Tom Chubb reviews a study of young people, transitions and social exclusion and Joanne Sherlock looks at a census of mental health users’ opinions of day centers.

Young people

A qualitative study of young people, drawing
out the factors influencing their transition to adulthood.

This is an excellent example of qualitative
research practice. It has clearly been carried out by people who
know their subject well and this report of the research project is
essential reading for anyone interested in the subject area or in
research methods.

Its style is compact and thoroughly engaging.
Following an introductory section setting out the theoretical and
policy context for the research and research methodology, we are
introduced to “six cameos of youth transition”, chosen
from the larger sample. These grip the reader and set the tone for
the following discussions, which are lively, informed, critical and
ultimately optimistic.

Undoubtedly, one of the strongest aspects of
this work is the level of the critical discussion. The authors
identify key themes from the cameos and set them against sound
frameworks of knowledge. For example, they comment on the
relationship between personal agency and structural constraints in
the careers of young people.

They consistently focus on the inescapable
tensions which exist between different aspects of the field
personal narratives or biographies, culture (including history,
language and transition), location, career pathways, and the wider
socio-political arena that includes the economic conditions that
bear upon the lives of the subjects.

The summarised findings are followed by a
discussion of policy implications. Here again, we find a compact
discussion of

complex and wide-ranging issues presented with
clarity, nicely illuminated by extracts from some of those involved
in the research.

Three brief appendices summarise some of the
data graphically: this is always helpful, although the publishers
might have given a little more thought to the colour schemes of the
graphs. This is a minor point, however, and should in no way
detract from what is essential reading for anyone involved in
working with young people.

Source: Les Johnston, Robert
MacDonald, Paul Mason, Louise Ridley and Colin Webster, Snakes and
Ladders: Young People, Transitions and Social Exclusion, The Policy
Press, 2000 (01235 465500).

Tom Chubb is an independent tutor and
trainer.

Mental health day care

A census study into clients’ views and
experiences of mental health day centers.

This study was a one-week census on four local
authority day centres to establish their usage and role. All
catered for clients with long-standing mental health problems and
were were funded by social services, but run by the Family Welfare
Association (FWA) and the local branch of Mind.

The centres differed in the range of
activities offered and although group programmes were newly
implemented, a predominantly drop-in culture still prevailed.

The key findings of the study were as
follows:

– Interviewed clients had been in contact with
services for an average of 17.8 years.

– Most were not working and just over half
lived alone.

– The commonest diagnoses were schizophrenia
(40 per cent) and depression (20 per cent).

– Average attendance was 24 clients per day
per centre.

– Sixty seven per cent were in the care of
community mental health team and most reported seeing their
key-worker regularly.

– The most popular aspect of the day centres
described was the company, followed by the food and the group
activities, art and music being the most popular.

– More than half were happy with staff contact
and the time available to talk to staff.

– Some 66 per cent reported physical health
problems, some of them unknown to those in the mental health
system. Lack of knowledge about physical health problems was more
noticeable for clients in the community than those in in-patient
wards.  

Day centres appeared to be highly valued by
clients, provided a “sense of belonging”  and were able to cater for a
wide range of needs. A study is under way to distinguish between
day centres and day hospitals, as differences between the two are
not always clear.

Further research needs to be done to
investigate the needs of this client group to inform service
planners.

Source: Jocelyn Catty and Tom Burns,
“Mental Health Day Centres – Their Clients and Role”
Psychiatric Bulletin (25), 2001.

Joanne Sherlock is a research
associate at the Sainsbury Centre for Mental Health.