Journal articles on the topic 'Mentally ill children – Education – Ontario'

BackgroundThe baseline findings from a controlled study of the effect of a public education campaign on community attitudes to mental illness are presented.MethodA census of attitudes to mental illness was conducted in two areas, prior to the opening of supported houses for the mentally ill Factor analysis of the Community Attitudes toward the Mentally III (CAMI) inventory revealed three components: Fear and Exclusion, Social Control and Goodwill.ResultsThe only determinant of Fear and Exclusion was having children. The main determinants of Social Control were social class, ethnic origin, age, having suffered mental illness and having children. The main determinant of Goodwill was educational level The attitude factors were predictive of respondents' behavioural intentions toward the mentally ill. Respondents with children and non-Caucasians were more likely to object to the mentally ill living in their neighbourhood.ConclusionsAny intervention aimed at changing attitudes to mentally ill people in the community should be targeted at people with children and non-Caucasians, as these groups are more likely to object.

Background/Aim. The family functioning and characteristics are the major risk factors in the genesis and persistence of mental disorders in children. The aim of this study was to evaluate the characteristics of functioning of family with mentally ill children and adolescents. Methods. This study explored 47 families with a child/adolescent suffering from mental disorders and 47 families of age matched healthy children/adolescents. The socio-demographic questionnaire, Social Adaptation Self-evaluation scale (SASS) and Family Adaptability and Cohesion Evaluation Scale (FACES III) (Olson, 1983) were completed by parents. Results. For all three FACES III dimensions multivariate analysis of variance (MANOVA) showed significant differences between groups ( Wilks ? = .887; F = 3.839; df = 3; p = 0.012). Univariate analysis results showed significant differences for cohesiveness F = 6.99 p = 0.001 and adaptability F = 10.07 p = 0 .001. The analysis of the social adaption (SASS) assessment showed that the mean score for clinical vs. non-clinical group was 39.66 ? 6.82 vs. 38.06 ? 8.44 without significant difference between groups (p = 0.32). The families of mentally ill children showed frequently lower socioeconomic status and education level, higher number of children per family, and broken home. Conclusion. The results suggested that cohesiveness and adaptability were significantly more prominent among families with mentaly ill children, but adaptation was similar to families with healthy children. It would be useful to evaluate adaptability, cohesiveness and adaptation of primary families when planning prevention and rehabillitation of mentally ill children and adolescent.

The results of the PISA studies over recent years have revealed the social selectivity of the scholastic education system. Based on my empirical research on families with mentally ill parents, I show how, for the children involved, social exclusion begins before they even start school; how the parents' mental illness is seen to affect the children, and what support the families in question require. This shows how important it is to take family coping situations into account in the educational discourse on the child and youth welfare services and formal education systems.

In many cultures, it has been a long-established practice to apply various domains of art as therapy methods in asylums, prisons and rehabilitation centres in order to help people express themselves and their current circumstances and to aid cure themselves. Hans Prinzhorn’s book entitled ‘Artistry of the mentally ill’, which was published in 1924 in Berlin has been the initial resource for Art Brut, also known as ‘raw art’. A French artist, Jean Dubuffet has first used Art Brut as an artistic term in 1945, which has ignited major debates in the artistic milieu. The ultimate goal of these artists was to unveil the works of those with no art education, of mentally ill patients, rejected and marginalised individuals, children and major criminals, in order to question the authenticity of all established approaches to art through the revelation of instinctive expression andthe purest form of creation.Keywords: Art Brut, Jean Dubuffet, raw art, outsider art, primitive art.

The personalised nature of mental illness obscures from general view the intolerable burden of private and public distress that people with serious mental illness carry. Invariably the mentally ill person encounters rejection and humiliation that are in some way tantamount to a "second illness." The combination either disrupts or puts beyond reach the usual personal and social life stages of marriage, family life, raising children, sexual relationships, the choice of treatment, affordable housing, transportation, education and gainful employment. As a result of their lack of financial and social support and their experience of rejection from society, persons with mental illness tend to neglect themselves and their diet, and frequently delay seeking treatment. Against this background, this contribution critically focuses on the human rights that influence the mentally ill patient in South African medical law. Specific attention is paid to the relevance and meaning of sections 9 (the equality clause), 27 (access to health care services), 30 and 31 (language, culture and religion) of the Constitution of the Republic of South Africa, 1996.

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient

It is important to run a family therapy alongside treatment of a patient with depression. The patient's family commits quite a frequent mistake of treating depression complaints as a manifestation of laziness, fatigue and ill will. There are two stages in education. In the first one, the essence of depression to the patient and his family is explained. The second stage of education is to draw attention to the mental and social sphere of the patient. This stage consists of two phases: psychological and social. Therapeutic communication is a specific form of communication. Help is directed to people who cannot make order in their own emotions, thoughts and perceive correctly the surrounding reality. The purpose of communication is also to facilitate the patient's expression of emotions. Therefore, therapeutic communication of a healing nature is the basis for helping mentally ill patients. Suicide is usually committed on impulse in the first, acute phase of depression or after entering the latent phase. Suicide is now considered a multidimensional phenomenon, resulting from the complex interaction of biological, psychological, sociological and environmental factors. The psychological state of people with suicidal tendencies is characterized by three characteristics: ambivalence, impulsiveness, stiffness. Suicide in children and adolescents is of the utmost importance

Background and Objectives: Current psychiatric care is increasingly focusing on patients’ quality of life (QoL). Research is still trying to determine the main factors which influence QoL. The present study aims to assess the QoL of patients with chronic psychotic-spectrum disorders, as well as its relation to symptomatology, functionality, adaptive behavior, and perceived level of recovery. Materials and Methods: The study included a sample of 78 patients with chronic psychosis. Symptomatology and illness severity were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale-Severity (CGI-S) scales, respectively. The Global Assessment of Functioning Scale (GAFS) and the Adaptive Behavior Assessment System II (ABAS-II)-Adult Form were used for the assessment of patients’ functionality, and the Quality-of-Life Inventory (QOLI) scale was applied for the evaluation of QoL. Results: According to the CGI-Severity scale, 20.5% of the patients were borderline mentally ill, and 24.4% were mildly ill. The highest number of patients (34.6%) were moderately ill, while 14.1% and 2.6% were markedly ill and severely ill, respectively. Among the moderately ill patients, more than half (63%) were patients with schizophrenia, 18.5% were patients with delusional disorder, and 18.5% were patients with schizoaffective disorder. Most of the patients (43.6%) presented moderate functioning deficiency, while 38.5% of the patients presented severe deficiency, according to the GAFS score. When assessed with the ABAS, we observed that almost half of the patients (44.9%) showed an average functioning across skill areas in the conceptual, social, and practical domains. A percent of 67.9% of the patients presented an average QoL, while 15.4% and 12.8% showed a very low and low QoL. QoL was not influenced by the patients’ symptomatology, gender, and education level. Having children, family support, better social and conceptual skills, and a higher perceived level of recovery was correlated with an increased QoL, hierarchical multiple regression R2 = 0.379, F(9, 68) = 2.616, and p = 0.012. Conclusions: Psychiatric interventions in psychosis should focus not only on symptoms’ control, but also on improving social and family support, as well as adaptive skills to increase the patients’ QoL.

Currently, there are different types of dysfunctional families: conflictual, immoral, pedagogically untenable, asocial. The causes of family disadvantages may be crisis phenomena in the socio-economic sphere, disorder of intra-family relations between parents and children, physically or mentally ill parents, unfavorable heredity in children, or presence of children or adults with disabilities in the family. Prevention of family disadvantages implies a set of measures to work with parents and children in order to form and maintain normal family relations, focus on a healthy lifestyle, and revive the institution of family and marriage. There are various ways to organize effective work in this direction, but the most effective is the implementation of social partnership technology. Such a partnership can be implemented through the interaction of various social institutions, such as social protection management bodies and social protection institutions, education management bodies and educational institutions, commissions for minors and for protection of their rights, special institutions for minors in need of social rehabilitation, guardianship and custody authorities, health management bodies and health care institutions, internal affairs bodies, bodies, institutions, and public associations, implementing measures to prevent neglect and juvenile delinquency, etc. Within the framework of social partnership technology, specialists of these institutions can ensure the prevention of family disadvantages more successfully and effectively by creating a unified concept of joint actions in relation to a particular family. Also, the implementation of social partnership technology will allow for the exchange of information characterizing the situation of families and children in the subordinate territory that is necessary for carrying out activities in their interests with authorities, state and non-governmental institutions, organizations and services.

Mental health problems in society are becoming new and more distressing as explained by the Ministry of Health Malaysia and the World Health Organization. Mental problems occur amongst working adults, the elderly, adolescents and children, men and women. Recent research confirms that the causes of mental health problems are due to genetic problems, personal problems, financial problems, learning pressures and stress at workplace. The effects of mental health problems can lead to depression, emotional tension, personality disorder and suicide. In order to obtain a wealth of information, researchers have accompanied critical analysis studies by viewing at several empirically established from previous studies. The first finding shows that mental illness classified as a brain disorder, an emotional disorder and an abnormal attitude. The second finding explains that the level of mental health knowledge among students is still low. The third study examines the causes of schizophrenia, which have four causes of the disease, namely genetic factors, drugs, work stress and poverty. The fourth finding explains the experience of caring for a mentally ill person who is also having trouble in the life of the patient's family. Generally, this study explains that mental illness is a problem that has various negative effects on various people. Implications of mental illness transpire over the long term if treatment not properly performed. Therefore, proactive initiatives prerequisite to be taken by all parties to ensure the quality of life of the people will perfect and normal devoid of interruption of mental illness.

BackgroundAlthough the association between cannabis use and a wide range of psychiatric symptoms is fairly well established, it is not clear whether cannabis use is also a risk factor for general mental health problems at secondary school.MethodA total of 10 324 secondary school children aged 11–16 years, participating in an ongoing Public Health Service School Survey, gave information on demographics, substance use, school factors and stressful life events and completed the Strengths and Difficulties Questionnaire (SDQ).ResultsCannabis use in the past month was associated with a clinically relevant score on the SDQ [unadjusted odds ratio (OR) 4.46, 95% confidence interval (CI) 3.46–5.76]. Other risk factors associated with poor psychosocial functioning were: a low level of education, alcohol use, cigarette smoking, hard drug use, frequent truancy, an unfavourable school evaluation, feeling unsafe at school, being victimized, frequent absence due to illness, a mentally ill parent, molestation by a parent, financial problems and feeling distressed by an adverse event. In a full model adjusting for these risk factors, cannabis was not significantly associated with mental health problems, although an association at trend level was apparent. Of these risk factors, regular alcohol use, cigarette smoking, hard drug use, frequent truancy, an unfavourable school evaluation and frequent absence due to illness were also associated with cannabis use.ConclusionsThe association between cannabis use and poor psychosocial functioning in adolescence is due, at least in part, to confounding by other risk factors. Thus, cannabis use can best be viewed as an indicator of risk for mental health problems in adolescence.

