scwk

[scwk]

#RIPTwitter

Probably won’t be here but maybe I will. *blows cobwebs away*

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AASW Mental Health Practice Standards

If you’re applying to be an Accredited Mental Health Social Worker, you’ll be writing responses to the mental health practice standards - good luck!  The only copies of the practice standards I could find were in PDF documents, and the line breaks were all screwed up.  So i polished it up a bit, and here they are in HTML.  It’s just a bit easier to read, or use in documents.

Standard 1.1 Establishes a professional working relationship with the person who has a mental illness or disorder and their significant others

Indicators:

a. Listens respectfully to the person.

b. Provides the setting for an emotionally supportive, therapeutic relationship.

c. Values the lived experience of mental illness and consequences for the person and significant others, such as carers and family.

d. Gives due regard to the person’s age and cultural background, sensitive to ethnicity, race, socio economic standing and gender as variables that might affect the working relationship.

e. Works in partnership with the person and relevant others and ensures mutuality in assessment and action planning. Partnership and mutuality are values that extend to working with professional colleagues.

f. Communicates mutuality in the relationship by using inclusive language, avoiding terms that emphasise differences in experience, power and person hood between the person and the worker. Gathers and provides information in a way that respects the person’s experience, beliefs and feelings.

g. Welcomes and invites feedback from the person.

h. In all aspects of work, encourages maximum levels of the person’s participation in decision-making, emphasising self determination over day-to-day activities.

i. Is able to accommodate the needs language and understanding relevant to working with different age groups: children, young people, adults and older people.

j. When working with families and groups, recognises and seeks to accommodate the different experiences and perspectives of different family members and other relevant people

 Standard 1.2 Acts on the social justice issues related to people with a mental illness

Indicators:

a. Recognises the complexity of human experience, and sees the biopsychosocial assessment and interventions beyond the limits of illness, diagnosis, and treatment.

b. Challenges stigma and discrimination.

c. Facilitates access to necessary treatment and support services.

d. Promotes rights to participation in decision making and choice in mental health services.

e. Encourages organisations to be equitable, accessible and responsive to the needs and aspirations of people with mental illness and their significant others.

f. Ensures all civil and human rights are recognised.

 Standard 1.3 Integrates the concept of recovery into practice, promoting choice and self-determination within medico-legal requirements and duty of care

Indicators:

a. Supports people to take responsibility for their own recovery and wellbeing and to define their goals and wishes, irrespective of their legal status (for example, a person voluntarily participating in therapeutic intervention or a person receiving involuntary treatment and care).

b. Supports people to trust and collaborate with the mental health professional or multidisciplinary mental health team.

c. Works collaboratively and identifies the contribution of all people’s experience, expertise and strengths during all phases of contact, with particular regard to the person with the mental illness.

d. Promotes a service and organisational culture of optimism and understanding and uses language that conveys hope. Where necessary, challenges stigmatising attitudes and discrimination.

e. In situations where involuntary treatment is unavoidably indicated, works to minimise or eliminate the use of coercion, seclusion and restraint.

 Standard 2.1 Manages personal workload

Indicators:

a. Develops a clear understanding of the range of professional and administrative tasks required in their social work position or role.

b. Is conversant with the role of social work within the organisation, in promotional material if self-employed and to people with whom they engage.

c. Understands, respects and collaborates with other disciplines in the delivery of mental health services

d. Recognises the management structure of the agency or program and understands the lines of professional and administrative accountability.

e. Prioritises work activities.

f. Meets organisational or program professional and administrative deadlines.

g. Maintains organisational or program procedures for efficient completion of administrative and professional tasks.

h. Maintains agency or program requirements for record keeping, data collection and accountability of resources.

i. Complies with organisational occupational health and safety policies.

j. When self-employed, complies with professional indemnity requirements.

k. When self-employed applies sound business management practices to ensure the provision of effective services for people with a mental illness.

 Standard 2.3 Works as a professional in private practice, a member of a unit and/or a multidisciplinary team

Indicators:

a. Demonstrates respect for the profession of social work, and for other disciplines.

b. Understands the scope of the social work domain, skills, knowledge and values in the mental health area.

c. Is able to articulate a specific statement of social work purpose, roles and activities within the organisation and when collaborating with other organisations or private professionals.

d. Is familiar with the knowledge, values, and practice bases of social work in relation to other mental health disciplines.

e. Supports the activities of other mental health professionals in the organisation and when collaborating with other organisations or private professionals.

f. Promotes the importance of the domain of social work in mental health in developing a comprehensive service approach to understanding mental illness and providing services.

g. Applies a range of skills in problem solving, education, and conflict resolution to the management of day to day professional social work activity and when collaborating with other organisations or private professionals.

