Social Work Practice In Mental Health Research Articles

Implementing Connecting People in Adult Mental Health Social Work Practice: A Thematic Analysis of Postgraduate Student Assessed Placement Reports

Implementing Connecting People in Adult Mental Health Social Work Practice: A Thematic Analysis of Postgraduate Student Assessed Placement Reports

Mental Health Social Work Practice: Navigating Tensions

Abstract The United Nations Special Rapporteur has called for ‘a revolution in mental health care to end decades of neglect, abuse and violence…enabl[ing] a long overdue shift to a rights-based approach’ (United Nations Human Rights Office of the High Commissioner, 2017). Principles underpinning social work practice with people living with mental distress who receive diagnoses such as schizophrenia, personality disorders and bipolar disorder, align with sought after changes. Using Cooperative Inquiry and referring to the Model of Holistic Competence in Social Work, this study investigated mental health social work seeking to foster this shift. Findings confirmed inherent discordance between social work values and mental health care dominated by biomedical and neoliberal views. Upholding social work values in this context involves complex practice, integrating procedural and meta-competencies. By incorporating skills in relational practice and advocacy; knowledge of multiple explanatory frameworks for mental health and mental health systems literacy; self-regulation; fostering tenacity whilst addressing ‘othering’; and judgement informing choices around conformity and confrontation, social work navigates tensions associated with this discordance. This paper highlights the nature of values-based social work practice as aligned with mental health reforms.

Interweaving Narratives of Lived Experience in Mental Health Social Work Curriculum

ABSTRACT This study explored the metacurriculum of an undergraduate mental health social work subject that was developed and delivered collaboratively by lived experience and social work academics in a regional Australian university. Metacurriculum refers to implicit messages about how students learn how to learn that is, the ontological and epistemological positioning of curriculum. In this subject, students were invited to reflect on multiple, diverse, lived-experience narratives of mental distress as they developed their understanding of mental health social work practice. Using cooperative inquiry, we collectively critically reflected on the experience of teaching and learning with this curriculum. Coresearchers included a student who had completed the subject; a mental health social work practitioner/tutor, a social work academic, and a lived-experience academic who coproduced the subject material; and mental health academics acting as critical friends. Findings revealed engaging with lived-experience narratives was experienced as generating compassion for all humanity; challenging stigma by sharing the responsibility of positioning; and enabling critically reflexive dialogue. We concluded that diverse, lived-experience narratives can be incorporated to enact metacurriculum that aligns social work teaching and learning with emerging transformative approaches to mental health. IMPLICATIONS Incorporating diverse narratives of mental distress into curriculum can highlight the operation of intersectionality and privilege. Engaging with multiple narratives of mental distress undermines the binary construction of “them” and “us”. Metacurriculum enacting inclusive, collaborative knowledge development aligns teaching and learning with transformative mental health.

Supporting Dialogue: Using Self-Selected Material Objects to Explore Spirituality, Mental Distress and the Social Worker Role

Abstract This article is based upon a qualitative doctoral study about the role, if any, of spirituality in the lives of mental health service users, and how the subject is engaged with mental health social workers in Northern Ireland (NI). One-to-one interviews with twelve mental health service users and twelve mental health social workers were conducted with participants invited to bring an object. The object was used to assist dialogue with participants regarding their experience of spirituality, and its application in practice. International research proposes that spirituality plays a supportive role for some people experiencing mental health problems. The acknowledgement of spirituality in mental health social work practice in NI is, however, challenging due to various factors. Of particular significance is NI’s history of violent political conflict, shaped in part by the contested role of religion in the creation of the NI state. This article considers how the selection, presence and absence of the object were used to support participants in exploring a subject that can be challenging to communicate. This article proposes the use of objects within mental health social work practice and research as useful aides to explore culturally sensitive and personal topics.

The United Nations Convention on the Rights of Persons with Disabilities and Social Work: Evidence for Impact?

