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This PowerPoint presentation on Stigma was originally
                presented at a Scottish Drug Forum Conference on
                               Drug Use and Stigma




Copyright © Buchanan 2008
People who may suffer stigma
                       ‱    A person with disability
                       ‱    A person from Black Minority Ethnic Group
                       ‱    A Gay/Lesbian person
                       ‱    A person with a drug problem
                       ‱    A person with mental health difficulties
                       ‱    A person from a religious minority
                       ‱    A person who is HIV+
                       ‱    Any person who is defined as ‘different’


Copyright © Buchanan 2008
What is Stigma?
                             The concept of stigma refers to negative
                               stereotypes assigned to a people when
                               their attributes are considered both
                               different from or inferior to societal
                               norms.

                             For Goffman stigma was about the social
                               interactions between ‘stigmatized’ and
                               ‘normal’ persons in society.

                             The process of stigma is deeply discrediting.
         (Goffman 1963)


Copyright © Buchanan 2008
Process
                                                            stereotypes
  of stigma                          STIGMA                    &
– involves severe social                                     labels
  disapproval of a persons
  characteristics or their
  beliefs which at the time
  are considered to be
  unacceptable to
  dominant cultural norms      Internalised
                                                                    roles
                               & reinforced
                                                                      &
                              tainted identity
                                                                 expectations


                                                   diminished
                                                 opportunities
Copyright © Buchanan 2008
Impact of Stigma
                  Isolation                – lack of social capital
                  Rejection                – reduced life opportunities
                  Hostility                – even violence (e.g. Stephen Lawrence)
                  Marginalised             – face discrimination and exclusion

                  Restricts a person's ability to develop their potential and impact
                     negatively upon:

                            –   Relationships
                            –   Housing
                            –   Health
                            –   Employment
                            –   Insurance
                            –   Education
                            –   Travel
Copyright © Buchanan 2008
Stigma reflects cultural shifts in norms
                       ‱    What was acceptable in the past may be
                            unacceptable today.

                       ‱    What was unacceptable in the past may be
                            acceptable today.

                       ‱    What is unacceptable today may be
                            acceptable in the future.

                       ‱    What is acceptable today may be
                            unacceptable in the future.
Copyright © Buchanan 2008
Smoking
      was once an
       approved
          and
       promoted
        cultural
         norm


Copyright © Buchanan 2008
Copyright © Buchanan 2008
Smoking is no longer an approved
                     cultural norm

                     Smoking now attracts stigma



Copyright © Buchanan 2008
Copyright © Buchanan 2008
The
       stigmatization
              of
           tobacco
            users


Copyright © Buchanan 2008
In the UK opium was once a
    socially acceptable and widely used
                     drug
    for recreational as well as medicinal
                  purposes.


          The Lakeland poets were a
     distinguished group of opium users
Copyright © Buchanan 2008
Samuel
                                                      Taylor
                            Laudanum, a solution of   Coleridge
                            opium and alcohol




Copyright © Buchanan 2008
Opiate use today carries
         considerable stigma and is
      presented as an evil in our society




Copyright © Buchanan 2008
Drugs & Drug Users - the Enemy?
       ‘hardly a family is unaffected by the evil of drugs
 Drug-related
                                                     drugs
          crime blights our communities. It destroys families and young
          lives and fuels a wide range of criminal activity, including
          burglary and robbery
.. We won’t tolerate the menace of
                         robbery
          drugs in our communities – it causes misery and costs lives
.
                                                                    lives
          This new money will enable agencies to step up their fight
          against drugs and the crime it breeds. It will get drug dealers
                                          breeds
          off our kids’ backs and into prison and help safeguard our
          communities’

                                     HM Treasury Press Release, 49/01 09 April 2001

Copyright © Buchanan 2008
Drug use is portrayed in the media
        as the key causal factor in violent
              and abhorrent crimes

