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- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Social Work Practices for Young People with Complex Needs : An Integrative Review
- 2018
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In: Child and Adolescent Social Work Journal. - : SPRINGER. - 0738-0151 .- 1573-2797. ; 35:3, s. 207-219
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Research review (peer-reviewed)abstract
- The aim of this integrative review is to investigate research of social work practices for adolescents and young adults with complex needs. The research questions are: What are the major themes in studies of practices for young people with complex needs? How do studies suggest that complex needs can be met in ways that are beneficial for young people? A young person with complex needs is in this review defined as an adolescent or young adult who, due to mental ill-health in combination with different types of social vulnerabilities, is receiving assistance from multiple welfare services. Searches were conducted in seven databases. These searches resulted in a sample of 1677 records, published 2007-2016, which in the screening process were reduced to 24 publications, all peer-reviewed articles. The participants in the studies in the articles consisted of young people, parents and professionals from mainly Anglo-Saxon countries. The articles were analyzed with qualitative summative content analysis. Three empirically generated themes were found in studies of work practices targeting young people with complex needs: collaboration-, relationship- and empowerment-oriented practices. In conclusion, the practices contain a wide variety of features, but with the joint aim of acknowledging young people's needs. The results can be used by practitioners and policymakers to further the development of services for youth with mental ill-health and social vulnerabilities, who use multiple welfare services.
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2. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Where Lies the Complexity? : Interviews with Swedish Young People who Receive Support from Social Services and Psychiatric Care.
- 2018
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Conference paper (peer-reviewed)abstract
- Mental ill-health among young people has increased in the past decades in Sweden as well as in other western countries. When mental ill-health is connected with social vulnerability such as difficulties in completing education, unemployment or substance abuse you may be considered to have “complex needs”. This paper presents findings from a project (2016-2018) in two municipalities. The data consists of semi-structured interviews from two sub studies. One with 13 young persons (15-25 years) who have been or are recipients of long-term support from social services as well as psychiatric care, and one with 24 professionals from social services and psychiatric care. The aim is to investigate young people’s and professionals’ experiences of work practices aiming at increased well-being for young people labelled as having complex needs. The research questions are: What barriers for work practices for sustainable support are there from the young people’s perspective? How to overcome work practice barriers for giving sustainable support, from the professionals’ perspective? The questions are reflected in three themes; empowerment, relationships and collaboration. Barriers mentioned by the young people are high employee turnover as well as too many professionals involved in activities. Professionals might have their own ideas about what should be done, not taking the wishes of the young person into consideration to a satisfying level. In collaboration between different organizations, the professionals consider it important with at least one person who has the influence in several of them. To take the young person seriously as well as staying on in difficult times are considered important. We argue that the expression complex needs, when used as a way to categorize young people, may obscure that the problem also lies with highly specialized and complex welfare state organizations. They do not always succeed in catering for the interconnected needs of their clients.
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3. |
- Almqvist, Anna-Lena, 1963-, et al.
(author)
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Young people with complex needs meet complex organizations : an interview study with Swedish professionals about sustainable work practices
- 2018
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In: Community, Work and Family. - : Routledge. - 1366-8803 .- 1469-3615. ; 21:5, s. 620-635
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Journal article (peer-reviewed)abstract
- This paper concerns preconditions for the well-being of young people with mental ill-health combined with social vulnerabilities, also referred to as youth with complex needs. Research questions are: What barriers to sustainable work practices for young people labelled as having complex needs do professionals encounter? What do professionals identify as possible ways to overcome these barriers? Sustainable work practices are reflected in three themes: empowerment, relationships and collaboration. The findings are based on semi-structured interviews with 24 professionals, 3 men and 21 women, working in psychiatric care and the social services in two Swedish municipalities in 2016 and 2017. Major barriers are lack of continuity and co-ordination in staff and support, and fragmentation of work practices. As a consequence of the increased specialization of human service organizations, young people have to interact with many different professionals which could cause disparate interventions. Possible ways mentioned to overcome these barriers are supported through good interactional skills, using keyworkers as well therapeutic alliances, wrap-around services and case management. Complexity is linked to organizations and work practices rather than to young people. An often dysfunctional service delivery system in organizations with rigid boundaries may also affect professionals’ aim for sustainable support.