On 13 May 1978, the Italian Parliament approved Law 180, universally known as ‘Basaglia Law’ after the name of the leader of the anti-institutional movement which promoted this radical community mental health care reform. Forty years later, Italian psychiatry still runs a community care system, albeit with degrees of solidity and quality very varied along the peninsula. Mental health care is still an integral part of the National Health System, with liberal regulations on coercion and a lowest number of general hospital and residential facilities beds. Recently, Italy has also closed the special forensic psychiatric institutions and brought the care of the mentally ill offenders within the responsibilities of local Mental Health Departments. Over time, psychiatric deinstitutionalisation inspired policies in other sectors of Italian society, such as those regarding physical and intellectual disabilities, education of children with special needs, drug addictions and management of deviant minors. Furthermore, debate about Law 180 has reached and maintained an international dimension, becoming a term of reference for international agencies such as the World Health Organization and the European Commission, for good and for evil. The overall balance sheet of the Reform process would seem mostly positive, though the last decade has seen many threats challenging the system. Mental health care services have been asked to do much more, in terms of care to a larger population with very diversified needs, but with much less resources, due to the financial consequences of the economic crisis. Although there is no evidence of a trend towards re-institutionalisation, intensity and quality of care may have fallen below acceptable standards in some parts of Italy.

Background: Stigma is one of the major distresses that are experienced by people with mental illness. Stigmatisation results in a reduction in quality of life of those affected.Objective: The objective of this study was to assess the stigmatising attitudes of adolescents towards individuals withmental illness, their perception of community reaction and factors influencing it in Nigeria.Method: In school Adolescents (N = 402) participated in the research. They completed self-administered questionnaires regarding socio-demographic details and questions based on a vignette of a young person witha mental disorder using the Standardized Stigmatisation Questionnaire (SSQ1). The study was cross-sectional in nature and employed a multistage sampling technique.Result: The mean age was 14.44years (SD=1.84).There were 265(65.9%) males and 137(34.1%) females. Approximately seventy percent of the adolescents would not be happy to sit next to a man with mental illness in a bus, 58.2% would not want him to teach their children, and an even higher percentage (72.9%) believe that most people in the community would do same. Seventy percent are aware that he did not develop his problems to avoid difficult situations of life and 78.2% also know that it’s not a punishment for bad deeds. Independent predictors of stigma related attitude include age p<0.002, gender p<0.010 and community perception p<0.001.Conclusion: Stigmatisation of mental illness is highly prevalentamong adolescents. Given that a significant percentage of the participants were well informed, formation of stigmatising attitude towards mental illness might be deeper than lack of knowledge. There may be a need to work on societal structure despite traditional education interventions and also encourage their contactwith mentally ill persons.Key words: Stigmatisation Adolescents, community, Mental Illness, Perception, Societal structure

ObjectivesIndigenous people in Canada are not only over-represented among the homeless population but their pathways to homelessness may differ from those of non-Indigenous people. This study investigated the history and current status of Indigenous and non-Indigenous people experiencing homelessness and mental illness. We hypothesised that compared with non-Indigenous people, those who are Indigenous would demonstrate histories of displacement earlier in life, higher rates of trauma and self-medication with alcohol and other substances.Design and settingRetrospective data were collected from a sample recruited through referral from diverse social and health agencies in Winnipeg and Vancouver.ParticipantsEligibility included being 19 years or older, current mental disorder and homelessness.MeasuresData were collected via interviews, using questionnaires, on sociodemographics (eg, age, ethnicity, education), mental illness, substance use, physical health, service use and quality of life. Univariate and multivariable models were used to model the association between Indigenous ethnicity and dependent variables.ResultsA total of 1010 people met the inclusion criteria, of whom 439 self-identified as Indigenous. In adjusted models, Indigenous ethnicity was independently associated with being homeless at a younger age, having a lifetime duration of homelessness longer than 3 years, post-traumatic stress disorder, less severe mental disorder, alcohol dependence, more severe substance use in the past month and infectious disease. Indigenous participants were also nearly twice as likely as others (47% vs 25%) to have children younger than 18 years.ConclusionsAmong Canadians who are homeless and mentally ill, those who are Indigenous have distinct histories and current needs that are consistent with the legacy of colonisation. Responses to Indigenous homelessness must be developed within the context of reconciliation between Indigenous and non-Indigenous Canadians, addressing trauma, substance use and family separations.Trial registration numberISRCTN42520374,ISRCTN57595077,ISRCTN66721740.

The child is the bud of life and the right of life in this life is a fundamental right, from which several rights are protected and surrounded by safety until he reaches the age that makes him physically, mentally and psychologically qualified to take over his duties and his duties towards his society and the direction of others.The rights of the child to protection have been little or significant since the inception of the first human being. However, the need for development and the protection of the human race that human senses have begun to create different rights for the child do not in themselves constitute real protection for them . Until it culminated in the era of Islamic light, which embodied the highest forms of protection for this sensitive vulnerable group in society. Voices from around the world called on States to actively intervene through criminal texts to ensure the child's right to be protected from ill-treatment, especially after the international community has issued numerous international instruments and declarations dealing with the rights of the child. The most important of these are the 1989 Convention on the Rights of the Child, On the life and development of the child as well as the preservation of his identity and his right to education, health and comfort and to have a standard of living adequate for its growth as well as protect it from exploitation and all kinds of violence. Sexual violence against children involving a child under the age of 18 years, rape or exploitation of sexual activity is not fully understood and can not be granted. The conduct of the offender is contrary to the laws, customs, traditions and customs of the community. The child's physical and mental health, mental, psychological and social well-being are seriously jeopardized. The child is characterized by weak physical strength and poor mental abilities. Therefore, the international system should have called upon the ratifying States to protect the rights that have been adopted in favor of the child With special criminal provisions to protect him from crimes of sexual violence.Sexual violence against children constitutes a grave violation of the rights of the child. It represents a global reality in all countries of the world, but it has become a real phenomenon of concern especially in recent times and in some countries such as Iraq, Syria, Libya and other countries that have become visible as a result of war, displacement, The other reasons, and this calls for immediate treatment through the intervention of the criminal law in most of the world, including Iraqi and Syrian law, the subject of our research, to criminalize these acts protect a range of rights and interests, including: the protection of the right to sexual freedom of the female, The protection of the family entity from collapse and the protection of the offspring from mixing and protecting the social entity from the scourge of moral corruption, and immunization of society from sexual and reproductive diseases. At the national and international levels, this law prohibits any activity that takes the form of rape, sodomy, sexual harassment, sexual exploitation in prostitution or pornographic material Since the Criminal Code is one of the most widely used instruments of the State to protect the legal status of persons and to protect human rights from potential attacks and the conviction of the Iraqi and Syrian legislators of the importance of repudiation and punishment in protecting vulnerable parties within society, for example, their legislation included significant repudiation provisions that criminalize any act or omission May result in a form of sexual violence against children.Thus, by extrapolating the texts of the criminal law of both Iraq and Syria, as well as some of the texts contained in other laws or independently, our research entitled "Sexual Violence Against Children" focused on a scientific plan consisting of two subjects: In the second, I refer to the types of crimes that sexual violence against children has included and we deal with successively and through three demands. First we address the crime of rape and homosexuality. In the second child to indecent assault against the child crime and in the third to the crime of sexual exploitation against children and Khtmana We discussed with the most important conclusions and recommendations