 Standard 3.1 Understands the way mental illness and mental health are conceptualized in the person’s culture of origin

Indicators:

In the person’s presentation, be aware of:

a. The extent to which the person accepts the concepts of mental illness and mental health in terms of their culture of origin.

b. Sources of possible conflicting views and practices between the culture of origin and Australian mainstream mental health and how differences may be accommodated or resolved.

c. Culturally appropriate ways in which the person can be effectively assisted, including collaboration with or referral to a multicultural mental health service.

 Standard 3.2 Understands the way mental illness and mental health are conceptualized in Aboriginal and Torres Strait Islander peoples’ culture and origin

Indicators:

In the person’s presentation, be aware of:

a. The extent to which the person accepts the concepts of mental illness and mental health in terms of Aboriginal and Torres Strait Islander culture.

b. Sources of possible conflicting views and practices between the culture of origin and Australian mainstream mental health and how differences may be accommodated or resolved.

c. Culturally appropriate ways in which the person can be effectively assisted, including collaboration with or referral to an Aboriginal and Torres Strait Islander mental health service.

 Standard 4.1 Possesses current knowledge, concepts and evidence-based theories of the individual in society

Indicators:

Be aware of:

a. Concepts and theories of human bio-psychosocial development through the lifespan, including development within a family and social context.

b. Knowledge of theories on child, young persons and adult psychopathology.

c. Concepts and theories of family formation and functioning.

d. Knowledge of the family in the Australian context covers areas such as marriage, separation and divorce, parenting, step parenting, extended family support systems, and changes to family functioning over time. It also includes recognition of diversity in family form based on ethnicity, culture, socio-economic status, and rurality, and significant relationships beyond the traditional family structure, such as same sex relationships.

e. Group behaviour and theories of group work.

f. The impact of illness on the person’s sense of self and their social roles, including issues of stigma, social disadvantage, and social justice.

g. The impact of abuse and trauma in the person’s life.

h. The recovery and the strengths perspectives of individual, family, and community functioning that support the process of people with mental illness achieving a better quality of life.

i. The impact of illness on the individual’s socio-economic status and wellbeing, including issues of income security, housing, employment and broader quality of life.

j. The relationship between mental health and family welfare and potential compromises to children’s and significant others’ roles.

k. Disability theory and the application of disability concepts to mental illness, treatment and rehabilitation.

l. Individual, family and group interventions.

m. General social work theory and its application to practice in the mental health field.

n. Organisational structures, change processes and dynamics within organisations.

 Standard 4.4 Possesses knowledge of mental health psychopathology

Indicators:

Understands:

a. Health, illness, disease and disability.

b. The expression of mental illnesses or disorders at different life stages.

c. The psychiatric classification, major syndromes, evidence-based theories and knowledge of aetiology, and evidence-based theories and knowledge of therapeutic interventions.

d. The interaction of mental illness with other comorbidities, such as alcohol and other drugs (dual diagnosis) and intellectual disability (dual disability).

e. Recovery principles and their application in relation to individuals, families, and communities.

f. The social determinants of mental illness.

g. The range of therapeutic, including psychosocial, interventions in mental health, and the evidence base for those interventions.

h. The issues likely to affect people with a mental illness and their significant others, including the sociology of alienation and oppression, and the history of mutual support and empowerment processes.

i. The practice paradigms of the other mental health disciplines.

 Standard 4.6 Has knowledge of government mental health policy

Indicators:

a. Is familiar with the principles of national and state policy.

b. Is familiar with the mental health policies of relevant peak bodies.

c. Seeks out related human service policies relevant to social work practice in mental health, and to people with a mental illness and their significant others, such as disability policy, broader health policy, income security and housing policies.

d. Articulates the principles and policy specific to the organisation in which the social worker is employed, and agencies with which the social worker has ongoing contact.

e. Applies these principles and policies in practice in determining work priorities and procedures.

f. Identifies and documents areas where policies conflict with each other or conflict with the social work professional code of ethics, or where policy is deficient in addressing the needs of clients.

 Standard 5.1 Completes a comprehensive bio-psycho-social assessment and case formulation addressing the physical, psychological and social aspects of the person and their situation

Indicators:

In consultation with the person:

a. Explores their understanding of their difficulties and strengths taking account of their physical, emotional, intellectual and, if sought, spiritual needs.

b. Gathers information from a range of sources to build up a comprehensive understanding of the person’s situational problems and strengths.

c. Undertakes a Mental State Examination and other assessments of clinical functioning as part of providing a comprehensive assessment service. This includes the application of specific assessment schedules, as appropriate, to develop a detailed knowledge of specific aspects of the problems and strengths.

d. Undertakes other assessments in specific clinical and related areas, for which additional specific training may be required to attain competence. These may be social work based, or related to other disciplines or multidisciplinary practice. Examples are the use of outcome measures, assessment of psychiatric disability, vocational capacities, age-related matters concerning children, adolescents, or older people, forensic issues, or the application of standardised assessment schedules requiring skilled analysis of data.

