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information for practice August 2008 archives

August 29, 2008

The mission of NIMH is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery and cure. For the Institute to continue fulfilling this vital public health mission, it must foster innovative thinking and ensure that a full array of novel scientific perspectives are used to further discovery in the evolving science of brain, behavior, and experience. In this way, breakthroughs in science can become breakthroughs for all people with mental illnesses. In support of this mission, NIMH will generate research and promote research training to fulfill the following four objectives:
- Promote discovery in the brain and behavioral sciences to fuel research on the causes of mental disorders
- Chart mental illness trajectories to determine when, where, and how to intervene
- Develop new and better interventions that incorporate the diverse needs and circumstances of people with mental illnesses
- Strengthen the public health impact of NIMH-supported research

The aim of this report has been to examine lessons learned around the contribution of voluntary and statutory social care services in the coordination and provision of psychosocial support following an emergency or major incident. The report is particularly interested in unpicking lessons learned from previous incidents as recounted in the research literature and through case study interviews.

This report examines participatory research conducted with women in poverty living in Birmingham, Cardiff and London. The project aimed to build their political capacity so that they could take their collective knowledge and experience, present it as policy proposals to policy-makers and actively help to produce policy change.

All States, the District of Columbia, Guam, and Puerto Rico have statutes or regulations requiring background investigations of prospective foster and adoptive parents and all adults residing in their households. In most States, the background investigation includes a check of Federal and State criminal records. Many States also require checks of child abuse and neglect registries. States may deny approval of a foster care license or adoption application if any adult in the household has been convicted of certain crimes, such as sexual abuse of a minor.

Nationally and statewide, children in the foster care system are more likely to have significant health concerns that can affect their ability to become healthy adults. The Northwest Foster Care Alumni Study, conducted by the Casey Foundation, found that young adults who spent time in foster care were disproportionately more likely than others their age to have disabling health conditions, particularly mental illness. In addition, children in foster placement experienced significant economic disadvantages, including household incomes beneath the poverty level, episodes of homelessness and a lack of health insurance. An additional challenge is that children in foster care may face changing placements – making it more difficult to access providers and achieve continuity of care.

The various ways that parents shape their children’s development have been a regular source of theorising by scientists, philosophers and, centre stage, by parents themselves. Within the scientifi c perspective, much of the empirical work linking parental behaviour to developmental outcomes in children has been produced by those working in psychology, sociology and criminology. But other disciplines have contributed both theories and methods including historians, anthropologists and biological sciences. For example, fi ndings from ethology have demonstrated the biological basis and evolutionary signifi cance of the child’s attachment to the parent, while research in physiology, endocrinology and genetics has influenced considerably our understanding of parenting and its effects on offspring.

August 28, 2008

Presents data from the 2005 and 2006 Survey on Sexual Violence, an administrative records collection of incidents required under the Prison Rape Elimination Act of 2003 (Public Law 108-79) of youth-on-youth and staff-on-youth sexual violence reported to juvenile correctional authorities. The report provides counts of sexual violence, by type, for juvenile correctional facilities. The report also provides an in-depth analysis of substantiated incidents, including where the incidents occur, time of day, number and characteristics of victims and perpetrators, nature of the injuries, impact on the victims and sanctions imposed on the perpetrators. The appendix tables include counts of sexual violence, by type, for all state systems, and all sampled locally or privately operated facilities.

There is evidence that the range of developments since 1995 in all services has achieved some notable improvements in all education, social care and health services, particularly the requirement on Local Authorities and Primary Care Trusts to produce a co-ordinated Child and Adolescent Mental Health Strategy. That said, comprehensive improvement in access to services for all children and consistency of provision across the full range of services has not yet been achieved. This is the case from health promotion and prevention work in early years settings, schools and the Child Health Promotion Programme delivered by health visitors services, through to early intervention and specialist services for children with established and severe problems.

The burden of IPV on racial and ethnic minorities is not well documented. Some population-based studies have demonstrated few differences in the prevalence of IPV among these persons (5), yet other studies find substantially greater violence among racial and ethnic minorities. For example, the IPV prevalence rate for whites, African Americans, and Hispanics has been demonstrated to be 11%, 25%, and 25%, respectively (6). Likewise, results from the 1985 National Family Violence Survey show higher rates of partner violence among African Americans and Hispanics as compared with rates among whites, although those differences can be largely attributed to economic differences between racial/ethnic groups.

Despite the efforts of the child protection system, child maltreatment fatalities remain a serious problem. Although the untimely deaths of children due to illness and accidents have been closely monitored, deaths that result from physical assault or severe neglect can be more difficult to track because the perpetrators, usually parents, are less likely to be forthcoming about the circumstances. Intervention strategies targeted at solving this problem face complex challenges.

In the last few years, the everyday word ‘resilience’ has captured the attention and imagination of an increasing number of academics and professionals. Resilience has positive connotations and entails understanding and seeking out good outcomes for individuals or families in circumstances where problems were to be expected. Compared with the traditional study of child development, which has tended to portray ‘normal’ and ‘abnormal’ patterns, a resilience approach offers a more differentiated account. In professional practice, resilience means looking for strengths and opportunities to build on, rather than (or alongside) problems, deficits or psychopathology to be remedied or treated.

August 27, 2008

The National Child Measurement Programme (NCMP) is one element of the Government’s work programme on childhood obesity, and is operated jointly by the Department of Health (DH) and the Department for Children, Schools and Families (DCSF). The NCMP was established in 2005. Every year, as part of the NCMP, children in Reception and Year 6 are weighed and measured during the school year to inform local planning and delivery of services for children; and gather population-level surveillance data to allow analysis of trends in growth patterns and obesity.

This research report presents findings from a qualitative study specifically designed to explore the effects of benefit sanctions on lone parents' employment decisions and moves into employment. Forty lone parents who had been referred for a sanction following non-attendance at a Work Focused Interview (WFI) were interviewed in depth. Focus groups were also carried out with Jobcentre Plus staff.

It may shock you to know that one out of every eleven teens reports being hit or physically hurt by a boyfriend or girlfriend in the past twelve months. But why is that, and how can we change it? In "Break The Silence: Stop the Violence," parents talk with teens about developing healthy, respectful relationships before they start dating.

What’s so special about Indians and why do they have their own law?
This is a question often heard in the halls of public child welfare agencies. Many child welfare practitioners and policy makers believe that since all children are entitled to permanency and safety, a universal approach to providing these should suffice. If American Indians have their own child welfare law and standards, why are there not laws specific to other cultural groups?
A reasonable argument could be made that good practice should include knowledge of each family’s ethnic heritage, culture and nationality. What makes American Indians different from other minority groups is a unique political status.

This Guide is for mothers who have experienced abuse and whose children are in supervised visitation programs. It will tell you basic information about how supervised visitation programs work and how you can prepare yourself and your children for the experience. If you are afraid of your children’s father or were abused by him, then the information in this Guide will be particularly helpful. If your children are in a visitation program, then you’ve already taken important steps for you and your children to be safe and to build new lives. Even if the court case didn’t end the way you wanted it to, you’ve already accomplished a lot. You might feel relieved, mad, hopeful, sad, scared, or just plain tired out. Whatever your experience, there are people who understand what you’re going through and who care about you and your children.

This document presents statistics collected by the Child Support Agency on tracing non-resident parents, working out how much maintenance they should pay and collecting and enforcing payments.

August 26, 2008

This white paper explores how kinship care may be used as a strategy for (1) preventing children from entering the formal foster care system, (2) reducing the number of children already in the foster care system, and (3) achieving permanency outcomes for a greater number of children. Permanency is defined as one of four ways of finding a permanent home for a foster child: through adoption, legal guardianship, reunification, or placement with a fit and willing relative. This paper first looks at what kinship care is and explores the current composition of kinship care in the United States. We then explore research findings on kinship care, identifying both the positive outcomes associated with kinship care as well as areas in which research has raised concerns. Next, we look at current federal and state programs, policies, legislation, and services available to kinship caregivers and kinship families. Finally, based on the issues discussed, we provide policy recommendations to provide and improve kinship care as a reduction and permanency strategy.

