- ItemResponding to Black African immigrant parents of children with disabilities in Irish Early Intervention Services: parental experiences and professional perspectives in the search for culturally competent practice(University College Cork, 2023) Jingwa, Ndemazia Asonglefack; Bantry White, Eleanor; Edwards, ClaireThere has been growing concern in recent years about how health and social care services in Ireland can respond appropriately to the needs of an increasingly diverse population. Internationally, literature demonstrates that immigrant families experience significant discrimination and racism in many areas of their life, including access to services, but we know less about these experiences in the Irish context. This research explores how black African immigrant parents of children with disabilities (from Nigeria, Cameroon and South Africa) in Ireland understand and experience accessing and engaging with Early Intervention Services; and how health and social care professionals respond to and engage with these families. It also explores the barriers and challenges experienced by families and indeed professionals, and specifically interrogates the concept of cultural competence in terms of its potential to offer a route to culturally responsive professional practice. The research took a qualitative approach based on constructionism. It used semi-structured audio-taped interviews to explore the experiences of ten parents and ten professionals. Purposive sampling was utilised. Interviews were transcribed, anonymised, coded and analysed through an inductive thematic analytic approach. Research findings indicate that parental service experiences are influenced by their cultural perceptions of disability and expectations for their child with a disability. While findings reveal parent appreciation for services being provided for their child, they also reveal tension and ambivalence in parent-professional relationships. The complexities of intersecting identities, compounded by unfamiliarity with the health care system, and other structural challenges are seen as influencing parental interaction with services. In conclusion, the research suggests that the concept of cultural competence in its current form is inadequate to respond effectively to the needs of African immigrant families, and that professionals do not feel adequately equipped and supported to engage in culturally competent practice. Drawing on insights from intersectionality theory, the research proposes a synergistic relationship between cultural competence and intersectionality to create the process of intersectional cultural competence.
- ItemVulnerabilities of trafficked rural Chinese girls in the UK asylum system: a thematic analysis(University College Cork, 2022-10-06) Murphy, Helen Louise; O'Riordan, Jacqui; Martin, ShirleyThis thesis presents the cases of ten rural Chinese girls who were transnationally trafficked and claimed asylum in the UK after presenting to the UK authorities as unaccompanied minors. The ten case-studies are drawn from a point-in-time historical sample of asylum case files which were created between the years 2007 and 2012. The thesis draws upon an ecological systems theoretical framework to analyse the girls’ lives and experiences as they were conveyed by the girls themselves to British immigration officials in a series of interviews and statements given over the course of the asylum process. It is underpinned by Pearce et. al’s conceptual framework of human trafficking as a social process and not a one-off event. The aim of the thesis is to identify forces at play both in China and the UK which may contribute to victims’ vulnerability to a recurring cycle of trafficking and re-trafficking. All ten girls were refused leave to remain by the Home Office and all ten refusal decisions were appealed against in Asylum and Immigration Tribunals. The available documents were accumulated by Professor Jackie Sheehan in her capacity as China Country Expert Witness in the girls’ appeals. As well as asylum interviews, witness statements and Home Office refusal letters, the asylum case files included practitioners’ reports, including those from support and advocacy groups and social workers and medical reports. All documents were systematically analysed and coded using thematic analysis. The data reveals much about official responses to child trafficking and provides an opportunity to track the asylum process and identify shortcomings which put child trafficking victims at risk of continued trafficking even whilst under the auspices of the UK authorities. It is argued that the prioritization of immigration status over safeguarding and a culture of hostility, disbelief, and feigned ignorance among Home Office civil servants and practitioners responsible for the welfare of the children can be viewed as secondary victimization which causes further harm to traumatised girls in relation to their safety, their physical and psychological wellbeing, and in relation to the outcome of their cases.