e. Identifies and assesses relevant indicators in order to minimise risk to the person or to others. Risk assessment includes the risk of self harming behaviour, the person’s vulnerability to domestic violence and other safety issues in the home and living environment, including child safety, and the potential for the person’s capacity to harm others.

f. Establishes or confirms the likely mental health condition and the influence and priority of factors affecting the person’s condition (or, in the absence of a formal diagnosis, forms a provisional diagnosis until this can be confirmed and discusses the priority factors affecting the person’s condition).

g. Applies knowledge and theory to the information gathered to develop a comprehensive statement linking the person's functioning and their strengths and problems with those in their social context.

h. Reviews this assessment statement with the person so as to develop a mutual understanding and agreement about the assessment as well as identifying and using the appropriate interventions as part of the intervention or service plan. Part of this process involves setting measurable goals as agreed with the person.

i. Regularly review the assessment and the intervention or service plan with the person to retain the focus on shared understanding of problems and strengths.

j. Maintains records of activity as required by accountability standards within the organisation or program.

 Standard 5.2 Develops and implements one or more evidence based, therapeutic interventions with the person

Indicators:

a. Identifies the evidence base for the therapeutic, including psycho social, intervention.

b. Forms a therapeutic relationship with the person.

c. Contracts with the person to establish a basis for the intervention.

d. Provides the person with information about the purpose, nature, risks, and likely outcomes of the intervention.

e. Negotiates a timeline for the intervention with the person.

f. Monitors and evaluates the implementation of the intervention with the person.

g. Undertakes additional training as necessary, including at an advanced level, in specialised therapeutic interventions.

 Standard 5.3 Advocates with and for person in relation to rights and resources

Indicators:

In consultation with the person:

a. Establishes the need for some form of advocacy to address identified rights or problems.

b. Explores the range of alternative actions available in order to address the identified need and supports action chosen.

c. Makes representations and facilitates negotiation as appropriate.

d. Monitors the activity of the treatment team to ensure that all decision making at every stage is respectful and inclusive of the needs and wishes of both the person and their family members.

e. Supports and encourages self advocacy through assisting with preparation, providing resources and giving feedback on performance.

f. Uses principles of mediation, negotiation, assertion, and conflict resolution.

g. Links individuals, carers and family members with support and advocacy groups as a resource as appropriate.

h. Challenges organisations or systems of service provision that are disempowering or discriminatory of people with mental illness and their significant others.

i. Uses high level communication skills to ensure the person’s best interests are represented.

j. Evaluates the outcome of advocacy.

k. Advocates with and for people within specialist complex contexts such as the forensic provisions of mental health legislation

 Standard 5.4 Undertakes case management (or a similar function)

Indicators:

In consultation with the person:

a. Develops an assessment of their psychological and social circumstances and needs and, where applicable, other members of the treatment team, other service providers, and family and friends, when possible and desired by the person.

b. Develops an intervention or service plan that takes account of short term and long-term goals and identifies how the case manager will support those goals.

c. Implements the intervention or service plan.

d. Consults with the person’s significant others, members of the treatment team and other service providers as appropriate for the implementation of the service plan.

e. Advocates to obtain resources and to support the person to achieve goals.

f. Reviews, revises and monitors the plan regularly

 Standard 5.7 Collaborates with other services

Indicators:

a. Makes contact with stakeholders from all sectors relevant to mental health, including housing, income security and employment, as well as health care practitioners.

b. Develops a working knowledge of relevant services in the community, and maintains formal and informal contact with service providers and management within these services.

c. Provides information about the social worker’s organisation and encourages appropriate liaison between this organisation and the range of community services.

d. Supports communication networks and co operation among all stakeholders of services in the community relevant to people with a mental illness and their families.

e. Brings individuals and groups together to share ideas on issues of common concern and potential solutions.

 Standard 8.1 Maintains a critical reflective approach to social work practice in mental health with the aim of improving currency of knowledge and skills

Indicators:

a. Identifies personal strengths in skill development and knowledge.

b. Maintains systematic records of social work practice activities as a basis for reflection.

c. Identifies areas for personal development in knowledge and skill base for practice.

d. Identifies recurring problems and achievements of the service or program as a whole.

e. Explores areas of key professional activity as described and developed in the research literature.

f. Shares critical reflections on practice within the professional supervision process and in formal and informal discussions with colleagues.

g. Reflects on professional activity in relation to the research literature.

 Standard 8.2 Access the research and literature to be informed of the evidence based for professional mental health practice

Indicators:

a. Regularly consults books and peer-reviewed journals relevant for practice through professional library resources and reliable web sources.

b. Critically evaluates research literature and web sources by applying knowledge of research design, processes, and standards for the analysis of data.

c. Maintains reading and exploration of knowledge in relevant research areas in order to inform practice.

[scwk]

Stress

Last night, my new meat cleave broke while chopping pumpkin.  That was kind of the cherry on top of a pretty awful week.

Some of the stress is good stuff, like planning for the birth of my first child, and how to be be a full time dad, and helping put together the amazing Burning Seed event.