Adolescence is a period of accelerated growth and change that bridges the complex transition from childhood to adulthood. The second decade of life is often a turbulent period in which adolescents experience hormonal changes, physical maturation, and, frequently, opportunities to engage in risk behaviors. The patterns of behavior they adopt may have long-term consequences for their health and quality of life. Because of the rapid physical, cognitive, and emotional developments that take place during this age period, adolescence is also a time when many health problems may first emerge. Moreover, adolescents also experience special vulnerabilities, health concerns, and barriers to accessing health care. . . . This report is divided into sections on population characteristics, health status, violence and victimization, reproductive health, risk behaviors, and health care access and utilization. The 40 figures and accompanying text are followed by technical notes and data tables for each figure. Data tables include estimates in the figures plus standard errors when available, and, for some charts, additional related data are presented.

This updated reference library contains resources with the latest data on health insurance coverage in the U.S. and various health reform proposals at the national and state levels. The library also links to analyses of issues and policies involving the uninsured, such as tax credits and expansions of public programs.

Research and practice over sixty years demonstrates the harmful effects of institutionalisation upon children. The purpose of this document is to assist policy makers, practitioners and other concerned individuals to transform systems of institutional care into those based on family and community support. All countries have to make arrangements for those children who, for whatever reason cannot live with their parents, either temporarily or indefinitely. This is achieved by providing children three main types of substitute care. These are fostering and guardianship (the latter is usually provided by relatives), residential care and adoption. Most countries have used institutional care for children at some time. Institutions are often established with good intentions, in the belief that this is the best way to look after children. However, evidence demonstrates that family and community based forms of care are more likely to meet the needs of children. Experience in de-institutionalisation in a number of countries suggests that this process is beneficial to children, families, communities and governments.

In Montana there are more than 6,000 grandparents raising grandchildren. Most grandparents become involved due to a family crisis. This guide answers many of the common questions grandparents and other relative caregivers have when they are faced with parenting a second time around.

These reports describe the work done by four task forces in charge of developing a new carers' strategy.

August 25, 2008

This publication outlines the content of the expression of interest in becoming a national skills academy for social care that was submitted to the Learning and Skills Council. It gives details of the proposed programmes, structure and way of working together with an updated timetable.

With grim economic news coming from many directions, it's easy to get discouraged about our ability to repair the damage of years of failed economic policies. And yet, there are pragmatic solutions to our biggest challenges, including ways to restore health care and retirement security, to create family-supporting jobs, and to reestablish a leadership role in the global economy. Collaborating with some of the nation's top progressive thinkers, EPI researchers have been exploring and refining solutions for the better part of two years. Now, just in time for national debates on economic direction, EPI has compiled the best of these proposals into a small, easy-to-read Policy Handbook called A Plan to Revive the American Economy.

In this narrated slide tutorial, Diane Rowland, Sc.D., executive vice president, Kaiser Family Foundation, and executive director, Kaiser Commission on Medicaid and the Uninsured, discusses health coverage for the uninsured, a significant policy issue in the upcoming 2008 election. The tutorial examines the characteristics of the uninsured population, the impact that lacking coverage has on health and health care access, and approaches for extending coverage to the uninsured.

Open adoption is designed to be a child-centered arrangement based upon the premise that humans need genetic continuity to attain a healthy identity. Open adoption benefits children by providing a lifelong, authentic relationship and a genuine connection to their lineal heritage, ongoing answers to questions, and healing for the losses that permeate adoption. Open adoption benefits birthparents because the grieving process that follows all adoption need not be complicated by having to live with the ambiguity of not knowing what happened to their children. Adoptive parents feel parental entitlement in open adoption and have access to the continuing genetic, medical and family information needed to raise the child.

In this session, teams from three states will describe the promising strategies they have used to improve recruitment and retention of child welfare staff. All of these sites have implemented innovative initiatives that have had a positive impact on the child welfare workforce. They have addressed the array of issues that are critical to retaining staff – targeted and realistic recruitment and screening, strengthening supervision, leadership training, mentoring and organizational development. This session will include time for discussion, during which the other grantees and other agencies can share their experience and additional approaches that have been effective.

The project supports the Children’s Bureau in training State Review Teams on procedures related to the Child and Family Services Reviews (CFSRs).

In 2005, the U.S. Department of Health and Human Services reported that 24,407 foster youth exited care through “emancipation.” In other words, youth who had been removed from their families and communities—primarily due to allegations of maltreatment or child behavior problems—left care by virtue of their age, not because they had achieved a specific permanency outcome such as reunification, adoption, or guardianship. When the state fails to connect a youth to a permanent legal family, youth struggle to create their own family or support network to meet legal, emotional, psychological, and cultural needs. Many youth who age out of foster care will return to live with their birth families. If the circumstances of their families of origin have not changed, however, it is unlikely that the family will be prepared to provide the supports youth need to successfully transition to adulthood.

August 22, 2008

Burnout is not a single event but a process in which everyday stresses and anxieties that are not addressed gradually undermine the carer’s mental and physical health, so that eventually caregiving and personal relationships suffer. Burnout is the fi nal stage in the stress process when everything falls apart. As a medical condition, burnout has no clear defi nition, but as a psychological condition it has been well defi ned1 and is increasingly recognized by people in the caring professions. Burnout has long been identifi ed as a crucial issue in HIV care and support; yet there is relatively little known about what measures can be taken to prevent or mitigate it. This document looks at strategies to lessen the risk of carer burnout. It briefly reviews the approach developed and used by one faith-based organization to care for its staff and volunteers who work as carers in the community and also with the families of those living with HIV. The organization is guided by its beliefs but many of their approaches and lessons learnt can be used by secular nongovernmental organizations.

The findings presented in this issue brief speak to key issues HDs and CBOs face in developing and implementing effective responses to the HIV epidemic among BMSM. The focus was on obtaining perceptions and experiences of staff within HDs and CBOs and on giving this often overlooked but extremely important group of stakeholders and on-theground responders a “voice.” The findings presented allowHD and CBO staff and practitioners, community members and leaders, and the Black community as whole to have a better understanding of important issues that must be addressed in order to effectively respond to the HIV crisis among BMSM.

Monitoring the Future (MTF) is a long-term study of American adolescents, college students, and adults through age 45. The study, ongoing on an annual basis since its inception in 1975, is conducted by the University of Michigan’s Institute for Social Research and is supported under a series of investigatorinitiated, competing research grants from the National Institute on Drug Abuse. The need for a study such as MTF is evident. Substance use by American young people has proven to be a rapidly changing phenomenon, requiring frequent assessments and reassessments. Since the mid-1960s, when illicit drug use burgeoned in the normal youth population, it has remained a major concern for the nation. Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. How vigorously the nation responds to teenage substance use, how accurately it identifies the substance abuse problems that are emerging, and how well it comes to understand the effectiveness of the many policy and intervention efforts largely depend on the ongoing collection of valid and reliable data.

In 2006, for the first time in recent history, the total number of annual deaths among children under the age of five fell below 10 million, to 9.7 million. This represents a 60 per cent drop in the rate of child mortality since 1960. However, there is no room for complacency. The loss of 9.7 million young lives each year is unacceptable, especially when many of these deaths are preventable. And despite progress, the world is not yet on track to achieve the Millennium Development Goal target of a two-thirds reduction in the rate of child mortality by 2015.

Scotland's New Ethnicity Classification for Scottish Official Statistics and Recommended for Scotland's 2011 Census . . . . The classification was developed with the help of wide consultation and research (including question testing) to ensure that it is based on sound evidence. Most evidence is qualitative rather than quantitative.

August 21, 2008

In order to measure the outcomes and the impact that housing support services have for service users, in 2006 the then Scottish Executive commissioned research to review existing models to assess outcomes. This review recommended that the distance travelled model developed by City of Edinburgh Council would be suitable for application more widely. After some refinement it was decided to pilot the Supporting People (Housing Support) Outcomes Framework and to evaluate that pilot. The evaluation was undertaken by Craigforth.