OBJECTIVES/SPECIFIC AIMS: Stigma has been recognized as a major impediment to accessing mental health care among Vietnamese and Asian Americans (Leong and Lau, 2001; Sadavoy et al., 2004; Wynaden et al., 2005; Fong and Tsuang, 2007). The underutilization of mental health care, and disparities in both access and outcomes have been attributed to a large extent to stigma and cultural characteristics of this population (Wynaden et al., 2005; Jang et al., 2009; Leung et al., 2010; Spencer et al., 2010; Jimenez et al., 2013; Augsberger et al., 2015). People with neurotic or behavioral disorders may be considered “bad” as many Vietnamese people believe it is a consequence of one’s improper behavior in a previous life, for which the person is now being punished (Nguyen, 2003). Mental disorders can also been seen as a sign of weakness, which contributes to ambivalence and avoidance of help-seeking (Fong and Tsuang, 2007). Equally important is the need to protect family reputation; having emotional problems often implies that the person has “bad blood” or is being punished for the sins of his/her ancestors (Herrick and Brown, 1998; Leong and Lau, 2001), which disgraces the entire family (Wynaden et al., 2005). In these cases, public stigma (as opposed to internal stigma) is the primary reason for delays in seeking help (Leong and Lau, 2001). Other research has also highlighted the influences of culture on how a disorder may be labeled in different settings, although the presentation of symptoms might be identical (see Angel and Thoits, 1987). In Vietnamese culture, mental disorders are often labeled điên (literally translated as “madness”). A điên person and his or her family are often severely disgraced; consequently the individuals and their family become reluctant to disclose and seek help for mental health problems for fear of rejection (Sadavoy et al., 2004). Despite the critical role of stigma in accessing mental health care, there has been little work in trying to understand how stigmatizing attitudes towards mental illness among Vietnamese Americans manifest themselves and the influences of acculturation on these attitudes. Some previous work indicated a significant level of mental illness stigma among Vietnamese Americans, and experiences of living in the United States might interact with the way stigma manifests among this population (Do et al., 2014). Stigma is a complex construct that warrants a deeper and more nuanced understanding (Castro et al., 2005). Much of the development of stigma-related concepts was based on the classic work by Goffman (1963); he defined stigma as a process by which an individual internalizes stigmatizing characteristics and develops fears and anxiety about being treated differently from others. Public stigma (defined by Corrigan, 2004) includes the general public’s negative beliefs about specific groups, in this case individuals and families with mental illness concerns, that contribute to discrimination. Public stigma toward mental illness acts not only as a major barrier to care, but can also exacerbate anxiety, depression, and adherence to treatment (Link et al., 1999; Sirey et al., 2001; Britt et al., 2008; Keyes et al., 2010). Link and Phelan (2001) conceptualized public stigma through four major components. The first component, labeling, occurs when people distinguish and label human differences that are socially relevant, for example, skin color. In the second component, stereotyping, cultural beliefs link the labeled persons to undesirable characteristics either in the mind or the body of such persons, for example people who are mentally ill are violent. The third component is separating “us” (the normal people) from “them” (the mentally ill) by the public. Finally, labeled persons experience status loss and discrimination, where they are devalued, rejected and excluded. Link and Phelan (2001) emphasized that stigmatization also depends on access to social, economic, and political power that allows these components to unfold. This study aims to answer the following research questions: (1) how does public stigma related to mental illness manifest among Vietnamese Americans? and (2) in what ways does acculturation influence stigma among this population? We investigate how the 4 components of stigma according to Link and Phelan (2001) operationalized and how they depend on the level of acculturation to the host society. Vietnamese Americans is the key ethnic minority group for this study for several reasons. Vietnamese immigration, which did not start in large numbers until the 1970s, has features that allow for a natural laboratory for comparisons of degree of acculturation. Previous research has shown significant intergenerational differences in the level of acculturation and mental health outcomes (e.g., Shapiro et al., 1999; Chung et al., 2000; Ying and Han, 2007). In this study, we used age group as a proxy indicator of acculturation, assuming that those who were born and raised in the United States (the 18–35 year olds) would be more Americanized than those who were born in Vietnam but spent a significant part of their younger years in the United States (the 36–55 year olds), and those who were born and grew up in Vietnam (the 56–75 year olds) would be most traditional Vietnamese. The language used in focus group discussions (FGDs) reflected some of the acculturation, where all FGDs with the youngest groups were done in English, and all FGDs with the oldest groups were done in Vietnamese. METHODS/STUDY POPULATION: Data were collected through a set of FGDs and key informant interviews (KIIs) with experts to explore the conceptualization and manifestation of mental illness public stigma among Vietnamese Americans in New Orleans. Six FGDs with a total of 51 participants were conducted. Participants were Vietnamese American men and women ages 18–75. Stratification was used to ensure representation in the following age/immigration pattern categories: (1) individuals age 56–75 who were born and grew up in Vietnam and immigrated to the United States after age 35; (2) individuals age 36–55 who were born in Vietnam but spent a significant part of their youth in the United States; and (3) individuals age 18–35 who were born and grew up in the United States. These groups likely represent different levels of acculturation, assuming that people who migrate at a younger age are more likely to assimilate to the host society than those who do at a later age. Separate FGDs were conducted with men and women. Eleven KIIS were conducted with 6 service providers and 5 community and religious leaders. In this analysis, we focused on mental illness public stigma from the FGD participants’ perspectives. FGDs were conducted in either English or Vietnamese, whichever participants felt more comfortable with, using semistructured interview guides. All interviews were audio recorded, transcribed and translated into English if conducted in Vietnamese. Data coding and analysis was done using NVivo version 11 (QSR International, 2015). The analysis process utilized a Consensual Qualitative Research (CQR) approach, a validated and well-established approach to collecting and analyzing qualitative data. CQR involves gathering textual data through semistructured interviews or focus groups, utilizing a data analysis process that fosters multiple perspectives, a consensus process to arrive at judgments about the meaning of data, an auditor to check the work of the research team, and the development of domains, core-ideas, and cross-analysis (Hill et al., 2005). The study was reviewed and approved by Tulane University’s Internal Review Board. RESULTS/ANTICIPATED RESULTS: Components of public stigma related to mental illness. The 4 components of public stigma manifest to different extents within the Vietnamese Americans in New Orleans. Labeling was among the strongest stigma components, while the evidence of the other components was mixed. Across groups of participants, Vietnamese Americans agreed that it was a common belief that people with mental disorders were “crazy,” “acting crazy,” or “madness.” “Not normal,” “sad,” and “depressed” were among other words used to describe the mentally ill. However, there were clear differences between younger and older Vietnamese on how they viewed these conditions. The youngest groups of participants tended to recognize the “craziness” and “madness” as a health condition that one would need to seek help for, whereas the oldest groups often stated that these conditions were short term and likely caused by family or economic problems, such as a divorce, or a bankruptcy. The middle-aged groups were somewhere in between. The evidence supporting the second component, stereotyping, was not strong among Vietnamese Americans. Most FGD participants agreed that although those with mental disorders may act differently, they were not distinguishable. In a few extreme cases, mentally ill individuals were described as petty thefts or being violent towards their family members. Similarly to the lack of strong evidence of stereotyping, there was also no evidence of the public separating the mentally ill (“them”) from “us”. It was nearly uniformly reported that they felt sympathetic to those with mental disorders and their family, and that they all recognized that they needed help, although the type of help was perceived differently across groups. The older participants often saw that emotional and financial support was needed to help individuals and families to pass through a temporary phase, whereas younger participants often reported that professional help was necessary. The last component, status loss and discrimination, had mixed evidence. While nearly no participants reported any explicit discriminatory behaviors observed and practiced towards individuals with mental disorders and their families, words like “discrimination” and “stigma” were used in all FGDs to describe direct social consequences of having a mental disorder. Social exclusion was common. Our older participants said: “They see less of you, when they see a flaw in you they don’t talk to you or care about you. That’s one thing the Vietnamese people are bad at, spreading false rumors and discrimination” (Older women FGD). One’s loss of status seemed certain if their or their loved one’s mental health status was disclosed. Shame, embarrassment, and being “frowned upon” were direct consequences of one’s mental health status disclosure and subsequently gossiped about. Anyone with mental disorders was certain to experience this, and virtually everyone in the community would reportedly do this to such a family. “You get frowned upon. In the Vietnamese culture, that’s [a family identified as one with mental health problems] the big no-no right there. When everybody frowns upon your family and your family name, that’s when it becomes a problem” (Young men FGD). This is tied directly to what our participants described as Vietnamese culture, where pride and family reputation were such a high priority that those with mental disorders needed to go to a great extent to protect—“We all know what saving face means” as reported by our young participants. Even among young participants, despite their awareness of mental illness and the need for professional help, the desire to avoid embarrassment and save face was so strong that one would think twice about seeking help. “No, you just don’t want to get embarrassed. I don’t want to go to the damn doctor and be like ‘Oh yeah, my brother got an issue. You can help him?’ Why would I do that? That’s embarrassing to myself…” (Young men FGD). Our middle-aged participants also reported: “If I go to that clinic [mental health or counseling clinic], I am hoping and praying that I won’t bump into somebody that I know from the community” (Middle-aged women FGD). Vietnamese people were also described as being very competitive among themselves, which led to the fact that if a family was known for having any problem, gossips would start and spread quickly wherever they go, and pretty soon, the family would be looked down by the entire community. “I think for Vietnamese people, they don’t help those that are in need. They know of your situation and laugh about it, see less of you, and distant themselves from you” (Older women FGD). Culture and mental illness stigma, much of the described stigma and discrimination expressed, and consequently the reluctance to seek help, was attributed to the lack of awareness of mental health and of mental health disorders. Many study participants across groups also emphasized a belief that Vietnamese Americans were often known for their perseverance and resilience, overcoming wars and natural disasters on their own. Mental disorders were reportedly seen as conditions that individuals and families needed to overcome on their own, rather than asking for help from outsiders. This aspect of Vietnamese culture is intertwined with the need to protect one’s family’s reputation, being passed on from one generation to the next, reinforcing the beliefs that help for mental disorders should come from within oneself and one’s family only. Consequently persons with mental health problems would be “Keeping it to themselves. Holding it in and believing in the power of their friends” (Middle-aged FGD) instead of seeking help. Another dimension of culture that was apparent from FGDs (as well as KIIs) was the mistrust in Western medicine. Not understanding how counseling or medicines work made one worry about approaching service providers or staying in treatment. The habit of Vietnamese people to only go see a doctor if they are sick with physical symptoms was also a hindrance to acknowledging mental illness and seeking care for it. Challenges, including the lack of vocabulary to express mental illness and symptoms, in the Vietnamese language, exaggerated the problem, even among those who had some understanding of mental disorders. It was said in the young men FGD that: “when you classify depression as an illness, no one wants to be sick,… if you call it an illness, no one wants to have that sort of illness, and it’s not an illness that you can physically see…” (Young men FGD). Another young man summarized so well the influence of culture on mental illness stigma: “Us Southeast Asian, like, from my parents specifically has Vietnam War refugees. I think the reason why they don’t talk about it is because it’s a barrier that they have to overcome themselves, right? As refugees, as people who have been through the war… [omitted]They don’t want to believe that they need help, and so the trauma that they carry when they give birth to us is carried on us as well. But due to the language barrier and also the, like, they say with the whole health care, in Vietnam I know that they don’t really believe in Western and Eurocentric medicine. So, from their understanding of how, like from their experience with colonization or French people, and how medicine works, they don’t believe in it” (Young men FGD). One characteristic of the Vietnamese culture that was also often mentioned by our FGD participants (as well as KIIs) was the lack of sharing and openness between generations, even within a family. Grandparents, parents, and children do not usually share and discuss each other’s problems. Parents and grandparents do not talk about problems because they need to appear strong and good in front of their children; children do not talk about problems because they are supposed to do well in all aspects, particularly in school. The competitiveness of Vietnamese and high expectations of younger generations again come into play here and create a vicious cycle. Young people are expected to do well in school, which put pressure on them and may result in mental health problems, yet, they cannot talk about it with their parents because they are not supposed to feel bad about school, and sharing is not encouraged. The Asian model minority myth and the expectations of parents that their children would do well in school and become doctors and lawyers were cited by many as a cause of mental health problems among young people. “Our parents are refugees, they had nothing and our parents want us to achieve this American Dream…. [omitted] It set expectations and images for us…. It was expected for all the Asians to be in the top 10, and for, like a little quick minute I thought I wasn’t going to make it, I was crying” (Yong men FGD). As a result, the mental health problems get worse. “If you’re feeling bad about something, you don’t feel like you can talk about it with anyone else, especially your family, because it is not something that is encouraged to be talked about anyway, so if you are feeling poorly and you don’t feel like you could talk to anybody, I think that just perpetuates the bad feelings” (Middle-aged women FGD). Acculturation and mental illness stigma Acculturation, the degree of assimilation to the host society, has changed some of the understanding of mental illness and stigmatizing attitudes. Differences across generations expressed in different FGDs indicated differences in perceptions towards mental illness that could be attributed to acculturation. For example, the young generation understood that mental illness was a health problem that was prevalent but less recognized in the Vietnamese community, whereas a prominent theme among the older participants was that mental illness was a temporary condition due to psychological stress, that it was a condition that only Caucasians had. Some of the components of public stigma related to mental illness seemed to vary between generations, for example the youngest participants were less likely to put a label on a person with mental health problems, or to stereotype them, compared to the oldest and middle-aged participants. This was attributed to their education, exposure to the media and information, and to them “being more Americanized.” However, there was no evidence that acculturation played an important role in changing the other components of public stigma, including stereotyping, separating, and status loss and discrimination. For example, the need to protect the family reputation was so important that our young participants shared: “If you damage their image, they will disown you before you damage that image” (Young men FGD). Young people, more likely to recognize mental health problems, were also more likely to share within the family and to seek help, but no more likely than their older counterparts to share outside of the family—“maybe you would go to counseling or go to therapy, but you wouldn’t tell people you’re doing that” (Young women FGD). The youngest participants in our study were facing a dilemma, in which they recognized mental health problems and the need for care, yet were still reluctant to seek care or talk about it publicly because of fears of damaging the family reputation and not living up to the parents’ expectations. Many young participants reported that it actually made it very difficult for them to navigate mental health issues between the 2 cultures, despite the awareness of the resources available. “I think it actually makes it harder. Only because you know to your parents and the culture, and your own people, it’s taboo, and it’s something that you don’t talk about. Just knowing that you have the resources to go seek it… You want advice from your family also, but you can’t connect the appointment to your family because you’re afraid to express that to your parents, you know? So I think that plays a big part, and knowing that you are up and coming, but you don’t want to do something to disappoint your family because they are so traditional” (Young men FGD). Some participants felt more comfortable talking about mental health problems, like depression, if it was their friend who experienced it and confided in them, but they would not necessarily felt open if it was their problem. Subtle cultural differences like this are likely overlooked by Western service providers. One older participant summarized it well “They [the young generation] are more Americanized. They are more open to other things [but] I think that mental health is still a barrier.” DISCUSSION/SIGNIFICANCE OF IMPACT: This study investigated how different components of public stigma related to mental illness manifest among Vietnamese Americans, a major ethnic group in the United States, and how acculturation may influence such stigma. The findings highlighted important components of public stigma, including labeling and status loss, but did not provide strong evidence of the other components within our study population. Strong cultural beliefs underlined the understanding of mental health and mental illness in general, and how people viewed people with mental illness. Several findings have been highlighted in previous studies with Asian immigrants elsewhere; for example, a study from the perspectives of health care providers in Canada found that the unfamiliarity with Western biomedicine and spiritual beliefs and practices of immigrant women interacted with social stigma in preventing immigrants from accessing care (O’Mahony and Donnelly, 2007). Fancher et al. (2010) reported similar findings regarding stigma, traditional beliefs about medicine, and culture among Vietnamese Americans. Acculturation played a role in changing stigmatizing attitudes as evidenced in intergenerational differences. However, being more Americanized did not equate to being more open, having less stigmatizing attitudes, or being more willing to seek care for mental health issues. Consistent with previous studies (Pedersen and Paves, 2014), we still found some level of stigma among young people aged 18–35, although some components were lessened with an increased level of acculturation. There was also a conflict among the younger generation, in which the need for mental health care was recognized but accessing care was no easier for them than for their parent and grandparent generations. The study’s findings are useful to adapt existing instruments to measure stigma to this population. The findings also have important program implications. One, they can be directly translated into basic supports for local primary and behavioral health care providers. Two, they can also be used to guide and inform the development and evaluation of an intervention and an additional study to validate the findings in other immigrant ethnic groups in the United States. Finally, based on results of the study, we can develop a conceptual framework that describes pathways through which social, cultural, and ecological factors can influence stigma and the ways in which stigma acts as a barrier to accessing mental health care among Vietnamese Americans. The guiding framework then can be validated and applied in future programs aimed to improve mental health care utilization among ethnic minorities.

