Research Process for the Rights of the Mentally Ill to Have Children Paper

Process for the Rights of the Mentally Ill to Have Children - Research Paper Example Literature Review Nicholson et al. (1993) conducted a study to find out whether the state departments of mental health of sixteen states are giving enough healthcare rights to mentally ill women who have preschool aged children. They found that not many states had satisfying policies to provide outpatient services to mentally ill women, and there were no policies regarding the visitation of their children to them when they were hospitalized. This study shows that much improvement is needed in this area and insufficient healthcare is restricting the rights of the mentally ill to look after their children properly. Jacobsen and Miller (1998) conducted their research on mentally ill mothers to find out if they are capable of looking after their children properly. They found that many mentally ill parents are deprived the right of their children’s custody â€Å"due to child abuse or neglect†, due to which the children have to live in foster care. The researchers claim that since parents with long chronic mental illnesses cannot ensure safe parenting, hence they should be denied their parental rights. Feldman, Stiffman and Jung state in their study that children of mentally ill parents are likely to suffer from many behavioral disorders (1987). The researchers studied 306 children of ages between six and sixteen. They found that the children had disturbed relationships with their mentally ill parents because the parents could not provide them with secure family environment. This study supports the fact that mentally ill parents are not able to care for their children properly. Cohler et al. (1980) compared the two groups of participants, one of which consisted of mothers who were discharged from psychiatric hospitals and the other one consisted of normal mothers to find out â€Å"child rearing attitudes and adaptation to adult social roles†. They found that mentally ill mothers were unable to foster healthy relationships with their children and could not differentiate between their own and children’s needs. This hindered with the children’s abilities to adapt adult roles later in life. Gamer et al. (1977) had also reached the same conclusion earlier in 1977 when they conducted their research on three year old children performing an interaction task with their well and mentally ill mothers suffering from psychosis. They found that there were â€Å"differences in the pattern of intercorrelations among these interaction variables between the two groups† (Gamer et al., 1977). Bagedahl-Strindlund (1986) found that acute mental illness was positively related to pregnancy complications. They studied pregnant mothers admitted in psychiatric hospitals and found that delivery complications were also there in those patients who showed prepartum onset of mental illness. Mentally ill mothers also had a history of more abortions than well women. Mohit (1996) supported this research by finding in their research that seriously mentally ill mothers underwent frequent psychiatric hospitalization due to motherhood strain. This study helps prove that mentally ill mothers are not able to cope with motherhood roles efficiently. Stanton, Simpson and Wouldes (1999) found that mentally ill mothers are also involved in filicide. They interviewed mentally ill women who pretended to be very caring toward their children but at the same time regretted the killing of their children under unexplainable intentions. Research Question The research question formulated is that: Are the mentally ill able to bear and

No chosen yet (sociology) Essay Example | Topics and Well Written Essays - 750 words

No chosen yet (sociology) - Essay Example Oneida community is a religious commune founded in 1848 by John Humphrey Noyes. This organization practices communalism where the members practice communal labor in which men and women have to work together and become an engaging community. Not only labor did members come together but in almost any occasions. Members likewise participate in enjoyment and self improvement thus they are not left in solitude. How the community worked and lived together in a â€Å"Mansion House† painted an unusual picture of a rich and happy community. Complex marriage is also practiced where in men are married to every women and women are married to every men. Other practices of the community include mutual criticism and ascending Fellowship. After many years of existence, the community later transformed into a capitalist enterprise known as the Oneida community, Ltd. (Olin, 1). Today, Oneida’s â€Å"Mansion House† serves as a tourist attraction. The Church of Scientology is another organization founded by Lon Hubbard with the goal to promote scientology. Under the organization are several separate incorporations with their own local boards, executives and directors responsible for the activities of each corporate and ecclesiastical. Members are taught that people are immortal spiritual being who have forgotten their own nature. In addition to this teaching, the organization believes that the experience of man could be extended beyond a single lifetime with unlimited capabilities. Thus they believe that events in the past affect the present limitations. Furthermore, they consider that man is good who seek to survive. However, his survival depends on him, his fellows, and his attainment of brotherhood in the universe. They also practice giving study materials and auditing course but with a corresponding donations. Just like Oneida, the Church of Scientology has its own controversy. Many believed that it operates as a cult and as a commercial enterprise. The Mor mons is founded by Joseph Smith in 1820. The name Mormons refer to the followers and their religion Mormonism. This cultural group is a form of Christian primitivism where other small independent denominations were based. The movement seeks maintain doctrines that supports the practice of polygamy. The members share a common belief with the Latter day Saint movement where they adopt teachings from the Bible especially the old testament, other religious texts, Books of Mormons, doctrines and covenants. The movement also accepts the Pearl of Great Price as part of their canon. Mormons believe in the Living Christ and the importance of eternal marriage. The Jehovah witness is founded by Charles Taze Russell in 1870’s with members that is over 18 millions. Jehovah base their teachings solely from the Bible however they have they own translation that they prefer to use. They believe in the destruction of the earth which they refer to as Armageddon. They claim that the only solutio n to all problems of human kind would be the establishment of the Kingdom of God. Jehovah witnesses are known for several activities. They are the religious group distributing The Watchtower and Awake magazines. They are known for their door to door teaching of their translated Bible, the New World translation of the Holy Scriptures, and are known not to accept military services and blood donation and transfusion. These religious organizations become a sociological interest because some of their practices are considered bizarre by