We count the number of uninsured children at 8.7 million for 2006, the latest figure available from the Census Bureau. This applies to children under age 18. There were slightly more than 9 million uninsured children under age 19 in 2006. Other analysts, also using Census data, estimate more than 9 million children are without coverage. Regardless of the counting method used, the United States has far too many uninsured children and action is required soon at the federal and state levels to help them gain health coverage.

Today, the HIV/AIDS epidemic continues to disproportionately impact African American men and women across the United States. Although African American communities make up less
than 13 percent of the U.S. population, African Americans accounted for nearly 50 percent of all HIV/AIDS cases diagnosed in 2006. African American women comprise only 12 percent of the female population in the United States, yet they accounted for 64 percent of women
living with HIV/AIDS at the end of 2006, as illustrated in Table 1. The rate of AIDS diagnosis for African American women was 20 times the rate of White women by the end of 2006.

As the number of Americans without health insurance continues to grow, and, year after year, the cost of health care rises faster than workers’ wages, elected officials are taking a renewed interest in changing the nation’s health care system. However, discussions of health reform typically focus on the roles that state and federal governments play in financing coverage, frequently leaving out the stakeholders on the very front lines of the issue—cities and their leaders.

The use of contraception varies widely around the world, both in terms of total use and the types of methods used. In many countries, women and couples rely largely on one or two contraceptive methods, because of government policies, the way that national family planning programs have evolved, and cultural or social preferences . . . Understanding why people prefer some contraceptive methods over others can be useful for strengthening family planning programs. Having a broad range of methods available is a key element of the quality of family planning services and raises the overall level of contraceptive use. Family planning programs ideally should offer choices of methods for all stages of people’s reproductive lives, so that they can have the number of children they want, when they want them.

Statistics on Private Fostering arrangements in England: Year ending 31 March 2008 and include data from England. The SFR covers figures on children cared for and accommodated in private fostering arrangements. The latest statistics report the year ending 31 March 2008 and update those previously released on 8 November 2007.

August 20, 2008

People with anxiety disorders feel extremely fearful and unsure. Most people feel anxious about something for a short time now and again, but people with anxiety disorders feel this way most of the time. Their fears and worries make it hard for them to do everyday tasks. About 18% of American adults have anxiety disorders. Children also may have them. Treatment is available for people with anxiety disorders. Researchers are also looking for new treatments that will help relieve symptoms. This booklet is about one kind of anxiety disorder called panic disorder. For information about other kinds of anxiety disorders, please see the end of this booklet.

The shortage of diverse, bilingual and culturally competent mental health personnel able to staff California’s community mental health services is widely recognized. This policy brief provides an overview of findings from focus groups and key informant interviews with California social work educators, managers, practitioners and students. Key themes emerging from the data in the areas of recruitment and retention of a culturally diverse mental health workforce are reviewed and recommendations for strategies for improvements in these areas are highlighted.

Many children and youth in the child welfare system and those at risk of abuse and neglect have a variety of physical, mental, social, emotional, educational, and developmental needs. Child welfare professionals have worked with their counterparts in other agencies for years to piece together the services available for these children and youth and their families. Systems of care is a service delivery approach that builds partnerships to create a broad, integrated process for meeting families' multiple needs. This approach is based on the principles of interagency collaboration; individualized, strengths-based care practices; cultural competence; community-based services; accountability; and full participation of families and youth at all levels of the system. A centralized focus of systems of care is building the infrastructure needed to result in positive outcomes for children, youth, and families.

The Mental Capacity Act 2005 created the Independent Mental Capacity Advocate (IMCA) service as a safeguard for people without the capacity to make certain important decisions. The Act also introduced a legal duty on NHS and social care staff to refer eligible people to the IMCA service. The IMCA service started on 1st April 2007 and this is the report on its first year’s work.

Low-wage jobs can be unstable, leaving families struggling to cope with employment gaps and financial emergencies that can strike without warning. About four in five low-income families are "asset poor," lacking enough liquid savings to live for three months at the federal poverty level without earnings. In this essay, McKernan and Ratcliffe suggest a cluster of policies that would improve financial markets and savings opportunities for low-income families across the life cycle.

When Traditional Asset Building Is Not Enough by Jessica Gordon Nembhard

Comment on “Enabling Families to Weather Emergencies and Develop" by Edward N. Wolff

Enabling Families to Weather Emergencies and Develop: Summary by Signe-Mary McKernan and Caroline Ratcliffe

There is a considerable body of existing research which examines the characteristics that are
associated with young people’s involvement in anti-social and other problem behaviours. These
characteristics are often referred to as ‘risk factors’. There is a corresponding and growing body of research which provides evidence of characteristics which can counteract these risk factors; these are commonly referred to as ‘protective’ or ‘resilience’ factors. The two chapters in this volume present the findings of two studies carried out on a sample from the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective birth cohort study, at two key ages – 8½ and 10½ years.

Disabled people and others have long argued that it does not make sense to spend money on services which limit people’s choices and their opportunities to live ordinary lives. The alternative, personalisation, aims to support people to make choices and to be included. It goes under many different names, including ‘independent living’, ‘person-centred support’ and ‘self-directed support’. They are all based on the same principle: if disabled people are to participate and contribute as equal citizens they must have choice and control over the support they need to go about their daily lives. This is a matter of social justice. It is an issue therefore which is fundamental to the kind of society we are, and the kind of society we want to be.

August 19, 2008

Summary: This paper attempts to quantify the impact of the HIV/AIDS epidemic on social capital with cross-country data. Using data from the World Values Survey, the authors estimate reduced-form regressions of the main determinants of social capital controlling for HIV prevalence, institutional quality, social distance, and economic indicators. The results obtained indicate that HIV prevalence affects social capital negatively. The empirical estimates suggest that a one standard deviation increase in HIV prevalence will lead to a decline of at least 1 percent in trust, controlling for other determinants of social capital. Moving from a country with a relatively low level of HIV prevalence, such as Estonia, to a country with a relatively high level, such as Uganda, there is a more than 11 percent point decline in social capital. These results are robust in a number of dimensions and highlight the empirical importance of an additional mechanism through which HIV/AIDS hinders the development process.

This research draws on original material gathered from six UK sites with different experiences of migration and post-industrial transformations, and comprising different populations of long-term residents and new immigrants. Between them, they illustrate various contexts of social cohesion in England, Northern Ireland and Scotland.

Disability and Health in the United States, 2001–2005 examines health-related differences between disabled and nondisabled noninstitutionalized adults aged 18 years and over using data from the National Health Interview Survey (NHIS). The basic actions difficulty measure of disability used in this report identifies noninstitutionalized adults with respondent-reported difficulties in movement or sensory, emotional, or cognitive functioning that is associated with some health problem. The complex activity limitation measure of disability identifies noninstitutionalized adults with respondent-reported limitations in self-care tasks (activities of daily living (ADL) or instrumental activities of daily living (IADL)) work limitations, or limitations or restrictions in the ability to participate fully in social activities.

The Early Years Foundation Stage (EYFS) is a new framework for learning, development and care for children from birth to five. This leaflet is aimed at parents and provides an introduction to the EYFS, including the emphasis on play, how it will affect providers and how it will be implemented.

Early intervention has been around since the mid 1970’s. Why has there been so much attention in the last ten years? Because there has been an explosion of research into child development and its relation to brain development. It was once thought that children were highly adaptable and too immature to be impacted by emotional truama. We now know that this is not true. Ninety percent of brain growth takes place by the time the child is three, very young children can and do show signs of depression, and traumatic stress can cause long lasting changes to the developing brain. Young children are at the greatest risk for maltreatment, however as a society we often intervene later with more expensive forms of intervention – residential facilities, hospitals, foster homes and if all else fails prisons.

Only 37 percent of adults in low-income working families had employer-sponsored health insurance and 42 percent had no coverage. Health care costs are also rapidly rising out of reach for even middle-income Americans. In this essay, Perry and Blumberg propose comprehensive reform that ensures coverage for everyone at every income level, while still encouraging work. Their proposals include state purchasing pools, individual mandates, and strategies for reducing health care costs.