BackgroundIn Germany, approximately three million children under the age of eighteen have a mentally ill parent. These children are at an increased risk of developing a mental illness themselves (1) as well as a physical illness (2). While research has identified numerous evidence-based family-oriented interventions, little is known about how to implement such interventions effectively and efficiently in clinical practice in Germany. This implementation study (ci-chimps) evaluates three clinical implementation projects with three different implementation interventions for the optimal implementation of the tailored family-oriented preventive and therapeutic interventions in the CHIMPS-NET (children of mentally ill parents—research network) with an implementation model for children of mentally ill parents.MethodsA two-group randomized controlled multicenter trial will examine changes in family-oriented practice and aspects of implementation at baseline as well as at 12- and 24-months follow-up. The CHIMPS-Network consists of 20 clinical centers. The centers in the intervention group receive the support of all of the three implementation interventions: (1) optimal pathways to care, (2) education and a training program for professionals, and (3) systematic screening for children. The centers in the control group do not receive this specific implementation support.DiscussionWhile we know that children of mentally ill parents are an important target group to be addressed by preventive and therapeutic interventions, there is often a lack of structured implementation of family-oriented interventions in clinical practice in Germany. Using a randomized controlled multicenter trial design with a large and wide-ranging sample (clinics for adult psychiatry and clinics for child and adolescent psychiatry, university clinics and clinics at the real health care) will provide a robust understanding of implementing family-oriented changes in German clinical practice.Trial RegistrationThe CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019-12-19 (DRKS00020380) and with Clinical Trials on 2020-4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021-08-27, the Clinical Trials registration is in review process.

Good health refers to the mind and body's soundness and the state in which its tasks are carried out properly and effectively. Health is described by the World Health Organization as "a condition of complete physical, mental, and social well-being". There are a variety of elements that influence health in developing nations like India, such as poverty, food insecurity, food pricing and malnutrition, pollution and deterioration of the environment, occupational and reproductive health issues, cost prices of private health care systems, public health care delivery systems, and so on. The health of mothers, new-borns, and children is currently the prime agenda of multilateral organizations, international cooperation agencies, and governments around the world. Children are our future, and maintaining their health, development, and growth should be the top priority for all nations. Malnutrition, infectious diseases, being born underweight, maternal or neonatal or infant mortality, and other factors make new-borns and children more susceptible. This paper looks at the changes in the Mental Health Act 1987 to the new legislation of 2017 for the treatment and care of a mentally ill person and analyzes the various provisions of it from a psycho-socio-legal perspective.

This paper presents an analysis of the Province of Ontario’s elementary school physical education curriculum with respect to the dominant discourses that framed policy documents from the 1850s to 2000. Through an examination of curriculum documents, archival materials, and interviews with those who were teachers and lecturers at the time, the paper argues that a male-centered physical education agenda—dominated by fitness and competitive sport—eclipsed a female-centered tradition, characterized by more broadly conceived movement curriculum of dance, games and gymnastics. This paper examines these competing ideologies in the waves of curriculum reform that characterized Ontario elementary school physical education curriculum during the nineteenth and twentieth centuries.

The article deals with charitable activities of Kyiv eparchy monasteries and convents during the second half of the 19th century and the early 20th century. It shows that charitable activities of the Orthodox church reached its peak in the post-reform period. The charitable activities within the specified time frame lay in the provision of schools, hospitals, orphanages, almshouses, and hotels for the poor and pilgrims. Kyiv eparchy monasteries and convents a) distributed alms, organized free lunches, provided material and medical assistance, b) handled education issues by establishing parish schools, c) supported almshouses by aiding sick people, lonely elderly people, people with special needs, and the mentally ill. At the beginning of World War I, Kyiv eparchy monasteries and convents became actively involved in the provision of assistance to the population, as well as the establishment and maintenance of shelters for children (orphans) of fallen soldiers. Such children were provided with proper care and timely medical assistance. Charitable institutions at the premises of Kyiv eparchy monasteries and convents operated at the expense of funds received from their economic activities, as well as donations from private individuals. Kyiv eparchy monasteries and convents comprised the greatest number of hospitals and almshouses of all those operating in the territory of the then Kyiv Governorate.

Globally, approximately 10% - 20% of children and adolescents experience mental health problems and the majority of them are living in low- and middle-income countries. Children of female sex workers are often exposed to unsafe environments, traumatic experiences and a mentally ill parent, putting them at risk for developing mental health problems themselves. Research on the mental health and functioning of children of female sex workers during their school age is limited. This paper will explore the mental health and functioning of female sex workers’ children. Method: The study included 160 female entertainment workers (FEWs) and 60 of their children from four provinces of Cambodia. FEW’s mental health, and children’s mental health and functioning were measured. Result: FEWs demonstrated high rates of depression (67%) and anxiety (61%), and 54.38% reported symptoms of post-traumatic stress disorder. Of the 60 children, the majority got their education at primary school (68%) and secondary school (25%). 46.7% of them reported symptoms of functional impairment, 18.33% suffered from psychological distress, and 36.67% have PTSD symptoms above the clinical threshold. Children’s psychological distress was significantly predicted by mothers’ early childhood traumatic experiences, mothers’ current mental health problems, mothers’ anxiety and PTSD. Mother’s PTSD predicted children’s psychological distress [β = 0.282, R2 = 0.079] and functioning [β = 0.285, R2 = 0.081]. Conclusion: School age children of FEWs have high rates of depression, anxiety and PTSD. Children’s psychological problems impair their functioning at school and home. FEW’s PTSD predicts their children’s psychological distress and functioning. Further research on the mental health and functioning of FEW’s children should be continued with a larger sample size. Mental health professionals and educators should provide mental health care for FEWs and their children, and develop evidence-based approaches to improving children’s mental health and functioning

