People with psychosocial disabilities and mental health conditions are commonly exposed to human rights violations within the mental health care system and the general community. The negative consequences of such violations have been widely documented but attempts to change the status quo have met with little success. The present dissertation aims to challenge this situation and advance the human rights-based global agenda for mental health by promoting a change within the mental health care system and the general community. Chapter 2 is a scoping review that comprehensively examines the literature on interventions that apply a human rights-based approach to promote the rights of persons with psychosocial disabilities and mental health conditions in health settings and the general community. Chapter 3 is an empirical paper that evaluates the psychometric properties of three instruments that can be used to assess the effect of future interventions aiming to promote the rights of persons with psychosocial disabilities and mental health conditions. Chapter 4 is an empirical paper that assesses the efficacy of the WHO QualityRights e-training, a new intervention to promote the human rights of persons with psychosocial disabilities and mental health conditions. The scoping review indicated that there is a growing body of literature on interventions that apply a human rights-based approach to promote the rights of people with psychosocial disabilities and mental health conditions. However, many of the studies evaluating these interventions are currently low-quality and there is urgent need for additional and methodologically robust research on this topic. Additionally, our findings showed that worldwide there are many promising practices and interventions that are currently unexamined or insufficiently evaluated. The psychometric analyses in Chapter 3 indicated that the three instruments developed to assess the knowledge about the rights of persons with mental health conditions and psychosocial disabilities (WHO QualityRights Knowledge), the attitudes towards them and their role as rights holders (WHO QualityRights Attitudes), and mental health professionals’ practices related to substitute decision-making and coercion (WHO QualityRights Practices) are sufficiently valid and reliable and could be used in future research. Finally, the data analyzed in Chapter 4 demonstrated that the WHO QualityRights e-training, compared with a placebo intervention, is effective in improving mental health professionals’ knowledge about human rights and attitudes towards people with psychosocial disabilities and mental health conditions and their role as rights-holders. Furthermore, these improvements are maintained over time. The WHO QualityRights e-training was also effective in reducing self-reported practices related to substitute-decision making and restraint both at 3 and 6 months. Given the impact that human rights violations have on the health and wellbeing of persons with psychosocial disabilities and mental health conditions, more efforts are needed to develop new interventions and carry out methodologically strong research in this area. This dissertation is a right step in this direction.

A one sample pre-post design was used simultaneously with three work groups to study the effects of a health team development intervention on interdisciplinary (ID) team processes. Effects were measured by participant questionnaires, managerial diagnostic and follow-up interviews, and by direct observation of team meetings. The intervention, as conducted by internal facilitators, was published in Improving the Coordination of Care: A Program for Health Team Development by Rubin, Plovnick, and Fry. Positive changes were found in members' perceptions of their team's general effectiveness, their leader's approachability, and the value of their meetings. No changes were found in member participation and influence, however, when pre-post differences were compared using the Dunn-Bonferroni approach to multiple t-tests on nine Mean Factor Difference Scores of the Group Behavior Inventory. Structured observation data showed increases in proportional frequencies of Interpretative statements, Alternatives suggested, and Decisions made during teams' meetings. Questions asked and Information given categories on the Team Observation Protocol data showed decreases. No change occurred on the two seldom-used categories, affective statements about Client and Team. Pre-intevention diagnostic interviews had shown that senior management's and team facilitators' expectations were congruent with the goals, roles and procedural areas targeted for change by the team development program. However, Follow-up interviews corroborated prior organization development research. That is, a comprehensive organizational diagnosis of teamwork problems was needed prior to the selection and implementation of team development with ID teams. Especially sensitive areas for management-consultant negotiation in future efforts to implement HTD should include the use of internal or external third party facilitators, the selection of teams, role of team leaders, and the adaptation of materials and activities to suit ID team tasks. Where conflict exists between senior management and team leaders, other interventions may be needed before team development can be expected to affect positively, ID team members' participation and involvement. Recommendations were made for structural changes to strengthen ID teamwork at the training center. The absence of an empirically-derived theory of ID team performance effectiveness continues to be a barrier to the demonstration of intervention effects and to education for teamwork. Research is needed to describe empirically relations between problem-solving processes in ID team meetings and treatment decisions. Research is also needed to delineate team-role competencies required by members and leaders as prerequisites to establishing indicators of ID team performance effectiveness. / Ed. D.

