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Personalisation in disability support funding is premised on the notion that services come together through the individual. Where people have very complex needs, many individuals and their supporters find it difficult to facilitate services themselves. This article examines the Integrated Service Response (ISR), an Australian response to complexity implemented during the National Disability Insurance Scheme (NDIS) roll-out. We explore its facilitation of collaboration in the context of the NDIS.
Results from interviews and observation of collaboration suggest there are multiple challenges with effective inter-organisational collaboration under the NDIS, including communication between services, and the loss of previous ways of addressing complexity and crisis. Participants valued ISR as a response to complexity, including its ability to facilitate collaboration by ‘getting the right people at the table’.
While programmes such as ISR may improve inter-organisational collaboration around specific clients, broader ongoing systemic approaches are required to address system-wide issues.
Previous research in clinical, community, and school settings has demonstrated positive outcomes for the Secret Agent Society (SAS) social skills training program. This is designed to help children on the autism spectrum become more aware of emotions in themselves and others and to ‘problem-solve’ complex social scenarios. Parents play a key role in the implementation of the SAS program, attending information and support sessions with other parents and providing supervision, rewards, and feedback as their children complete weekly ‘home mission’ assignments. Drawing on data from a school-based evaluation of the SAS program, we examined whether parents’ engagement with these elements of the intervention was linked to the quality of their children’s participation and performance. Sixty-eight 8–14-year-olds (M age = 10.7) with a diagnosis of autism participated in the program. The findings indicated that ratings of parental engagement were positively correlated with children’s competence in completing home missions and with the quality of their contribution during group teaching sessions. However, there was a less consistent relationship between parental engagement and measures of children’s social and emotional skill gains over the course of the program.
This study aimed to understand the coping strategies used by men with Adult Onset Epileptic Seizures (AOES) following elective neurosurgery, and in particular, how those adaptive skills relate to their subjective wellbeing (SWB). Open-ended qualitative interviews were conducted with five men with a history of neurosurgery for AOES (aged 34–59). The interview data was thematically analysed utilising interpretive phenomenological analysis. The findings indicated that the men experienced significant role marginalisation by family and co-workers, and also poor communication provided by health care professionals. They reported a higher sense of SWB with the use of ego-buffering strategies, such as positive reframing, threat minimisation, emotional self-acceptance and engaging in wish-fulfilling fantasies. Self-blame led to lower SWB. Findings imply that agentic behaviour is important to successful living with AOES following neurosurgery.
The research I present here uses the embodied–inscribed–enacted framework to interrogate data gathered from a large qualitative research project that has sought to understand the way that knowledge functions in relation to Scottish mental health policy. This formed the first part of the work conducted by the Scottish health team under the KNOWandPOL project, which aimed to understand the different dimensions of knowledge use in relation to policymaking across Europe. My overarching interest in this chapter is on how the new framework might help to answer these questions and add to the analytic toolbox from which policy scholars draw.
In order to assess its utility, I applied the embodied–inscribed–enacted schema retrospectively to data already analysed in order to understand what new perspectives it could offer on the way knowledge functions across this particular policy sphere. The original analysis had been conducted before the framework had been devised and, as we shall see, that initial analysis was productive of further research questions. However, in pursuing that further research, it became apparent that the ideas about knowledge employed for the initial analysis were of limited utility for developing our more detailed case studies. It is therefore interesting to revisit those data to determine what new analytical approaches and insights the embodied–inscribed–enacted schema might open up. In doing so, I ask: how can this framework be applied to an existing set of data? What new insights can it add to previous attempts to understand this field? How might we redescribe the different kinds of knowledge that have come to shape this policy domain?
Scotland, mental health and policy: mapping the field
Previous research on mental health policy in Scotland has characterised it as a knowledge-based community with high levels of interaction between actors and a high degree of consensus over aims and approaches to improving mental health (Smith-Merry et al, 2008). As a policy field, mental health in Scotland underwent a radical reorganisation over a short period of time between 2000 and 2010. Drawing on major reviews of the system, new legislation and new policies for services and population mental health were launched: the Mental Health (Care and Treatment) (Scotland) Act 2003; and the government's National programme for improving mental health and wellbeing, which began in 2003, and its policy statement Delivering for mental health (2006).
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