English paper book write up Essay Example | Topics and Well Written Essays - 750 words

English paper book write up - Essay Example All this changes when he meets a wannabe thug named Cleveland, and they explore a darker side of Pittsburgh together. Without any real direction, Art decides to discover a more dangerous life than what he had previously known. Art, being the son of a gangster, feels unable to express his sexual confusions openly with his family. The novel centers on the struggles of the protagonist as he searches for ways to satisfy his own desires while living up to his father’s expectations. As we find in the book, this isn’t a possibility. The book handles the issues of the main character’s sexuality very plausibly. The reader can feel his frustration and see his confusion as he goes back and forth between heterosexual lovers and homosexual lovers. Many of the characters, in fact, seem to have an overwhelming sense of uncertainty, except for Phlox and her unsympathetic views of homosexuals. The book relies heavily on its setting to influence the mood of the book. Growing in Pittsburgh himself and attending the University of Pittsburgh, Chabon was right at home as he was describing his characters walking through Oakland, Shadyside, Squirrel Hill, amongst other locations. The industrious nature of the city also adds to the rather bleak nature. The â€Å"cloud factory,† one of the many factories of Pittsburgh, also plays an important role later on in the book. Set in the mid-80’s the characters are constantly making pop-culture references, perhaps as an ode to Andy Warhol’s pop art as Warhol was another Pittsburgh native. Chabon’s prose is very fluid, and the descriptions he gives of the city of Pittsburgh paints the city very vividly. The bleak landscape becomes very real for the reader. However, sometimes his penchant for creating interesting writing goes too far, and some of the dialogue between characters tends to be lofty and unrealistic. This can be a bit

Profile in Leadership Term Paper Example | Topics and Well Written Essays - 1750 words - 2

Profile in Leadership - Term Paper Example nd of the coin is the pro choice debate that believes that a fetus does not have rights and whether to abort pregnancy or not is dependant on the fetus’ mother. According to the pro-life opinion and even according to the pro-choice opinion, a fetus has similar rights that are entitled to a human being (GeÃŒ rard 138). But pro-choice perspective states that a fetus does not have the ability to make decisions and have no self awareness. Pro-life perspective counters this argument by stating that individuals who are regarded as adults, and are retarded, do not have ability to make reasonable decisions and experience lack of self awareness. Pro-life advocates state that if a fetus is a human being, he has rights and by aborting a fetus, the society takes away the fetus’ right to make decisions and choose what is best for himself. Pro-choice advocates state that a fetus is not a fully developed individual and does not have any human rights and by not allowing a female to abort pregnancy, the law and the society is infringing upon the rights of the women to decide what is good for her (Panza 235). For this purpose, pro-choice take a utilitarian stance and state that those decisions should considered as right that have the highest number of positive benefits as compared to the costs that are incurred due to that particular action (Soble 6). Several advantages have been figured out that are achieved by the society if abortion takes place. These advantages include population control and well being of the society. The cost is the death of a fetus which does not even have complete human rights. Pro-life advocates even take a religious stand and state that a fetus is a human life and all living individuals are sacred and the decision of life and death is in the hands of God so abortion should not take place as by aborting, individuals are working against God’s will. Abortion leads to cognitive dissonance among health care professionals, health care professionals have

English paper book write up Essay Example | Topics and Well Written Essays - 750 words

English paper book write up - Essay Example All this changes when he meets a wannabe thug named Cleveland, and they explore a darker side of Pittsburgh together. Without any real direction, Art decides to discover a more dangerous life than what he had previously known. Art, being the son of a gangster, feels unable to express his sexual confusions openly with his family. The novel centers on the struggles of the protagonist as he searches for ways to satisfy his own desires while living up to his father’s expectations. As we find in the book, this isn’t a possibility. The book handles the issues of the main character’s sexuality very plausibly. The reader can feel his frustration and see his confusion as he goes back and forth between heterosexual lovers and homosexual lovers. Many of the characters, in fact, seem to have an overwhelming sense of uncertainty, except for Phlox and her unsympathetic views of homosexuals. The book relies heavily on its setting to influence the mood of the book. Growing in Pittsburgh himself and attending the University of Pittsburgh, Chabon was right at home as he was describing his characters walking through Oakland, Shadyside, Squirrel Hill, amongst other locations. The industrious nature of the city also adds to the rather bleak nature. The â€Å"cloud factory,† one of the many factories of Pittsburgh, also plays an important role later on in the book. Set in the mid-80’s the characters are constantly making pop-culture references, perhaps as an ode to Andy Warhol’s pop art as Warhol was another Pittsburgh native. Chabon’s prose is very fluid, and the descriptions he gives of the city of Pittsburgh paints the city very vividly. The bleak landscape becomes very real for the reader. However, sometimes his penchant for creating interesting writing goes too far, and some of the dialogue between characters tends to be lofty and unrealistic. This can be a bit

Logistics and Supply Chain Essay Example for Free