Other stress is not as joyful, like having professional social work responsibility to people whose lives are in some pretty sad places.

Other stress just plain sucks, like watching Albo lead the Labor party away from a commitment to social justice, or feeling my humanity is being crunched in the cogs of a bureaucracy that appears to give not one shit about me.

I think I've hit a bit of a threshold this week, and I'm spending today reflecting on how to better handle the stress I'm feeling, what I can let go of, and how make sure I'm happy enough in the moment, instead of just anticipating happiness in the future.

It was around 2am on Saturday night,and I was standing next to a social work mate at the amazingly great Unicorns club.  I took a moment to soak in the atmosphere. I turned to her & remarked that I need to make sure I've got plans to enjoy the moment more than I do. I think I put too much effort into the future, and not enough energy into actually appreciating this hard work when it comes to fruition.

I like David Allen's Getting Things Done methodology for life, and I went to see what what he said about stress. His conclusion: you can't hide from stress (I certainly put a lot of effort into trying!!) and you'll never get to the end of everything that needs doing. The existentialist in me likes this bleak sounding assessment, because it demands an aswer- how to be happy in spite of this?

As a productivity guru, his answer is to have a system that actually handles the stuff you need to get done. I happen to like his system, and I generally feel a lot more effective as a result, but he's also pointing to a bigger existential truth. I can either hide from stress, or hope that I'll get to the end of it by grinding away. But both of them won't make me happy, and I've gotta find a way to stay on top of my stuff and be happy at the same time.

[scwk]

Not sure how this is one post instead of two, but I was chatting with my Grandfather again last weekend.  I fired off a few question’s I’d written for my partner’s Med Student Society trivia night, and he just blammed through them all like he had google hardwired into his brain.

Gender, Sex & Medical Records

Researching the above, and collected a list of articles, thought I’d share the the titles or link here and tag them, maybe they will be useful to someone.

Resources

Directly Dealing with recording sex/gender information

• Recommendations for Inclusive Data Collection of Trans People in HIV Prevention, Care & Services

• Collecting Sexual Orientation and Gender Identity Data in Electronic Health

• Does your organization use gender inclusive forms? Nurses’ confusion about trans* terminology

Of relevance

• http://www.aissg.org/PDFs/Dreger-Nomenclature-2005.pdf - VERY Clinical, but a useful resource for debunking SCIENCE SAYS THERE ARE TWO GENDERS WHAT IS THIS POLITICALLY CORRECT GARBAGE AND WONT SOMEBODY THINK OF THE DATABASE AND IT’S NEEDS???

• http://www.transhealth.ucsf.edu/trans?page=guidelines-terminology - excellent set of terms

• http://who.int/mediacentre/factsheets/fs403/en/ WHO factsheet & links on Sex & Gender

• Counting Trans Populations - http://www.transhealth.ucsf.edu/trans?page=lib-trans-count

• Identifying Training Needs of Health-Care Providers Related to Treatment and Care of Transgendered Patients: A Qualitative Needs Assessment Conducted in New England

Of Interest

• Serving Transgender People in California: Assessing Progress, Advancing Excellence

Unreviewed as yet, but the titles look relevant

• http://ee6qx5bs9t.scholar.serialssolutions.com/?sid=google&auinit=CA&aulast=Alegria&atitle=Transgender+identity+and+health+care:+Implications+for+psychosocial+and+physical+evaluation&id=doi:10.1111/j.1745-7599.2010.00595.x&title=Journal+of+the+American+Academy+of+Nurse+Practitioners&volume=23&issue=4&date=2011&spage=175&issn=1041-2972

• Reporting Sex, Gender, or Both in Clinical Research?

• Let’s Talk About Sex…and Gender!.

• Transitions to new concepts of gender.

• A novel method for estimating transgender status using electronic medical records.

• Gender incongruence/gender dysphoria and its classification history

• Gender Dysphoria and Gender Incongruence: An evolving inter-disciplinary field.

• Non-binary or genderqueer genders. [Review]

• Sexual identity and prevalence of alcohol and other drug use among Australians in the general population.

• Guidelines for psychological practice with transgender and gender nonconforming people.

• The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings.

• Gender, status, and psychiatric labels.

• Psychiatric management of intersexed patients.

