To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Third-sector organizations provide essential services, but not all types of organizations operate equally well given different intensities of public problems. This article argues for maps that would help social service funding bodies. Those maps would include three elements: (1) a measure of service demanded by a community, (2) data on the full range of organizations able to supply those services, and (3) a chart that identifies those organizations that provide services at different intensities of need. By providing information about the supply of organizations in a community, with measures of demand for services, state funding bodies, foundations, and individual philanthropists can make informed decisions about where to allocate funds. An ideal map is illustrated by using the case of the Holy Cross Dispute (2001), whereby a host of voluntary sector organizations provided a voice for residents in this divided Belfast community. The result is a call for more intensive mapping exercises of voluntary sector social service provision.
This article adds a much needed microlevel perspective to the literature on interactions between civil society organizations and governments. I argue that a microlevel perspective assists in making connections between two dominant streams in the literature on government–CSO relations: an empirical–analytical stream and a critical stream. It aims to better understand the interactions and relations, by analysing the institutional work done by CSOs’ members. Adopting this approach puts CSO members in a more agentic position. Interactional processes are brought to the centre of analysis. The Dutch Community Sport Coach programme was used as a case to illustrate the usefulness of the approach. Through a one-year organizational ethnography, the article scrutinizes the way in which members of one CSO enact the organization’s service delivery relationship with a municipality. Through a multidimensional perspective on agency, the analysis shows how individual CSO members act as embedded agents that assimilate a public logic into the dominant community logic. It further shows the CSO’s members efforts and struggle to maintain their community logic. The article argues that an analysis of the microfoundations of government–civil society organization relations foregrounds the multivocality of the relationship as foundational.
What factors make it more likely that political associations will engage in community service provision? This article examines the service provision activities of minority-identified political associations in the Middle East prior to the Arab Spring, giving an important view of associational activity during the period leading up to substantial political change in the region. Drawing from two distinct bodies of literature—on nonprofit organizations and on political violence—the paper analyzes organizational level data for more than 100 minority-identified, politically oriented voluntary associations in the Middle East and North Africa during the period from 1980 to 2004. We find that the likelihood of political associations also providing community services aligns more closely to variables found in the political violence literature than the literature on nonprofit organizations, making an important case for more cross-disciplinary analysis when examining associational life in the Middle East and North Africa.
The term “mapping” has garnered a lot of attention in civil society research and nonprofit studies. Important contributions to mapping discussions have often focused on definitional issues, what to include and not include, what the data is intended for, and measurement challenges. However, the who is undertaking the mapping is often neglected in these discussions. This short article comments on Brent Never’s recent piece in Voluntas and the mapping of civil society and nonprofit organizations in general. Never’s analysis pushes the conversation forward by recommending better maps with both supply and demand of services for funders and policymakers at the local level. However, it neglects the question of who should conduct the mapping and the implications resulting from who these mappers are.
LGBTQ+ organizations have a crucial dual role. They advocate and lobby for equality, while simultaneously providing vital services for LGBTQ+ communities. Different literatures provide perspectives on the hybridity of these organizations’ activities, highlighting the relation between political context and organizational capabilities. Yet, each body of literature emphasizes different elements. Building on key insights from nonprofit, social movement, and interest group literatures, this study investigates the contextual and organizational factors shaping the political and community-oriented activities of 294 LGBTQ+ organizations across 17 European Union countries. Using a unique dataset, it reveals that organizations faced with governmental repression reduce their political activities and increase their community-oriented activities. Organizational factors such reliance on membership fees and amount of funding sources have only a limited influence on organizations’ activities. These findings offer a more comprehensive understanding of how political and organizational contexts shape the work of LGBTQ+ organizations and emphasize the need for LGBTQ+ organizations to balance advocacy with community engagement, particularly in diverse and repressive environments.
According to social and fiscal contract theories, governments provide core social services largely to maintain their legitimacy. But does the state itself have to provide the services? In most developing countries, both nonprofit and for-profit schools and health clinics exist alongside those of the state. However, limited research has measured the relationship among citizens’ use of these services and attitudes about state legitimacy. This paper examines whether nonstate service provision is associated with decreased government legitimacy. We find a negative relationship between the use of for-profit services and state legitimacy, but no clear relationship between nonprofit service provision and legitimacy, even when controlling for satisfaction with services provided. We propose several explanations for why for-profit service provision could affect legitimacy that are not present in nonprofit services.