- ItemInclusion paradoxes in mental health: critical reflections on knowledge, (in)justice and privilege(University College Cork, 2022-09-04) Sapouna, Lydia; Dukelow, Fiona; O'Donovan, OrlaThis PhD thesis by prior publication speaks to and interrogates my engagement with mental health matters through a critical re-examination of the body of work submitted for consideration. The thesis is theoretically and politically located in the emerging field of Mad Studies, with a focus on epistemic justice and epistemic humility as expressions of prefigurative action. This is a thesis about knowing and knowers. It highlights my contribution to critical knowledge in mental health, while also interrogating the extent to which this knowledge prefigures more democratic and epistemically just ways of knowing and practicing. This is a thesis about the complexities, tensions and opportunities embedded in inclusion strategies in the mental health field. Adopting reflexive auto-critique as a methodology guides a double take on my engagement with mental health education, research, and activism. It also guides an examination of the nuanced politics of inclusion, innovation, and criticality in mental health. A reflexive auto-critique involves positioning myself in the making of inclusionary knowledge and practice, providing possibilities for insights into issues of knowing, privileging, engaging, and being an ally. A common thread linking this body of work is a concern with the paradoxes of inclusion strategies in the field of mental health which, despite being heralded as solutions to social exclusion, do very little to disrupt dominant exclusionary responses to madness and distress. Through this body of work, and this thesis, I propose that innovation and inclusion can only be meaningful when challenging the power imbalances in the context within which they take place. The emerging field of Mad Studies provides a conceptual framework to inquire about knowledge and knowers, to consider issues of co-option and epistemic violence, to focus on pedagogies for unlearning, to ask questions about representational politics and the complexities of being an engaged academic and Mad positive ally. This thesis is a product of my increasing unease about the appropriation and co-option of potentially radical ideas, such as recovery and service-user involvement, to serve institutional and professional interests. Moving beyond a critique of external systems, I consider how this appropriation and co-option can also happen, willingly or inadvertently, by critical initiatives, including my own praxis. I argue that criticality that fails to engage with the complexities of madness and distress can reproduce patterns of the exclusion it aims to eliminate. I examine how critical initiatives can privilege certain ways of knowing and therefore perpetuate power relations of superiority and epistemic injustice. I also consider how binary positions, including positions critical of dominant biomedical practice, can preserve a culture of knowing about rather than with and from Mad people, ultimately marginalising Mad knowledge. These are unsettling considerations but provide opportunities to unlearn by engaging with the complexities of Mad matters more deeply. Through these considerations, the concept of prefigurative politics emerges as a central concern in this thesis. Genuine engagements with mental health matters need to model the changes we aim to achieve. Engaging with the tensions of inclusion politics, the complexities of Madness, and the unsettledness this engagement generates, can be a source of knowing through epistemic humility and a resource for networks of solidarity.
- ItemWho gets ongoing service and why? An exploration of assessment, judgments and decision making during initial assessments in child protection and welfare social work in Ireland(University College Cork, 2022-10-07) O'Leary, Donna; Christie, Alastair; Perry, Ivan J.; Irish Research Council; TuslaBackground: Deciding whether or not to provide ongoing services following an Initial Assessment of alleged child abuse and or welfare concerns is one of the most important decisions that Social Workers make in Child Protection and Welfare. Despite this, very little is known about this practice or decisions at the conclusion of Initial Assessments or about the characteristics of children and families involved and their service needs. To fill these gaps, this thesis addresses the following issues: (i) current Irish policy for assessment and decision-making with reference to international developments; (ii) the organisational context for assessment practice; (iii) judgment and decision-making strategies that social workers use to determine eligibility for ongoing service; (iv) the characteristics of children and families who undergo Initial Assessment compared to the general population; (v) factors that are associated with the decision to provide ongoing service following an Initial Assessment; and (vi) comments on the efficacy of the current legislative and policy framework for assessment practice. Methods: Two empirical studies were informed by an extensive narrative literature review. A case study was designed to explore assessment practice in nine social work departments within a large administrative region of Tusla during the first quarter of 2016. Information collected from case file records (n=45) and interviews with SWs (n= 2 teams; n= 7 individuals) was thematically analysed to gain insight into the context for practice and into the sense-making and rationales provided for decisions. Secondly, a descriptive and analytic cross-sectional study was designed to profile children in Initial Assessments and to identify factors associated with the decision to provide ongoing service. Descriptive and multivariable analysis was applied to a complete sample of 480 children whose Initial Assessments concluded in seven social work departments in Tusla in the first quarter of 2016. That study also explored the use of the California Structured Decision Making© Family Risk Assessment (NCCD, 2017) to support decision-making. Results: The case study revealed that consistent with the literature, in situations of limited resources, a number of heuristic strategies were used to make decisions for ongoing service provision. Although social workers operate under a dual mandate of welfare and protection, in situations of high demand they prioritised caseload management over individual risk management leading to regret about judgments and decisions made in this specific practice context. The descriptive findings of the cross-sectional study revealed that families involved in Initial Assessments have greater burdens compared to the general population in addition to the specific child abuse and welfare-related difficulties investigated. The prevalence of exposures to risk factors is identified. Almost 2 in every 5 children (38.5%, n=185) remained open for ongoing service following Initial Assessment. In a multivariable model, several clinical and organizational factors were associated with ongoing service. In the analysis, the Irish model was compared to the California Structured Decision Making© Family Risk Assessment tool. The latter model would have allocated more children to ongoing service. Conclusions: The study makes many novel and important contributions to the literature. Through the originality of the study design, the research presents an in-depth exploration of the context for assessment practice and a detailed understanding of how SWs make decisions for ongoing service provision within this situated context. The findings are discussed in relation to their theoretical, practical, and research implications.