• https://s3.amazonaws.com/amo_hub_content/Association140/files/Standards%20of%20Care%20V7%20-%202011%20WPATH%20(2)(1).pdf

• ‘I demand to be treated as the person I am’: experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

• Perceived efficiency impacts following electronic health record implementation: An exploratory study of an urban community health center network

• Transgender identity and health care: Implications for psychosocial and physical evaluation

• The Opportunity for Medical Systems to Reduce Health Disparities Among Lesbian, Gay, Bisexual, Transgender and Intersex Patients

• Beyond the binary: a proposal for uniform standards for gender identity and more descriptive sex classifications in electronic medical records

• Lesbian, Gay, Bisexual, and Transgender Healthcare, pp 51-63, Clinic and Intake Forms, Craig A. Sheedy

• Understanding Gender Through the Lens of Transgender Experience

• Improving health care encounters and communication with transgender patients

• Sex and Gender in Acute Care Medicine, By Alyson J. McGregor, Esther K. Choo, Bruce M. Becker

• Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

• Unanticipated: Healthcare Experiences of Gender Nonbinary Patients and Suggestions for Inclusive Care

• Minnesota Lesbian, Gay, Bisexual, Transgender, and Queer PATIENT TOOLKIT

• Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

• Psychological and Medical Care of Gender Nonconforming Youth

• The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives

• Trauma in Transgender Populations: Risk, Resilience, and Clinical Care

• The Creation and Implementation of a Transgender Cultural Competence Nursing Education Toolkit

• Promoting an Integrated Approach to Ensuring Access to Gender Incongruent Health Care

• Gender Identity: Pending? Identity Development and Health Care Experiences of Transmasculine/Genderqueer Identified Individuals

• Best Practices for Teachers and Providers: A Cross Systems Training to Support Gender-Variant Youth

Good Words

Procrustean

prə(ʊ)ˈkrʌstɪən/

adjective

1. (especially of a framework or system) enforcing uniformity or conformity without regard to natural variation or individuality.

“a fixed Procrustean rule”

Neatest Template I’ve Found So Far:

1. What is your gender identity? ☐ Male ☐ Female ☐ Transgender man / Transman ☐ Transgender woman / Transwoman ☐ Genderqueer / Gender nonconforming Additional identity (fill in) ________________ ☐ Decline to state 2. What sex were you assigned at birth? ☐ Male ☐ Female ☐ Decline to state

It’s concise, has some room for free response but also prompts.

[scwk]

Four years ago...  WTF america

Forward! Obama Wins 2nd Term

(Photo credit: Wikipedia)

Rachel L. West, MSW, LMSW The Political Social Worker

Ohio has…

View Post

shared via WordPress.com

[scwk]

Hanging with my cousins & grandfather yesterday, drinking whiskey & I mention my new word Procrustean.  Grandad enquires about the spelling & casually comments “I wonder if that’s related to Procrustes of Greek mythology.  He was fond of cutting people down or stretching them out to fit into a bed.”

I’d been meaning to look up the etymology of the word, and a quick search later confirmed my grandad is a walking google.

Gender, Sex & Medical Records

Researching the above, and collected a list of articles, thought I’d share the the titles or link here and tag them, maybe they will be useful to someone.

Resources

Directly Dealing with recording sex/gender information

• Recommendations for Inclusive Data Collection of Trans People in HIV Prevention, Care & Services

• Collecting Sexual Orientation and Gender Identity Data in Electronic Health

• Does your organization use gender inclusive forms? Nurses’ confusion about trans* terminology

Of relevance

• http://www.aissg.org/PDFs/Dreger-Nomenclature-2005.pdf - VERY Clinical, but a useful resource for debunking SCIENCE SAYS THERE ARE TWO GENDERS WHAT IS THIS POLITICALLY CORRECT GARBAGE AND WONT SOMEBODY THINK OF THE DATABASE AND IT’S NEEDS???

• http://www.transhealth.ucsf.edu/trans?page=guidelines-terminology - excellent set of terms

• http://who.int/mediacentre/factsheets/fs403/en/ WHO factsheet & links on Sex & Gender

• Counting Trans Populations - http://www.transhealth.ucsf.edu/trans?page=lib-trans-count

• Identifying Training Needs of Health-Care Providers Related to Treatment and Care of Transgendered Patients: A Qualitative Needs Assessment Conducted in New England

Of Interest

• Serving Transgender People in California: Assessing Progress, Advancing Excellence

Unreviewed as yet, but the titles look relevant

• http://ee6qx5bs9t.scholar.serialssolutions.com/?sid=google&auinit=CA&aulast=Alegria&atitle=Transgender+identity+and+health+care:+Implications+for+psychosocial+and+physical+evaluation&id=doi:10.1111/j.1745-7599.2010.00595.x&title=Journal+of+the+American+Academy+of+Nurse+Practitioners&volume=23&issue=4&date=2011&spage=175&issn=1041-2972

• Reporting Sex, Gender, or Both in Clinical Research?

• Let’s Talk About Sex…and Gender!.

• Transitions to new concepts of gender.

• A novel method for estimating transgender status using electronic medical records.

• Gender incongruence/gender dysphoria and its classification history

• Gender Dysphoria and Gender Incongruence: An evolving inter-disciplinary field.

• Non-binary or genderqueer genders. [Review]

• Sexual identity and prevalence of alcohol and other drug use among Australians in the general population.

• Guidelines for psychological practice with transgender and gender nonconforming people.

• The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings.

• Gender, status, and psychiatric labels.

• Psychiatric management of intersexed patients.