The United Nations Convention on the Rights of Persons with Disabilities (hereafter CRPD) has provided a radical imperative for the reform of mental health and capacity legislation around the world. The interpretation of the CRPD has been controversial, ranging from the complete abolition of detention, forcible treatment, and substitute decision-making to accepting that elements of these measures need to be retained based on non-discriminatory criteria, additional safeguards, and a comprehensive shift towards supported decision-making. While the potential effects of the CRPD on mental health social work and social work generally are considerable given their shared commitment towards social justice, to date there has been no review of research evidence exploring their relationship. In addressing this knowledge gap, this study held a preliminary discussion with practitioners and academics at the European Association of Social Work Mental Health Special Interest Group in Amsterdam 2022, followed by a scoping literature review on the question: What impact, if any, has the CRPD had on social work practice? The review produced four main findings: impact on legislation; positive impact on practice; limited impact on practice; and impact on social work education and research. In sum, while there were some positive indications of social work and mental health social work practice being influenced by the CRPD, these were scant. Barriers to change included tendencies among some social workers to practise substitute decision-making, in part related to resourcing and policy contexts, and understandings of disability aligned to individualised/medical rather than social perspectives. The results indicate that legal reform on its own is insufficient to impact social work practice, and that realising the potential of the CRPD will necessitate good quality training, as well as improving social workers' knowledge of the human rights of people with mental impairment.

Becoming Woke by the ASWB Pass Rates: A Closer Look at Racial Inequities in Social Work

ABSTRACT There has been widespread outrage within the social work profession regarding racial disparities in pass rates of licensing exams developed and administered by the Association of Social Work Boards (ASWB). The most supported remedy has been to eliminate testing for some categories of licensure with Connecticut, Illinois, and Rhode Island leading the way. Standardized testing has historically been a gatekeeping practice criticized for its exclusionary nature with no empirical evidence linking it to more competent mental health and other social work practice. Thus, the profession is correct in questioning an exam’s relevance in social work regulation. However, the licensure test has become a lightning rod issue preventing more substantive analyses, debate, and antiracist reforms within the profession’s policy, practice, and education arenas. This article uses the disparity in ASWB pass rates as the impetus for a more critical look at systemic issues in social work adversely impacting Black individuals entering the profession. The authors acknowledge that an anti-racist agenda in social work requires tackling long-standing problems that will not be as easily solved as eliminating multiple choice testing.

Implementing motivational interviewing in adult mental health social work practice: an analysis of postgraduate student assessed placement reports

ABSTRACT Motivational interviewing is commonly taught on social work qualifying programmes as it is a core skill which practitioners can use in a variety of practice settings. However, the extent to which students can apply it in their practice learning placements is rarely evaluated. This paper reports a content analysis of a random selection of postgraduate social work students’ practice learning placement reports (n = 16) to assess the extent to which they were able to apply it in their practice. The findings revealed many examples of students’ adherence to motivational interviewing principles and practice, facilitated by their self-reported knowledge and confidence in using the approach. However, the analysis also found some students who struggled to utilize it because of a poor understanding or a practice context that mitigated against its use. Therefore, although it is possible to train social work students to use motivational interviewing in their practice learning, further evaluations are required to assess their use of it in their post-qualifying practice and the outcomes of this for service users.

Resilience as Part of Recovery: The Views of Those with Experiences of Psychosis, and Learning for British Mental Health Social Work Practice. A Scoping Review