                - as if taking an illicit substance
                  turns people into monsters


Copyright © Buchanan 2008
Copyright © Buchanan 2008
Demonizing drugs and drug users
                  Government Voices
                            – ‘Drug misuse can ruin individual lives, tear open families and
                              blight whole communities with the menace of dealers and crime
                              driven by drug abuse
 more drug dealers – people who profit in
                              the misery of others – behind bars
 more addicts into
                              treatment
further powers for police to drug test suspected
                              addicts on arrest
 vicious circle of drugs and crime 
dealers will
                              face harsher sentences where they prey on children 
Drugs are a
                              scourge on the world’ (2005)

                  Media Voices
                            – ‘Cannabis caused a 14-year-old to kill’ 
. ‘Woman murdered was
                              deliberately run down by suspected drug addicts’

Copyright © Buchanan 2008
Demonizing drugs and drug users (2)
                    Community Voices
                            – ‘there’s always junkies 
 they fight people are
                              aggressive, do dealing in houses, break-ins and
                              steal from cars 
..get rid of all the junkies
nuke
                              the junkie scum’


                    Drug User Voices
                            – ‘They look down on me as scum of the earth and
                              as someone not to be associated with’ another
                              said ‘They see me as a drug addict, a smackhead
                              and they think I’d rob them’
Copyright © Buchanan 2008
The
     Drug
     Divide



    Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use, in R. Carnwell & J. Buchanan (eds)
        Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Second edition, Open University
        Press, Maidenhead.

Copyright © Buchanan 2008
The Barrier of Exclusion
       ‘it is evident that the anti-drug campaigns over the past
           20 years have added to the isolation and
           marginalization of the discarded working-class youth
           
. In addition to having to overcome their addiction,
           one of the biggest hurdles they have to face is
           breaking through the barrier of social exclusion.

       JULIAN BUCHANAN & LEE YOUNG
       The War on Drugs -a war on drug users?
       Drugs: education, prevention and policy, Vol. 7, No. 4, 2000


Copyright © Buchanan 2008
House of Commons Science and
                            Technology Committee: Evidence 2006:
                            Ev 114




Copyright © Buchanan 2008
Problem drug users
                                                     ‘The motivations for using illegal drugs are largely the same
                                                     as the motivation for using legal drugs – a pleasurable habit,
                                                     to be social, to relax and generally enjoy the affect of the
                                                     drug. However, a small proportion of people who use drugs
                                                     (legal and illegal substances) develop serious drug problems
                                                     (UNODC 2007). The vast majority of drug users are
                                                     recreational users who use drugs in a controlled manner
                                                     without incurring significant social, psychological and/or
                                                     physical problems to themselves or others around them. In
                                                     contrast the minority who develop problems sometimes
                                                     referred to as ‘problem drug users’ become socially,
                                                     psychologically and/or physically dependent and this lack of
                                                     control tends to have a detrimental impact upon their social,
                                                     psychological and/or physical well-being, and is likely to have
                                                     a negative impact upon those around them.’

 Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds)
         Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead.
Copyright © Buchanan 2008
The USA & UK War on Drugs
                            - locking up drug users?
        In 1996 the US prison population was 1.6m
                 Today it exceeds 2.3m


        In 1985 the UK prison population figure was 47,500
                 Today it exceeds 83,000

        Many prisoner have severe social and psychological problems:
            reading, writing, numeracy, mental health, dyslexia, drugs, no
              qualifications, poor family support
Copyright © Buchanan 2008
Institutionalised stigma has
                  invited widespread
                    discrimination
                 Discrimination involves those in positions of power
               exercising prejudicial beliefs, actions, or judgments and
                  using their power against the less powerful. The
            discrimination is based on difference and serves to maintain
            division and power by drawing upon and reinforcing stigma
                                   and stereotypes.


Copyright © Buchanan 2008
Discrimination – more than just being rude


                            DISCRIMINATION =

                 POWER + DIFFERENCE + PREJUDICE



Copyright © Buchanan 2008
PCS Model
Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave




              ‱ Personal
              ‱ Cultural
              ‱ Structural                                   P
                                                             C   C   S

           Discrimination occurs at
             three distinct levels

Copyright © Buchanan 2008
Damaged identities
             ‘The constant experience of this
             marginalization has led many problem
             drug users to internalize their problems
             and blame themselves for their plight. This
             loss of self-esteem then becomes a
             serious debilitating factor as they feel
             isolated and excluded from society.’ (p.394)
           Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on
                                              Problem Drug Use Vol 51 No.4 pp.387-397
Copyright © Buchanan 2008
Mixing with ‘Non’ Drug Users
         ‘I feel a bit beneath them, they make you feel like that’


         ‘I used to avoid them like the plague’


         ‘I’ve got to watch what I say so I don’t land myself in it. They blame
             smack heads for everything.’