• https://s3.amazonaws.com/amo_hub_content/Association140/files/Standards%20of%20Care%20V7%20-%202011%20WPATH%20(2)(1).pdf

• ‘I demand to be treated as the person I am’: experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

• Perceived efficiency impacts following electronic health record implementation: An exploratory study of an urban community health center network

• Transgender identity and health care: Implications for psychosocial and physical evaluation

• The Opportunity for Medical Systems to Reduce Health Disparities Among Lesbian, Gay, Bisexual, Transgender and Intersex Patients

• Beyond the binary: a proposal for uniform standards for gender identity and more descriptive sex classifications in electronic medical records

• Lesbian, Gay, Bisexual, and Transgender Healthcare, pp 51-63, Clinic and Intake Forms, Craig A. Sheedy

• Understanding Gender Through the Lens of Transgender Experience

• Improving health care encounters and communication with transgender patients

• Sex and Gender in Acute Care Medicine, By Alyson J. McGregor, Esther K. Choo, Bruce M. Becker

• Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

• Unanticipated: Healthcare Experiences of Gender Nonbinary Patients and Suggestions for Inclusive Care

• Minnesota Lesbian, Gay, Bisexual, Transgender, and Queer PATIENT TOOLKIT

• Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

• Psychological and Medical Care of Gender Nonconforming Youth

• The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives

• Trauma in Transgender Populations: Risk, Resilience, and Clinical Care

• The Creation and Implementation of a Transgender Cultural Competence Nursing Education Toolkit

• Promoting an Integrated Approach to Ensuring Access to Gender Incongruent Health Care

• Gender Identity: Pending? Identity Development and Health Care Experiences of Transmasculine/Genderqueer Identified Individuals

• Best Practices for Teachers and Providers: A Cross Systems Training to Support Gender-Variant Youth

Good Words

Procrustean

prə(ʊ)ˈkrʌstɪən/

adjective

1. (especially of a framework or system) enforcing uniformity or conformity without regard to natural variation or individuality.

“a fixed Procrustean rule”

Neatest Template I’ve Found So Far:

1. What is your gender identity? ☐ Male ☐ Female ☐ Transgender man / Transman ☐ Transgender woman / Transwoman ☐ Genderqueer / Gender nonconforming Additional identity (fill in) ________________ ☐ Decline to state 2. What sex were you assigned at birth? ☐ Male ☐ Female ☐ Decline to state

It’s concise, has some room for free response but also prompts.

[scwk]

Gender, Sex & Medical Records

Researching the above, and collected a list of articles, thought I’d share the the titles or link here and tag them, maybe they will be useful to someone.

Resources

Directly Dealing with recording sex/gender information

• Recommendations for Inclusive Data Collection of Trans People in HIV Prevention, Care & Services

• Collecting Sexual Orientation and Gender Identity Data in Electronic Health

• Does your organization use gender inclusive forms? Nurses' confusion about trans* terminology

Of relevance

• http://www.aissg.org/PDFs/Dreger-Nomenclature-2005.pdf - VERY Clinical, but a useful resource for debunking SCIENCE SAYS THERE ARE TWO GENDERS WHAT IS THIS POLITICALLY CORRECT GARBAGE AND WONT SOMEBODY THINK OF THE DATABASE AND IT'S NEEDS???

• http://www.transhealth.ucsf.edu/trans?page=guidelines-terminology - excellent set of terms

• http://who.int/mediacentre/factsheets/fs403/en/ WHO factsheet & links on Sex & Gender

• Counting Trans Populations - http://www.transhealth.ucsf.edu/trans?page=lib-trans-count

• Identifying Training Needs of Health-Care Providers Related to Treatment and Care of Transgendered Patients: A Qualitative Needs Assessment Conducted in New England

Of Interest

• Serving Transgender People in California: Assessing Progress, Advancing Excellence

Unreviewed as yet, but the titles look relevant

• http://ee6qx5bs9t.scholar.serialssolutions.com/?sid=google&auinit=CA&aulast=Alegria&atitle=Transgender+identity+and+health+care:+Implications+for+psychosocial+and+physical+evaluation&id=doi:10.1111/j.1745-7599.2010.00595.x&title=Journal+of+the+American+Academy+of+Nurse+Practitioners&volume=23&issue=4&date=2011&spage=175&issn=1041-2972

• Reporting Sex, Gender, or Both in Clinical Research?

• Let's Talk About Sex...and Gender!.

• Transitions to new concepts of gender.

• A novel method for estimating transgender status using electronic medical records.

• Gender incongruence/gender dysphoria and its classification history

• Gender Dysphoria and Gender Incongruence: An evolving inter-disciplinary field.

• Non-binary or genderqueer genders. [Review]

• Sexual identity and prevalence of alcohol and other drug use among Australians in the general population.

• Guidelines for psychological practice with transgender and gender nonconforming people.

• The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings.

• Gender, status, and psychiatric labels.

