Department of social work

This research investigates how the term “insight” was employed in 25 decisions from mental health review proceedings in Victoria, Australia. The application of insight appears problematic in these decisions. First, there is little clarification of its meaning. Second, the logic applied when insight is related to compliance is often unclear. Third, there are frequent allusions to an implicit and undefined scale of insight, offering the appearance of objectivity. We have analysed insight as an ‘interpretive resource’, focusing on its various functions in the complex social context of commitment hearings and with a view to its therapeutic jurisprudence implications. The variable application of insight—its interpretive flexibility—appears useful in addressing complex problems faced by review boards. Hence, a key function of insight is to bridge between legal and clinical discourses. Insight is also a convenient means to avoid complicated debates regarding the person's credibility. By analysing insight in Victoria, we hope to contribute to better theoretical understanding of decision-making patterns in mental health law in general. Copyright © 2006 John Wiley & Sons, Ltd.

The aim of this article is to analyse the role of the legal representative in therapeutic law, specifically in Swedish administrative court hearings relating to compulsory care. Data are collected from three types of cases where a health or social welfare authority argues that it is necessary to apply coercion to a citizen: the Care of Young Persons (Special Provisions) Act, the Care of Alcohol and Drug Abusers (Special Provisions) Act and the Compulsory Psychiatric Care Act. The data consist of audio-recordings from 39 hearings, supplemented by 28 interviews with participants in these hearings, and court documents. Three primary roles of the legal representatives are identified: defender, spokesperson and therapist. We show how the primary role of the attorney becomes that of the spokesperson, but also that the role of the therapist takes precedence over that of the defender.

This article draws on observations from ethnographic fieldwork to develop a theoretical understanding of the power dynamics in psychiatric care. The aim is to analyze how psychiatric clinicians solve compliance problems by invoking “coercion context”. It is suggested that clinicians take a rather instrumental approach to laws regulating coercive intervention. Clinicians may invoke a coercion context even with voluntary patients. For example, they may use wordings that connote coercion, or they may make use of how treatment wards are set up to accommodate involuntary patients, thus stalling voluntary patients who cannot exit through locked doors. A coercion context can also be invoked to solve mundane practical problems, e.g. when clinicians talk about “coerced showers”. The management of information and maintaining a suitable “awareness context” with regards to coercion is an essential feature in clinical attempts to achieve compliance from patients.In conclusion, the notion of coercion context helps explain the confusing findings from previous research about patients' apparent misconceptions of their formal legal status. Furthermore, it is argued that research that rely on decontextualised, objectifications of “coercion” risk to miss the meaning coercion is assigned in everyday clinical practice.

The aim of this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20 years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State.In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, there was agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framed within an ideology of integrating the disabled. The new legislation allowed for a broad range of measures to control patients at the same time as it was presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community.The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.

In recent years, organizations within the public sector have become increasingly attentive to how they are perceived by the public. Professional news management is primarily associated with the private sector, where the rationale has been to maximize profit and market value. For organizations under democratic authority, the ultimate goals are different. The aim of this paper is to describe and compare news management in three types of public sector organizations: school, police and social services. The three types of organizations are chosen because they appear different in some respects that might potentially affect news management.
The paper draws on data from a national survey of all 21 Swedish regional police authorities and a representative sample of municipal school (n=90) and social service administrations (n=91) (attrition rate < 10%). Data are analyzed in terms of policies, personnel and activities.
With the exception of a couple of small municipalities, all organizations have a systematic and professional organization for media relations. The police authorities stand out in having implemented more developed strategies. The school administrations tend to be somewhat more active in their media relations than social services.
Differences between the types of organizations are discussed in terms of variation in institutional conditions for news management. The reason why the police stand out can be attributed to a higher newsworthiness, higher public visibility and less strict secrecy rules. We conclude that conditions relating to public interests have the most impact on the formation of news management.

