The paper uses the concept of recognition to investigate how young people labelled as having 'complex needs' experience their encounters with welfare state actors. Semi-structured interviews were ...held in 2018 with 14 young people, aged 15-22 years, in two Swedish municipalities. The participants have received multiple, long-term interventions from social services and psychiatric care. Research questions are: What aspects in the encounters between welfare state actors and young people may contribute to complexity in their life situations? How can Honneth's concept of recognition illuminate this complexity? Aspects that have contributed to complexity in young people's life situations are related to acts of dismissal. These dismissals by welfare state actors are interpreted as forms of disrespect as regards affection, rights or solidarity. Barriers to recognition are also related to the participants' young age and position as children, and what this implies in a particular society. Our findings show that the difficulties young people face in their encounters with welfare state actors are partly due to the high level of specialization which contributes to an increased organizational complexity. Implications include that, when encountering young people in complex life situations, welfare state actors need to consider the importance of recognition as regards affection, rights, and solidarity. Recognition is central to achieving a positive outcome in working with young people in complex life situations and is expressed in social interactions. Therefore, building relationships needs to be more highly prioritized in welfare state organizations.
•Increased collaboration between the social services and psychiatric care is needed for young people in out-of-home care.•Out-of-home care - more containment than support to undergo ...change.•Experiences of liminality induce hopes and fears.•Lack of influence of the placement’s duration and content.
The objective of this paper is to further the understanding of young people’s experiences of out-of-home care (OHC). The focus will be on the tension between negative and positive experiences of OHC, refracted through the concept of liminality. The study is based on semi-structured interviews with 10 young people aged 15–22 (7 women, 3 men) with long-term contact with social services and psychiatric care. OHC can be experienced as a liminal space in both a negative and a positive sense. It is negative when perceived as containment rather than meaningful treatment. It can also be a negative experience when connected to fear, a lack of influence, and uncertainty in terms of being in between the social services and psychiatric care. It is positive when it is perceived as a turning point that enables positive change. It is then connected to feelings of meaningfulness, being respected, hope, and empowerment. The young people participating in the study also connect their experiences of OHC to a context of greater austerity in the welfare state. They reflect upon the benfits of OHC in terms of costs for society, but also the costs for the young person if the OHC is not perceived as meaningful support leading towards positive change. The participants have complex, interrelated needs and problems, and they also experience institutional gaps between psychiatric care and social services. It is important to overcome these gaps, so that young people are not located in ‘in-between spaces’ in terms of service provision.
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.
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.
This thesis explores the increasing medicalization of society, the process whereby social phenomenon are transformed into medical problems. Alike the general tendency of neuropsychiatric diagnoses, ...the number of people with ADHD (Attention Deficit Hyperactivity 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 NGOs 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 cognitivity. 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 example, 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 pharmaceutical 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 inequalities 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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