Kim Hopper

• Nathan Kline Institute

This introduction to the Special Issue Indigenous Youth Resilience in the Arctic reviews relevant resilience theory and research, with particular attention to Arctic Indigenous youth. Current perspectives on resilience, as well as the role of social determinants, and community resilience processes in understanding resilience in Indigenous circumpol...

This qualitative study of youth resilience takes place in an Alaska Native community, which has undergone rapid, imposed social change over the last three generations. Elders, and successive generations have grown up in strikingly different social, economic and political contexts. Youth narratives of relationships in the context of adolescent growt...

This commentary revisits dilemmas of relevance that applied anthropology in the U.S. has long grappled with, no matter the rigor and depth of inquiry. Direct action, collaborative research and active public engagement offer proven alternatives for upping the participatory quotient, but they remain the exception. A third, more common, middle ground...

Indigenous circumpolar youth are experiencing challenges of growing up in a context much different from that of their parents and their grandparents due to rapid and imposed social change. Our study is interested in community resilience: the meaning systems, resources, and relationships that structure how youth go about overcoming difficulties. The...

Indigenous circumpolar youth are experiencing challenges of growing up in a context much different from that of their parents and their grandparents due to rapid and imposed social change. Our study is interested in community resilience: the meaning systems, resources, and relationships that structure how youth go about overcoming difficulties. The...

President Obama should convene a National Commission on the Health of Americans to address the social causes that have put the U.S.A. last among comparable nations.

This introduction to the Special Issue Indigenous Youth Resilience in the Arctic reviews relevant resilience theory and research, with particular attention to Arctic Indigenous youth. Current perspectives on resilience, as well as the role of social determinants, and community resilience processes in understanding resilience in Indigenous circumpol...

This qualitative study of youth resilience takes place in an Alaska Native community, which has under- gone rapid, imposed social change over the last three generations. Elders, and successive generations have grown up in strikingly different social, economic and political contexts. Youth narratives of relationships in the context of adolescent gro...

The articles in this special section rejoin a conversation about the terms and conditions of social participation that was suspended some time ago. While welcoming the move, this commentary raises some questions about the vehicle. The formidable achievements of supported housing notwithstanding, it still functions as an abeyance mechanism ensuring...

The aim of this study was to identify components of cultural competence in mental health programs developed for cultural groups by community and mental health professionals from these groups. Three programs were studied: a prevention program primarily serving African-American and Afro-Caribbean youth, a Latino adult acute inpatient unit, and a Chin...

The compatibility of recovery work with the Assertive Community Treatment (ACT) model has been debated; and little is known about how to best measure the work of recovery. Two ACT teams with high and low recovery orientation were identified by expert consensus and compared on a number of dimensions. Using an interpretive, qualitative approach to an...

Although psychiatric stigma in China is particularly pervasive and damaging, rates of high expressed emotion ("EE" or family members' emotional attitudes that predict relapse) are generally lower than rates found in Western countries. In light of this seemingly incongruous juxtaposition and because Chinese comprise approximately one-fifth of the wo...

We sought to increase the accuracy of New York City's estimates of its unsheltered homeless population. We employed 2 approaches to increasing count accuracy: a plant-capture strategy in which embedded decoys (or "plants") were used to estimate the proportion of visible homeless people missed by enumerators and a postcount survey of service users d...

Quality of life, once a priority in caring for people with severe mental illness, has since been eclipsed by other concerns. This article returns attention to quality of life by offering a theory of social integration (as quality of life) for persons disabled by severe mental illness. Data collection for this qualitative study consisted of 78 indiv...

Objective: Quality of life, once a priority in caring for people with severe mental illness, has since been eclipsed by other concerns. This article returns attention to quality of life by offering a theory of social integration (as quality of life) for persons disabled by severe mental illness. Methods: Data collection for this qualitative study c...

Resurgent hopes for recovery from schizophrenia in the late 1980s had less to do with fresh empirical evidence than with focused political agitation. Recovery's promise was transformative: reworking traditional power relationships, conferring distinctive expertise on service users, rewriting the mandate of public mental health systems. Its institut...

Despite decades of deinstitutionalization, individuals with psychiatric disabilities living outside the hospital may be described as in the community, but not of it. To effectively address the persisting problem of social exclusion of persons with psychiatric disabilities, new conceptual tools are needed. To address this need, a new definition of s...

Received wisdom and a substantial body of epidemiological work indicate that early psychosis bodes ill for matrimonial prospects. Using follow-up data from ISoS, the WHO-Collaborative International Study of Schizophrenia, we confirm an earlier local finding that marital success, 15 years after first-break psychosis, is quite favourable in India: 74...

