Re-framing 'binge drinking' as calculated hedonism: empirical evidence from the UK.

BACKGROUND: Recent debates on 'binge drinking' in the UK have represented the activities of young drinkers in urban areas as a particular source of concern, as constituting a threat to law and order, a drain on public health and welfare services and as a source of risk to their own future health and well being. The discourse of moral panic around young people's 'binge drinking' has pervaded popular media, public policy and academic research, often differentiating the excesses of 'binge drinking' from 'normal' patterns of alcohol consumption, although in practice definitions of 'binge drinking' vary considerably. However, recent research in this area has drawn on the notion of 'calculated hedonism' to refer to a way of 'managing' alcohol consumption that might be viewed as excessive. METHODS: The paper presents a critical analysis of contemporary discourses around 'binge drinking' in the British context, highlighting contradictory messages about responsibility and self control in relation to the recent liberalisation of licensing laws and the extensive marketing of alcohol to young people. The paper analyses marketing communications which present drinking as a crucial element in 'having fun', and as an important aspect of young people's social lives. The empirical study involves analysis of focus group discussions and individual interviews with young people aged 18-25 in three areas of Britain: a major city in the West Midlands, a seaside town in the South-West of England and a small market town also in the South-West. RESULTS: The initial findings present the varied forms and meanings that socialising and drinking took in these young people's social lives. In particular the results illustrate the ways in which drinking is constituted and managed as a potential source of pleasure. CONCLUSION: The paper concludes that the term 'calculated hedonism' better describes the behaviour of the young people in this study and in particular the way they manage their pleasure around alcohol, than the emotive term 'binge drinking'.

Adolescents' perception of risk and challenge: a qualitative study.

Concern has been mounting about the increasing numbers of adolescents who engage in risky behaviours. This qualitative study aimed to identify adolescents' perception of risk and explored the factors that adolescents felt influenced their decisions about engaging in risky behaviours. The results indicated that adolescents perceived risk to be something where the outcome was uncontrollable. In contrast, challenges were thought of as having a known end point that was difficult to achieve. They considered themselves to be well-informed about health risks facing them, yet mentioned occasions when they lacked the ability to state that they did not want to engage in certain "risky" behaviours. The implications of the findings for future interventions are discussed.

Using therapeutic community principles to improve the functioning of a high care psychiatric ward in the UK.

The effects of interventions within a high-care psychiatric ward, based upon the principles of a therapeutic community, were evaluated. Interventions included an enhanced physical environment, improved communication, clear rules and aims, and improved safety procedures. A Ward Atmosphere Scale, an Attitude Scale, and interviews with staff indicated improvements in ward atmosphere and staff attitudes. Ward records showed a substantial reduction in the use of seclusion for aggressive patient behaviour, and a 62% reduction over 2 years in short-term staff illness. The authors conclude that similar interventions could be used to improve the functioning of other psychiatric wards.

Admissions to hospital for deliberate self-harm in England 1995-2000: an analysis of hospital episode statistics.

BACKGROUND: Rates of deliberate self-harm (DSH) were increasing in the United Kingdom during the 1980s and early 1990s, particularly among young adult males. Self-poisoning with paracetamol was the most common means, with overdoses of anti-depressants becoming more frequent. Changes to paracetamol pack size regulations in 1997 have been followed by a reduction in overdoses, and there has been more prescription of anti-depressants less likely to necessitate hospitalization if overdosed. Improved liaison psychiatry services and increased levels of employment are among the factors that would suggest an impact on hospital admissions for self-harm. This study analysed DSH admissions to hospitals in England from 1995/96 to 1999/2000 to examine changes. METHODS: A retrospective analysis of the Hospital Episode Statistics database was carried out. RESULTS: Hospital admissions for DSH rose to 153 per 100000 in 1997/98, then declined to 143 per 100000 in 1999/2000. Paracetamol overdoses decreased from 77 to 67 per 100000. The use of anti-depressants or tranquillizers grew from 56 to 75 per 100000 during the 5 years. Self-injury, narcotics overdoses and the use of alcohol continued to increase over time. CONCLUSIONS: Yearly increases in admissions for DSH to hospitals in England reversed in 1998/99 and stabilized in 1999/ 2000. These changes were most noticeable for the 16-24 years age group. The use of paracetamol decreased, whereas other means of self-harm increased. Regional differences and the relationship between rates of DSH in the community and hospital should be explored further.