- ItemDiscretion at the frontline of homeless service administration: primary and secondary rationing by street level bureaucrats in Irish local authorities(University College Cork, 2022-11) Murphy, Niamh; O'Connell, Cathal; Finnerty, Joseph; Irish Research CouncilThe number of people experiencing homelessness in Ireland has increased significantly in recent years, with almost 11,000 currently using homeless accommodation. In order to access services, people are required to present to their local authority as homeless. Subsequently, frontline workers are required to make decisions around whether a person is considered homeless, as well as the level of service that they will be offered. Despite the high numbers of people presenting as homeless, little is known about this process of assessment and placement. To guide determinations of eligibility, the statutory definition of homelessness is outlined in the Housing Act, 1988. However, owing to the legislation’s ambiguity, local authorities can widen or narrow the definition as they see fit. As the definition is based on ‘the opinion of the local authority’ to determine whether someone is in accommodation which they can ‘reasonably occupy’, assessment staff must use substantial discretion when determining eligibility for services. In addition to the ambiguous statutory definition, the opacity of this area of welfare administration is compounded by the lack of additional formal guidance around determining eligibility. Likewise, this informal approach extends to decision-making around the type of accommodation offered to those who are eligible. Due to the informal work environment, a high level of discretion is granted to these frontline workers. Accordingly, Lipsky’s (1980) conceptual framework provides a useful means to examine the use of discretion among assessment and placement staff. Lipsky (1980) coined the term ‘street level bureaucrat’ to describe public service workers who have direct interaction with citizens and substantial discretion in the execution of this work. Through in-depth qualitative interviews with frontline workers based around Ireland, the research examined how discretion is used by these street-level bureaucrats to make decisions around rationing of homeless services at both a primary (assessment) and secondary (placement) level. The research found that although the frontline workers had a high level of discretion available to them in making decisions, management could influence how this discretion was used in some circumstances. This was mainly done through applying scrutiny when discretionary decisions resulted in offers of services to people whose eligibility was unclear, and through inattention when discretion was used to gate-keep services. Additionally, the research found that a narrow interpretation of the statutory definition of homelessness is being used by most of the frontline workers involved in the research, with rooflessness constituting homelessness that they described as genuine. People who presented to the local authority from living situations described as grey, for example couch surfing, were more likely to experience gatekeeping and denial of access to services. In some cases the frontline workers avoided the need to deny access to services through using an approach of covert deterrence. This involved presenting emergency accommodation in a negative way to an applicant so that they may be deterred from entering it, thus rationing demand for these services. Furthermore, significant differences were found in the approach of frontline workers towards homeless families and single people. Singles were more likely to experience gatekeeping behaviours than families were. This was most notable with regards to access to private emergency accommodation which the frontline workers stated was no longer available to single people except for in exceptional circumstances. As the first piece of research in Ireland examining homeless service administration from this perspective, the thesis is a starting point to fill a gap in knowledge around this subject. As such, it has begun the process of making an opaque area of public service delivery more transparent and therefore makes a significant empirical contribution to knowledge in the fields of streetlevel bureaucracy and the administration of homeless services in Ireland.