Photo by Hédi Benyounes on Unsplash ABSTRACT The current incarceration facilities for the growing number of women are depriving expecting mothers of adequate care crucial for the child’s mental and physical development. Programs need to be established to counteract this. INTRODUCTION Currently, Diana Sanchez was eight months pregnant when she was arrested for identity theft and put in a prison cell in Denver. At five a.m., two weeks after being incarcerated, she announced to a deputy outside her cell that she was going into labor. Footage from a camera in her cell shows her pacing anxiously or writhing in her bed for the five hours preceding the arrival of her son. She banged on the door and begged for help. All she received was an absorbent pad. She gave birth alone in her prison cell on July 31, 2015, around 10:45 am. At 11:00 am, a prison nurse walked in to cut the umbilical cord and take Sanchez’s newborn baby without offering postnatal care. Sanchez was later sent to a hospital, and her baby was separated from her until she was put on probation. In 2018, on behalf of her three-year-old son, Sanchez sued Denver Health and Denver Sheriff Department and won a $480,000 settlement.[1] Though many more men are incarcerated than women, the rate of growth of female incarceration has exceeded that of male incarceration for decades. One study estimated that 231,000 women are currently incarcerated in the US,[2] 80 percent of whom are mothers, and 150,000 pregnant.[3] Another recent study of 1,396 incarcerated pregnant women found that 92 percent had live births, 6.5 percent had stillbirths or miscarriages, and 4 percent terminated the pregnancy. The authors found that there is no system of reporting pregnancy outcomes in US prisons. There is a noteworthy ethical lapse in mental, emotional, and medical care that threatens the well-being of pregnant women in prison. According to Carolyn Sufrin, “Pregnant incarcerated people are one of the most marginalized and forgotten groups in our country… and women who don't get counted don't count.” [4] Poor documentation, visibility, and transparency contribute to the systemic abuse of incarcerated women. Studies document women giving birth alone in cells and shackles in solitary confinement. Their complaints regarding contractions, bleeding, and other pains of labor are often ignored.[5] l. Prenatal Care in American Prisons Diana Sanchez was not offered any prenatal care after she was incarcerated. And neither she nor her son received appropriate postnatal care.[6] Sanchez was on medication for opioid withdrawal while pregnant, which could have been detrimental to her baby’s health.[7] There is an unacceptable absence of pre- and postnatal care in most US prisons. A lack of regulation makes the availability of perinatal care unpredictable and unreliable. Several studies confirmed that there is not a standard for prenatal care for women incarcerated during pregnancy. [8] Knowledge of the appropriate mental and physical care pregnant women require, addiction support, and support for maternal-infant bonding all exists outside the prison system and ought to be used as a benchmark. At the very least, pregnant women, birthing women, and new mothers should not be placed in solitary confinement or shackled.[9] In the prenatal arena, depriving an individual of adequate healthcare is not appropriate and could be cruel and unusual. Only 18 percent of funding in prisons goes to health care for the prisoners. That is roughly $5.7 thousand per prisoner, according to an NIH study done in 2015.[10] There should be an adequate amount of funding for the health needs of incarcerated pregnant women. By depriving pregnant women of healthcare, the prisons are depriving the fetus of adequate care. ll. Respect for Autonomy During Incarceration Women maintain healthcare autonomy even when incarcerated. The purpose of a prison sentence is retribution for crimes and rehabilitation to prevent reoffending.[11] The separation of a mother and newborn causes significant developmental and psychological harm to the child and the parent. Parent-child separation does not serve the purpose of retribution or rehabilitation and is authorized only due to prisons’ limited space and resources that make it difficult to accommodate children, as well as a state interest in children’s best interests or the custody rights of the other parent. When it is possible to keep a family together, prisons should make every effort to do so for the health of the mother-child relationship. Incarcerated people may become a burden to family or society due to prison medical neglect. For example, diabetes and hypertension, which can occur during pregnancy, can worsen without treatment. The inability to access the care they would otherwise want and need endangers women and poses a burden to the healthcare system after incarceration, Depersonalizing individuals convicted of crimes must be placed in the context of historical eugenics practices. State-sanctioned sterilization and efforts to prevent women from reproducing were widespread during the early 20th century.[12] Cases of coerced and nonconsensual sterilization of incarcerated women and men evidence the history of eugenics.[13]Abortions are offered to some incarcerated women.[14] However, many incarcerated women are denied the right to see healthcare providers to thoroughly discuss abortion or other options.[15] Although the abortions are consensual, the quality of consent is questionable. lll. Prison Nursery Programs, “I need something to live for…” Indiana Women’s Prison (IWP), a max security female prison, has a program called Wee Ones that enables women convicted of nonviolent crimes to spend 30 months bonding with their newborn child. It is one of eight programs in the country that allows pregnant mothers to spend the last few months of their sentence with their children. It is a voluntary program that allows pregnant offenders a private room in a housing unit. It offers parent education, resources that are accessible after release, and career education. The program application process and the rules to which women must adhere to remain in the program are stringent. The programs generally have a zero-tolerance policy. Even simply sleeping in the same bed as the child or arguing with other mothers can result in termination from the program. Kara, a pregnant woman incarcerated for drug possession, had a history of abuse in her family and tended to act out in anger against her peers in the program. She was learning how to have healthy reactions to anger when handling her child, but her temper ultimately led to her removal from the program. Her son was placed in foster care, and Kara returned to the regular cells. In an interview before her transfer, she told the camera that Charlie gave her a purpose. With tears in her eyes, she said, “Charlie was my way of life here [...] I need something to live for [,] and I screwed up.”[16] Pregnancy in prison can be a way to improve quality of life for some women. Studies demonstrate that nursery programs improve mental health of the incarcerated women.[17] The secure attachment of the infant to its primary caregiver promotes healthy development in the child and a bonded relationship with the mother.[18] The close bond between mother and child in prisons has been shown to decrease recidivism and to reduce the burden on the foster care system.[19] Women who do not qualify for these programs, or are incarcerated in prisons without them, are separated from their newborn babies and their other children. The disconnect can lead to the child rejecting the incarcerated mother once she is released.[20] Programs like Wee Ones honor women’s autonomy while they are incarcerated. During interviews, the women expressed that although raising a child in that environment is difficult, it was better than not being with their children. While rocking a baby in her lap, one inmate expressed her frustrations with Wee Ones but then paused to express gratitude and said, “After all, it’s prison. And prison ain’t supposed to be nice.”[21] The ethical issue of autonomy reflects a more difficult dilemma in the prison landscape. lV. Counter Arguments: Do the Nursery Programs Work for the Children and the Women Typically, newborns are taken from their incarcerated mothers within two to three days of birth and sent to live with a relative or placed in foster care. Many women are never reunited with their babies. There is much debate over whether the programs are beneficial to the children. One ethical issue is whether children, as innocents, are being punished either by being in the prison system or by being separated from their mothers. Skeptics, like James Dwyer, have argued against keeping innocent babies in the custody of incarcerated mothers asserting that there is little evidence demonstrating that the programs rehabilitate the women.[22] Dwyer commented on the “reckless” hopefulness the programs provide: "It might, in fact, be the babies distract them from rehabilitation they should be doing instead. […] They're so focused on childcare and have this euphoria — they think they'll be just fine when they get out of prison and they're not. We just don't know."[23] One study showed that 58 percent of incarcerated women are arrested again after release, 38 percent are reconvicted, and 30 percent return to prison within three years.[24] Dwyer uses this data to argue that the programs are not worthwhile. However, the data is not limited to the special population that had the prison nursery experience. The data applies to all incarcerated women limiting its applicability. More importantly, there is compelling evidence to support prison nursery programs.[25] The programs do decrease recidivism[26] and prison misconduct,[27] and they allow women to create stronger bonds with their children.[28] Bev Little argues that allowing mothers to bond with their babies only delays the inevitable separation and will cause trauma and have other ill effects on the baby. [29] But others feel that stronger maternal-fetal attachment is best for both parties. There is evidence that the bond, once formed, is long-lasting. Later in life, there is less drug addiction among children who stayed in the nursery rather than being separated from their mothers.[30] Another counterargument is that the policies in prison nurseries are not as useful for motherhood outside of the facility; thus, an issue with recidivism occurs because the women are less prepared for motherhood upon release from prison. Prison nursery programs establish methods and procedures for successful motherhood that are unique to operation within correctional environments. Yet, fortunately, parenting classes offered by prisons and jails emphasize sacrifice, self-restraint, and dedicated attention to the baby. These classes aptly apply to motherhood outside of prison.[31] One incarcerated mother experiencing addiction, Kima, was described as ambivalent toward her pregnancy. “It’s something about knowing but not knowing that makes me not accountable or makes me think I’m not accountable,” Kima shared.[32] After the nurse confirmed her pregnancy, she acknowledged fear and knew she would be held accountable to the baby. The occurrence of pregnancy ambivalence is common.[33] A study of a population of prisoners from Rhode Island found that 41 percent of the women expressed ambivalent attitudes about pregnancy. 70 of the women from a population in San Francisco expressed ambivalent or negative attitudes towards pregnancy.[34] But the ambivalence of some women toward pregnancy is not a reason to prevent women who feel differently from reaping the full benefits of programs that support them during pregnancy. Another counterargument is that prison is becoming a comfort that women might seek if they are homeless or housing insecure. For example, Evelyn was released from a San Francisco jail after being arrested for using cocaine. She was 26 weeks pregnant and had a four-year-old son in the custody of her aunt. Following her release, she was homeless and using drugs in the streets. She felt that her only hope of keeping her baby safe was to go back to jail. Like Kima, she had been in and out of jail from a young age. She grew accustomed to and dependent on the care provided there. While incarceration can provide a home and a nursery, there is no ethical reason to argue for making prison less comfortable by separating babies and children from incarcerated women. Instead, these facts suggest we are not doing enough for women outside prisons either. CONCLUSION Many experts stress the dearth of research and information on these women and their babies. There is no empirical data to show how big the problem is, but there is evidence that programs providing nursery care for the children of incarcerated women have many benefits. Because the research is not largescale enough, many pregnant women in the prison system are ignored. Many women give birth in unacceptable conditions, and their children are taken from them the moment the umbilical cord is cut. While the US incarcerates too many women, a movement to expand prison nurseries could help new mothers bond with their children. Strong educational programs could aid in lowering the rates of recidivism by providing therapeutic resources for mothers.[35] There is a growing problem of mass incarceration in the US as many women are placed in correctional facilities. Most of these women are convicted of possession or use of illegal substances.[36] Many women come from disadvantaged backgrounds, poverty, and have experienced addiction. Depriving an expectant mother of adequate care is cruel and irresponsible both to the mother and her innocent child. The criminal justice system is harming children both mentally and physically. Reform of the system is needed to provide the basic care those children need. Programs like IWP’s Wee Ones are necessary for physical, psychological, and social development. A program that offers a place for mothers to raise their babies in the community of other mothers would incentivize and facilitate healthy parental habits. Further programs for mothers who are released from prison would give them valuable resources to keep them from returning and encourage healthy relationships between the mother and the baby. - [1] Li, D. K. Video allegedly shows woman giving birth in Denver jail cell alone, with no assistance. Denver: NBC News, 2019. [2] Kajstura, Aleks. “Women's Mass Incarceration: The Whole Pie 2019.” Prison Policy Initiative, 29 Oct. 2019, https://www.prisonpolicy.org/reports/pie2019women.html. (“Including those in prisons, jails, and other correctional facilities.”) [3] Swavola, E, K Riley and R Subramanian. "Overlooked: Women and Jails in an Era of Reform." Vera Institute of Justice August 2016. [4] Sufrin, C. Pregnant Behind Bars: What We Do and Don't Know About Pregnancy and Incarceration Allison Chang. 21 March 2019. Transcript. [5] Sufrin, C., 2019. (Suffrin expressed that she had seen such practices firsthand working as an OB/GYN for incarcerated women.) [6] Padilla, M. “Woman Gave Birth in Denver Jail Cell Alone, Lawsuit Says,” New York Times, Sep. 1, 2019. [7] Li, D. “Video allegedly shows woman giving birth in Denver jail cell alone, with no assistance,” NBC U.S. News, Apr. 29. 2019. [8] Knittel, A. and C. Sufrin. "Maternal Health Equity and Justice for Pregnant Women Who Experience Incarceration." JAMA Network Open 3.8 (2020). A study in Ontario, Canada, coincided with a study done in Australia. [9] Sufrin, C., et al. "Pregnancy Outcomes in US Prisons, 2016–2017." p. 803-804. [10] Sridhar, S., R. Cornish and S. Fazel. "The Costs of Healthcare in Prison and Custody: Systematic Review of Current Estimates and Proposed Guidelines for Future Reporting." Frontiers in Psychiatry 9.716 (2018). [11] Kifer, M., Hemmens, C., Stohr, M. K. “The Goals of Corrections: Perspectives from the Line” Criminal Justice Review. 1 May 2003 [12] Perry, D. M. "Our Long, Troubling History of Sterilizing the Incarcerated." The Marshall Project: Sterilization of Women in Prison 26 July 2017. [13] Rachel Roth & Sara L. Ainsworth, If They Hand You a Paper, You Sign It: A Call to End the Sterilization of Women in Prison, 26 Hastings WOMEN's L.J. 7 (2015); See Skinner v. Oklahoma ex rel. Williamson, 316 U.S. 535 (1942) (procreation considered a fundamental right; fact pattern of male sterilization in prison based on type of crime.) [14] Sufrin, C., M. D. Creinin, J. C. Chang. “Incarcerated Women and Abortion Provision: A Survey of Correctional Health Providers.” Perspectives on Sexual and Reproductive Health. p. 6-11. 23 March 2009. [15] Kasdan, D. “Abortion Access for Incarcerated Women: Are Correctional Health Practices in Conflict with Constitutional Standards?” Guttmacher Institute. 26 March 2009. [16] Born Behind Bars. Season 1, Episode 5, “They Can Take Your Baby Away,” produced by Luke Ellis, Francis Gasparini, & Jen Wise, aired on 15 Nov. 2017 A&E Networks [17] Bick, J., & Dozier, M. (2008). Helping Foster Parents Change: The Role of Parental State of Mind. In H. Steele & M. Steele (Eds.), Clinical applications of the Adult Attachment Interview (pp. 452–470). New York: Guilford Press. [18]Sroufe, L. A., B. Egeland, E. A. Carlson, W. A. Collins. (2005). The Development of the Person: The Minnesota Study of Risk and Adaptation from Birth to Adulthood. New York: Guilford Press. [19] Goshin, L. S., & Byrne, M. W. “Converging Streams of Opportunity for Prison Nursery Programs in the United States.” Journal of Offender Rehabilitation. 15 Apr 2009. [20] Babies Behind Bars. Dirs. W. Serrill and S. O'Brien. 2015. Another IWP pregnant woman is Taylor. At the time of the show, she was pregnant and expecting twins. In interviews throughout the episode, she expressed how her pregnancies in prison had put her in a better mood and felt beneficial to her. She had tried to sign up for the nursery program for her previous pregnancy, but her sentence was too long to get it. Her child was sent to live with a caregiver, and when Taylor was on probation, Taylor’s daughter didn’t want to be around Taylor. Taylor was so distraught that she messed up and went back, this time, pregnant with twins. After she was reincarcerated, she was able to be accepted into Wee Ones. She expressed to the camera man that the program might help her feel more like a mother so that when she gets out, she will have someone to care for. Taylor, Kara, and many other women depend on their children or their pregnancy for a purpose while behind bars. They relied on their babies to be a boon for them. [21] Babies Behind Bars. Dirs. W. Serrill and S. O'Brien. 2015. [22] Corley, C. "Programs Help Incarcerated Moms Bond with Their Babies in Prison." Criminal Justice Collaborative (2018). [23] Corley, C. "Programs Help Incarcerated Moms Bond with Their Babies in Prison." Criminal Justice Collaborative (2018). [24] Owen, B. & Crow, J. “Recidivism among Female Prisoners: Secondary Analysis of the 1994 BJS Recidivism Data Set” Department of Criminology California State University (2006) p. 28 [25] Prison Nursery Programs: Literature Review and Fact Sheet for CT. Diamond Research Consulting, 2012, www.cga.ct.gov/2013/JUDdata/tmy/2013HB-06642-R000401-Sarah Diamond - Director, Diamond Research Consulting-TMY.PDF. [26] New York Department of Correction Services (NYDOCS). (1993). Profile of Participants: The Bedford and Taconic Nursery Program in 1992. Albany, NY. Department of Correction Services.Rowland, M., & Watts, A. (2007). Washington State’s effort to the generational impact on crime. Corrections Today. Retrieved September 12, 2007, from http://www. aca.org/publications/pdf/Rowland_Watts_Aug07.pdf. [27] Carlson, J. R. (2001). Prison nursery 2000: A five-year review of the prison nursery at the Nebraska Correctional Center for Women. Journal of Offender Rehabilitation, 33, 75–97. [28] Carlson, J.R. [29] Little, B. "What Happens When a Woman Gives Birth Behind Bars?" A+E Networks, 29 October 2019. <https://www.aetv.com/real-crime/what-happens-when-a-woman-gives-birth-in-jail-or-prison>. [30] Margolies, J. K., & Kraft-Stolar, T. When “Free” Means Losing Your Mother: The Collision of Child Welfare and the Incarceration of Women in New York State 1, 9 (Correctional Association of N.Y. Women in Prison Project 2006) [31] Sufrin, C. Jailcare: Finding the Safety Net for Women Behind Bars. Berkeley: University of California Press, 2017. [32] Sufrin, C. Jailcare: p. 155. [33] Peart, M. S. & Knittel, A. K. “Contraception need and available services among incarcerated women in the United States: a systematic review.” Contraception and Reproductive Medicine. 17 March 2020 [34] LaRochelle, F., C. Castro, J. Goldenson, J. P. Tulsky, D.L. Cohan, P. D. Blumenthal, et al. “Contraceptive use and barriers to access among newly arrested women.” J Correct Health Care. (2012) p. 111–119. [35] Goshin, L., & Byrne, M. (2009). “Converging streams of opportunity for prison nursery programs in the United States.” Journal of Offender Rehabilitation. 2009. p.271–295. [36] Elizabeth Swavola, Kristine Riley, Ram Subramanian. Overlooked: Women and Jails in an Era of Reform. New York: Vera Institute of Justice, 2016.