何欣. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 272-284) / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in Chinese and English. / He Xin.

The environmental transactions of mentally retarded adults were investigated in three community-based programs as a measure of client adjustment to community living. Specific features of the interaction between clients and the physical and social environment were identified and evaluated. The research settings and subjects were: a group home (7 clients/4 staff); a semi-independent apartment setting (13 clients/4 staff); and a work adjustment program (11 clients/5 staff). Methodological procedures were: observational procedures, including the Community Interaction Assessment instrument, a form of behavior mapping which emphasized social interaction, and the Bales Interaction Process Analysis, an observational technique for structured groups; the structured questionnaires which make up the Moos Multiphasic Environmental Assessment Procedure (MEAP); and unstructured observations and interviews, used as procedures in the various settings in the larger community. Results were presented in terms of the particular features of the physical and social environment which were related to the incidence of social interaction. Rank order correlations of the MEAP residential and staff data revealed a significant positive relationship among all three settings, indicating similarities across all research settings in staff and resident characteristics. A significant positive correlation was also found in the group home and apartment environmental evaluations, indicating strong similarities in staff attitudes in the two residential settings. An analysis of variance indicated a significant difference in the MEAP policy data obtained for the three settings, suggesting important differences primarily in the areas of policy choice, resident control, and provision for privacy. Normative data was presented for the residential programs based on MEAP findings. Results were discussed in terms of the implications of findings for design, program, and community integration issues and suggestions for future research were presented.

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

published_or_final_version / Urban Planning / Master / Master of Science in Urban Planning

Since the enactment of Public Law 94-142, the Education for All Handicapped Children Act, 1975, the Office of Special Education (OSE) within the United States Department of Education (USDE) has channeled funds directly into services for handicapped American Indian children. Despite the multiple service providers and the funds available, services provided for handicapped Indian children do not seem to be adequate. Bureau of Indian Affairs' (BIA) studies show that Indian children have a higher than average incidence of handicaps but are not afforded the services necessary to deal with these handicaps. A paucity of information exists about services for Indian youth, and research on the adequacy of services provided by the multiple service agencies appears to be limited. Various service components such as identification, evaluation, placement, and service continuum may be administered by different agencies and complicates systematic accountability in the care of handicapped children. Reservations generally have five main service providers: (1) state and local education agencies (SEAs and LEAs); (2) Bureau of Indian Affairs (BIA); (3) Health and Human Services (HHS); (4) Indian Health Service (IHS); and (5) Tribal agencies. This study analyzed policies of the five agencies and the legal provisions under which they operate. The study also offers some solutions to the chronic problems in education that are confronted by handicapped Indian children on Arizona Indian Reservations.