Logistics and Supply Chain Essay Supply Chain Management Review introduces a new series called â€Å"Back to Basics. † It’s a look into how excellence in the core logistics and supply chain activities leads to overall business success. The articles in this seven-part series are written by educators from the University of Tennessee. Pictured: Wendy L. Tate, Assistant Professor of Logistics, Department of Marketing and Logistics, University of Tennessee. By Wendy L. Tate, Assistant Professor of Logistics, Department of Marketing and Logistics, University of Tennessee October 21, 2010  Globalization, increased competition, fluctuating availability of raw materials and pricing conditions have increased the need for better management of the suppliers who provide goods and services to the organization. According to the U. S. Census Bureau, the cost of purchased materials is approximately 54% of the value of shipments for manufacturers. Also, the cost of services that organizations purchase is continuing to increase as firms try to focus on what they do best. More emphasis is being placed on spend management and on those that are responsible for locating and managing the suppliers that provide the materials and services needed to meet customer expectations. Sourcing and procurement are generally responsible for this task. A focus on spend management is not new to the purchasing area. But the increasing magnitude of requested reductions is driving purchasing departments to think creatively about ways to more strategically manage the supply base and continue to drive unnecessary costs from everyday purchases. The task of sourcing and procurement professionals is to find an effective means to balance the demands of both internal and external customers with economic considerations while taking into account the potential for supply disruption and technological change. The challenge is to establish both the philosophy and practice of an integrated supply system as part of the firm’s strategic positioning. Strategic purchasing involves finding ways to use supplier capabilities to drive sales, leverage the purchasing spend to achieve and/or maintain competitive advantage, and use the supply market to strengthen the company’s strategic position. Historically, purchasing has been overlooked as a strategic contributor and instead viewed as more of a tactical function with a largely internal focus. The tendency of even the most seasoned buyers has been to react to problems rather than proactively incorporate the strategic focus needed to support the current operating environment. The primary focus of procurement is to support the firm’s operational requirements by ensuring uninterrupted flow of the appropriate quality materials, products, and services. However, purchasers must do so in the most efficient and effective manner, in light of limited resources. The key for sourcing managers is to minimize risk to the organization. To minimize vulnerabilities in supply and make the most of the organization’s buying power, purchasers should assess and segment purchased materials, services, and components in terms of importance to the organization and difficulty in accessing the materials. This segmentation process allows purchasers to take a more strategic perspective on the management of the supplies and the supply base while applying more appropriate cost management tools and negotiation strategies. Using the segmentation system developed by Kraljic (1983) as a foundation, four major categories emerge (see Figure 1). Noncritical (low importance, low supply risk), leverage (high importance, low supply risk), strategic (high importance, high supply risk), and bottleneck (low importance, high supply risk). Each of the categories requires a distinctive and strategic purchasing approach. Each of these classifications will be described in the paragraphs below. In the case of non-critical, or generic purchases, the focus is on finding the lowest possible purchase price from a field of many suppliers. For these types of items, there are low switching costs allowing for easy â€Å"supplier hopping†. Typical procurement approaches to these types of purchases include the use of purchasing cards (p-cards) and short-term contracts. Relationships with the suppliers of these types of products are often arms-length and transactional. Office supplies and paper purchases typically fall into this category. Buyers use competitive bidding, price indices, price lists and catalogs to facilitate the buying process. The suppliers of these types of materials and services understand that low price and ease of purchase are key to retaining buyers. Staples, for example, introduced the â€Å"Easy Button†. Buyers that are in the market for office supplies can download software directly to their computer, shop from on-line catalogs, and use their p-cards to streamline the purchases of these generic items. Many suppliers are capable of providing the products and services that fall into the leverage category; these are the more â€Å"commodity-type† items. These types of products and services have a great importance to the organization in terms of volume purchased, percentage of total purchase cost, or impact on product quality or business growth. The purchasing decision for these items is generally based on consolidation, leveraging volumes is key to success. Some approaches used to leverage volume include supply base reduction and reverse auctions. The idea is to combine the requirements of different operating units and capitalize on supplier fixed cost allocation and improved productivity. The following example makes the point. A technology company had multiple business units all with individuals responsible for the purchase of customer contact center services. Through informal discussions about the performance of the suppliers of these services, the heads of the business units discovered that some were using the same suppliers, but being charged different rates and there were multiple suppliers providing almost identical services across the organization. The purchasing area was called in to help better manage the purchase of these services. They followed a typical sourcing process (see Figure 2) and put these services out for bid to both existing and new suppliers. The final pool of suppliers included fewer suppliers, volumes were leveraged, the price that was being paid ultimately fell, and the relationship with the suppliers improved. The company instituted a single point of contact for the suppliers and an end-to-end procure to pay management process (Ellram and Tate, 2004). The strategic items have more complexity and risk involved in the purchase often because of limited availability or fewer suppliers with the technical capabilities to provide the goods or services. These are the items that are the most critical for the organization to obtain to ensure success and meet the demand for products. There is much more collaboration and integration between the buying and supplying firm with a focus on continuous