This study aimed to evaluate the general practitioner (GP) referral pathway for adult attention deficit hyperactivity disorder (ADHD) devised by the Irish Health Service Executive’s (HSE) National Clinical Programme for Adult ADHD (NCPAA). Primary objectives were to (i) quantify GP referrals to community mental health teams (CMHTs) for adult ADHD screening, (ii) measure workload on CMHTs related to screening adult ADHD referrals without comorbid mental health problems, and (iii) quantify access to adult ADHD screening through CMHTs and subsequent assessment and treatment access through specialist adult ADHD teams.
Methods:
An observational cohort design was used to retrospectively analyse ADHD-related referral data collected by clinical staff across 11 Irish CMHTs, and three specialist adult ADHD teams from January to December 2023.
Results:
There was high variability in adult ADHD referrals to CMHTs, ranging from 14 to 122 over one year. There was also high variability in the number of referrals seen by CMHTs, ranging from 9 to 82. From 304 referrals seen across 11 CMHTs, 25.3% required initial treatment for another mental health condition. Specialist adult ADHD teams received 3–4 times more referrals than they were able to assess during this timeframe.
Conclusions:
The NCPAA has provided crucial services for adults with ADHD in Ireland. However, an increase in neurodiversity awareness and demand for services suggests that a range of referral pathways depending on complexity level may be required. Alternative models are proposed, which require allocation of resources and training through primary care, secondary mental health services and specialist teams.
Community leaders attempt to deflect the stigma of the “angry” and “disorderly” Muslim by participating in local politics. In the wake of urban unrest affecting disadvantaged neighborhoods in France, Muslim leaders of the UOIF have leveraged their community influence to facilitate the integration of migrant-origin populations and keep these neighborhoods quiet. This chapter sheds light on their politics during episodes of social turmoil, such as the 2001 unrest in Lille and the 2005 riots throughout France. Beyond times of crisis, their role as social troubleshooters is reflected in the dissemination of an ethos of responsibility. Through various activities, including charitable assistance, professional insertion, and campaigns against drugs, these Muslim leaders partially converge with public authorities about the need to preserve order in “sensitive neighborhoods.” In ways reminiscent of Black middle-class reformers in the early twentieth-century US, UOIF leaders promote the uplift ideology that values self-reliance, discipline, and hard work. They seek to transform young urban worshippers into moral subjects, committed to avoiding the dishonorable pitfalls of idleness and incivility. However, positioning themselves as social troubleshooters is costly as these leaders unwittingly reproduce the dominant representations of migrants’ neighborhoods as problematic and, consequently, tend to divert attention from the structural causes of marginalization.
Edited by
David Kingdon, University of Southampton,Paul Rowlands, Derbyshire Healthcare NHS foundation Trust,George Stein, Emeritus of the Princess Royal University Hospital
CL psychiatry is one of the newer sub-specialties of adult psychiatry and is concerned with the practice of psychiatry in non-psychiatric settings. Typically, this means in general hospital wards and outpatient clinics, although in some countries, it also includes liaison with primary care. In recent years, there have been important changes in general medicine relevant to CL psychiatry. There is now a much wider recognition of the high prevalence of psychiatric and physical comorbidity and how this influences consultation frequency, service utilisation, treatment adherence, the physical prognosis and probably the overall cost as well. The relationship between physical disease and mental disorder is influenced by biological factors contributing to psychological change in physical disease, psychological factors in physical disease, social factors and comorbidity. There has also been recognition of the high prevalence of non-organic complaints among general medical patients as well as an awareness of the high costs of investigating these patients, which has led to a search for better ways to manage this group of patients.
Collaboration between general medical and psychiatric staff is essential. Psychological treatment and psychotropic medication can be effective. Mental capacity is an important and sometimes complex issue.