Comment on "Making Work Pay II" by Jack Meyer

Comment on "Making Work Pay II" by Len Nichols

Health Insurance for Low-Income Working Families—Summary

Parents in low-wage jobs lack both the time and resources needed to fill their dual roles of worker and parent. In this essay, the authors outline a “family security” approach that would help parents fulfill their roles effectively. They suggest policies for enabling parents to improve prospects for their children and combine work with child rearing. Among the recommendations are flexible and paid leave policies for working parents, guaranteed child care, and expansion of the Early Head program.

Putting Children’s Welfare First by Wade F. Horn

Policies to Promote Family Security by Jane Waldfogel

Supporting Parents' Employment and Children's Development—Summary

This analysis by the National Alliance on Mental Illness (NAMI) and the National Council for Community Behavioral Healthcare (National Council) examines benefits for mental illness and substance use disorders for adults in state plans that cover the uninsured. The paper, which is based on research on 18 states’ initiatives and proposals, includes important findings on the following topics:
• The scope of the problem
• The history of financing for mental health and substance use treatment
• Analysis of state benefit packages
• Issues for future exploration
• Implications for the future

August 18, 2008

This code of practice aims to improve the accessibility of air travel to disabled people. It is aimed at all those involved in air travel but is not intended as a guide for disabled people.

Every parent eventually faces the decision to leave their child home alone for the first time. Whether they are just running to the store for a few minutes or working during after-school hours, parents need to be sure their children have the skills and maturity to handle the situation safely. Being trusted to stay home alone can be a positive experience for a child who is mature and well prepared. It can boost the child's confidence and promote independence and responsibility. However, children face real risks when left unsupervised. Those risks, as well as a child's ability to deal with challenges, must be considered. This factsheet provides some tips to help parents and caregivers when making this important decision.

One-third of America's families with children are low income, meaning their incomes fall below twice the federal poverty level. Although four in five of these families work, many don't bring home enough to cover the everyday costs of living. In this essay, Acs and Turner outline their proposals to enhance low-income families' purchasing power and reduce unusually high housing costs through a package of reforms and policy initiatives that tackle both the income side and expenditure side of family budgets.

Review of “Making Work Pay Enough” by Jared Bernstein

Using the Housing We Have by John C Weicher

Making Work Pay Enough—Summary

The statistics can feel overwhelming. In 2006, an estimated 905,000 children in the United States were found to be victims of child abuse and neglect. However, child abuse and neglect can be prevented. State and local governments, community organizations, and private citizens take action every day to protect children. You can help. Research has shown that parents and caregivers who have support—from family, friends, neighbors, and their communities—are more likely to provide safe and healthy homes for their children. When parents lack this support or feel isolated, on the other hand, they may be more likely to make poor decisions that can lead to neglect or abuse.

GAO estimates that at least 2.4 million young adults aged 18 through 26—or 6.5 percent of the non-institutionalized young adults in that age range— had a serious mental illness in 2006, and they had lower levels of education on average than other young adults. The actual number is likely to be higher than 2.4 million because homeless, institutionalized, and incarcerated persons were not included in this estimate—groups with potentially high rates of mental illness. Among those with serious mental illness, nearly 90 percent had more than one mental disorder, and they had significantly lower rates of high school graduation and postsecondary education. GAO also found that about 186,000 young adults received SSA disability benefits in 2006 because of a mental illness that prevented them from engaging in substantial, gainful activity.

This study examined parenting during early and middle childhood within different social and cultural groups in Britain, using a ‘parenting score’ derived from different measurements of parents’ relationships with their children. The study was based on parents’ reports of attitudes, feelings and behaviour recorded in response to specific questions relating to parenting. The study also assessed changes in parenting across time.

This business plan for the new Pension, Disability and Carers Service outlines the service’s plans and objectives for the period from April 2008 to March 2009. It summarises the progress the agency intends to make as well as its targets and objectives for the year.

August 17, 2008

The decision to exclude a pupil is a serious one. It will usually be the final step in a process for dealing with disciplinary offences following a wide range of strategies that have been tried without success. Headteachers, teachers in charge of a Pupil Referral Unit (PRU), governing bodies, local authorities (LAs) and Independent Appeal Panels (IAPs) must by law have regard to this guidance when making decisions on exclusions and administering the exclusion procedure. This means that, whilst the guidance does not have the force of statute, there is an expectation that it will be followed unless there is good reason to depart from it.

August 15, 2008

This study was commissioned by the Office of the Minister for Children with the overall aim of examining the views of service users on the child protection services, including their perception of being included in decision-making and having their views taken seriously. Child protection services were defined as those services that provide an integrated response to reported child protection concerns, principally the Child and Family Services of the Health Service Executive (HSE). Service users in this context were defined as children, young people, caregivers and extended family members who have been involved with child protection services through their own initiative or who had been referred by others on their behalf.

The New Targeting Social Need (New TSN) strategy aimed to tackle social need and social exclusion by targeting efforts and available resources to people, groups and areas in greatest objective social need. One of its actions was to develop a system to monitor New TSN progress towards reducing inequalities between disadvantaged areas and the Northern Ireland average, and between rural and non-rural areas. The Northern Ireland Health and Social Care Inequalities Monitoring System (NIHSCIMS)2 was established by the Department of Health, Social Services and Public Safety and comprises indicators which are monitored over time to assess area differences in mortality, morbidity, utilisation and access to health and social care
services.

Affordable and comprehensive insurance coverage for mental health treatment is a critical health and economic issue. Persons with serious mental illnesses die approximately 25 years younger than the general population, with male consumers likely to die at about 53 years and female consumers at 59 years. The chronic physical disabilities that contribute to these premature death rates include obesity, high blood pressure, diabetes, stroke, chronic heart disease and heart attack. Conversely, individuals with chronic medical conditions (e.g., diabetes, heart disease) are more likely to have a mental illness such as depression.

We wanted to know what kind of self-help or self-improvement activities, if any, Hispanics ages 40 and older had done in the past two years. We found that a majority of Hispanics have tried to eat a healthier diet (78%) or tried to exercise regularly (69%) for self-improvement purposes. Approximately one-third have sought spiritual advice (35%) or used self-improvement books, tapes, or DVDs (30%) for the purpose of selfhelp or self-improvement. One-quarter of our respondents said that they have attended self-help seminars.

The State Fact Sheets provide descriptive information on the condition of vulnerable children in all fifty states and the District of Columbia, using indicators of child protection, health, child care, education, and income support.

In a rapidly changing world it is vital that nursing continues to command the confidence and trust of patients. For the growing numbers of older people admitted to our busy hospital wards this is determined by the whole care experience; yet we constantly hear of deficiencies in caring. Confidence in caring developed in response to this. It emerged from a national project with patients, relatives and staff in several hospitals across the country; it aimed to help nurses meet the many challenges of caring today and put the values and ideals on which nursing is founded, into practice. Confidence in caring offers a shared language and shared understanding of what caring means for older people and describes what caring looks like so that it can be observed, improved and rewarded.

Rural communities face significant challenges, including higher poverty and fewer resources. In addition, in the last several years substance abuse, particularly the manufacture and use of methamphetamines, has dramatically increased in rural America. At the same time, the child welfare infrastructure and the supporting social service, health, and mental health services are severely lacking. Decisions tend to be made in urban government centers, often without consideration of rural circumstances. Some states have centralized their intake processes, some have provided contracts and financial incentives that are cost-efficient when addressing large concentrated populations, but no longer competitive with smaller numbers of children and families with a larger geographic distribution. As states have had to reduce the size of their social service supports, these reductions appear to have disproportionately impacted rural communities. These communities have fewer foundations, a smaller economic base, smaller city and county governments, and fewer state jobs—both in real numbers and proportionately.

These directions explain the changes to the Mental Health Act that come into force in November 2008.