improvement. Buying firms often enter into long term, cost-based contracts with the suppliers of these items and may in fact engage the suppliers early in the process of new product development. Buyers look to these suppliers for innovation and cost reduction ideas. Ford and Mobil for example entered into a broad based trategic alliance to speed the development and integration of break-through fuel and vehicle technologies (Dieselnet, 1998). The intent of these strategic alliances is to help strengthen collaboration, and develop a sustainable business model. Bottleneck items, or items that are more project oriented or unique, have a high level of supply market complexity. These types of purchases often consume a disproportionate amount of time, relative to the item’s value. The focus for purchasing is to simplify the procurement of these items, or if possible get it out of this quadrant and into the leverage or strategic quadrants. Companies buying products or services that fall in the category could participate in buying consortiums to better leverage the spend and minimize the associated risk. For example, a utility company was paying a significant amount of money to audit their suppliers. A number of their competitors were using the same suppliers and spending the same money for the audits. These companies agreed to hire a third party to perform the audits, thus consolidating the spend and simplifying the purchase. Another company was procuring project-based environmental services. Each project required the buyer to closely manage the supplier to ensure that each step in the process was completed in a timely and accurate fashion and that payments were made as promised. There were many of these projects occurring simultaneously with different suppliers. One supplier became an â€Å"expert† in this area allowing the buying firm to assign the supplier more projects, thus increasing the level of importance and moving it to the strategic category. Successful managers today require a broad view of the procurement and sourcing areas and the strategic role that this function can play in an integrated supply chain. Organizations need to take a long-term perspective, avoiding the low price sourcing temptation without considering the total cost and the total value provided by the function and its relationship to the supply base. Purchasing needs to strategically manage its supplies and its supply base. The first step in doing this is to understand what is being purchased, the importance of the purchase to the organization, and the complexity of the supply market. The goal is to ensure that the supplies that are purchased add value to the customer’s that ultimately buy our goods and services.

Children Born Into Families With Mental Illness Social Work Essay

Children Born Into Families With Mental Illness Social Work Essay With an apparent increase in the number of children born to parents experiencing mental illness many issues have been raised concerning parenting capacity and the welfare and development of these children. This has many implications for social work practice in both Childrens Teams and Community Mental Health Teams and also for future policy development and service provision. Within this dissertation it is my intention to explore that the mentally ill are indeed capable of parenting their children safely and effectively and attempt to disprove the suggestion that mentally ill parents are unsafe and incapable. Adults with mental health problems are one of the most excluded groups in society, however many are also parents and may need support to care for their children safely (Garley et al 1997). This means that service provision must encompass the needs of both parents and their children and assessments must take into account the needs of both these vulnerable groups. The human cost for parents with mental ill health is in attempting to parent their children in the face of stigma and adversities. Social Workers do not only need to support these parents but they also need to challenge the stigmas and adversities perpetuated by society. Society has perceptions of people with mental illness and this is largely negative, with the greatest misunderstandings being the perceptions of the more severe mental health conditions. Severe mental health conditions such as schizophrenia although not as prevalent as the depressive disorders are thought to affect one in two hundred adults each year (Mental Health and Social Exclusion Report 2004) and these conditions have a wider impact on the lives of the family, friends and community. It is widely recognised that one in four people of working age experience mental ill health at some point in their life, (Office for National Statistics 2008) but these problems can present in a variety of ways, depending upon the individual and their circumstances. What perhaps is most important to consider is how the person presents in relation to what is normal for them. Any great changes in mood or behaviour can be important indicators of deterioration in mental health, but it is clear that it would be dangerous to view this in isolation. It is therefore important to recognise that we all may experience various degrees of mental difficulty at some point in our lifetime. People with good mental health can; develop emotionally, creatively, intellectually and spiritually. They are able to initiate, develop and sustain mutually satisfying personal relationships; they can face problems, resolve and learn from them. They can be confident and assertive, are aware of others and have an ability to empathise; they can use and enjoy fun as well as laugh at themselves and the world. Good mental health is not something we have, but something that we do to take care of ourselves and value who we are as people (www.pmhcwn.org). However people experiencing mental illness do not always possess these attributes therefore need support to achieve wellness. To make the distinction between people who have children and then develop a mental illness or those who have a diagnosed condition before they have children the focus will be on the experiences of those people with mental illness who become parents and so have already been living with their condition or diagnosis. The aim of my dissertation will be to explore these issues by critically examining current research, practice, service provision and policy. This will be in the form of a literature based review where I want to question whether people with mental health issues can indeed parent their children safely. Firstly the Methodology used to assimilate the research will be examined with an explanation of the methods selected. Chapter One will define mental health, then focus on the historical context, policy and legislation and on the theories and approaches to ways of working considering