         ‘I feel labelled 
 like they thought I was dirt’


         ‘Most people look down their noses if drugs are mentioned’
Copyright © Buchanan 2008
Stigma & discrimination worse than
                       the drugs?
                    ‘In an environment frightened with powerful moral
                    and legal reactions to the use of drugs, the stigma
                    attached to drugs may come to be a more
                    important factor than the biology of addiction. The
                    demonization of drugs and the criminalization of
                    the drug user (i.e. the war on drugs) could be
                    more damaging to the individual and society than
                    drug use or addiction’ (p.31)
              Drucker, E. (2000) ‘From Morphine to Methadone: Maintenance Drugs in the Treatment of Opiate Addiction’, in J.A. Incardia
                   and L.D. Harrison (eds) Harm Reduction National and International Perspectives, pp. 27–45. London: Sage.



Copyright © Buchanan 2008
Impact of drug users
             ‘I’m sick of it. I see people with their own houses, family and
                            friends. I’d like friends who don’t use’


                            ‘I’ve been wanting to change for five years’


                  ‘I want to be drug free, get a job and lead a normal life’


           ‘It is difficult you feel divorced from the mainstream. I want to
                                        get back into it’
Copyright © Buchanan 2008
Arguably the biggest hurdle a recovering
                long term problem drug user has to
              overcome is not physical addiction, nor
           psychological cravings - but trying to break
            through the ‘wall of exclusion’ that keeps
               them in a drug ghetto. This makes it
            extremely difficult for them to acquire new
             routines, friendships, skills, hobbies and
         lifestyle. They are often ostracised, criticised
                           and distrusted.
Copyright © Buchanan 2008
The struggle for re-integration




                 Adapted from Buchanan J (2004) Tackling Problem Drug Use: A New Conceptual Framework,
                 pp117-138, in Social Work in Mental in Health, Vol. 2 No 2/3, Haworth press
                 Free article download from http://epubs.newi.ac.uk/siru/1/
Copyright © Buchanan 2008
Re-integration or integration
       ‘When considering treatment and rehabilitation it must be recognised that
         many problem drug users have had such limited options in life, that they
         lack personal resources (confidence, social skills and life skills) and have
         limited positive life experiences to lean upon or return to.


       This client group need social integration not social reintegration, they need
          habilitation not re-habilitation – it seems that many have never really been
          able to get started in life in the first place. This makes living without drugs a
          very tough option indeed.’ (p.397)


               Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on
                  Problem Drug Use Vol 51 No.4 pp.387-397



Copyright © Buchanan 2008
Challenging Stigma & Discrimination
       ‱ Must happen at all three levels: personal, cultural and
         structural.

       ‱ Requires an ongoing public campaign to challenge
         existing stereotypes and promote positive images.

       ‱ Requires a challenge to existing language, notions and
         images used to make sense of drugs.

       ‱ Require education and training to inform people.
Copyright © Buchanan 2008
Challenging Discrimination
    high
                                                           It is easier to have impact at
                                                          tackling personal attitudes and
                                                          behaviours but tackling cultural
                                                            and structural discrimination
                    Degree of                               (institutional) is much more
                                                                       difficult.
                    Influence




     low
                 Personal                        Cultural                Structural

                   Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave(Thompson N 2006)
Copyright © Buchanan 2008
A different way of seeing?
                                    We are all drug users

              Low risk                                                                            High risk
      ‘All drug taking presents a degree of risk and some legal drugs will pose greater risk than some illegal
      drugs. It is argued then that rather than consider legal drugs as safer and illegal drugs more harmful,
      and rather than assess drugs according to a hierarchical table of risk posed by different drugs, there is
      a need for a comprehensive individual assessments to be made for each person according to the
      nature and context of the drug taking and this is best placed upon a broad continuum of risk which is
      applicable for all {legal user and illegal users alike] 
 it should be remembered then that virtually
      everyone uses drugs, and all drug taking presents some risk’ .


             Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R
             Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach,
             Open University Press, Maidenhead.
Copyright © Buchanan 2008
julian.buchanan@vuw.ac.nz

                                           Home page:
                             http://julianbuchanan.wordpress.com/




                                                      PLEASE NOTE:

                            Feel free to use any of this material just make sure you reference.
                                       If you want more information do contact me.
                                                           thanks
Copyright © Buchanan 2008

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The Social Construction of Stigma & Problem Drug Use

  • 1. This PowerPoint presentation on Stigma was originally presented at a Scottish Drug Forum Conference on Drug Use and Stigma Copyright © Buchanan 2008
  • 2. People who may suffer stigma ‱ A person with disability ‱ A person from Black Minority Ethnic Group ‱ A Gay/Lesbian person ‱ A person with a drug problem ‱ A person with mental health difficulties ‱ A person from a religious minority ‱ A person who is HIV+ ‱ Any person who is defined as ‘different’ Copyright © Buchanan 2008
  • 3. What is Stigma? The concept of stigma refers to negative stereotypes assigned to a people when their attributes are considered both different from or inferior to societal norms. For Goffman stigma was about the social interactions between ‘stigmatized’ and ‘normal’ persons in society. The process of stigma is deeply discrediting. (Goffman 1963) Copyright © Buchanan 2008
  • 4. Process stereotypes of stigma STIGMA & – involves severe social labels disapproval of a persons characteristics or their beliefs which at the time are considered to be unacceptable to dominant cultural norms Internalised roles & reinforced & tainted identity expectations diminished opportunities Copyright © Buchanan 2008
  • 5. Impact of Stigma Isolation – lack of social capital Rejection – reduced life opportunities Hostility – even violence (e.g. Stephen Lawrence) Marginalised – face discrimination and exclusion Restricts a person's ability to develop their potential and impact negatively upon: – Relationships – Housing – Health – Employment – Insurance – Education – Travel Copyright © Buchanan 2008
  • 6. Stigma reflects cultural shifts in norms ‱ What was acceptable in the past may be unacceptable today. ‱ What was unacceptable in the past may be acceptable today. ‱ What is unacceptable today may be acceptable in the future. ‱ What is acceptable today may be unacceptable in the future. Copyright © Buchanan 2008
  • 7. Smoking was once an approved and promoted cultural norm Copyright © Buchanan 2008
  • 9. Smoking is no longer an approved cultural norm Smoking now attracts stigma Copyright © Buchanan 2008
  • 11. The stigmatization of tobacco users Copyright © Buchanan 2008
  • 12. In the UK opium was once a socially acceptable and widely used drug for recreational as well as medicinal purposes. The Lakeland poets were a distinguished group of opium users Copyright © Buchanan 2008
  • 13. Samuel Taylor Laudanum, a solution of Coleridge opium and alcohol Copyright © Buchanan 2008
  • 14. Opiate use today carries considerable stigma and is presented as an evil in our society Copyright © Buchanan 2008
  • 15. Drugs & Drug Users - the Enemy? ‘hardly a family is unaffected by the evil of drugs
 Drug-related drugs crime blights our communities. It destroys families and young lives and fuels a wide range of criminal activity, including burglary and robbery
.. We won’t tolerate the menace of robbery drugs in our communities – it causes misery and costs lives
. lives This new money will enable agencies to step up their fight against drugs and the crime it breeds. It will get drug dealers breeds off our kids’ backs and into prison and help safeguard our communities’ HM Treasury Press Release, 49/01 09 April 2001 Copyright © Buchanan 2008
  • 16. Drug use is portrayed in the media as the key causal factor in violent and abhorrent crimes - as if taking an illicit substance turns people into monsters Copyright © Buchanan 2008
  • 18. Demonizing drugs and drug users Government Voices – ‘Drug misuse can ruin individual lives, tear open families and blight whole communities with the menace of dealers and crime driven by drug abuse
 more drug dealers – people who profit in the misery of others – behind bars