Today more American children are growing up in homes without their biological father than at any other point in American history. Trends such as divorce and remarriage, as well as more children being born outside of marriage, result in a diminishing role of fathers in the daily lives of their children. Engaging fathers in the lives of their children becomes an even greater challenge when his children are involved in the public child welfare system. This is especially true in cases where the child has been removed from the home and placed in non-relative or stranger’s care. Reunifying children with their birth families, as quickly as possible, without jeopardizing the children’s safety, is the first priority. However, identifying family resources, especially non-resident fathers and paternal relatives, has been challenging for the child welfare system.

The following section presents some of the highlights from the All-Ireland and North/South components that are available in the interim release (see Table 1). Highlights relate to:
3.1 Smoking prevalence
3.2 Poor quality housing
3.3 Effective vaccination service
3.4 Suicide
3.5 North-South comparisons
3.6 Rural-urban comparisons
3.7 Deprivation.

August 14, 2008

This report summarises the progress the Department has made in promoting gender equality in the first 12 months of the scheme by providing information and evidence gathered, and by identifying the next steps. . . . Our Gender Equality Scheme set out three priority areas for action – economic engagement, civic engagement, and supporting vulnerable women

Mental health can be influenced by a number of factors or determinants of health, including individual, physical, social, cultural and socio-economic characteristics. These and other factors can influence mental health in complex ways that are not always well understood. By focusing on specific groups within the population we can further explore these links. Such groups include youth and adults at risk of committing delinquent or criminal acts and those with a mental illness who are involved with Canada’s criminal justice system. Improving the Health of Canadians: Mental Health, Delinquency and Criminal Activity is the second of three reports on mental health that CPHI will release over an 18-month period. The first report in the series, Improving the Health of Canadians: Mental Health and Homelessness, was released in August 2007.

Historically, women have been neglected in HIV/AIDS research, treatment, care, and prevention efforts in the U.S. and around the world. This lack of attention to women’s health issues, combined with biological differences in the ways HIV affects men and women, social and economic inequities, and environmental factors, has led to a dramatic rise in the number of women living with HIV, as well as an increase in AIDS-related deaths among women. These factors, along with research and prevention efforts that focused on men only, have left many women unaware that they are vulnerable to the disease. As a result, the proportion of women in the U.S. living with HIV/AIDS has more than tripled since the beginning of the epidemic. In 2005, women represented 26 percent of HIV/AIDS diagnoses, compared with 8 percent in 1985.

- At 31 March 2008, 1,330 children were reported as being cared for and accommodated in private fostering arrangents in England. This compares with 1,250 children reported at 31 March 2007 and 980 at 31 March 2006.
- 1,560 new private fostering arrangements began during the year to 31 March 2008, and 1,170 private fostering arrangements ended during the year.
- Of the number of cases where action was taken in accordance with requirements for carrying out visits, 78% were subject to action within 7 working days; in 2007 this figure was 69%.

All States, the District of Columbia, Guam, and Puerto Rico have statutes or regulations requiring background investigations of prospective foster and adoptive parents and all adults residing in their households. In most States, the background investigation includes a check of Federal and State criminal records.1 Many States also require checks of child abuse and neglect registries. States may deny approval of a foster care license or adoption application if any adult in the household has been convicted of certain crimes, such as sexual abuse of a minor.

The following represent minimally acceptable standards for the supervision of children. These guidelines have been developed by social work professionals in collaboration with the community. REMEMBER, they are guidelines only.

August 13, 2008

Currently, development research is mainly assessed in terms of its contribution to meeting the Millennium Development Goals, in particular MDG1: to halve absolute poverty by 2015. However, achieving the first MDG would still leave some 800 million people living in absolute poverty and deprivation – many of whom will be chronically poor. Their lives are extremely difficult and, being marginalised, their story is rarely told. This report tries to tell parts of their story. It does so through the lives of seven chronically poor people: Maymana, Mofizul, Bakyt, Vuyiswa, Txab, Moses and Angel. Chronic poverty is a varied and complex phenomenon, but at its root is powerlessness. Poor people expend enormous energy in trying to do better for themselves and for their children. But with few assets, little education, and chronic ill health, their struggle is often futile. The CPRC aims to bring these issues to the world’s attention, and to set out ways to end chronic poverty.

This report is a summary of the EOEA-IGSW Online Certificate in Aging Program, a collaboration between the Executive Office of Elder Affairs (EOEA) and the Institute for Geriatric
Social Work (IGSW) at Boston University. A total of 269 case managers at 27 aging service access points (ASAPs) across Massachusetts enrolled in the program.The program consists of five courses developed by IGSW, including: Basic Issues in Aging, Geriatric Assessment, Mental Health and Aging Issues, Substance Abuse among Older Adults, and a Guide to the Aging Network.

There is no doubt that our population is aging. In fewer than 25 years, one‐in‐five Americans will be aged 65 years or older, and with the increasing uncertainty of the public assistance programs on which many older adults rely, changing family structures, and as medical advances extend the lives of those with chronic conditions, older adults will come into contact with nonprofit social service agencies in greater numbers than ever before. Social and human service nonprofit agencies, many of which have traditionally focused on youth and nuclear families, must begin preparing to address the implications of an aging society.

Reports findings from the 2006 National Youth Gang Survey. Data on the number of gangs, gang members, and gang-related homicides in larger cities, suburban counties, smaller cities, and rural counties are provided to accurately reflect youth gang activity in the United States. Based on survey results, it is estimated that nearly 3,400 jurisdictions across the United States experienced gang activity in 2006.

The Safe and Timely Interstate Placement of Foster Children Act of 2006 (Safe and Timely Act) was adopted to amend sections of the Social Security Act.4 The Safe and Timely Act conditions the receipt of federal funding on the timeliness of the completion of out-of-state home study requests. The Program Instructions for the Court Improvement Program (CIP) require that states review their interstate placement system as part of their CIP grant application.5 Thus, in addition to the four categories of assessments previously listed in Section 438(a)(1) of the Social Security Act, state courts that receive the Basic CIP grant are required to assess their role, responsibilities and effectiveness in the interstate placement of children, and must implement strategies to expedite these placements.

Racial disproportionality occurs when the population of children of color in any system including the child welfare system is higher than the population of children of color in the general population.

August 12, 2008

Twenty years after enactment of the Nursing Home Reform Law, concerns over quality in America’s nursing homes persist. The issues are multi-faceted—related to problems such as nurse staffing shortages, inadequate enforcement of standards and reimbursement disincentives. No matter the reason, substandard quality in many nursing homes leaves consumers with a general impression that in their final years of life, nursing homes are not where they want to be. Couple this notion with certain demographic trends and the enormity of the issue is clear: by 2050 one in five people in the US will be 65 or older and 12 million of them will need long-term care. Those over 85, the cohort most likely to need longterm care, will total five percent of the population.

As part of the implementation of the Care Standards Act (2000), the Department of Health introduced the Protection of Vulnerable Adults (POVA) list on 26 July 2004, as a complement to the requirement for the development of local multi-agency adult protection policies and procedures. In 2005, the Department of Health (DH) commissioned and funded Kings College London to undertake a review of the first 100 referrals to the POVA list and their research report was published on the DH website on 26 July 2005. DH also commissioned and funded this second phase of research to provide a more in-depth study aimed at exploring the factors leading to a placement on the POVA list

Together Women began operating between late 2006 and early 2007 at five centres in the North West and Yorkshire & Humberside National Offender Management Service (NOMS) Regions. The project was set up to address the needs of women who had offended to reduce their re-offending, and the needs of women described as being ‘at risk’ of offending to prevent them becoming involved in crime. Together Women was also expected to lead to women being diverted from prosecution and custody. Although the exact range of support varies a little between the five centres, according to local demand and local partnerships, it includes training on issues such as parenting, managing mental health, life skills, thinking skills and addressing offending behaviour. Each centre arranges for service providers to hold surgeries covering a range of issues (such as accessing benefits or housing) but also functions as a drop-in centre where women can access activities such as reading groups and complementary therapies. Where suitable provision exists, Together Women attempts to tap into it; where there is a gap in provision, it commissions another provider or delivers it in-house. In this way Together Women seeks to link up and extend local services without duplicating them. A key element of the Together Women approach is that the level and range of services a woman receives are determined by an assessment of need. The resulting support plan is intended to be holistic. Involving service users in the design and review of such plans is expected to be empowering which is seen as an important step in getting women to take control of their lives.