the challenges that the social workforce face in supporting service users with mental health needs. Chapter Two will explore the experience of those parents with mental health problems; consider the capacity of people with mental health problems and the experiences of children of the mentally ill. This will be considered, from both a childs and a parents perspective. Chapter Three will focus on the main theme s to emerge from my research which are stigma, risk, resilience and attachment. The Results and Findings will be explored which will discuss the findings and present an overview of common themes which have emerged. The Conclusion will then draw together all the information gathered. Methodology When approaching this dissertation the decision was made to conduct a literature review of the research currently available. This was because mental health is an area of interest and combined with a placement in a childrens team, where it became obvious that many parents experience mental health issues it was an opportunity to combine the two areas. Previously the author has worked in a statutory provision which was a service supporting children and young people experiencing mental health issues and also had a placement in a community mental health team. All of these experiences have made the author inquisitive to the difficulties that parents encounter when attempting to take care of their children and the views of services of their abilities to do so. The search strategy used to locate appropriate material was to consider the various terms used when thinking about parental mental illness. Therefore a decision was made to search for the following terms; parental mental illness, children living with the mental illness of parents and capacity of parents with mental illness. When further considering what needed to be learnt, the terms; risk of children with mentally ill parents and resilience of children with mentally ill parents were then explored as were attachment of mentally ill parents and stigma and mental health. The concentration was on English speaking countries and so research was drawn together from Great Britain, Ireland, The United States of America and Australia. This was felt to be the most pertinent approach, as to broaden the search to further countries could create too much information and a difficulty in assimilating the research. Various databases were searched which included; Science Direct, Jstor and SwetsWise. T he British Journal of Psychology, The British Journal of Social Work and Social Care Institute for Excellence proved to be invaluable as did the various mental health websites such as MIND. Government reports and Department of Health documentation added a further breadth to the research which was drawn together. This search produced a significant number of journal articles in the area which were appropriate for the purpose, and coupled with mental health websites and books on parenting capacity a rich variety of material was gathered. The information further obtained from legislation and policy documentation was also invaluable. If there had been the time to explore this area in further detail it would have been suitable to have conducted a focus group amongst service users within the mental ill health community. From the research available it is clear that this research method was considered to be the most rewarding as service users felt the least threatened by the process (Garley et al 1997). It also garnered the most honesty from the participants and clarity of their experiences. They had felt safe in the knowledge that their recounting of their experiences would not be judged and their parenting abilities would be afforded due respect. Another option could possibly have been to send out questionnaires to ascertain the level of support service users felt they were receiving from community mental health teams and childrens services. However this method may not have produced such a wealth of results as it would not have been a face to face intervention. When viewing research, non face to face approaches have sometimes not been as well responded to by prospective participants. Chapter One This chapter will focus on how mental illness is defined; look at the historical context of mental illness service provision, the legislation and policy documentation and approaches and theories to ways of working. Defining Mental Illness Mental illness can affect one in four adults of working age at some point in their life, according to the World Health Foundation (2001). This demonstrates how prevalent mental illness is within our communities and how anyone can be affected by it at some point in their lifetime. However mental illness is defined by society in a variety of ways; there is the legal definition, clinical definitions and popular public misconceptions. This sections aim is to identify the three definitions of mental illness when considering the legal, clinical and public meanings. Mental disorder is defined in a legal context as arrested or incomplete development of mind, psychopathic disorder or any other disorder or disability of the mind (www.yourrights.org.uk). There are various definitions of mental health and amongst these the Mental Health Act 1983 offers three different definitions for mental disorder: severe mental impairment, which is defined as a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned (Mental Health Act 1983, Part 1). Mental impairment, which is defined as a state of arrested or incomplete development of mind (not amounting to a severe mental impairment) which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned ( MHA 1983, P art 1). Then psychopathic disorder which is defined as a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned ( MHA 1983, Part 1). However the 2007 Mental Health Act amendments changes the way the 1983 act defines mental disorder, so that a single definition applies throughout and abolishes references to categories of disorder( MHA 2007) The clinical definition comes from ICD-10, which is the International Classification of Diseases which was approved by the forty-third World Health Assembly in May 1990 and came into use in World Health Organisation member countries as from 1994. It is the international model for diagnostic categorisation of all general epidemiological conditions and health management. Within the ICD-10 there is classification of mental illness and mental disorders and this is used by clinicians to diagnose and therefore treat those people with mental illness. The foremost definition used is that any of various psychiatric conditions, usually characterised by impairment of an individuals normal cognitive, emotional, or behavioural functioning, and caused by physiological or psychosocial factors (ICD-10 Chapter V). When considering the public perceptions