She leant lazily across the picnic hamper and reached for my hearing aid in my open-palmed hand. I jerked away from her, batting her hand away from mine. The glare of the summer sun blinded me. I struck empty air. Her tendril-fingers seized the beige seashell curve of my hearing aid and she lifted the cargo of sound towards her eyes. She peered at the empty battery-cage before flicking it open and shut as if it was a cigarette lighter, as if she could spark hearing-life into this trick of plastic and metal that held no meaning outside of my ear. I stared at her. A band of horror tightened around my throat, strangling my shout: ‘Don’t do that!’ I clenched my fist around the new battery that I had been about to insert into my hearing aid and imagined it speeding like a bullet towards her heart. This dream arrived as I researched my anthology of memoir-style essays on deafness, The Art of Being. I had already been reflecting and writing for several years about my relationship with my deaf-self and the impact of my deafness on my life, but I remained uneasy about writing about my deaf-life. I’ve lived all my adult life entirely in the hearing world, and so recasting myself as a deaf woman with something pressing to say about deaf people’s lives felt disturbing. The urgency to tell my story and my anxiety to contest certain assumptions about deafness were real, but I was hampered by diffidence. The dream felt potent, as if my deaf-self was asserting itself, challenging my hearing persona. I was the sole deaf child in a family of five muddling along in a weatherboard war commission house at The Grange in Brisbane during the nineteen fifties and nineteen sixties. My father’s resume included being in the army during World War Two, an official for the boxing events at the 1956 Melbourne Olympic Games and a bookie with a gift for telling stories. My mother had spent her childhood on a cherry orchard in Young, worked as a nurse in war-time Sydney and married my father in Townsville after a whirlwind romance on Magnetic Island before setting up home in Brisbane. My older sister wore her dark hair in thick Annie-Oakley style plaits and my brother took me on a hike along the Kedron Brook one summer morning before lunchtime. My parents did not know of any deaf relatives in their families, and my sister and brother did not have any friends with deaf siblings. There was just me, the little deaf girl. Most children are curious about where they come from. Such curiosity marks their first foray into sexual development and sense of identity. I don’t remember expressing such curiosity. Instead, I was diverted by my mother’s story of her discovery that I was deaf. The way my mother tells the story, it is as if I had two births with the date of the diagnosis of my deafness marking my real arrival, over-riding the false start of my physical birth three years earlier. Once my mother realized that I was deaf, she was able to get on with it, the ‘it’ being to defy the inevitability of a constrained life for her deaf child. My mother came out swinging; by hook or by crook, her deaf daughter was going to learn to speak and to be educated and to take her place in the hearing world and to live a normal life and that was that. She found out about the Commonwealth Acoustics Laboratory (now known as Australian Hearing Services) where, after I completed a battery of auditory tests, I was fitted with a hearing aid. This was a small metal box, to be worn in a harness around my body, with a long looping plastic cord connected to a beige ear-mould. An instrument for piercing silence, it absorbed and conveyed sounds, with those sounds eventually separating themselves out into patterns of words and finally into strings of sentences. Without my hearing aid, if I am concentrating, and if the sounds are made loudly, I am aware of the sounds at the deeper end of the scale. Sometimes, it’s not so much that I can hear them; it’s more that I know that those sounds are happening. My aural memory of the deep-register sounds helps me to “hear” them, much like the recollection of any tune replays itself in your imagination. With and without my hearing aids, if I am not watching the source of those sounds – for example, if the sounds are taking place in another room or even just behind me – I am not immediately able to distinguish whether the sounds are conversational or musical or happy or angry. I can only discriminate once I’ve established the rhythm of the sounds; if the rhythm is at a tearing, jagged pace with an exaggerated rise and fall in the volume, I might reasonably assume that angry words are being had. I cannot hear high-pitched sounds at all, with and without my hearing aids: I cannot hear sibilants, the “cees” and “esses” and “zeds”. I cannot hear those sounds which bounce or puff off from your lips, such as the letters “b” and “p”; I cannot hear that sound which trampolines from the press of your tongue against the back of your front teeth, the letter “t”. With a hearing-aid I can hear and discriminate among the braying, hee-hawing, lilting, oohing and twanging sounds of the vowels ... but only if I am concentrating, and if I am watching the source of the sounds. Without my hearing aid, I might also hear sharp and sudden sounds like the clap of hands or crash of plates, depending on the volume of the noise. But I cannot hear the ring of the telephone, or the chime of the door bell, or the urgent siren of an ambulance speeding down the street. My hearing aid helps me to hear some of these sounds. I was a pupil in an oral-deaf education program for five years until the end of 1962. During those years, I was variously coaxed, dragooned and persuaded into the world of hearing. I was introduced to a world of bubbles, balloons and fingers placed on lips to learn the shape, taste and feel of sounds, their push and pull of air through tongue and lips. By these mechanics, I gained entry to the portal of spoken, rather than signed, speech. When I was eight years old, my parents moved me from the Gladstone Road School for the Deaf in Dutton Park to All Hallows, an inner-city girls’ school, for the start of Grade Three. I did not know, of course, that I was also leaving my world of deaf friends to begin a new life immersed in the hearing world. I had no way of understanding that this act of transferring me from one school to another was a profound statement of my parents’ hopes for me. They wanted me to have a life in which I would enjoy all the advantages and opportunities routinely available to hearing people. Like so many parents before them, ‘they had to find answers that might not, for all they knew, exist . . . How far would I be able to lead a ‘normal’ life? . . . How would I earn a living? You can imagine what forebodings weighed on them. They could not know that things might work out better than they feared’ (Wright, 22). Now, forty-four years later, I have been reflecting on the impact of that long-ago decision made on my behalf by my parents. They made the right decision for me. The quality of my life reflects the rightness of their decision. I have enjoyed a satisfying career in social work and public policy embedded in a life of love and friendships. This does not mean that I believe that my parents’ decision to remove me from one world to another would necessarily be the right decision for another deaf child. I am not a zealot for the cause of oralism despite its obvious benefits. I am, however, stirred by the Gemini-like duality within me, the deaf girl who is twin to the hearing persona I show to the world, to tell my story of deafness as precisely as I can. Before I can do this, I have to find that story because it is not as apparent to me as might be expected. In an early published memoir-essay about my deaf girlhood, I Hear with My Eyes (in Schulz), I wrote about my mother’s persistence in making sure that I learnt to speak rather than sign, the assumed communication strategy for most deaf people back in the 1950s. I crafted a selection of anecdotes, ranging in tone, I hoped, from sad to tender to laugh-out-loud funny. I speculated on the meaning of certain incidents in defining who I am and the successes I have enjoyed as a deaf woman in a hearing world. When I wrote this essay, I searched for what I wanted to say. I thought, by the end of it, that I’d said everything that I wanted to say. I was ready to move on, to write about other things. However, I was delayed by readers’ responses to that essay and to subsequent public speaking engagements. Some people who read my essay told me that they liked its fresh, direct approach. Others said that they were moved by it. Friends were curious and fascinated to get the inside story of my life as a deaf person as it has not been a topic of conversation or inquiry among us. They felt that they’d learnt something about what it means to be deaf. Many responses to my essay and public presentations had relief and surprise as their emotional core. Parents have cried on hearing me talk about the fullness of my life and seem to regard me as having given them permission to hope for their own deaf children. Educators have invited me to speak at parent education evenings because ‘to have an adult who has a hearing impairment and who has developed great spoken language and is able to communicate in the community at large – that would be a great encouragement and inspiration for our families’ (Email, April 2007). I became uncomfortable about these responses because I was not sure that I had been as honest or direct as I could have been. What lessons on being deaf have people absorbed by reading my essay and listening to my presentations? I did not set out to be duplicitous, but I may have embraced the writer’s aim for the neatly curved narrative arc at the cost of the flinty self-regarding eye and the uncertain conclusion. * * * Let me start again. I was born deaf at a time, in the mid 1950s, when people still spoke of the ‘deaf-mute’ or the ‘deaf and dumb.’ I belonged to a category of children who attracted the gaze of the curious, the kind, and the cruel with mixed results. We were bombarded with questions we could either not hear and so could not answer, or that made us feel we were objects for exploration. We were the patronized beneficiaries of charitable picnics organized for ‘the disadvantaged and the handicapped.’ Occasionally, we were the subject of taunts, with words such as ‘spastic’ being speared towards us as if to be called such a name was a bad thing. I glossed over this muddled social response to deafness in my published essay. I cannot claim innocence as my defence. I knew I was glossing over it but I thought this was right and proper: after all, why stir up jagged memories? Aren’t some things better left unexpressed? Besides, keep the conversation nice, I thought. The nature of readers’ responses to my essay provoked me into a deeper exploration of deafness. I was shocked by the intensity of so many parents’ grief and anxiety about their children’s deafness, and frustrated by the notion that I am an inspiration because I am deaf but oral. I wondered what this implied about my childhood deaf friends who may not speak orally as well as I do, but who nevertheless enjoy fulfilling lives. I was stunned by the admission of a mother of a five year old deaf son who, despite not being able to speak, has not been taught how to Sign. She said, ‘Now that I’ve met you, I’m not so frightened of deaf people anymore.’ My shock may strike the average hearing person as naïve, but I was unnerved that so many parents of children newly diagnosed with deafness were grasping my words with the relief of people who have long ago lost hope in the possibilities for their deaf sons and daughters. My shock is not directed at these parents but at some unnameable ‘thing out there.’ What is going on out there in the big world that, 52 years after my mother experienced her own grief, bewilderment, anxiety and quest to forge a good life for her little deaf daughter, contemporary parents are still experiencing those very same fears and asking the same questions? Why do parents still receive the news of their child’s deafness as a death sentence of sorts, the death of hope and prospects for their child, when the facts show – based on my own life experiences and observations of my deaf school friends’ lives – that far from being a death sentence, the diagnosis of deafness simply propels a child into a different life, not a lesser life? Evidently, a different sort of silence has been created over the years; not the silence of hearing loss but the silence of lost stories, invisible stories, unspoken stories. I have contributed to that silence. For as long as I can remember, and certainly for all of my adult life, I have been careful to avoid being identified as ‘a deaf person.’ Although much of my career was taken up with considering the equity dilemmas of people with a disability, I had never assumed the mantle of advocacy for deaf people or deaf rights. Some of my early silence about deaf identity politics was consistent with my desire not to shine the torch on myself in this way. I did not want to draw attention to myself by what I did not have, that is, less hearing than other people. I thought that if I lived my life as fully as possible in the hearing world and with as little fuss as possible, then my success in blending in would be eloquence enough. If I was going to attract attention, I wanted it to be on the basis of merit, on what I achieved. Others would draw the conclusions that needed to be drawn, that is, that deaf people can take their place fully in the hearing world. I also accepted that if I was to be fully ‘successful’ – and I didn’t investigate the meaning of that word for many years – in the hearing world, then I ought to isolate myself from my deaf friends and from the deaf culture. I continued to miss them, particularly one childhood friend, but I was resolute. I never seriously explored the possibility of straddling both worlds, despite the occasional invitation to do so. For example, one of my childhood deaf friends, Damien, visited me at my parents’ home once, when we were both still in our teens. He was keen for me to join him in the Deaf Theatre, but I couldn’t muster the emotional dexterity that I felt this required. Instead, I let myself to be content to hear news of my childhood deaf friends through the grape-vine. This was, inevitably, a patchy process that lent itself to caricature. Single snippets of information about this person or that person ballooned into portrait-size depictions of their lives as I sketched the remaining blanks of their history with my imagination as my only tool. My capacity to be content with my imagination faltered. * * * Despite the construction of public images of deafness around the highly visible performance of hand-signed communication, the ‘how-small-can-we-go?’ advertorials of hearing aids and the cochlear implant with its head-worn speech processor, deafness is often described as ‘the invisible disability.’ My own experience bore this out. I became increasingly self-conscious about the singularity of my particular success, moderate in the big scheme of things though that may be. I looked around me and wondered ‘Why don’t I bump into more deaf people during the course of my daily life?’ After all, I am not a recluse. I have broad interests. I have travelled a lot, and have enjoyed a policy career for some thirty years, spanning the three tiers of government and scaling the competitive ladder with a reasonable degree of nimbleness. Such a career has got me out and about quite a bit: up and down the Queensland coast and out west, down to Sydney, Melbourne, Canberra, Adelaide and Hobart, and to the United Kingdom. And yet, not once in those thirty years did I get to share an office or a chance meeting or a lunch break with another deaf person. The one exception took place in the United Kingdom when I attended a national conference in which the keynote speaker was the Chairman of the Audit Commission, a man whose charisma outshines his profound deafness. After my return to Australia from the United Kingdom, a newspaper article about an education centre for deaf children in a leafy suburb of Brisbane, prompted me into action. I decided to investigate what was going on in the world of education for deaf children and so, one warm morning in 2006, I found myself waiting in the foyer for the centre’s clinical director. I flicked through a bundle of brochures and newsletters. They were loaded with images of smiling children wearing cochlear implants. Their message was clear: a cochlear implant brought joy, communication and participation in all that the world has to offer. This seemed an easy miracle. I had arrived with an open mind but now found myself feeling unexpectedly tense, as if I was about to walk a high-wire without the benefit of a safety net. Not knowing the reason for my fear, I swallowed it and smiled at the director in greeting upon her arrival. She is physically a small person but her energy is large. Her passion is bracing. That morning, she was quick to assert the power of cochlear implants by simply asking me, ‘Have you ever considered having an implant?’ When I shook my head, she looked at me appraisingly, ‘I’m sure you’d benefit from it’ before ushering me into a room shining with sun-dappled colour and crowded with a mess of little boys and girls. The children were arrayed in a democracy of shorts, shirts, and sandals. Only the occasional hair-ribbon or newly pressed skirt separated this girl from that boy. Some young mothers and fathers, their faces stretched with tension, stood or sat around the room’s perimeter watching their infant children. The noise in the room was orchestral, rising and falling to a mash of shouts, cries and squeals. A table had been set with several plastic plates in which diced pieces of browning apple, orange slices and melon chunks swam in a pond of juice. Some small children clustered around it, waiting to be served. When they finished their morning fruit, they were rounded up to sit at the front of the room, before a teacher poised with finger-puppets of ducks. I tripped over a red plastic chair – its tiny size designed to accommodate an infant’s bottom and small-sausage legs – and lowered myself onto it to take in the events going on around me. The little boys and girls laughed merrily as they watched their teacher narrate the story of a mother duck and her five baby ducks. Her hands moved in a flurry of duck-billed mimicry. ‘“Quack! Quack! Quack!” said the mother duck!’ The parents trilled along in time with the teacher. As I watched the children at the education centre that sunny morning, I saw that my silence had acted as a brake of sorts. I had, for too long, buried the chance to understand better the complex lives of deaf people as we negotiate the claims and demands of the hearing world. While it is true that actions speak louder than words, the occasional spoken and written word must surely help things along a little. I also began to reflect on the apparent absence of the inter-generational transfer of wisdom and insights born of experience rather than academic studies. Why does each new generation of parents approach the diagnosis of their newborn child’s disability or deafness with such intensity of fear, helplessness and dread for their child’s fate? I am not querying the inevitability of parents experiencing disappointment and shock at receiving unexpected news. I accept that to be born deaf means to be born with less than perfect hearing. All the same, it ought not to be inevitable that parents endure sustained grief about their child’s prospects. They ought to be illuminated as quickly as possible about all that is possible for their child. In particular, they ought to be encouraged to enjoy great hopes for their child. I mused about the power of story-telling to influence attitudes. G. Thomas Couser claims that ‘life writing can play a significant role in changing public attitudes about deafness’ (221) but then proceeds to cast doubt on his own assertion by later asking, ‘to what degree and how do the extant narratives of deafness rewrite the discourse of disability? Indeed, to what degree and how do they manage to represent the experience of deafness at all?’ (225). Certainly, stories from the Deaf community do not speak for me as my life has not been shaped by the framing of deafness as a separate linguistic and cultural entity. Nor am I drawn to the militancy of identity politics that uses terms such as ‘oppression’ and ‘oppressors’ to deride the efforts of parents and educators to teach deaf children to speak (Lane; Padden and Humphries). This seems to be unhelpfully hostile and assumes that deafness is the sole arbitrating reason that deaf people struggle with understanding who they are. It is the nature of being human to struggle with who we are. Whether we are deaf, migrants, black, gay, mentally ill – or none of these things – we are all answerable to the questions: ‘who am I and what is my place in the world?’ As I cast around for stories of deafness and deaf people with which I could relate, I pondered on the relative infrequency of deaf characters in literature, and the scarcity of autobiographies by deaf writers or biographies of deaf people by either deaf or hearing people. I also wondered whether written stories of deafness, memoirs and fiction, shape public perceptions or do they simply respond to existing public perceptions of deafness? As Susan DeGaia, a deaf academic at California State University writes, ‘Analysing the way stories are told can show us a lot about who is most powerful, most heard, whose perspective matters most to society. I think if we polled deaf/Deaf people, we would find many things missing from the stories that are told about them’ (DeGaia). Fighting my diffidence in staking out my persona as a ‘deaf woman’ and mustering the ‘conviction as to the importance of what [I have] to say, [my] right to say it’ (Olsen 27), I decided to write The Art of Being Deaf, an anthology of personal essays in the manner of reflective memoirs on deafness drawing on my own life experiences and supported by additional research. This presented me with a narrative dilemma because my deafness is just one of several life-events by which I understand myself. I wanted to find fresh ways of telling stories of deaf experiences while fashioning my memoir essays to show the texture of my life in all its variousness. A.N.Wilson’s observation about the precarious insensitivity of biographical writing was my guiding pole-star: the sense of our own identity is fluid and tolerant, whereas our sense of the identity of others is always more fixed and quite often edges towards caricature. We know within ourselves that we can be twenty different persons in a single day and that the attempt to explain our personality is doomed to become a falsehood after only a few words ... . And yet ... works of literature, novels and biographies depend for their aesthetic success precisely on this insensitive ability to simplify, to describe, to draw lines around another person and say, ‘This is she’ or ‘This is he.’ I have chosen to explore my relationship with my deafness through the multiple-threads of writing several personal essays as my story-telling vehicle rather than as a single-thread autobiography. The multiple-thread approach to telling my stories also sought to avoid the pitfalls of identity narrative in which I might unwittingly set myself up as an exemplar of one sort or another, be it as a ‘successful deaf person’ or as an ‘angry militant deaf activist’ or as ‘a deaf individual in denial attempting to pass as hearing.’ But in seeking to avoid these sorts of stories, what autobiographical story am I trying to tell? Because, other than being deaf, my life is not otherwise especially unusual. It is pitted here with sadness and lifted there with joy, but it is mostly a plateau held stable by the grist of daily life. Christopher Jon Heuer recognises this dilemma when he writes, ‘neither autobiography nor biography nor fiction can survive without discord. Without it, we are left with boredom. Without it, what we have is the lack of a point, a theme and a plot’ (Heuer 196). By writing The Art of Being Deaf, I am learning more than I have to teach. In the absence of deaf friends or mentors, and in the climate of my own reluctance to discuss my concerns with hearing people who, when I do flag any anxieties about issues arising from my deafness tend to be hearty and upbeat in their responses, I have had to work things out for myself. In hindsight, I suspect that I have simply ignored most of my deafness-related difficulties, leaving the heavy lifting work to my parents, teachers, and friends – ‘for it is the non-deaf who absorb a large part of the disability’ (Wright, 5) – and just got on with things by complying with what was expected of me, usually to good practical effect but at the cost of enriching my understanding of myself and possibly at the cost of intimacy. Reading deaf fiction and memoirs during the course of this writing project is proving to be helpful for me. I enjoy the companionability of it, but not until I got over my fright at seeing so many documented versions of deaf experiences, and it was a fright. For a while there, it was like walking through the Hall of Mirrors in Luna Park. Did I really look like that? Or no, perhaps I was like that? But no, here’s another turn, another mirror, another face. Spinning, twisting, turning. It was only when I stopped searching for the right mirror, the single defining portrait, that I began to enjoy seeing my deaf-self/hearing-persona experiences reflected in, or challenged by, what I read. Other deaf writers’ recollections are stirring into fresh life my own buried memories, prompting me to re-imagine them so that I can examine my responses to those experiences more contemplatively and less reactively than I might have done originally. We can learn about the diversity of deaf experiences and the nuances of deaf identity that rise above the stock symbolic scripts by reading authentic, well-crafted stories by memoirists and novelists. Whether they are hearing or deaf writers, by providing different perspectives on deafness, they have something useful to say, demonstrate and illustrate about deafness and deaf people. I imagine the possibility of my book, The Art of Being Deaf, providing a similar mentoring role to other deaf people and families.References Couser, G. Thomas. Recovering Bodies: Illness, Disablity, and Life Writing. Wisconsin: University of Wisconsin Press, 1997. Heuer, Christopher Jon. ‘Deafness as Conflict and Conflict Component.’ Sign Language Studies 7.2 (Winter 2007): 195-199. Lane, Harlan. When the Mind Hears: A History of the Deaf. New York: Random House, 1984 Olsen, Tillie. Silences. New York: Delta/Seymour Lawrence. 1978. Padden, Carol, and Tom Humphries. Deaf in America: Voices from a Culture. Cambridge, Mass.: Harvard University Press, 1998. Schulz, J. (ed). A Revealed Life. Sydney: ABC Books and Griffith Review. 2007 Wilson, A.N. Incline Our Hearts. London: Penguin Books. 1988. Wright, David. Deafness: An Autobiography. New York: Stein and Day, 1969.