For more than 40 years, health centers in the United States have delivered comprehensive, high-quality primary health care to patients regardless of their ability to pay. During that time, health center grantees have established a tradition of providing care for people underserved by America’s health care system: the poor, uninsured, and homeless; minorities; migrant and seasonal farmworkers; public housing residents; and people with limited English proficiency. Federal support for entities that would later be called health centers began in 1962 with passage
of the Migrant Health Act, which funded medical and support services for migrant and seasonal farmworkers and their family members. Two years later, the Economic Opportunity Act of 1964 provided Federal funds for two “neighborhood health centers,” which were launched in 1965 by Jack Geiger and Count Gibson, physicians at Tufts University in Boston.

Family, friend, and neighbor (FFN) child care (also referred to as informal care, home-based care, kith and kin care, kin care, relative care, legally unlicensed, and license-exempt care) is growingly recognized as homebased care – in the caregiver’s or child’s home – provided by caregivers who are relatives, friends, neighbors, or babysitters/nannies. While FFN care is typically unlicensed or subject to minimal – if any – regulation, the distinction between FFN care and licensed family child care (FCC) can sometimes be blurred since variation in state or county regulations may mean that care that is regulated in one state may not be regulated in another. Research on FFN care is still in early phases. While studies have not consistently defined FFN caregivers, a growing number of national, state, and multi-site studies indicate the following about the demographics of families that use FFN care and provide this type of care.

A Comprehensive Functional Assessment is a dynamic and ongoing process of gathering, analyzing, comparing, and synthesizing the information from various sources to come to an understanding of family strengths and needs relating to child’s safety, permanency and wellbeing. A good assessment has a direct effect on better outcomes for children. This assessment provides a shared understanding with the family of the child and family’s situation and identifies the change necessary for safe case closure. The family assessment is the foundation of good case planning. Assessing includes understanding the family functioning and family systems, the functional strengths and needs within the domains, and cycle of need including the underlying need. Without identifying correctly the underlying needs and relationship issues, our efforts to help the family cannot be successful.

Protecting the sexual and reproductive health of today’s Central American youth is urgent. El Salvador, Guatemala, Honduras and Nicaragua have the highest rates of adolescent childbearing in all of Latin America. Moreover, current HIV prevalence has surpassed the 1% threshold for a generalized epidemic in Honduras and is nearing that magnitude in El Salvador and Guatemala. Preserving young people’s health is not only important for youth themselves; it is also a vital development priority. This report, based on recent national surveys, presents key patterns and trends in the sexual and reproductive behavior of 15–24‐year‐olds in these four countries, and identifies important gaps and needs.

Medicaid and the State Children’s Health Insurance Program (SCHIP) are important sources of health coverage for children in working families. Currently, 44 states, including the District of Columbia, cover children in families with income up to 200 percent of the federal poverty line ($42,400 per year for a family of four in 2008) or higher.2 The most recent data show that the vast majority of children in Medicaid and SCHIP — 75 percent — are in families with at least one worker.3 Many low-income workers are not offered health insurance through their employers, or coverage for dependents is not available or is too expensive. Thus, Medicaid and SCHIP provide critical help by making health coverage affordable for families whose incomes are insufficient to enable them to purchase health insurance on their own. The methods used to determine whether a child qualifies for coverage, based on his or her family income, vary from state to state. Under longstanding federal law, states must follow certain rules in determining income-eligibility, but they also have considerable flexibility regarding whether they will count or exempt certain types or amounts of income and whether they allow deductions for certain types or amounts of expenses.

The Opening Doors Project: As a judge, lawyer or other child welfare professional do you understand the risk factors common to lesbian, gay, bisexual, transgender and questioning (LGBTQ) youth? These include high suicide rates, substance abuse, health issues, and harassment in foster care and in school. Do you know how a youth’s LGBTQ status affects permanency (including reunification, adoption, guardianship, or placement with a fit and willing relative)?

August 11, 2008

Deciding what sentences are appropriate for women offenders is rightly entirely a matter for the courts but the Government agrees that more must be done to ensure that custody is only used for those women who really need to be there. The Government is keen to encourage greater use of community alternatives for women wherever possible. We are committed to looking specifically at how to tackle women’s offending and addressing the adverse impact of imprisonment on women and their families, particularly their children. The consequence of a mother’s imprisonment for the children makes it all the more important that women offenders are dealt with as far as possible with community sentences. Options will be developed over the coming months to create a deliverable plan of action to achieve this.

This guidance explains the transitional provisions associated with changes to the Mental Health Act that come into force in November 2008.

Social anxiety disorder (SAD) is a serious medical condition that has a severe negative impact on the lives of most of those who have been diagnosed with it. The disorder affects many aspects of daily life including relationships with family and friends and happiness with career or job. SAD has a negative impact on:
- Personal relationships (87%)
- Ability to carry out normal daily activities (75%)
- Level of satisfaction with career or work (73%)

The federal and state governments have long subsidized contraceptive and sterilization services, and to a lesser extent abortion, for low-income Americans. Public funding for contraceptive and related services come from a variety of sources . . . In this report we present the results of a survey of FY2006 public expenditures for family planning client services, family planning education and outreach activities, sterilization services and abortion services. We also compare FY 2006 data for family planning client services with those from a series of prior surveys between FY 1980 and FY 2001.

GAO estimates that at least 2.4 million young adults aged 18 through 26—or 6.5 percent of the non-institutionalized young adults in that age range— had a serious mental illness in 2006, and they had lower levels of education on average than other young adults. The actual number is likely to be higher than 2.4 million because homeless, institutionalized, and incarcerated persons were not included in this estimate—groups with potentially high rates of mental illness. Among those with serious mental illness, nearly 90 percent had more than one mental disorder, and they had significantly lower rates of high school graduation and postsecondary education. GAO also found that about 186,000 young adults received SSA disability benefits in 2006 because of a mental illness that prevented them from engaging in substantial, gainful activity. Young adults with serious mental illness can have difficulty finding services that aid in the transition to adulthood, according to researchers, public officials, and mental health advocates. Because available mental health, employment, and housing services are not always suited for young adults with mental illness, these individuals may not opt to receive these services.

Of the approximately 7.2 million applicants for the low-income subsidy, SSA approved approximately 2.8 million as of March 2008, and SSA has improved some key measures for its subsidy application processes. SSA approved about 570,000 applicants, denied about 403,000 applicants, and determined that no decision was required for about 281,000 applicants in fiscal year 2007. The table below shows that excess income was the primary reason applicants were denied benefits, while many other applicants were denied benefits because their resources exceeded program limits. Further, SSA has collected data and established some goals to monitor its progress in implementing and administering the subsidy benefit.

August 8, 2008

Low-wage jobs are often characterized by uncertainty and unpredictable gaps in employment. A majority of workers in these jobs do not have access to the temporary income of unemployment insurance to tide them over when they suffer a job loss. This summary outlines recommendations for updating the program by extending benefits to more workers through changes in eligibility rules and establishing more uniform periods of benefit receipt.

Unemployment Insurance Is in Desperate Need of Modernization by Howard Rosen

States Will Find Their Own Solutions by Larry Temple

Weathering Job Loss—Summary

In 2004 DH commissioned a three-year research project to evaluate the effects of the policy change in social work education and the move from a 2 year Diploma to a 3 year honours degree as the professional qualification in social work. The work was undertaken by three teams of researchers from Glasgow School of Social Work, Sharpe Research and the Social Care Workforce Research Unit at Kings College. The core research agenda was to evaluate the impact of the new three-year social work degree on the quality and quantity of recruits to the professional social care workforce.

Financial exclusion is the inability, difficulty or reluctance to access appropriate, so-called mainstream, financial services. The reduction of financial exclusion is a priority for the present government because it can lead to social exclusion. This study was a review of current policies and practices aimed at reducing financial exclusion. The financial services covered included money and debt advice, financial capability, banking, affordable credit and insurance.