Thesis (MScMedSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: This was an investigation into the needs of people with physical disabilities in the district of Butterworth, and their accessibility to available resources, conducted with the aim of improving service delivery in the area. As a physiotherapist the researcher has always been in close contact with people with physical disabilities, and could see the problems they had. The researcher then embarked on conducting this study with the aim of helping them. The study was conducted in three areas, a rural area called Zangwa Administrative Area, Bika, a township, and Skiti, an informal settlement. The research methodology used was qualitative research. Participants in this research included people with physical disabilities, caregivers of people with physical disabilities, and service providers dealing with people with physical disabilities in the district of Butterworth. Methods of data collection used were focus group interviews for people with physical disabilities and caregivers, and questionnaires for service providers. The reason why service providers were given questionnaires, and not interviewed in focus groups, was that they were from different government departments and it was not possible for them to be part of a focus group due to the commitments they had. Questions in the questionnaires and in the interview schedules used in the focus group interviews were similar to each other, and were open ended. A total of 24 people with physical disabilities were recruited to take part in the focus group interviews in identified locations. Nine caregivers of people with physical disabilities, drawn from two of the above locations participated in this study. Focus group interviews were tape recorded, with the informed consents of the participants. The response rate to the questionnaires was 81%: 13 of the 16 service providers returned completed forms. Data analysis was done through a process of listening to the tapes, together with other students, to ensure the trustworthiness of the data, taking detailed notes, translating the interviews from Xhosa to English, coding the data and putting them into categories, with similar categories building up into themes. In the case of the questionnaires, similar responses were grouped together, and those showing the same responses from participants were prioritised. The results of the research indicated that the primary needs of people with physical disabilities were housing, employment, skills‟ development - emphasising training in those skills which could bring them an income - assistance with income generating projects, suitable public transport, accessibility of buildings and facilities, driving schools catering for people with physical disabilities, and Primary Health Care. They needed Primary Health Care to not only address their basic health needs, but to include preventative care, the promotion of effective care, curative and rehabilitative care. At a personal level they required disability grants, caregivers, intimate relationships and marriage. While caregivers placed greater emphasis on assistive devices and Day Care Centres to give them some respite time, service providers emphasised on education for children with disabilities, which neither people with physical disabilities nor caregivers had mentioned. The service providers also said nothing about the need for caregivers and housing. These disparities in the needs mentioned by these three groups of participants showed that needs that may seem important to professionals and other service providers, may not be important to people with disabilities, therefore it is important to consult with the consumers first, before planning for service delivery. It was clear that services were not easily accessible, due to transport and financial problems, as travelling for people with physical disabilities meant additional expenses in terms of hiring special vehicles. Another barrier to accessing resources was lack of knowledge about the availability of those resources, and how they could be accessed. On the basis of this study, recommendations have been made to relevant service providers for the planning and improvement of service delivery. These include more accessible buildings, good roads, and the appointment of suitable individuals to fill vacant posts in different government departments so as to be able to reach all people with physical disabilities in the district of Butterworth. Finally, the researcher emphasizes the need for outreach programmes to raise awareness about available services. / AFRIKAANSE OPSOMMING: Hierdie ondersoek ten opsigte van die behoeftes van mense met fisiese gestremdhede in die Butterworth distrik en hul toegang tot die beskikbare hulpbronne is gedoen met die oog daarop om dienslewering in die omgewing te verbeter. Die navorser het die studie in drie areas naamlik: Zangwa Administratiewe Area,`n landelike gebied, Bika, „n dorp en Skiti, „n informele nedersetting gedoen. Kwalitatiewe navorsingsmetodes is gebruik. Studie deelnemers het bestaan uit mense met fisiese gestremdhede, versorgers van mense met fisiese gestremdhede en diensverskaffers aan mense met fisiese gestremdhede in die Butterworth distrik. Fokus groep besprekings met mense met fisiese gestremdhede en hulle versorgers is gebruik om data in te samel. Voorts is data verkry vanaf vraelyste wat deur diensverskaffers voltooi is. Vier en twintig persone met fisiese gestremdhede, uit bogenoemde drie areas, is geselekteer om aan die fokusgroep besprekings deel te neem. Nege versorgers van persone met fisiese gestremdhede, uit twee van bogedoemde areas, het ook aan die studie deelgeneem. Fokusgroep besprekings is op band opgeneem, met die toestemming van die deelnemers. Dertien van die sestien diensverskaffers (81%) het voltooide vraelyste ingehandig. Volgens die resultate het persone met fisiese gestremdhede `n behoefte aan behuising, werk, vaardigheidsontwikkeling, projekte wat inkomste genereer, geskikte openbare vervoer, toegang tot geboue en fasiliteite, bestuurskole wat voorsiening maak vir mense met fisiese gestremdhede en primêre gesondheidsorg. Die volgende persoonlike behoeftes is geidentifiseer: ongeskiktheidstoelae, versorgers, intieme verhoudings en huwelike. Die versorgers het meer klem geplaas op hulpmiddels en dagsorgsentrums. Die behoefte aan dagsorgsentrums kan aanduidend wees daarvan dat versorgings verligting van die sorg las nodig het.. Diensverskaffers het op hulle beurt klem gelê op `n behoefgte aan onderwys vir kinders met gestremdhede. Dit is nie deur of persone met fisiese gestremdhede of versorgers genoem nie. Die diensverskaffers het niks oor versorgers gesê nie. Die verskille tussen die behoeftes wat deur die drie groepe deelnemers uitgelig is dui daarop dat behoeftes wat as belangrik voorkom vir proffesionele persone en ander diensverskaffers nie noodwendig belangrik is vir mense met gestremdhede nie. Dit is dus belangrik om eers die klient te raadpleeg voordat dienslewering beplan word. Vervoer en finansiele probleme het daartoe gelei dat dienste ontoeganklik was. Vervoer vir mense met fisiese gestremdhede bring addisionele onkostes mee omdat `n spesiale voertuig gehuur moet word. „n Verdere struikelblok met betrekking tot toegang tot hulpbronne was `n gebrek aan kennis oor die beskikbaarheid van hulpbronne in die studie area. Aanbevelings na aanleiding van die studie sluit in: groter toeganklikheid tot geboue, goeie paaie en die aanstelling van geskikte individue om vakante poste in die verskillende staatsdepartemente te vul om sodoende die mense met fisiese gestremdhede in die Butterworth distrik te bedien. Ten slotte, wil die navorser klem lê op die behoefte aan uitreikprogramme om mense bewus te maak van beskikbare dienste.