 more addicts into treatment
further powers for police to drug test suspected addicts on arrest
 vicious circle of drugs and crime 
dealers will face harsher sentences where they prey on children 
Drugs are a scourge on the world’ (2005) Media Voices – ‘Cannabis caused a 14-year-old to kill’ 
. ‘Woman murdered was deliberately run down by suspected drug addicts’ Copyright © Buchanan 2008
  • 19. Demonizing drugs and drug users (2) Community Voices – ‘there’s always junkies 
 they fight people are aggressive, do dealing in houses, break-ins and steal from cars 
..get rid of all the junkies
nuke the junkie scum’ Drug User Voices – ‘They look down on me as scum of the earth and as someone not to be associated with’ another said ‘They see me as a drug addict, a smackhead and they think I’d rob them’ Copyright © Buchanan 2008
  • 20. The Drug Divide Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use, in R. Carnwell & J. Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Second edition, Open University Press, Maidenhead. Copyright © Buchanan 2008
  • 21. The Barrier of Exclusion ‘it is evident that the anti-drug campaigns over the past 20 years have added to the isolation and marginalization of the discarded working-class youth 
. In addition to having to overcome their addiction, one of the biggest hurdles they have to face is breaking through the barrier of social exclusion. JULIAN BUCHANAN & LEE YOUNG The War on Drugs -a war on drug users? Drugs: education, prevention and policy, Vol. 7, No. 4, 2000 Copyright © Buchanan 2008
  • 22. House of Commons Science and Technology Committee: Evidence 2006: Ev 114 Copyright © Buchanan 2008
  • 23. Problem drug users ‘The motivations for using illegal drugs are largely the same as the motivation for using legal drugs – a pleasurable habit, to be social, to relax and generally enjoy the affect of the drug. However, a small proportion of people who use drugs (legal and illegal substances) develop serious drug problems (UNODC 2007). The vast majority of drug users are recreational users who use drugs in a controlled manner without incurring significant social, psychological and/or physical problems to themselves or others around them. In contrast the minority who develop problems sometimes referred to as ‘problem drug users’ become socially, psychologically and/or physically dependent and this lack of control tends to have a detrimental impact upon their social, psychological and/or physical well-being, and is likely to have a negative impact upon those around them.’ Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead. Copyright © Buchanan 2008
  • 24. The USA & UK War on Drugs - locking up drug users? In 1996 the US prison population was 1.6m  Today it exceeds 2.3m In 1985 the UK prison population figure was 47,500  Today it exceeds 83,000 Many prisoner have severe social and psychological problems:  reading, writing, numeracy, mental health, dyslexia, drugs, no qualifications, poor family support Copyright © Buchanan 2008
  • 25. Institutionalised stigma has invited widespread discrimination Discrimination involves those in positions of power exercising prejudicial beliefs, actions, or judgments and using their power against the less powerful. The discrimination is based on difference and serves to maintain division and power by drawing upon and reinforcing stigma and stereotypes. Copyright © Buchanan 2008
  • 26. Discrimination – more than just being rude DISCRIMINATION = POWER + DIFFERENCE + PREJUDICE Copyright © Buchanan 2008
  • 27. PCS Model Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave ‱ Personal ‱ Cultural ‱ Structural P C C S Discrimination occurs at three distinct levels Copyright © Buchanan 2008
  • 28. Damaged identities ‘The constant experience of this marginalization has led many problem drug users to internalize their problems and blame themselves for their plight. This loss of self-esteem then becomes a serious debilitating factor as they feel isolated and excluded from society.’ (p.394) Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on Problem Drug Use Vol 51 No.4 pp.387-397 Copyright © Buchanan 2008
  • 29. Mixing with ‘Non’ Drug Users ‘I feel a bit beneath them, they make you feel like that’ ‘I used to avoid them like the plague’ ‘I’ve got to watch what I say so I don’t land myself in it. They blame smack heads for everything.’ ‘I feel labelled 
 like they thought I was dirt’ ‘Most people look down their noses if drugs are mentioned’ Copyright © Buchanan 2008