Meeting the needs of these young women and their partners more effectively will improve the life chances of the young parents and their children, while also helping to meet the national and local targets on early access to maternity care; on reducing infant mortality, smoking and teenage conceptions; and on increasing breastfeeding. This guide makes the case for increased attention to the planning, organisation and delivery of maternity services for teenagers and gives practical suggestions on how to achieve a high quality service that meets their needs.

Welfare programs require people to work, but some low-income adults struggle with major personal challenges that make it hard to find or hold down a job. In this essay, Loprest and Martinson recommend both short term changes to current programs and longer term efforts through a program for competitive federal matching block grants to states. These grants would support efforts to integrate programs that alleviate barriers to work with employment services and to evaluate these initiatives so policymakers can better understand what works.

Comment on "Supporting Work for Low-Income People with Significant Challenges" by Dan Bloom

Comment on "Supporting Work for Low-Income People with Significant Challenges" by Don Winstead

Supporting Work for Low-Income People with Significant Challenges—Summary

Low-wage adult workers have trouble getting and keeping higher-paying jobs. Most lack the basic skills and education needed to move up, but certain kinds of assistance might give some the edge they need to break the pattern. In this essay, Holzer and Martinson recommend competitive federal matching block grants that reward states for developing new advancement systems which are linked to state workforce development structures. They would also require partnerships with employers and training providers, including community colleges.

Comment on “Helping Poor Working Parents Get Ahead” by Lawrence Mead

Comment on “Helping Poor Working Parents Get Ahead” by Evelyn Ganzglass

Helping Poor Working Parents Get Ahead—Summary

This research explores the impact of new migration on receiving communities, in particular on community, integration and cohesion. Based on research carried out in Cardiff and Merthyr Tydfil, it explores the perspectives of both new and settled residents.

August 7, 2008

The U.S. correctional system is facing critical challenges as the number of incarcerated people continues to grow. At the end of 2006, there were nearly 2.26 million inmates in state, federal, and local correctional facilities, a rate of 751 inmates per 100,000 U.S. residents. This is a record high for the U.S. and is the highest incarceration rate in the world. For the first time, more than one in every 100 adults in America is now confined in a jail or prison. Such high rates of incarceration have far-reaching implications for the health and well-being of families, communities, and society at large. The increasing size of the incarcerated population also has serious cost implications for the healthcare infrastructure, particularly since the cost of medical care in the U.S. is now more than seven times higher than it was in 1980.

This working paper provides practical guidance for researchers who are designing studies that randomize groups to measure the impacts of interventions on children. To do so, the paper: (1) provides new empirical information about the values of parameters that influence the precision of impact estimates (intra-class correlations and R-squares); (2) examines the implications of planning group-randomized studies for three-level hierarchical situations, using empirical information obtained by estimating two-level hierarchical models (which under many conditions appears to not be problematic); and (3) assesses the implications of the uncertainty that exists when the design of group-randomized studies is based on estimates of intra-class correlations. Data for the paper come from two studies: the Chicago Literacy Initiative: Making Better Early Readers study (CLIMBERs) and the School Breakfast Pilot Project (SBPP). The analysis sample from CLIMBERs comprised 430 4-year-old children from 47 preschool classrooms in 23 Chicago public schools. The analysis sample from the SBPP study comprised 1,151 third-graders from 233 classrooms in 111 schools in six school districts.

This Findings examines patterns of anti-social and other problem behaviour amongst young children and seeks to identify some of the individual child and family characteristics that are associated with such behaviour. The findings are based on results from the Avon Longitudinal Study of Parents and Children (ALSPAC). This is a large study following a cohort of children born to mothers living in Avon while pregnant in the early 1990s. Findings are based on a sample of 5,757 children (2,834 males, 2,923 females) for whom there was data on antisocial behaviour at both age 81⁄2 and 101⁄2 from the overall ALSPAC sample.

The FCD CWI is a composite measure that makes it possible to analyze national trends in overall child well-being over time. It is based on 28 indicators in seven key areas of well-being beginning in 1975.

This guidance will help local authorities and primary care trusts deliver a programme to provide short breaks for disabled children, a central component of a wider change programme for disabled children’s services.

The Review is focussed on the full spectrum of mental health and psychological well-being for 0-19 year olds and their families. This ranges from the protective factors and activities which help all children and young people to develop resilience and strong psychological well-being, (e.g. health promotion), to intensive specialised therapeutic interventions for those who are experiencing severe mental illness.

This is the Government's response to a consultation on proposed changes to marriage visas and to applications for settlement based on such visas.

This reference guide details the updated key standards for the inspection of adoption, children's homes, fostering services, residential family centres, boarding schools, residential special schools, accommodation of students under 18 by further education colleges and private fostering.

August 6, 2008

Communities in control tells the story of power, influence and control and how people can use existing and new tools to access it. The White Paper looks at who has power, on whose behalf is it exercised, how is it held to account, and how can it can be accessed by everyone in local communities.

This report presents findings of a qualitative research project commissioned by the Department for Work and Pensions (DWP) to investigate the relationship between mental health and employment. The research was conducted during 2007 by the Social Policy Research Unit at the University of York and the Institute for Employment Studies. The study was designed to address a gap in knowledge about the circumstances that lead people to claim Incapacity Benefit because of a mental health condition and what factors contribute to people with mental health conditions returning to work after a period on Incapacity Benefit. The study also explored employers' understanding and experience of dealing with mental health conditions in the workplace.

In 2005–2006, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA), with guidance from the Centers for Medicare & Medicaid Services (CMS), jointly sponsored a study to identify the barriers to, and possible solutions for, reimbursement of mental health services provided in primary care settings. The Federal Action Agenda, emanating from the 2003 report of the President’s New Freedom Commission, “Transforming Mental Health Care in America," includes direct reference to addressing barriers to reimbursement for mental health in primary care. This study, in response to that identified need, was divided into two main efforts to better understand the payment policies and practices that may prohibit or discourage the provision of mental health services in primary care settings.

The focus of the survey is on the 20 core offences that are covered in the most detail. Although all of these core offences are legally defined offences, many of the cases identified by the OCJS will not have been serious enough to come to police attention. The findings from the 2006 OCJS showed that the majority of young people were law-abiding.

A Safeguarding Children report is published every three years. It assesses how well agencies are working at both national and local levels to safeguard children and young people. Safeguarding children is more than protecting children from abuse or neglect. It also means ensuring their health and development is not impaired, and that they are growing up safe and well cared for in order to have the best possible life chances.

During the past several decades, child protective services (CPS) agencies have been challenged by large volumes of child abuse and neglect reports, growing caseloads involving increasingly complex problems, and limited resources (U.S. General Accounting Office, 1997; Shusterman, Hollinshead, Fluke, & Yuan, 2005). At the same time, there has been growing recognition that "one size does not fit all" in responding to child maltreatment reports. As a result, State and local CPS agencies have introduced significant reforms to child protection systems. One such reform is differential response, in which CPS agencies offer both traditional investigations and assessment alternatives to families reported for child abuse and neglect, depending on the severity of the allegation and other considerations.

Many factors affect how children react to and recover from sexual abuse. Parents play an important role in their children?s recovery. This factsheet includes information to help foster and adoptive parents of children who have been sexually abused. It includes information about child sexual abuse, tips for establishing guidelines for safety and privacy in the family, and guidance on when and how to seek help, if needed. You may be a foster or adoptive parent of a child who was sexually abused before coming to your home. In some cases, you will not be certain that abuse has occurred, but you may suspect it. You may even be exploring becoming a foster or adoptive parent to a child in the foster care system; many of these children have been abused or neglected—physically, emotionally, or sexually—before coming into care.

With concentrations of people disadvantaged in the labour market, disadvantaged areas tend to have high rates of worklessness. But both the kinds of work available and the kinds of people without work vary between areas. Solutions need to be local, reflecting the kind of jobs people are likely to be able to get, and the individuals living in the area and their individual problems.