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4. |
- Lassinantti, Kitty, 1968-
(author)
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Diagnosens dilemman : Identitet, anpassning och motstånd hos kvinnor med ADHD
- 2014
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Doctoral thesis (other academic/artistic)abstract
- This thesis explores the increasing medicalization of society, the process whereby social phenomenon are transformed into medical problems. Alike the general tendency of neu- ropsychiatric diagnoses, the number of people with ADHD (Attention Deficit Hyperactiv- ity Disorder) has increased and expanded from a boys’ diagnosis to include both adult men and women. Studies on the latter category is however scarce. The objective of the thesis is to contribute with a micro sociological and critical perspective on the effects of the biomedicalization process, by focusing women's experience of getting and living with ADHD. The empirical material consists of narrative interviews with sixteen women, diagnosed with ADHD in adulthood. The participants, age 20 to 50, were enrolled via Swedish NGO:s in 2010 and 2013.The thesis resides on four analytical themes: biomedicalization, pharmaceuticalizaton, functionality and gender. It shows how diagnostics evokes processes that involve learning and using a biomedical terminology to describe and understand oneself. ADHD is, in general, depicted as diffuse, expansionary, masculine and deviant sociability and cognitiv- ity. Unlike depression and anxiety, described as temporary and unwanted illnesses, the ADHD-diagnosis embraces the whole personality. Hence, the women find it difficult to identifying and separating ADHD from the self. Furthermore, categorizations of oneself as a ‘woman with ADHD’ imply constructions of individual and collective identity that has ideological implications, i.e. the individual narratives are related to grand narratives. These contradictory grand narratives bring about ideological dilemmas that are handled rhetorically in the women's everyday life. The masculine connotation of ADHD, for ex- ample, render the women experiencing themselves as transgressing not only femininity but also ADHD-personhood. Additionally, as social actions are attributed to the ‘ADHD brain’, the brain is portrayed as a pathological deviant and dysfunctional object for phar- maceutical intervention. Nevertheless, this discourse is also contested by the women by pointing to 1) positive aspects of the ‘ADHD-brain’ in everyday life, or 2) gender inequal- ities and demands of the late-modern society. Concluding, the women in this study are not only victims of their bodies or societal norms, but also agents negotiating– adapting and opposing to – expectations of how to be an ideal citizen or woman.
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6. |
- Lassinantti, Kitty, 1968-, et al.
(author)
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The categorization ‘complex needs’ : Constructions of complexity as a problem in professionals’ discourse
- 2018
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Conference paper (peer-reviewed)abstract
- In social work discourse, youth with mental ill-health in combination with social vulnerability are more frequently referred to as “youth with complex needs”. The aim of this paper, based on two interview studies, one with professionals in psychiatric care and social work, and one with youth (age 15-25 years), is to critically investigate how "complex needs" is used as a way to categorize youth. Youth with complex needs are by professionals in the study constructed as recipients of long-term but less successful support from social work services and psychiatric care. They are also, from the perspective of professionals, described as a category that in various ways present challenges for welfare services. Categorizations of people and needs are prerequisites for legal, bureaucratic and professional systems within the welfare state. Welfare organizations construct knowledge and strategies regarding specific target groups according to these categorizations. In the paper we discuss whether there is a risk that a categorization such as complex needs is used in a way that individualize problems, thereby obscuring problems that are related to complex organizations and care systems that cater for the needs of young people in less effective ways.
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7. |
- Lassinantti, Kitty, 1968-, et al.
(author)
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Young people with complex needs meet complex welfare state organizations. : An interview study with professionals in psychiatric care and social work.
- 2018
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Conference paper (peer-reviewed)abstract
- Title: Young people with complex needs. An interview study with professionals in psychiatric care and social workTheoretical background: Mental ill-health in youth has increased the past decade, in Sweden as well as in other countries. The most common diagnoses being depression, anxiety, and/or neuropsychiatric diagnoses such as Attention Deficit Hyperactivity Disorder or Autism Spectrum Disorder. Mental ill-health is often accompanied by social vulnerabilities, as for example difficulties in completing education, unemployment and substance abuse. Thus this is a group of young people who often need support from both social work services and psychiatric care. Young people with mental ill-health with multiple and interconnected needs are in social work discourse more frequently referred to as having “complex needs”. Categorizations of people and needs are prerequisites for legal, bureaucratic and professional systems within the welfare state who construct knowledge and strategies regarding specific target groups based on such categorizations. The aim of this study is to, on a local level, critically investigate how the target group youth with complex needs is constructed, and how these constructions inform policy and work practices among professionals in psychiatric care and social work.Research question: How do professionals in psychiatric care and social work services construct youth with complex needs? And how do these constructions inform policy and work practices among professionals in psychiatric care and social work?Method: The paper is based on 24 semi-structured interviews from 2016-2017 with professionals in psychiatric care and social work from two municipalities (100 000 and 150 000 inhabitants) in Sweden.Results: Youth with complex needs are constructed as recipients of long-term but less successful support from social work services and psychiatric care. Lack of collaboration and lack of flexibility in work practices, and diverging opinions among professionals on the nature of the problem, type of solution, or whether and to what extent the young person’s needs are the responsibility of their organization and profession are described as impediments to sustainable care.Discussion: In the paper we discuss whether there is a risk that a categorization such as complex needs is used in a way that individualize problems, as social problems are being transformed into medical problems. Biomedical power/knowledge may intersect with other socio-political factors, as in welfare state policies and practices, in a way that reflect and reinforce neoliberal ideology, thereby obscuring that problems experienced by youth are related to societal changes and complex organizations and care systems that cater for the needs of young people in less effective ways.
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