A research report submitted to the Faculty of Management, University of Witwatersrand, in partial fulfilment of the Degree of Masters of Management (in Public and Management Development) February 2017 / Accessibility in the built environment has always created barriers for persons with disabilities. Accessibility in public buildings is a key factor for persons with disabilities in achieving livelihoods and independence. However, inaccessible public buildings limits the rights of persons with disabilities to equal participation and prevents them from being equal citizens. Persons with disabilities are often faced with barriers that limit them from actively participating in social and economic life. Many of these barriers are related to accessibility in the built environment. This research report looked into the Department of Public Works’ Accessibility Programme. The accessibility programme intends to make all state-owned buildings accessible for persons with disabilities. The participants of the study were mostly implementers of the accessibility programme and participants from organisations of persons with disabilities. Most of the participants acknowledged the work the Department of Public Works has done. However, they also noted shortcomings in implementing the accessibility programme. The lack of knowledge on disability issues and understanding on how to address accessibility in the built environment was a contributing factor to the ineffective and efficient accessibility programme. The recommendations of the study include inclusive disability programmes in the built environment in the planning, policy development, designing and completion stages. Education and advocacy are highly recommended at all stages of the implementation of the accessibility programme. / MT2017

Although significant progress has been made to increase the throughput rate of students with disabilities in tertiary education, there is still much to be done as many disabled students face discrimination and difficulty in acquiring and receiving support. Moreover, disability policy often does not lead to practice at tertiary level. Many students with disabilities still need an ally for basic accommodations. The focus of this research study was on the perceptions and experiences of the students with disabilities at the University of KwaZulu-Natal: Howard College Campus regarding the University’s Disability Unit. This is in terms of the facilities and services offered by the Disability Unit as well as how effective it is in its functioning and meeting its students’ needs. This study was designed to explore the Disability Unit from the perspectives of students’, their experiences and responses to it. This research study was conducted with students with disabilities from the University of KwaZulu-Natal: Howard College Campus. The sample population included six participants from the major categories of disability at the University: visual and physical impairments. Of the six participants selected, two were without sight, two were partially sighted, and two were physically disabled. Furthermore, participants comprised both males and females and were studying at different levels at the University (i.e. first year, second year, fourth year and fifth year students). This research study aimed to explore the effectiveness of the Disability Unit at the University of KwaZulu-Natal: Howard College Campus in meeting the academic needs of its students with disabilities, from the perspective of the students with disabilities. Results from the current research study revealed that inadequate staff, resources and funding, poor coordination and communication between significant role players, substandard relationships, and insufficient awareness (around disabled students’ academic and social needs) among the entire University population represent major barriers to success for students with disabilities. Moreover, although student support services play a crucial role in supporting students with disabilities, the entire institution and university population, staff and students alike, is responsible for creating an inclusive environment where students with disabilities can experience a sense of community and attitudes of embracing diversity and accommodating differences. Responsibility, thus, lies with all relevant role players of the University of KwaZulu-Natal: Howard College Campus who must work together to overcome institutional as well as social barriers; accommodate for the students with disabilities, endeavour to meet their academic, emotional and social needs, and help them develop academically. In the future, progress can be made through the increased coordination of disability support services and programmes to educate faculties and peers about support, accommodations and rights of individuals with disabilities. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Durban, 2010.