ABSTRACT
Using a collective case study design with benchmarking features, research reported here sought to locate differences in agency practices between public mental health agencies in which African American clients were doing comparatively better on specific proxy outcomes related to community tenure, and agencies with less success on those same variables. A panel of experts from the Ohio Department of Mental Health matched four agencies on per capita spending, percentage of African American clients, and urban-intensive setting. The panel also differentiated agencies on the basis of racial group comparisons for a number of proxy variables related to successful community tenure. Two agencies had a record of success with this client group (benchmark agencies); and two were less successful based on the selected criteria (comparison agencies). Findings indicated that when service elements explicitly related to culture were similar across study sites, the characteristics that did appear to make a difference were aspects of organizational culture. Implications for administration practice and further research are discussed.
Subject(s)
Benchmarking , Black or African American/psychology , Community Mental Health Services/standards , Mental Disorders/ethnology , Organizational Culture , Outcome Assessment, Health Care , Public Health Administration/standards , Cultural Diversity , Decision Making , Female , Health Services Research , Humans , Male , Mental Disorders/rehabilitation , Ohio , Organizational Case Studies , Patient Care Team/standards , Professional Competence , Professional-Patient RelationsABSTRACT
The ecosystems perspective has become the most prevalent approach for understanding the relationship between person and social environment. It views the individual and larger social systems as separate but contiguous elements that transact with each other in relationships of mutual influence. This article revisions the relationship between person and social environment through the lens of critical theory. Emphasizing distinctively human characteristics, arguments define human actors as coconstructors of, not just interactors within, their social environments. It is suggested that the individual is "in" the larger social system not so much the way a smaller box is contained within a larger box but rather the way dancers are in a ballet or a football team is in a game. The dancers and the players co-constitute the dance and the game. Although human behavior is shaped by society and its structures, those very structures are recursively constructed, maintained, and reproduced by the social actions of human agents over time. Implications for social work practice, research, and education are discussed.