This chapter initially explains how dependencies are established when at least a part of an infrastructure system requires the provision of the service to function. Although the focus is on functional dependencies, this chapter also explores physical and conditional dependencies. Resilience metrics presented in previous chapters are broadened in order to represent the effect of dependencies on resilience levels. Dependencies established within an infrastructure system are also explained. The concept of buffer as a local storage of the resources related to the depending service is defined as part of these expanded metrics, and then it is exemplified by examining a practical application of such buffers: power plants for information and communication network (ICN) sites. After introducing the main concepts and ideas related to dependencies, this chapter takes a broader view by discussing interdependencies when those are established both directly and indirectly. The study of interdependencies for electric power grids and ICN also explores the relationship with other infrastructures, such as transportation networks and water distribution systems, and with community social systems.
Scholars and practitioners seek development solutions through the engineering and strengthening of state institutions. Yet, the state is not the only or the primary arena shaping how citizens, service providers and state officials engage in actions that constitute politics and development. These individuals are members of religious orders, ethnic communities, and other groups that make claims on them, creating incentives that shape their actions. Recognizing how individuals experience these claims and view the choices before them is essential to understanding political processes and development outcomes. This Element establishes a framework elucidating these forces, which is key to knowledge accumulation, designing future research and effective programming. Taking an institutional approach, this Element explains how the salience of arenas of authority associated with various communities and the nature of social institutions within them affect politics and development. This title is also available as Open Access on Cambridge Core.
The share of basic services that NGOs deliver has grown dramatically in developing countries due to increased receipt of aid and philanthropy in these countries. Many scholars and practitioners worry that NGOs reduce reliance on government services and, in turn, lower demand for government provision and undermine political engagement. Others argue that NGOs prop-up poorly performing governments that receive undeserved credit for the production, allocation, or welfare effects of NGO services. Using original surveys and a randomized health intervention, implemented in parallel to a similar universal government program, this article investigates the long-term effect of NGO provision on political attitudes and behavior. Access to NGO services increased preferences for NGO, relative to government, provision. However, political engagement and perceptions of government legitimacy were unaffected. Instead, the intervention generated political credit for the incumbent president. This study finds that citizens see NGOs as a resource that powerful government actors control, and they reward actors who they see as responsible for allocation of those resources.
Caring for a loved one with an eating disorder typically comes with a multitude of challenges, yet siblings and partners are often overlooked. It is important to understand if current clinical guidance for supporting carers are effective and being utilised for these groups, to help meet their needs.
Aims
To identify the experiential perspectives of siblings and partners of a loved one with an eating disorder compared with guidance for improving the adequacy of support provided to carers published by Beat and Academy for Eating Disorders.
Method
Three online focus groups were held for ten siblings and five partners from across the UK (12 females and three males). Carers had experience of caring for a loved one with anorexia nervosa (13 carers) or bulimia nervosa (two carers), across a range of therapeutic settings. Focus group transcriptions were analysed with thematic analysis.
Results
Four key themes were identified: (a) role-specific needs, (b) challenges encountered by siblings and partners, (c) generic needs and helpful strategies or approaches, and (d) accounts of service provision and family support.
Conclusions
Overall, the majority of experiences reported by siblings and partners did not meet the published guidance. Consequently, clinical practice recommendations were identified for services, alongside the charity sector, to take a proactive approach in detecting difficulties, providing skills training and emotional/practical support, adapting/tailoring peer support groups and supporting online facilitation. Our findings part-informed the design of our national online survey on loved ones’ experiences of care in eating disorders.
Services providing treatment for drug and alcohol users have developed considerably in the last 30 years. They are now provided in all areas of the UK and there are clear standards which govern how they should be provided and what they should provide. Over that period of development the outcomes services have been trying to achieve have changed. Initially, it was harm reduction and prevention of blood-borne viruses, then prevention of crime and most recently abstinence. Services for substance misusers are different from other services in that they are subject to a considerable amount of control from politicians and policy makers. Furthermore, services have had to change as drug and alcohol problems have changed. They have ebbed and flowed as funding sources have changed. Despite that they have been able to provide effective evidence-based treatment to many. This chapter explores the history of service provision, how treatment models have been developed and why and what elements of service provision are considered best practice.