of mental illness, what is clear are the many negative perceptions of mental illnesses and disorders. The stigma that goes along with being labelled as having a mental illness can have far reaching consequences and needs to be challenged as a social injustice for this group (Cleaver et al 1999). Stigma is largely a social construct, in that society reacts negatively as a result of being fed sensationalist stories by the media. The Mental Health Knowledge Centre at the Institute of Psychiatry within the Maudsley Clinic London aims to promote change in public perception by addressing attitudes towards mental health conditions. The aim is that this will be achieved through ongoing public engagement activities and providing information for friends, families and carers of those with mental illness. Also initiatives such as World Mental Health Day endeavour to change public perceptions by bringing the conditions into the public arena. People experiencing mental disorders are often excluded from some societal norms due to a lack of knowledge or fear on behalf of the community as the Mental Health and Social Exclusion Report of 2004 puts this Mental health problems can be both a cause and a consequence of social exclusion (Mental Health and Social Exclusion Report 2004 p11). What is known is that mental health problems can affect anyone at any point in their life. However the debates around the differing definitions of mental health are important to discuss in relation to exploring the issues for people with mental health problems who are also parents. Stereotypical views of people with mental illness are that they are violent, unstable, and irrational and therefore their abilities to parent are questionable. These perceptions have been perpetuated by an ignorant society and need to be challenged. The Office for National Statistics has collected data to illustrate the prevalence of common mental health problems in the general population (see fig 1). Figure 1: Office for National Statistics (2000) Psychiatric Morbidity Survey. According to the Office for National Statistics the average age of early onset psychosis is twenty-two, but up to half of mental health problems start in childhood. For men, the age at which common mental health problems peak is forty-five to forty-nine years and for women fifty-fifty-four years. When looking at the statistics in terms of gender prevalence, women experience higher rates of problems than men and their experiences tend to last longer with greater occurrences of relapse. However what is known is that young men aged twenty-five to thirty-four are the highest risk group for suicide (Office for National Statistics 2000). Mental health illness is referred to in a variety of ways in the literature and research; therefore for the purposes of this paper, mental illness, mental ill health and mental health problems will be used interchangeably with the main emphasis being placed on the conditions of schizophrenia and psychosis rather than the depressive conditions.    Schizophrenia is a diagnosis given to some people who are experiencing severely disrupted beliefs and experiences.  Ã‚  During an episode, a persons experience and interpretation of the outside world is disrupted. They may experience hallucinations, lose touch with reality or see or hear things that are not there and act in unusual ways. An episode of schizophrenia can last for several weeks and can be very frightening (www.rethink.org). An episode of psychosis can be experienced in much the same way. However to appreciate contemporary understanding of mental illness, the historical context needs to be explained and how parents have been viewed by society. Historical Context Historically those individuals who experience mental illness may be treated for their condition by their local General Practitioner in the local community, however those individuals who require more intensive interventions may fall under the support of The Mental Health Act 1983. Following years of the institutionalisation of individuals with mental health disorders came the Mental Health Act 1983, which made provision for these people to be supported in the community. This important legislation made provision for the safety and well being of those people experiencing mental distress. For the first time, mental illness was recognised as a condition that could be managed in the community and newly formed community mental health teams would be the people to assist. The Mental Health Act 1983 made provision for individuals needing treatment to be detained under section, which meant that they could be legally detained to ensure that appropriate treatment was administered either in the fo rm of therapeutic intervention and or medication. This act was further amended in 2007, where one of the main amendments was to make provision for Community Treatment Order (CTO). This declared that a patient could be re-called for treatment in hospital if they had been discharged into the community and were not complying with the restrictions of their order. Policies imposed by local authorities must work within the guidelines of both The Mental Health Acts 1983 and 2007 and The Children Act 1989 in conjunction with the Care Programme Approach 2008. These government laws state how the care and treatment of people with mental health and the care and protection of children should be managed. A comprehensive care plan should address all the issues around the person and allow for their ability to parent by assessing their parenting capacity. Every Child Matters (2002) was one such provision developed to support children, the main duties being to cooperate and improve well-being, and to safeguard and promote the welfare of all children in England (www.everychildmatters.gov.uk ). Every Child Matters was developed following Lord Lamings report of 2002 which was implemented following Victoria Climbià ©s death in 2000. He highlighted within his report that a lack of integrative working across the different services and agencies had contributed to Victorias death. Every Child Matters legislates for improving information sharing between agencies to ensure the safety of children known to local authorities and this would be done by reducing the technical difficulties with the different interfaces used by the diverse services (ECM 2002). A huge challenge to overcome with much work still needed in this area as health, education and social services remain largely fragmented (ECM 2002). To attempt to overcome this, a common assessme nt framework was devised across services to ensure the information followed each child and reducing the necessity for duplication of information. These tools were then used to ensure that if a parent came to the attention of mental health services then the worker would be able to instantly