Compulsory community care (CCC) was introduced in Sweden in 2008. This article investigates all written court decisions regarding CCC over a 6 month period in 2009 (N=541). The purpose is to examine how the legal rights of patients are protected and what forms of social control patients are subjected to.
51 % of CCC patients are women, and 84 % are being treated for a psychosis-related disorder. In the court decisions, only 9 % of patients are described as dangerous to themselves, while 18 % are regarded a danger to others. The most common special provisions that patients are subjected to are medication (79 %) and a requirement that they must maintain contact with either community mental health services (51 %) or social services (27 %).
In the decisions, both the courts and court-appointed psychiatrists agree with treating psychiatrists in 99 % of cases. Decisions lack transparency and clarity, and it is often impossible to understand the conclusions of the courts. There is considerable variation between regional courts as regards the provisions to which patients are subjected and the delegation of decision-making to psychiatrists. This means that decisions fail to demonstrate clarity, transparency, consistency and impartiality, and thus fail to meet established standards of procedural fairness.
Surveillance techniques of social control are more common than techniques based on therapy or sanctions. Because of the unique role of medication, social control is primarily imposed on a physical dimension, as opposed to temporal and spatial forms.
The article concludes that patients are at risk of being subjected to new forms of social control of an unclear nature without proper legal protection.

Key words: compulsory community care, community treatment orders, outpatient coercion, court hearings, legal rights, social control

The aim of this article is to understand how compulsory community care (CCC) has become a solution in mental health policy in so many different legal and social contexts during the last 20&#xa0;years. The recent introduction of CCC in Sweden is used as a case in point, which is then contrasted against the processes in Norway, England/Wales and New York State. In Sweden, the issue of CCC was initiated following high-profile acts of violence. Contrary to several other states, there was agreement about the (lack of) evidence about its effectiveness. Rather than focusing on dangerousness, the government proposal about CCC was framed within an ideology of integrating the disabled. The new legislation allowed for a broad range of measures to control patients at the same time as it was presented as a means to protect positive rights for patients. Compared to previous legislation in Sweden, the scope of social control has remained largely the same, although the rationale has changed — from medical treatment via community treatment and rehabilitation, to reducing the risk of violence, and then shifting back to rehabilitation in the community. The Swedish approach to CCC is similar to Norway, while New York and England/Wales have followed different routes. Differences in ideology, social control and rights orientations can be understood with reference to the general welfare and care regimes that characterize the four states.

ABSTRACT School social workers can be seen as a professional group operating on the margin of an educational logic that dominates schools as institutions. This conditions what tasks they are assigned and what aspects of social work knowledge they will find relevant. On the other hand, the role as a sole professional and relative outsider in the organization provides a potential for school social workers to transcend established theories of social work practice. This article aims to investigate how social work theory is applied in school social work. Twelve semi-structured interviews with school social workers were analysed in terms of how they relate to four knowledge approaches derived from the literature: task-centred, systems theory, strengths and anti-oppressive. Contrary to claims within the sociology of professions that social work practice is formed largely by organizational context rather than a discipline-specific knowledge base, the interviewees seemed to lean on a robust professional foundation within social work theory. Interviewees strongly emphasised their role as working for the individual pupil and positioned themselves as somewhat in opposition to a somewhat oppressive school environment.

The subject matter of this study is professional discourse concerning psychiatric assessments, particularly those relating to compulsory care. Discursive practices in two institutional settings are compared, namely a psychiatric clinic and an administrative court. In ...

This research investigates how the term &amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;insight&amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; was employed in 25 decisions from mental health review proceedings in Victoria, Australia. The application of insight appears problematic in these decisions. First, there is little clarification of its meaning. Second, the logic applied when insight is related to compliance is often unclear. Third, there are frequent allusions to an implicit and undefined scale of insight, offering the appearance of objectivity. We have analysed insight as an &amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;interpretive resource&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, focusing on its various functions in the complex social context of commitment hearings and with a view to its therapeutic jurisprudence implications. The variable application of insight-its interpretive flexibility-appears useful in addressing complex problems faced by review boards. Hence, a key function of insight is to bridge between legal and clinical discourses. Insight is also a convenient means to avoid complicated debates regarding the person&amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s credibility. By analysing insight in Victoria, we hope to contribute to better theoretical understanding of decision-making patterns in mental health law in general.