As the ageing population in China continues to grow, more people will be living with long-term health conditions and require support from family care-givers. This scoping review therefore aims to explore sources of stress and coping mechanisms adopted by care-givers of older relatives living with long-term conditions in mainland China. Literature searches were conducted in English (CINAHL, EMBASE, MEDLINE, PsycINFO and SCOPUS) and Chinese (CNKI, WANFANG DATA, CQVIP and CBM) databases between October and November 2019. The searches focused on the stressors and coping mechanisms utilised by family care-givers residing in the community. Narrative synthesis was used to identify themes within the data. Forty-six papers were included: 20 papers from English and 26 from Chinese databases. Six themes captured stressors: care-giving time (N = 22), financial resources (N = 17), role and personal strains (N = 42), preparedness (N = 4), social roles (N = 10) and lack of adequate formal support (N = 22); and one theme captured coping (N = 14). Unmet needs of care-givers of older relatives in mainland China were found to be extensive. Only a few studies had attempted to explore the causal link between stressors, coping and the influence of culture. Findings underscore the significance of adequately capturing intricacies around care-givers’ unmet needs, rather than generalising on the basis of culture. Qualitative studies are critical to providing a better understanding of the relationship between stressors, coping and resources afforded to care-givers by their cultural environment. Having such understanding is crucial to inform the development of competent care, which promotes self-efficacy and self-actualisation in care-givers in mainland China.
This chapter presents the book’s major insight: no single “energy transition” takes place as countries contemplate adding wind and solar power. Rather, the issue convokes a variety of state and societal actors responding to the interests and institutions associated with four different policy arenas: climate change, industrial policy, electricity service provision, and the siting of infrastructure projects in communities. As the book shows, national energy transition results from the intersection of these arenas; some push transition forward; others hold it back. The chapter previews the overarching empirical argument that South Africa’s reliance on fossil fuel for electricity meant that climate concerns presented the sector with an existential threat, leading it to challenge energy transition on industrial policy and cost/consumption grounds, in a politicized process. Meanwhile, electricity’s small role in Brazil’s climate emissions led to a less politicized process: a series of national bureaucracies followed discrete standard procedures in interaction with just a few business/citizen groups, with industrial policy and cost concerns most influential in Brazil’s overall outcomes.
Citizens expect their states to provide basic electricity services, of acceptable price and quality. Wind and solar power have affected that by making electricity accessible for additional consumers, especially through local generation of solar power (distributed solar power), even as their prices have often been much higher than alternative electricity sources. This chapter examines how the Brazilian and South African states used wind and solar power to provide electricity services to their household and industry consumers. As electricity access was nearly universal in Brazil, wind and solar power’s primary contribution was to supply grid-scale electricity, along with a small number of solar installations for remote consumers. Growing controversies focus on the subsidies to small-scale generation and increased urban self-provision. In South Africa, wind and solar power entered a highly unequal electricity system – 32 companies used 40 percent of the electricity while the apartheid government had left Black South Africans unserved – and have done little to redress the inequalities. The same coalitions fought over the true price of electricity options as prices rose precipitously.
Since 2012 England has seen year-on-year reductions in people accessing specialist community alcohol treatment, and year-on-year increases in alcohol-related hospital admissions.
Aims
We examined perceived barriers to accessing specialist treatment, and perceived reasons behind hospital admission increases.
Method
We conducted focus groups (n = 4) with service users and semi-structured interviews (n = 16) with service providers and service commissioners at four specialist community alcohol services in England, which experience either high or low rates of alcohol dependence prevalence and treatment access. Themes and subthemes were generated deductively drawing upon Rhodes’ risk environment thesis. Data were organised using the framework approach.
Results
Data reveal a treatment sector profoundly affected at all levels by changes implemented in the Health and Social Care Act (HSCA) 2012. Substantial barriers to access exist, even in services with high access rates. Concerns regarding funding cuts and recommissioning processes are at the forefront of providers’ and commissioners’ minds. The lack of cohesion between community and hospital alcohol services, where hospital services exist, has potentially created an environment enabling the reduced numbers of people accessing specialist treatment.
Conclusions
Our study reveals a treatment sector struggling with a multitude of problems; these pervade despite enaction of the HSCA, and are present at the national, service provider and individual service level. Although we acknowledge the problems are varied and multifaceted, their existence is echoed by the united voices of service users, service providers and service commissioners.