determine if their children were also known to childrens services. Legislation and Policy Documentation The National Service Framework for Mental Health, from the Department of Health (1999) document states that local authorities have a duty to provide effective services for people with mental illnesses. Its aim is for individuals, who may or may not be parents, with a severe mental illness to be able to access and receive the range of mental health services that they need and consequently crises will be anticipated and averted. Therefore even if a parent is considered to pose a threat to their child they should be maintained with parenting support in advance. The recommendation being that there will be the integration of health and social care services with a strong emphasis on Interprofessional collaboration and this joined up working will promote the active participation of service users. The Mental Health and Social Exclusion Report of 2004 activated by the Office of the Deputy Prime Minister detailed in action sixteen better support for parents and their children (Mental Health and Exclusion Report 2004 p105). This challenge was taken up by the Action Sixteen Group who would review its implementation. This body comprised of ;the Social Care Institute for Excellence, Barnardos, the Department of Health, National Children and Adolescent Mental Health Services Support Service, Family Action and the Mental Health Commission. This membership of the Action Sixteen Group brought together professionals who were dedicated to improving outcomes for parents affected by mental illness and their children. The key messages to emerge from their discussions were that the mental health services should think family (www.scie.org.uk). This would be achieved by improved awareness, sharing of information across services and the development of resources for positive practice. Action Sixteen worked together to review the existing provisions for parents with mental health needs, including the needs of mentally unwell parents who were also belonging to an ethnic minority group and or were also disabled parents. It determined that parents need to be enabled to lead fulfilling lives in the way that they chose. That sigma and discrimination must be challenged and the rights of parents must be promoted, social exclusion must be confronted through implementing evidence-based practice and getting the basics in order must be a priority (Fowler et al 2009). This means enabling mentally ill parents to have access to decent housing, advice on finance and benefits, training and employment. (Fowler et al 2009). All of this needs to be approached from an informed viewpoint and the most appropriate theories and ways of working considered. Ways of Working The challenges for the social work profession to assist mental health service users are immense, diverse and complex. When approaching work with any vulnerable service user group it is important for social workers to maintain their social work values and recommend a holistic approach to their interventions with families (GSCC codes of Practice 2002). This would mean balancing practical and emotional support, offering appropriate counselling and working in a therapeutic way to best support parents with mental health needs (Darlington et al 2005). As previously discussed parents with mental health issues may experience social exclusion or isolation and it is a challenge for social workers to support these individuals to maintain a more integrative life. They also need to be aware of the power relationship between those who provide and those who access mental health services and the disempowering consequences of being labelled a mental health service user (Williams and Keating 2000). Re search studies have shown that it is a considerable challenge for people with mental illnesses to sustain and maintain social contacts and relationships (Huxley and Thornicroft 2003). Further research into this area as to how parents with mental illnesses can be encouraged to lead a more integrative life is needed. The requirements for the social work workforce within the mental health sector are clear guidelines for working in an integrated team, with strong leadership and comprehensible policies to enable improved multi agency working. This is further challenged by maintaining and preserving the separate skill bases of each profession within a community mental health team. Community psychiatric nurses (CPN) have trained to specifically achieve a qualification, as indeed have their social work colleagues and the blurring of roles may create disquiet amongst individuals. With the new Approved Mental Health Professional (AMHP) role being made available to professionals from other disciplines this may create further challenges within multi-disciplinary working. Only those professionals trained to become a health professional have the ability to administer medication and a large part of their role in working with the mentally ill is to ensure medication compliance. However medication is best supported if it works in conjunction with therapies (www.rethink.org) and the most recognised therapy to assist with mentally unwell individuals is Cognitive Behavioural Therapy (CBT). Cognitive Behavioural Therapy was developed by Aaron Beck (1921- ) in the 1960s as a psychological approach to assist people in changing how they thought and felt (Beck 1975). This approach is widely recognised today as the foremost talking therapy when working with the mentally ill. Any professional will need to approach working with a mentally ill service user from an informed position. The experiences of the vast majority of people with mental health problems are that they are labelled. Labelling theory was first applied to the term mentally ill in 1966 when Thomas Scheffs book- Being Mentally Ill was published. Scheffs claim was that mental illness perceptions needed to be challenged as mental illness was a social construction. He purports that no one is deviant and no action is deviant unless society deemed it to be so and that symptoms of mental illness are regarded as violations of societal norms (Scheff 1966), so to challenge societys view of their perception of mental illness is one way to assist those with mental illness and the stigma they experience as a result of labelling. When considering a parent with mental illness and the approaches to working with these individuals a holistic approach would appear to be the most pertinent to consider appropriate. This means taking into account the persons physical and spiritual health as well as their mental health needs (Hunt 2009). The Care Programme Approach is now recognised as the best way to do this. The Care Programme Approach 2008 or CPA as it is referred to within services is a way of developing a plan of work