August 5, 2008

There is a considerable body of literature which explores numerous characteristics that are associated with young people’s involvement in anti-social behaviour and delinquency. These characteristics are often referred to as ‘risk factors’. Also, within the literature, there is evidence of characteristics which can counteract risk factors possessed by children who are considered to be at high risk of involvement in anti-social behaviour. These are known as ‘protective factors’.

In the chaotic aftermath of Hurricane Katrina, an increase in sexual violence became a tragedy within a tragedy. Women, children, and men who chose not to, or were unable to evacuate, often due to financial constraints, were trapped without safe drinking water, food, shelter, or sanitary facilities. Many people lost loved ones in the flooding that followed the storm; most lost their homes and possessions. A large majority of Gulf Coast residents lost their jobs, schools, and neighborhoods. Atop these atrocities, some women, children, and men became targets of sexual victimization by others, and suffered the additional pain and trauma of sexual assault.

In the autumn term of 2007, Ofsted undertook a survey in 20 schools across England where white British boys from low-income backgrounds performed better in public tests and examinations than their counterparts in other schools. The schools were identified from inspection evidence and discussion with local authorities. They included six primary schools, 10 secondary schools, three special schools and one pupil referral unit. The survey focused on white British boys whom the schools identified as being eligible for free schools meals or who came from households where the income was estimated to be well below the national average.

The earlier a person begins drinking alcohol, the more likely they are to have ever used other drugs illicitly, according to an analysis of data from the National Longitudinal Alcohol Epidemiologic Survey (NLAES). Approximately one-half of persons who began drinking at age 14 or younger had also used other drugs illicitly in their lifetime, compared to around one-tenth of those who began drinking at age 20 or older. Even after controlling for relevant sociodemographic and substance use factors*, starting alcohol use at a younger age was the strongest independent predictor of ever using drugs illicitly. A similar relationship was found between age atfirst alcohol use and ever being drug dependent—persons who began drinking before age 14 were nearly three timesmore likely to have ever been drug dependent that those who began drinking after age 20

The focus in housing policy on increasing housing supply, improving existing neighbourhoods, managing community relations, and offering more consumer choice make it important to understand how people make decisions about where they live. This research explored the housing aspirations of second generation south Asian and white British women. It questioned whether provision and services established to cater for first generation migrants remain relevant for second generation south Asian women.

August 4, 2008

Boomers will probably want to work longer than earlier cohorts, but their continued work requires that employers hire and retain them. Employers value older workers for their maturity, experience and work ethic, but worry about out of date skills and high costs. Slower overall labor supply growth will increase demand for older workers and occupations with higher shares of older workers will increase modestly as a share of all jobs. Future jobs will require less physical demands and more cognitive and interpersonal skills, trends that favor educated older workers, but job opportunities for less educated older workers may remain limited.

The Able to Work: Realising Potential project was introduced by the National Employment Panel (now Working Ventures UK). The project aimed to engage employers and promote recruitment opportunities for people with health conditions and disabilities. As part of the project, two sets of training events were developed, in partnership with Employers' Forum on Disability: one aimed at Jobcentre Plus staff and the other at employers. The events for Jobcentre Plus staff were held for staff who work with employers to help them promote the business benefits of disability confidence. 'Disability confidence' is a new concept developed by Employers' Forum on Disability to define the key characteristics of a company that is getting it right on disability issues. This report is based on an evaluation of the Jobcentre Plus staff events, conducted by SQW Consulting. The evaluation used surveys and in-depth interviews to assess the success of the Jobcentre Plus staff events, specifically looking at Jobcentre Plus staff's perceptions of the training process, the practical actions that follow and the extent to which Jobcentre Plus staff benefit from their participation in the programme.

Community Health Centers serve a disproportionate share of persons with limited English proficiency (LEP) as a direct result of their mission to serve the poor and uninsured. Community Health Centers (CHCs) serve three times the portion of LEP patients as their percentage in the U.S. population. In 2006 more than four million CHC patients were best served in a language other than English. That is almost one in every three patients seen in CHCs. Ninety-five percent of CHC patients surveyed in 2001 reported that their clinicians spoke their language. This contrasts with data on other service settings where many more patients said that they had trouble understanding their provider because of a language barrier.

- Combined data from SAMHSA's 2005 and 2006 National Surveys on Drug Use & Health (NSDUH) indicate than an annual average of 7% of adults aged 50 or older experienced serious psychological distress in the past year. Adults aged 50 to 64 were more likely to experience past year serious psychological distress than those aged 65 or older (8.8% vs. 4.5%).
- Adults aged 50 or older were more likely to experience serious psychological distress in the past year if they had less than a high school education than if they were college graduates (10.2% vs. 5.2%), had family incomes less than $20,000 compared with those with $75,000 or more (11.7% vs. 4.4%), and were without health insurance compared with those with health insurance (12.3% vs. 6.7%).
- Over half (53.7%) of the adults aged 50 or older with past year serious psychological distress received mental health treatment in the past year, 6.2% did not receive treatment although they felt they needed it, and 40.1% did not receive treatment and did not perceive a need for it.

One of the most controversial features of the 1990s welfare reforms was the imposition of time limits on benefit receipt. Time limits became a central feature of federal policy in the landmark 1996 welfare law, which created the Temporary Assistance for Needy Families (TANF) block grant. The law prohibits states from using federal TANF funds to assist most families for more than 60 months. Under contract to the Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services, The Lewin Group and MDRC have conducted a comprehensive review of what has been learned about time limits. The review, which updates a 2002 study, includes analysis of administrative data reported by states to ACF, visits to several states, and a literature review. The update is timely because most states now have several years’ experience with time limits. Federal law affords states great flexibility in setting time-limit policies. The federal 60-month limit does not apply to state-funded benefits; also, states may use federal TANF funds to support up to 20 percent of the caseload beyond 60 months. Thus, states may set a 60-month time limit, a shorter limit, or no time limit, and they may choose to exempt families from time limits. Not surprisingly, time-limit policies vary dramatically from state to state.

Information on abortions carried out in England and Wales in 2007 was released on 19 June 2008 according to the arrangements approved by the UK Statistics Authority. The information is obtained from the abortion notification forms returned to the Chief Medical Officers of England and Wales.

OVERVIEW — In 1965, Congress enacted the Older Americans Act, establishing a federal agency and state agencies to address the social services needs of the aging population. The mission of the Older Americans Act is broad: to help older people maintain maximum independence in their homes and communities and to promote a continuum of care for the vulnerable elderly. In successive amendments, the Act created area agencies on aging and a host of service programs. The “aging services network,” broadly described, refers to the agencies, programs, and activities that are sponsored by the Older Americans Act. The Act’s funding for services is supplemented by other federal funds, such as Medicaid, as well as state and local funds. As the number of older people increases with the aging of the baby boom
population, the need for a wide spectrum of services is expected to place pressure on aging services. Whether the aging services network will be able to sustain its momentum and fully realize its potential will depend on its ability to attract and retain additional resources.

During the 1990s, the federal government promised low-income families that work would pay. Parents moved into jobs in response to new welfare rules requiring work, tax credits and other work supports that boosted take-home pay. Unfortunately, the record shows that low-income families have not progressed much. Many don't bring home enough to cover the everyday costs of living. This paper synthesizes the current status of low-income families along with the findings from a set of essays that address key shortcomings in the safety net. The paper summarizes ideas for policies that would make work pay in today's economy.

This paper is based primarily on interviews conducted in early summer of 2007 with senior administrators from eight state Medicaid or State Children’s Health Insurance Programs (SCHIP) in California, Illinois, Louisiana, Massachusetts, New York, Oregon, Pennsylvania, and Washington. These states have been among those in the vanguard of pursuing the goal of covering all children and youth.

This document is the fourth annual report from the commission. It lists key achievements for the last year including improving poorer performing services and introducing a quality rating system that makes it easier for people to choose care services.

Approaching poverty and deprivation in the context of place is an increasing focus of regeneration policy. How can integration be strengthened between social and economic interventions for deprived places, and what are the key challenges to more effective delivery? This paper summarises evidence about the underlying forces affecting place-based economic deprivation across Britain, and explores how interventions aimed at both people and places can be strengthened to tackle disadvantage.

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