Exploring Community Treatment Orders: An Institutional Ethnographic Study
Notice bibliographique
Résumé
Community Treatment Orders (CTOs) involve mandated community treatment for individuals with severe, persistent mental disorders. The use of CTO legislation in Newfoundland and Labrador (NL), Canada is explored in this study through institutional ethnography (IE). This method is used by researchers seeking to elucidate everyday life experiences that occur within an institution. According to IE, the everyday work of individuals is coordinated and organized by social structures and discourses known as ruling relations that are inherent within an institution. These ruling relations exist often without our overt knowledge or awareness. One of the main findings in this study is that CTOs are socially organized to focus on legal issues of public safety and accountability. Worries about the possible risks to the public of severe, persistent mental illness supersede the therapeutic implications of the CTO. While health professionals’ activation of the CTO proceeds as though it is focused on treatment and recovery, the therapeutic interests are subordinate to the politico-legal interests of government. Informants in this study included family members, nurses and other healthcare team staff, managers, bureaucrats, and legal experts who had experience with CTOs. Data were collected through interviews and document review and examined for evidence of the social web of practices (ruling relations). The actual process of using the CTO legislation was mapped, highlighting the many points at which decisions were being made based on varying interpretations of the legislation. A number of disjunctures, or moments of incongruousness, were found. What the informants described as actually happening with the use of CTO legislation was sometimes in conflict with what they expected to happen, or with what the legislation identified as “suppose to happen”. Nurses’ professional ideology was also challenged in that nurses’ “therapeutic” actions often resulted in practices organized by the legislation that were at odds with the interests of patients and their families. The results of this study offer important insights about the use of CTOs in NL and should be of considerable interest to nurses and other health professionals, advocacy groups, families, and individuals with mental health concerns. It is hoped that increasing awareness to these social structures and disjunctures will foster a greater understanding of the challenges facing mental health nursing practice.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».