individualised to each persons needs. The Care Programme Approach has four main elements as defined in Building Bridges: A guide to arrangements for inter-agency working for the care and protection of severely mentally ill people (DoH 1995 p1). It works by assessing a persons needs and then developing a plan in response to those needs; the plan is then implemented and reviewed regularly to ensure that it is continuing to meet the individuals needs (www.dh.gov.uk). The latest development in policy implementation is New Horizons; a government program of action which has been launched to improve the mental well-being of people in England and drive up the quality of mental health care. New Horizons is a comprehensive initiative that will be delivered by local government, the voluntary sector and professionals with an aim of creating a society that values mental health. This will be achieved by ensuring the foundations of good mental health begin in childhood and continue through the lifespan, emphasising the importance of prevention as well as treatment and recovery (New Horizons 2009). All professionals will be encouraged to identify children whose parents may be experiencing difficulties and signpost them to appropriate services. The next chapter will consider how policy and legislation works in supporting parents with mental ill health by considering their experiences, how their capacity is measured and how their children view both their parents illness and treatment. Chapter Two This chapter will focus on the experiences of parents with mental health problems, their ability to parent, their parenting capacity and the experiences of children of the mentally ill. The numbers of parents who experience mental health issues is not clear but it is estimated that in excess of thirty per cent of the population may be affected. Experience of Parents with Mental Health Problems When considering the research available, what is clear is that the focus has been mainly on the female experience as women were found to be the main caregivers, Nicholson et al (1998). In a study, using focus groups with mothers, to explore the problems they faced as a result of their mental illnesses Nicholson et al concluded that the experiences these mothers recounted detailed their concerns, their struggles and their successes (Nicholson et al 1998 p 638). They discussed the anxiety of stigma and the worry of having their children removed by social services as well as the everyday struggles of looking after children (Nicholson et al 1998). In a study, to explore the experiences of new mothers Mowbray et al (1995) found that motherhood was a role of great significance for many women with mental health problems. The mothers in their study articulated just how important the experience of being a mother was to them, the joy that it brought for them and the growth in personal development it produced (Mowbray et al 1995). What is known is that parenting is viewed by society as being highly valued and although this is a common thread to all societies and cultures, most perceptions are that parents with mental illness are viewed negatively, (Mowbray et al 1995). Furthermore as parents with mental health problems are de-valued by society and their parenting capacities and abilities are questioned they fear that their children will be removed from their care therefore they avoid contact with social services even if they are aware they need support. This all adds to the stress that parents experience in coping with their mental i llness and the demands of parenting. Nicholson et al (1998) found that parents felt unable to ask for the support they may need due to the fear that social services would remove their children from their care. This was a great fear for the mothers in this study but further studies have also corroborated this, for example Cleaver et al (1998) reviewed data from research and discovered that forty- two per cent of children who were initially referred to child protection services following an assessment of their parent(s) mental health became subject to care proceedings. This indicates an equal fear on behalf of the professionals involved with parents with mental ill health, the need to protect balanced against the needs of the parent to maintain normal family life. Parents have therefore identified that they will be viewed as flawed by society and perhaps incapable of fulfilling one of societys most treasured roles and have their parenting abilities and capacity questioned (Ackerson 20 03). Parenting Capacity Parents with mental illness may have difficulty in caring for their children because they feel a need to focus on their own needs or are unable to recognise their childrens needs and this can impact on their parenting capacity. Other influences can also impact such as relationship breakdown, poverty, unemployment and social exclusion. There is a real difficulty in attempting to establish just how many parents have a diagnosis of schizophrenia or psychosis although it is estimated that as many as nine million adults may have a mental health need (www.family-action.org.uk ) Many of these illnesses go undetected with some parents refusing to acknowledge that they have a problem for fear of the consequences for their children (Beardslee et al 1983). For many parents the greatest fear being the removal of their children by social services. This is largely due to much of the current service provision being aimed at protecting children considered to be at risk from harm rather than supporting mentally ill parents to overcome the disabilities that hinder their parenting role. This could be better supported by intervention before a risk to the child becomes apparent (Kearney et al 2003). This is in direct conflict with the Children Act 1989, which recommends that wherever possible parents should be supported to care for th eir own children at home. This all creates a culture of fear for parents, as they cannot be honest about what they are experiencing as this may result in the removal of their children. However what is known is that there is a significant number of parents whose children are known to social services have a mental health problem (Crossing Bridges 1998). Having a mental illness can impact on the parents ability to care for their children in a variety of ways such as; being unable to provide food, clothing, shelter and warmth or indeed be able to keep their children safe from harm (White et al 1995). However if a parent makes what is perceived to be an unwise or eccentric decision this does not necessarily mean that they are lacking in capacity (Mental Capacity Act 2005). All parents are expected to provide; a safe physical and a secure emotional environment for their children, they are expected to demonstrate appropriate behaviour and provide opportunitie