization which puts the enterprise at risk