• Psychiatric management of intersexed patients.

• https://s3.amazonaws.com/amo_hub_content/Association140/files/Standards%20of%20Care%20V7%20-%202011%20WPATH%20(2)(1).pdf

• ‘I demand to be treated as the person I am’: experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

• Perceived efficiency impacts following electronic health record implementation: An exploratory study of an urban community health center network

• Transgender identity and health care: Implications for psychosocial and physical evaluation

• The Opportunity for Medical Systems to Reduce Health Disparities Among Lesbian, Gay, Bisexual, Transgender and Intersex Patients

• Beyond the binary: a proposal for uniform standards for gender identity and more descriptive sex classifications in electronic medical records

• Lesbian, Gay, Bisexual, and Transgender Healthcare, pp 51-63, Clinic and Intake Forms, Craig A. Sheedy

• Understanding Gender Through the Lens of Transgender Experience

• Improving health care encounters and communication with transgender patients

• Sex and Gender in Acute Care Medicine, By Alyson J. McGregor, Esther K. Choo, Bruce M. Becker

• Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7

• Unanticipated: Healthcare Experiences of Gender Nonbinary Patients and Suggestions for Inclusive Care

• Minnesota Lesbian, Gay, Bisexual, Transgender, and Queer PATIENT TOOLKIT

• Patient Perspectives on Gender Identity Data Collection in Electronic Health Records: An Analysis of Disclosure, Privacy, and Access to Care

• Psychological and Medical Care of Gender Nonconforming Youth

• The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives

• Trauma in Transgender Populations: Risk, Resilience, and Clinical Care

• The Creation and Implementation of a Transgender Cultural Competence Nursing Education Toolkit

• Promoting an Integrated Approach to Ensuring Access to Gender Incongruent Health Care

• Gender Identity: Pending? Identity Development and Health Care Experiences of Transmasculine/Genderqueer Identified Individuals

• Best Practices for Teachers and Providers: A Cross Systems Training to Support Gender-Variant Youth

Good Words

Procrustean

prə(ʊ)ˈkrʌstɪən/

adjective

1. (especially of a framework or system) enforcing uniformity or conformity without regard to natural variation or individuality.

"a fixed Procrustean rule"

Neatest Template I’ve Found So Far:

1. What is your gender identity? ☐ Male ☐ Female ☐ Transgender man / Transman ☐ Transgender woman / Transwoman ☐ Genderqueer / Gender nonconforming Additional identity (fill in) ________________ ☐ Decline to state 2. What sex were you assigned at birth? ☐ Male ☐ Female ☐ Decline to state

It’s concise, has some room for free response but also prompts.

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SharePoint Needs

I’m attempting to develop a working model of a SharePoint for my employer, Health NSW.  Developing innovations in Health can be difficult, as the focus is on delivering front-line services and allocating resources for everyday innovations is unusual.  So if it seems like I’m skimping on paying for help, this is because I’m not resourced to do this.  I’m building this model in the hope it will improve the health of people in NSW.

I have a test SharePoint Site up and running with a preloaded list of users.  I have been asked to develop this into a working proof of concept in the next few weeks.

The end result I’m hoping for is a communication tool that will be used by clinicians across the state to liaise referrals for patients who are highly mobile and are very complex.  

So it looks something like this:

The fields are as follows:

Patient Name : Clinicians enter the name of the patient, this is already set up. Assigned To : This is the name of the clinician who creates the entry, this is linked to the People database, which has the clinicians contact number and which District they work for. Issue Status : This is a choice item, I’ve already populated this with what stage of the referral process the patient is at. Priority : This is a choice item, I’ve already populated this with how urgent the referral is.    Destination : There are a number of locations that can receive referrals, again, this is a choice item that I have already populated.

Here is the first challenge for me!  

Home Local Health District : I want this field to be populated with data from the People database, so that the District that the Assigned To: clinician works for is automatically populated.

Here is the second challenge for me!  

Associated Local Health Districts :  This is another field I want autopopulated, based on the content of the preceeding field.  I will have another data list that links each district with it’s neighbouring districts.

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Pulled this out at work today. It's always a winner.

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How big is Comet 67P/Churyumov–Gerasimenko?

The above images depict the comet compared to:

1. Boeing 747 2. Los Angeles, California 3. Toronto, Ontario 4. Boulder, Colorado 5. Raleigh, North Carolina 6. Melbourne, Australia 7. Lelystad, Netherlands 8. New York City, NY

Perspective.

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Perspective.

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The last three hours condensed into three xkcd-frames http://space-pics.tumblr.com/

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Everyone’s celebrating today :)

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It’s the first spacecraft ever to land on the surface of a comet.

It had less than 75% chance of a successful landing.

It will tell us if comets made our planet blue.

Why is the Rosetta comet landing so exciting?

[scwk]

What message is the ADFA's Skype scandal verdict sending out?

