This article describes a European project which was aimed at improving the situation of persons with psychiatric or learning disabilities with regard to social participation and citizenship. The project took place in three countries (Estonia, Hungary and the Netherlands) and four cities (Tallinn, Budapest, Amersfoort and Maastricht). The project included research and actions at the policy level, the organizational level and the practice level. At the policy level, the framework of the United Nations Convention on the Rights of Persons with Disabilities (United Nations, 2006) and the European Disability Strategy (European Commission, 2010) were used to look at national and local policies, at the reality of the lives of those with disabilities and at the support that professional services offer with regard to participation and inclusion. The project generated a number of insights, recommendations and methods by which to improve the quality of services and increase the number of opportunities for community engagement. In this article, we present some of the lessons learned from the meta-analysis. Although the circumstances in each country are quite different with regard to policy, culture and service systems, it is remarkable that people with disabilities face many of the same problems. The study shows that in all three countries, access to services could be improved. Barriers include bureaucratic procedures and a lack of services. The research identified that in every country and city there are considerable barriers regarding equal participation in the field of housing, work and leisure activities. In addition to financial barriers, there are the barriers of stigma and self-stigmatization. Marginalization keeps people in an unequal position and hinders their recovery and participation. In all countries, professionals need to develop a stronger focus on supporting the participation of their clients in public life and in the development of different roles pertaining to citizenship
DOCUMENT
A growing interest in person-centered care from a biopsychosocial perspective has led to increased attention to structural screening. The aim of this study was to develop an easy-to-comprehend screening instrument using single items to identify a broad range of health-related problems in adult burn survivors. This study builds on earlier work regarding content generation. Focus groups and expert meetings with healthcare providers informed content refinement, resulting in the Aftercare Problem List (APL). The instrument consists of 43 items divided into nine health domains: scars, daily life functioning, scars treatment, body perceptions, stigmatization, intimacy, mental health, relationships, financial concerns, and a positive coping domain. The APL also includes a Distress Thermometer and a question inquiring about preference to discuss the results with a healthcare provider. Subsequently, the APL was completed by 102 outpatients. To test face validity, a linear regression analysis showed that problems in three health domains, i.e., scars, mental health, and body perceptions, were significantly related to higher distress. Qualitative results revealed that a minority found the items difficult which led to further adjustment of the wording and the addition of illustrations. In summation, this study subscribes to the validity of using single items to screen for burn-related problems.
DOCUMENT
Cannabis is commonly characterized as the most normalized illicit drug. However, it remains a prohibited substance in most parts of the world, including Europe, and users can still be subject to stigmatization. The objective of this study is to assess to what extent and how cannabis users in different countries with different cannabis policies perceive, experience and respond to stigmatization. We conducted a survey in the Dutch coffeeshops among 1225 last year cannabis users from seven European countries, with national cannabis policies ranging from relatively liberal to punitive. Three dimensions of cannabis-related stigma were investigated (discrimination, perceived devaluation and alienation) and a sum score was used to reflect the general level of stigmatization. Perceived devaluation was the highest-scoring dimension of stigma and discrimination the lowest-scoring. The general level of stigmatization was lowest in the Netherlands and highest in Greece. This indicates that punitive cannabis policy is associated with stigma and liberal cannabis policy is associated with de-stigmatization. Besides country, daily cannabis use was also found to be a significant predictor of stigma, but gender, age, household type and employment status were not.
DOCUMENT
Purpose: The aim of this study was to explore the functioning of people with lipoedema from their perspective. Methods: This was a qualitative study following a phenomenological perspective using individual in-depth interviews with a convenience sample of 13 Dutch people with lipoedema. The data were analysed by using an interpretative phenomenological approach. Results: Two overarching group experiential themes (GETs) were identified: (1) “physical complaints are only a part of their problems”, and (2) “longing for improved appearance and functioning”. The GETs were composed of the following subordinate GETs: “disproportionate functioning of the lower body”, “navigating daily life with lipoedema”, “coping with uncertainty”, “the toll of shame and stigmatization”, “consequences of a very negative self-image”, “desire for change and improved appearance and functioning”, and “an ongoing journey of acceptance”. Conclusions: Participants experience that physical complaints affect daily activities, but with adequate adaptability, participation issues are relatively limited. Instead, shame about their appearance and (fear of) stigmatization mainly leads to social avoidance. Additionally, participants long for freedom to do what they want, wear what they want, and desire a different appearance. Therefore, the experienced level of acceptance of the condition is context- and situation-dependent and not straightforward, which is complicated by the burden of knowing that the condition is chronic.
DOCUMENT
What happens when an etic category or label like “first-generation students” enters public discourse? In the Netherlands, public discussions of first-generation or first-in-family students and their predicaments have arisen in recent years. But few people grow up thinking of themselves in those terms. Not a common identity-marker, the concept is introduced in other moments, like in news items or in participatory research projects. But to what effect? And does it stigmatize or help?
LINK
Obesity, especially morbid obesity, is a major health problem with considerable impact on physical, mental and social quality of life. Assessment of quality of life is considered crucial to understand and evaluate the consequences of obesity. However, the heterogeneity of the quality of life concept makes it difficult to compare and value studies on quality of life. Both generic -applying to any disease- and obesity specific quality of life instruments can be used as assessment instruments in obesity. Generic instruments have the advantage that they can be used to compare the quality of life consequences of divergent diseases, whereas the major advantage of obesity specific instruments is that these are more sensitive to changes in obesity. Obesity has major consequences for quality of life, as a result of co-morbidities of obesity, weight stigmatization, and other less frequently ventilated problems. Bariatric surgery has been proven to lead to significant weight loss and improvement of quality of life. Instruments differ in the suitability to assess quality of life after surgery and weight loss, and they differ in the domains of quality of life that are tapped by the instruments. Besides obesity, also personal and psychosocial variables influence quality of life and affect the outcome of surgery. Obesity, even after substantial weight loss by gastric bypass surgery, is a chronic disease requiring life long consideration, in order to attain long standing quality of life improvement.
