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The following study evaluates the complex association between legal involvement and mental illness. It describes a population of consumers of community mental health programs, comparing those with legal involvement to those without legal involvement, on a number of demographic, clinical and social indicators. It is a secondary analysis of data collected in studies making up the Community Mental Health Evaluation Initiative (CMHEI) in the province of Ontario, Canada. Legal involvement was a significant issue among community mental health program consumers; about one in five consumers had at least some contact with the legal system in the preceding nine months. Legally involved consumers were more likely to be in receipt of social assistance and be unstably housed than those legally uninvolved. However, there were no significant differences between legally involved and uninvolved consumers with respect to severity of symptomatology, current medication use or number of hospitalization days in the past 9 months. A predictive model compared the differential impact of clinical and social determinants upon legal involvement. Analyses failed to uncover a significant relationship between severity of psychiatric symptomatology and legal involvement. Significant predictors of legal involvement included gender, race, drug use as well as housing instability, and receipt of social assistance. Legal involvement was attributable to factors other than the severity of mental illness; these results challenge assumptions that the most symptomatically severe consumers are most at risk of legal involvement. Accordingly, the rate of legal involvement in a sample of community mental health program users must be considered in a broad context, with particular emphasis on social disadvantage.
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Since the end of the Cold War, a number of regional conflicts worldwide have devastated innocent populations. The conflicts in Rwanda and in the Balkans come to mind as prominent examples. With these developments the literature about women and war has proliferated.
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A multisite evaluation of community mental health services is used to answer two questions: (a) How do diagnosis, functioning, and self–assessments of consumer/survivor initiative (CSI) and assertive community treatment (ACT) participants compare?, and (b) What other supports/services are CSI and ACT participants using? The sample is from an Ontario evaluation of consumer/survivor peer initiatives in four communities (n = 73). The reference group is new (n = 48) and ongoing (n = 134) clients of four ACT teams. Self–help organizations are serving a broader population of individuals who include a significant subgroup of persons with severe mental illness along with others with a mixed picture of higher functioning and greater instability. There is little overlap in the use of these modes of service delivery, which suggests that maintaining options within systems of care is critical to ensuring coverage and access for the broader population.
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The establishment of the Housing and Property Directorate (HPD) and Claims Commission (HPCC) in Kosovo has reflected an increasing focus internationally on the post-conflict restitution of housing and property rights. In approximately three years of full-scale operation, the institutions have managed to make a property rights determination on almost all of the approximate 30,000 contested residential properties. As such, HPD and HPCC are being looked to by many in other post-conflict areas as an example of how to proceed. While the efficiency of the organizations is commendable, one of the key original goals – the return of displaced persons to their homes of origin – has to a large degree been left aside. The paper focuses on two distinct failures of the international community with respect to the functioning of HPD/HPCC and its possible effect on returns: a failure of coordination between HPD/HPCC and other organizations working on returns, and the isolation of residential property rights determinations from other aspects of building a property rights-respecting culture in Kosovo.
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Author / Editor
- Anneke Smit (1)
- Annette Demers (2)
- Christopher Waters (2)
- David Tanovich (2)
- Gemma Smyth (2)
- Jasminka Kalajdzic (1)
- Jeff Berryman (1)
- Myra Tawfik (1)
- Tess Sheldon (2)