  • 30. Stigma & discrimination worse than the drugs? ‘In an environment frightened with powerful moral and legal reactions to the use of drugs, the stigma attached to drugs may come to be a more important factor than the biology of addiction. The demonization of drugs and the criminalization of the drug user (i.e. the war on drugs) could be more damaging to the individual and society than drug use or addiction’ (p.31) Drucker, E. (2000) ‘From Morphine to Methadone: Maintenance Drugs in the Treatment of Opiate Addiction’, in J.A. Incardia and L.D. Harrison (eds) Harm Reduction National and International Perspectives, pp. 27–45. London: Sage. Copyright © Buchanan 2008
  • 31. Impact of drug users ‘I’m sick of it. I see people with their own houses, family and friends. I’d like friends who don’t use’ ‘I’ve been wanting to change for five years’ ‘I want to be drug free, get a job and lead a normal life’ ‘It is difficult you feel divorced from the mainstream. I want to get back into it’ Copyright © Buchanan 2008
  • 32. Arguably the biggest hurdle a recovering long term problem drug user has to overcome is not physical addiction, nor psychological cravings - but trying to break through the ‘wall of exclusion’ that keeps them in a drug ghetto. This makes it extremely difficult for them to acquire new routines, friendships, skills, hobbies and lifestyle. They are often ostracised, criticised and distrusted. Copyright © Buchanan 2008
  • 33. The struggle for re-integration Adapted from Buchanan J (2004) Tackling Problem Drug Use: A New Conceptual Framework, pp117-138, in Social Work in Mental in Health, Vol. 2 No 2/3, Haworth press Free article download from http://epubs.newi.ac.uk/siru/1/ Copyright © Buchanan 2008
  • 34. Re-integration or integration ‘When considering treatment and rehabilitation it must be recognised that many problem drug users have had such limited options in life, that they lack personal resources (confidence, social skills and life skills) and have limited positive life experiences to lean upon or return to. This client group need social integration not social reintegration, they need habilitation not re-habilitation – it seems that many have never really been able to get started in life in the first place. This makes living without drugs a very tough option indeed.’ (p.397) Buchanan J (2004) Missing Links: Problem Drug Use and Social Exclusion, Probation Journal Special Edition on Problem Drug Use Vol 51 No.4 pp.387-397 Copyright © Buchanan 2008
  • 35. Challenging Stigma & Discrimination ‱ Must happen at all three levels: personal, cultural and structural. ‱ Requires an ongoing public campaign to challenge existing stereotypes and promote positive images. ‱ Requires a challenge to existing language, notions and images used to make sense of drugs. ‱ Require education and training to inform people. Copyright © Buchanan 2008
  • 36. Challenging Discrimination high It is easier to have impact at tackling personal attitudes and behaviours but tackling cultural and structural discrimination Degree of (institutional) is much more difficult. Influence low Personal Cultural Structural Thompson, N. (2006) Anti-Discriminatory Practice, Palgrave(Thompson N 2006) Copyright © Buchanan 2008
  • 37. A different way of seeing? We are all drug users Low risk High risk ‘All drug taking presents a degree of risk and some legal drugs will pose greater risk than some illegal drugs. It is argued then that rather than consider legal drugs as safer and illegal drugs more harmful, and rather than assess drugs according to a hierarchical table of risk posed by different drugs, there is a need for a comprehensive individual assessments to be made for each person according to the nature and context of the drug taking and this is best placed upon a broad continuum of risk which is applicable for all {legal user and illegal users alike] 
 it should be remembered then that virtually everyone uses drugs, and all drug taking presents some risk’ . Buchanan J (2009 forthcoming) Understanding and misunderstanding problem drug use: working together, in R Carnwell & J Buchanan (eds) Effective Practice in Health, Social Care & Criminal Justice: A partnership approach, Open University Press, Maidenhead. Copyright © Buchanan 2008
  • 38. julian.buchanan@vuw.ac.nz Home page: http://julianbuchanan.wordpress.com/ PLEASE NOTE: Feel free to use any of this material just make sure you reference. If you want more information do contact me. thanks Copyright © Buchanan 2008