DOCUMENT
The relevance of citizen participation in regeneration projects, particularly in shrinking cities, is widely acknowledged, and this topic has received a great deal of policy and academic attention. Although the many advantages of citizen participation in regeneration projects have been identified, its current forms have also received considerable criticism. In short, this criticism boils down to the conclusion that the ideal of citizen participation is not put into practice. This paper considers why this is the case, asking whether current participatory practices enable citizens to exercise influence as political actors in urban regeneration projects. In this paper, we examine this question based on Mouffe’s conception of the political, coupled with findings from our empirical research conducted in Heerlen North, The Netherlands. We conducted qualitative research on urban regeneration in the shrinking old industrial city of Heerlen. The findings reveal two distinct perspectives on citizen participation. Professionals see the existing context of citizen participation as a reasonable and practical but, in some respects, insufficient practice. Citizens’ views on participation are organized around feelings of anger, shame, and fear and are grounded in experiences of a lack of recognition. These experiences limit citizens’ abilities to exert true influence on regeneration projects. We conclude that efforts to regenerate shrinking cities should strive to recognize these experiences so as to create conditions that generate respect and esteem and, as such, enable urban social justice.
LINK
Immense beyond imagination, the untamed rainforests of western New Guinea represent a biodiversity hotspot, home to several unique species of flora and fauna. The territory’s astonishing beauty and diversity is underpinned by a stunning array of natural resources. The island is also home to many indigenous communities practicing hundreds of local languages and traditions and depending on their natural environment for maintaining their traditional livelihoods, identity and culture. The territory’s much-contested decolonization process in the 1950-60s led to widespread discontent among indigenous Papuans and gave rise to persistent dissent from Indonesian rule, routinely met with disproportionately violent action by Indonesian security forces. Adding to these longstanding colonial ills and grievances, indigenous Papuan communities also struggle to grapple with inequitable allocation of land and resources, extreme pollution and environmental degradation caused by the mining and palm oil sectors. In the meantime, climate-exacerbated weather events have become more frequent in the region creating new tensions by putting an additional strain on natural resources and thus leading to an increased level of insecurity and inequality. In particular, these challenges have a disproportionate and profound impact on indigenous Papuan women, whose native lands are deeply embedded in their cultural and ethnic identity, and who are dependent on access to land to carry out their prescribed roles. Displacement also puts women at further risk of violence. Adding to sexual violence and displacement experienced by indigenous Papuan women, the loss of traditional lands and resources has been identified as having a singularly negative impact on women as it impedes their empowerment and makes them vulnerable to continued violence. The Papuan experience thus serves as a timely illustration to exemplify how environmental factors, such as resource extraction and climate change, not only amplify vulnerabilities and exacerbate pre-existing inequalities stemming from colonial times, they also give rise to gendered consequences flowing from large-scale degradation and loss of the natural environment.
DOCUMENT
Het verzuim en de instroom in de WIA als gevolg van een psychische aandoening zijn hoog. Dat komt niet alleen door de aandoening, maar ook doordat werknemers met een psychische aandoening daar vaak niet open over durven te zijn. Ze zijn bijvoorbeeld bang dat collega’s en leidinggevenden hen buitensluiten of dat ze hun baan verliezen, als bekend wordt wat er aan de hand is. Deze angst is terecht want er bestaan veel vooroordelen over werken met een psychische aandoening en er is sprake van stigmatisering. Het gevolg van niet-open erover zijn is echter dat de werkgever er ook geen rekening mee kan houden. Veel medewerkers met een psychische aandoening staan er daardoor alleen voor, lopen op hun tenen of gaan onderpresteren. Eventuele klachten worden daardoor erger. Werkgevers en HR-professionals kunnen daar wat aan doen. In dit artikel bespreken Aukje Smit, Dorien Verhoeven en Tinka van Vuuren de vooroordelen, de benodigde maatregelen en de strategieën om werkgevers (en dus ook HR-professionals) in beweging te krijgen aan de hand van een literatuuronderzoek naar stigmatisering van werkenden met een psychische aandoening
DOCUMENT
ABSTRACT This study investigates how perceptions of radicalisation and co-occurring mental health issues differ between mental health care and the security domain, and how these perceptions affect intersectoral collaboration. It is generally thought that intersectoral collaboration is a useful strategy for preventing radicalisation and terrorism, especially when it concerns radicalised persons with mental health issues. It is not clear, however, what perceptions professionals have of radicalisation and collaboration with other disciplines. Data was obtained from focus groups and individual interviews with practitioners and trainers from mental health care and the security domain in the Netherlands. The results show a lack of knowledge about radicalisation in mental health care, whereas in the security domain, there is little understanding of mental health issues. This leads to a mad-bad dichotomy which has a negative effect on collaboration and risk management. Improvement of the intersectoral collaboration by cross-domain familiarization, and strengthening of trust and mutual understanding, should begin with the basic training of professionals in both domains. The Care and Safety Houses in the Netherlands offer a sound base for intersectoral collaboration. Future professionals from different domains ought to be familiarized with each other’s possibilities, limitations, tasks, and roles.
DOCUMENT
