Beyond the 50-minute hour: Increasing control, choice, and connections in the lives of low-income women.

Abstract

Although poverty is associated with a range of mental health difficulties among women in this country, mainstream mental health interventions are not sufficient to meet the complex needs of poor women. This article argues that stress, powerlessness, and social isolation should become primary targets of our interventions, as they are key mediators of the relationship between poverty and emotional distress, particularly for women. Indeed, if ways are not found to address these conditions directly, by increasing women's control, choice, and connections, the capacity to improve the emotional well-being of impoverished women will remain limited at best. This is the first of 5 articles that comprise a special section of the American Journal of Orthopsychiatry, called "Beyond the 50-Minute Hour: Increasing Control, Choice, and Connections in the Lives of Low-Income Women." Together, these articles explore the nature and impact of a range of innovative mental health interventions that are grounded in a deep understanding of the experience of poverty. This introduction: (a) describes briefly how mainstream approaches fail to address the poverty-related mental health needs of low-income women; (b) illuminates the role of stress, powerlessness, and social isolation in women's lives; (c) highlights the ways in which the articles included in this special section address each of these by either adapting traditional mental health practices to attend to poverty's role in participants' lives or adapting community-based, social-justice-oriented interventions to attend to participants' mental health; and (d) discusses the research and evaluation implications of expanding mental health practices to meet the needs of low-income communities.

Factors Associated with Poor Mental Health Status Among Homeless Women With and Without Dependent Children

“…Addressing the mental health needs of homeless women will, therefore, require an integrated approach that not only focuses on homelessness and its effects on mental health but also deals with confounding factors, such as domestic violence and drug use, that are associated with both prolonged homelessness and poor mental health status. Finally, interventions to treat mental health among this population should be grounded in women's experiences of homelessness and poverty and should address issues related to stress, powerlessness, and social isolation and exclusion (Goodman et al, 2010).…”

Leveraging Social Networks in Direct Services: Are Foundations Doing All They Can?

“…The conditions of entrenched, multigenerational poverty create an experience that becomes embedded and perpetuated in relational structures. Metaphorical chits cannot be stored; people need and are needed on such a constant basis that the very tool that is important for survival may lock members in just that: survival (Goodman, Smyth, & Banyard, 2010). Nonetheless, social networks persist because they still fill a host of needs, as described at the beginning of this section.…”

“…Underlying such an approach is the assumption that members of a social network have a rich "expertise" in the participant that can rarely, if ever, be rivaled by a service provider, just as service providers have expertise in particular issues that network members may not have (Goodman & Smyth, 2010). Figure 1 provides an example of this network-oriented practice in an initiative addressing homelessness.…”

‘Moving beyond violence’: Exploring new ways to support women and develop networked approaches following intimate partner violence

“…These suggestions parallel social work's traditional attention to contexts and ecosystems and complement agencies' interests in working for change (at both personal and structural/service-delivery scales). Networks and collaborations enable diverse expertise to be mobilised for women who frequently battle interwoven effects of IPV, historic child abuse, health challenges, financial constraints, loss of self-esteem and confidence, limited qualifications, parenting difficulties, and impaired employment options (Crown et al, 2010;Goodman & Epstein, 2008;Goodman, Smyth, & Banyard, 2010;Gorske, Larkby, Daley, Yenerall, & Morrow, 2006;Kulkarni, Bell, & Wylie, 2010;Liu et al, 2013;Mankowski, Galvez, Perrin, Hanson, & Glass, 2013;State of Victoria, 2004;Zweig et al, 2002).…”

“…First, women valued their increasing autonomy and capacity. As others have noted, women's recovery is firmly associated with their increased access to choices, personal control, and widening capacities and reflective skills (Cram et al, 2002;Giles & Curreen, 2007;Goodman et al, 2010;McDonald & Dickerson, 2013;State of Victoria, 2004). Second, women also recognised that strength (and better futures) would include the wisdom to call on 'help' and use their growing networks and resources, a theme increasingly noted in the literature (Fanslow & Robinson, 2010;Goodman & Smyth, 2011;Mancini et al, 2006;Suvak et al, 2013).…”