ADFA Skype case at the ACT Supreme Court. The two convicted cadets. At left is Dylan Deblaquiere and at right is Daniel McDonald. Photo: Graham Tidy

In August, former ADFA cadets Dylan Deblaquiere and Daniel McDonald were found guilty in the ACT Supreme Court of using a carriage service in an indecent manner. Back in 2011, the pair had orchestrated a scenario in which McDonald was filmed having sex with one of their ADFA colleagues and live streamed into a room of six men (including Deblaquiere).

On Wednesday, the pair were each sentenced to 12 month good behaviour bonds. The charges of indecency carry a maximum of five years, but Acting Justice John Nield took into consideration the pair’s "young age, their good prospects for rehabilitation, the likelihood they would not reoffend, and their otherwise unblemished criminal record".

So it appears that boys will be boys, or so the routinely offered mantra goes whenever society is forced to confront the abuses inflicted by men afforded individual and pack privilege.

Lawyer, Francis Cahill, centre front, addresses the media with Dylan Deblaquiere, left, and Daniel McDonald, centre back.Photo: Graham Tidy

Indeed, there was no small amount of blame attributed to the female victim when the case came to light. Sexual relationships between cadets are forbidden at ADFA, a fact which naturally led to a proportion of Australians arguing for equal retribution against the target of Deblaquiere and McDonald’s "prank" when the case first gained public attention.

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Evidently, being betrayed and then humiliated in front of her peers and subsequently ostracised and bullied by them (she recalls being referred to as "that Skype slut") wasn’t enough punishment for a woman who many saw as being the linchpin in the destruction of innocent boys’ careers. And make no mistake - there will be many in the community who welcome the end of her prospects while mourning the loss of theirs.

The social imperative to force complicity on to victims is strong in Australia, particularly when robust masculine codes are involved. Yes, what the men had done was wrong in a way - but she had to know what she was getting into, and why was she there in the first place, and what kind of woman, and she probably agreed and then regretted it and and and and all the other caveats and excuses we can come up with to avoid dealing with the stark reality that if there are dangerous fractures in the sexual conduct of our younger generations, they are agitated not by our women but by our men.

This communal act of disregard for another human being is not an isolated incident. The news is full of examples of men bonding over the violation of women, from Steubenville to the pack rapes in Cleveland, Texas to Daisy Coleman in Maryville; the pack rape of a 13 year old runaway in Austin, Texas to the gang rape of a 16 year old homeless girl in Brunswick; the rape and subsequent murder of Jyoti Singh Pandey on a New Delhi bus to the almost identical attack on Anene Booysen in Cape Town to the recent brutilisation of ayoung Kenyan girl that has left her in a wheelchair.

Not all of the incidents linked to directly above are exactly the same, but they all have one thing in common: they exist on a continuum of violence that is supported by a perceived sense of unquestionable masculine entitlement. Because what leads a group of men to participate in the pack degradation of another human being other than the deeply held belief that it is their right to do so?

When Deblaquiere contacted McDonald via text to say, “I just had a f---in sick idea pop into my head, f--- her n film it”, he wasn’t demonstrating a unique imagination. Rather, he was following in the footsteps of a long line of similarly privileged men who are empowered by society to behave exactly as they like towards women, and who will continue to be so as long as incidents like these are written off as the simple mistakes of men who got a little too carried away.

In all the noise surrounding women’s complicity in sex attacks and what women can do to avoid them and how it’s women’s responsibility to be aware, there is an infuriating resistance to identifying the real problem: to wit, that it is men en masse who perpetrate these crimes, and there is precisely nothing being done to challenge the behaviour that tells them it is their right.

In 2011, Deblaquiere and McDonald were not yet 20 years old. And yet, fresh from the "good" childhoods Acting Justice Nield said had been characterised by intelligence, positive performances in school and an otherwise unblemished criminal record, they thought nothing of orchestrating an event whose sole purpose was to sexually humiliate a female colleague for the gratification of their fellow peers, not one of whom was sufficiently disgusted by the act to try and stop it or even to report it.

Even throughout the trial, Deblaquiere and McDonald tried to protest their culpability, insisting that the woman had consented to being filmed despite identifiable evidence to the contrary. The lack of remorse isn’t just obvious, it’s downright frightening. And where does that come from, other than the internalised lifelong messaging that tells them they have the right to treat women like this because their dignity and right to experiment with "mistakes" is given precedence over a woman’s right to exist at all?

We are suffering a global epidemic of sexual violence, and it manifests in myriad different ways. The cancerous tumour at the core of all of this isn’t the brazen insistence of women to live "reckless" lives but the fundamental enforcement of masculine rights to space and power.

Lieutenant General David Morrison moved many people when he declared his intention to stamp out misogyny in the ADF. “The standard you walk past is the standard you accept,”he said, and those words have been quoted many times since. And yet, here we are again, walking past with a pathetic 12 month good behaviour bond. Nothing to see here folks. Keep it moving.

And the world, it keeps turning.