This study examined whether outcomes in housing, clinical status, and well-being of persons with severe mental illness and a history of homelessness differ between those in supported housing and those in community residences, two housing arrangements that substantially differ in the level of independence that is offered to its tenants. A quasi-expe...

Refusal of services has long been treated as prima facie evidence of a disordered mind; this paper inquires instead into the tainted nature of the offer. I first sketch the conflicted nature of relief in the American welfare state—hedged so as to ensure only the truly needy will apply—and the way symbolic means are deployed to that end. I then go o...

Established legal mandates and high expectations for psychiatric advance directives are not matched by empirical evidence documenting their actual implementation. To explore the interests, concerns and planning activities of informed mental health service users contemplating such directives. Standard qualitative research techniques were used: field...

Drawing on ongoing fieldwork in New York City, the authors distinguish two "genealogies," or developmental traditions, of supported housing. "Housing as housing" originated in the mental health field to champion normalized, less-structured alternatives to clinically managed residential programs. "Integrated housing development" traces its origins t...

The documentation amassed in these provisional assessments of the changing terms and conditions of psychiatric work amounts to a reconfiguring of the moral economy of care--those root value-laden assumptions about what constitutes proper conduct in a service or treatment context. Such a transformation appears to have been in the works for some time...

Conceptual and methodological problems plague efforts to prevent homelessness. Attempts to identify individuals at risk are inefficient, targeting many people who will not become homeless for each person who will. Such interventions may do useful things for needy people, but evidence that they prevent homelessness is scant. Subsidized housing, with...

Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables...

This article examines the long-standing and provocative finding of a differential advantage in course and outcome for persons with schizophrenia living in "developing" countries, using results from the newly completed World Health Organization (WHO) collaborative project, the International Study of Schizophrenia (ISoS). The article addresses two qu...

Medicine, Rationality, and Experience. Byron J. Good. New York: Cambridge University Press, 1994(cloth and paper). xvii. 242 pp.

Authors' reply - Volume 171 Issue 3 - T. Craig, C. Siegel, K. Hopper, S. Lin, N. Sartorius

Research on homelessness among persons with severe mental illness tends to focus on aspects of demand, such as risk factors or structural and economic forces. The authors address the complementary role of supply factors, arguing that "solutions" to residential instability-typically, a series of institutional placements alternating with shelter stay...

This paper compares the prevalence of mental illnesses and alcohol and drug abuse and the residential histories of homeless individuals identified as having a mental illness and individuals who are not so identified. The cohort consisted of single persons applying for shelter over a 12-week period in Westchester County, a suburban county in New Yor...

Data on the two-year pattern of course of illness have been collected in the WHO study of the Determinants of Outcomes of Severe Mental Disorder (DOSMD). These data are reanalysed using recursive partitioning, a method not yet applied to psychiatric data to test the hypothesis that subjects from participating centres in developing countries had bet...

Argues that neither shelters nor targeted housing programs have ever solved homelessness and that the homeless cannot be viewed as a discrete subclass of the poor. It is also argued that advocates of the homeless have at times resisted explanations of homelessness that appeared to implicate the characteristics or behavior of homeless people themsel...

A modified capture-recapture methodology was devised to monitor and assess the 1990 Shelter and Street Night (S-Night) street count in lower Manhattan. Observers were deployed at 41 sites. Results suggest that Census Bureau enumeration of homeless people in such sites fell short of a full count. Problems included the difficulty of counting sleeping...

The contemporary emphasis on the pathologies of shelter denizens and street‐dwellers tends to conceal the great variety of makeshift ways of life that have characterized “homelessness” over the centuries. Diversity notwithstanding, those considered “vagrants” were historically marked as suspect members of a poor apart, even when their numbers incre...

The histories of public shelter in Chicago and New York show that homelessness among single men has typically been viewed as a problem of troubled—and troublesome—individuals. In this viewpoint, the link between the labor market and emergency shelter use, so obvious during times of economic depression, has been lost. Shelters historically have been...

The presence of psychiatric disturbance is a much-noted feature of the new urban homelessness in the United States. An impaired capacity model of homelessness—which assumes that the disorder is responsible for the displacement—is a common inference. Drawing upon ethnographic research in New York and recent epidemiological literature, this article c...

Studies show a radical transformation in the ranks and numbers of the homeless, now including large numbers of young, severely disturbed and disabled street people. Without decent, safe, accessible shelter, therapeutic efforts are doomed.

In 1990, the Census Bureau conducted two operations designed to include homeless persons in the census: an enumeration of the occupants of emergency shelters, and a late night enumeration of street sites identified by cities and census offices as places where homeless people congregate. To assess the street enumeration, the Census Bureau sponsored...