“As the old technologies become automatic and invisible, we find ourselves more concerned with fighting or embracing what’s new”—Dennis Baron, From Pencils to Pixels: The Stage of Literacy Technologies In a world where nothing is certain… and even the objectivity of science is qualified by relativity and uncertainty, the single human voice, telling its own story, can seem the only authentic way of rendering consciousness. – David Lodge (“Sense and Sensibility”) Leon Edel expressed the central puzzle of writing biography as “every life takes its own form and a biographer must find the ideal and unique literary form that will express it” (qtd. in Novarr 165). My primary challenge in writing Poisoned: The Trials of Mary Dean – a biography in the form of a (fictionalised) first-person memoir purportedly written by the subject herself – was the location of a textual voice for Mary that, if not her own, could have credibly belonged to a woman of her time, place and circumstance. The ‘Dean case’ caused a sensation across Australia in the mid-1890s when George Dean was arrested for the attempted murder of his 20-year-old wife, Mary. George was a handsome Sydney ferry master who had played the romantic lead in a series of spectacular rescues, flinging himself into the harbour to save women passengers who had fallen overboard. When on trial for repeatedly poisoning his wife, his actions and motivations were not probed; instead, Mary’s character and behaviour and, by extrapolation, those of the entire female sex, were examined and analysed. This approach climaxed in defence counsel claims that Mary poisoned herself to frame her husband, but George was found guilty and sentenced to hang, the mandatory punishment for attempted murder at that time. Despite the persuasive prosecution evidence and the jury’s unanimous verdict, the Sydney press initiated a public outcry. After a series of inflamed community meetings and with a general election approaching, the Premier called for a Royal Commission into Dean’s conviction. This inquiry came to the extraordinary conclusion that: the facts, as shown, are quite as compatible with the hypothesis that Mrs. Dean ... administered the arsenic to herself – possibly at the prompting of her mother and without any intention of taking a fatal dose – as that the poison was administered to her by her husband with an intent to kill. (Regina v George Dean 16) George was freed with a Royal Pardon and Mary was publicly reviled as a pariah of the lowest order. This unhappy situation continued even after it was revealed that her husband had confessed his guilt to his solicitor, and charges of conspiracy and perjury were brought against George and his lawyers who were then members of the New South Wales Parliament. Although the lawyers both escaped relatively unscathed, George Dean was gaoled for 14 years. This was despite Mary’s story having obvious potential for a compelling biographical narrative. To begin with, she experiences the terror of suspecting her own husband is poisoning her as she convalesces after the birth of their child. She survives repeated doses of strychnine and arsenic, only to confront the humiliating certainty that her husband was desperate to be rid of her. Then, weak and ill, she has to endure the ordeal of police-court proceedings and a criminal trial when she is damned as a witch conspiring with her wicked mother to ruin her husband. Withstanding assertions that her childhood home was a brothel and she a prostitute, she spends long weeks in hospital knowing her husband is under sentence of execution, only to be released, destitute, with a sickly child she has poisoned with her own breast milk. Still physically debilitated, she is called before a Royal Commission where she is again violently cross-examined and, on the day of her twenty-first birthday, is confronted with the knowledge that not only was her mother a transported convict, but that she is, herself, of illegitimate birth. When the Commission finds in her husband’s favour, Mary has to watch her poisoner pardoned, freed and feted as a popular celebrity, while she faces an increasingly viperous press, and is jeered at and spat on in the streets. Next, she is forced to testify at yet another series of public trials and finally, even when her husband confesses his crime and is gaoled for perjury (his Royal Pardon saving him from again facing an attempted murder charge), she is ostracised as the penniless wife of a common criminal and illegitimate daughter of a transported convict. Despite this, and having little more than the shame of divorce to look forward to, Mary nevertheless regains her health and, four years after her final court appearance, marries a respectable shopkeeper. A year later, in 1902, she gives birth to her second child. together with examples written by women of her time, class and education, fabricating an extended letter (written by Mary, but based on historical evidence) seemed a viable textual solution. For centuries, domestic letters were a major means of autobiographical expression for ‘non-literary’, working-class women and, moreover, a textual format within which Mary (silenced for over a century) could finally relate her own version of events. These decisions aligned with what John Burnett has identified as the most common motivations for a working-class person to write an autobiographical narrative: “belief that he [sic] had some important … personal triumph over difficulties and misfortune … to leave for one’s children or grandchildren” (11). This relatively common human desire also tailored neatly with a central theme animating Mary’s life – that ignorance about the past can poison your future. To create a textual voice for Mary in her narrative, I utilised the literary process of ‘ventriloquising’ or providing a believable (fictional) voice for a historical character – the term ‘literary ventriloquism’ was coined by David Lodge in 1987 for how novelists create (and readers ‘hear’) the various voices in literary works (100). While biographies including Andrew Motion’s Wainewright the Poisoner (2000) and, as Richard Freadman has noted, Gertrude Stein’s The Autobiography of Alice B. Toklas (1933) have effectively employed varieties of biographical ventriloquism, this is a literary device more frequently used by fiction writers. It is also interesting to note that when skilled fiction writers employ ventriloquism, their resulting works are often perceived as much as biography-histories as imaginative pieces. Peter Carey’s The True History of the Kelly Gang (2000) is the invented document of which Kelly biographers dream, an autobiographical account supposedly written by Kelly so his infant daughter might “comprehend the injustice we poor Irish suffered” (5), but the voice Carey created was so credible that historians (including Ian Jones and Alex McDermott) debated its authenticity. This was despite Carey making no claims for the historical accuracy of his work. Of course, I primarily tested my text against such press interviews, Mary’s own letters and the articulations of her voice reported in the trial and other court records. Not that the latter group of texts can be taken as ‘verbatim’ transcriptions. Although court and other legal records provide, as Karen Dubinskyhas noted, “a window into instances of personal life … we can hear people talking about love, emotional and sexual intimacy, power, betrayal and broken promises” (4), such texts are profoundly mediated documents. The citations we now read in print passed through many hands – Mary’s testimonies would have been initially noted by the court stenographer, then transcribed, corrected, edited, typeset, corrected again, printed and bound – with each stage in the process incorporating inaccuracies, omissions and changes into the text. And, however accurate, such transcripts are never complete, neither indicating the tone in which answers were given, nor the speakers’ hesitations, pauses or accompanying gestures. The transcripts I used also record many examples of Lyndal Roper’s “forced discourse”, where Mary was directed to give only usually abbreviated responses to questions, questions which no doubt often directed the tone, content and even wording of her answers (54). Despite these limitations, it was following Mary in court through these texts, cringing at the humiliation and bullying she was subjected to, rallying when she showed spirit and almost cheering when she was finally vindicated, which allowed me to feel a real human connection with her as my subject. It was via these texts (and her own letters) that I also became aware that Mary Dean had been a person who, at the same time as she was living her life, was also (as are we all) remembering, forgetting and, probably, fabricating stories about that life – stories which, at times, challenged and contradicted each other. My aim was always to move beyond finding a persuasive textual voice for Mary, that is one which seemed authentic (and suitable for a novel), to one able to tell some of the contradictory stories of Mary’s life, as she no longer could. Ultimately, I wanted every utterance of my textual rendering of her speech to declare (as J. M. Coetzee has one of his characters say): “I live, I suffer, I am here. With cunning and treachery, if necessary, I fight against becoming one of the forgotten ones of history” (3). Works Cited Allen, Judith A. Sex and Secrets: Crimes Involving Australian Women Since 1880. Melbourne: Oxford U P, 1990. Burnett, John, ed. Useful Toil: Autobiographies of Working People from the 1820s to the 1920s. London: Allen Lane, 1976. Carey, Peter. The True History of the Kelly Gang, St. Lucia: U of Queensland P, 2000. Coetzee, J. M. In the Heart of the Country. London: Secker and Warburg, 1977. Daily Telegraph, 9 October 1895: 5. Dubinsky, Karen. Improper Advances: Rape and Heterosexual Conflict in Ontario, 1880-1929. Chicago and London: U of Chicago P, 1993. Freadman, Richard. â??Prose and Cons of a Bizarre Lifeâ?. The Age 27 May 2000: Saturday Extra, 7. Holmes, Katie. Spaces in Her Day: Australian Womenâ??s Diaries of the 1920s-1930s. St. Leonards: Allen and Unwin, 1995. â??Interview with Mrs. Dean.â? Truth 5 May 1895: 7. Jones, Ian. â??Not in Nedâ??s Natureâ?. The Weekend Australian 18-9 Aug. 2001: R12-3. Lodge, David. â??After Bakhtin.â? The Linguistics of Writing. Ed. Nigel Fabb, Derek Attridge, Alan Durant and Colin MacCabe. New York: Methuen, 1987: 89-102. Lodge, David. â??Sense and Sensibilityâ?. The Guardian Unlimited 2 Nov. 2002. [accessed 12/11/02] <http://books.guardian.co..uk/review/story/0,12084,823955,00.php> McDermott, Alex. â??Ned Kellyâ??s Yawp.â? Australian Book Review Mar. 2002: 16-8. McDermott, Alex. â??The Apocalyptic Chant of Edward Kellyâ?. The Jerilderie Letter. Melbourne: Text, 2001. v-xxxiv. Motion, Andrew. Wainewright the Poisoner. London: Faber, 2000. Novarr, David. The Lines of Life: Theories of Biography, 1880-1970. West Layfayette, In.: Perdue U P, 1986. Peers, Juliet. What No Man Had Ever Done Before. Malvern, Vic.: Dawn Revival, 1992. Regina v George Dean: Report of the Royal Commission, Appointed Seventh Day of May, 1895. Sydney: Government, 1895. Roper, Lyndal. Oedipus and the Devil: Witchcraft, Sexuality and Religion in Early Modern Europe. London and New York: Routledge, 1994. Seymour, Mary. Letter to George Clements, 12 October 1891. Letters to Frank Brereton, 22 October 1891, 30 December 1891, 25 April 1892. Regina v George Dean: Report of the Royal Commission: 244-46. Spender, Dale. â??Journal on a Journal.â? Womenâ??s Studies International Forum 10.1 (1987): 1-5. Sydney Morning Herald. 9 October 1895: 8, 10 October 1895: 5. Links http://books.guardian.co..uk/review/story/0 Citation reference for this article MLA Style Brien, Donna Lee. "Imagining Mary Dean " M/C: A Journal of Media and Culture <http://www.media-culture.org.au/0401/07-brien.php>. APA Style Brien, D. (2004, Jan 12). Imagining Mary Dean . M/C: A Journal of Media and Culture, 7, <http://www.media-culture.org.au/0401/07-brien.php>