Abstract There is a significant diversity in approach to ‘resilience’ in the context of mental health recovery following experiences of psychosis, varying from clinically measurable outcomes to a personal trait within a recovery ‘journey’. Given the contested nature of resilience within mental health literature, this study aimed to complete a scoping review to synthesise understandings of resilience by individuals with experiences of psychosis. Drawing on the holistic and person-centred principles that underpin social work approaches to mental distress, these perspectives are considered in the statutory, policy and critical contexts of British social work, establishing learning for practice. A meta-synthesis of qualitative studies was completed, drawing on searches of five databases (Social Care Online, APA PsychInfo, Cinahl, Medline and Web of Science), identifying twelve relevant papers. A thematic analysis identified three overarching themes (personal, social and professional factors) and eight associated sub-themes (personal responsibility, use of experience, coping strategies, peer support, social relationships, contribution, relationships with professionals and structured support). The study identifies systemic and life-course approaches as empowering service user engagements with psychosis, recovery and resilience, suggesting that the social work profession is well placed to engage with resilience enhancement in the context of mental health recovery.

Adverse Childhood Experiences and Student-Athlete Mental Health: A Social Work in Sports Perspective

The present discussion reviews the current literature on the impact of adverse childhood experiences (ACEs) on college student-athlete mental health and advocates for the inclusion of trauma informed mental health social work practice in addressing the needs of this uniquely at-risk, and vulnerable population. The sport ethic model is presented as a cognitive lens through which social workers may better understand the athletic context. Sports social work practitioners, skilled in trauma informed mental health practice, focus on the personal and contextual influences that potentially affect athlete mental health and well-being. In this way, sports social workers are uniquely qualified to address challenges of the athletic experience and provide athletes with the resources and support needed to successfully thrive in the athletic context.

Teaching Mental Health Social Work: What Are We Preparing Students for?

ABSTRACT The Australian social work course accreditation standards aim to ensure graduates have an understanding of the social, cultural, and political structures that influence psychosocial wellbeing. Unlike the previous standards, the current standards do not require the curricula to address specific knowledge and skills for working with people who live with severe mental distress or mental health conditions that might result in diagnoses such as schizophrenia, personality disorders, and bipolar disorder. Anticipating the revision of curricula resulting from these recent changes to the accreditation standards, four social work academics from across three Australian universities engaged in a peer review of mental health social work curricula. By exploring the purpose, emphasis, and challenges in curriculum design, this stage of the review aimed to identify the positioning of future curricula to prepare graduates who embrace the complex array of opportunities and demands of social work practice in this field. Our investigations confirmed diversity in mental health social work practice, revealing mental health social work curricula must meet multiple and evolving agendas. IMPLICATIONS International calls for transformative approaches to mental health present opportunities for enhanced recognition of the social justice orientation of social work. The absence of an accreditation requirement to address social work practice with people who live with severe mental distress or low prevalence mental health conditions might prove a regrettable gap in Australian Social Work Education Accreditation Standards 2021. Further collegial discussion and debate about the beneficial outcomes of mental health social work curricula are desirable.

“Housing is such a major part of someone’s life”: mental health social work practice in the context of a housing affordability crisis

ABSTRACT It is well-known that people with psychiatric diagnoses experience disproportionate rates of homelessness. However, few studies have explored the perspectives and practices of mental health social workers in responding to clients experiencing homelessness. This article reports on findings from three focus groups with inpatient mental health social workers in Sydney, Australia. Three themes were identified: stuck in a crisis; reliance on sub-standard housing conditions; and pressures to discharge. The study reveals the challenges experienced by social workers in navigating scarce housing resources, and the limitations of a biomedical paradigm in failing to address the social determinants of mental distress.

The Mindfulness-Based Social Work and Self-Care Programme: A Mixed Methods Evaluation Study

Abstract During their social work education, students engage in a number of stressful learning activities, often simultaneously, which can negatively impact their well-being, mental health and social work practice. Mindfulness practices are beginning to be integrated into social work curricula globally to enhance student self-care along with key social work practice skills and values. This mixed methods study examined the effects of a bespoke six-week online mindfulness-based social work and self-care (MBSWSC) programme on the stress, burnout, well-being, anxiety and depression levels of thirty social work students from two universities in the UK. This study also examined the effects of MBSWSC on a number of mindfulness-based mediators of change in these outcomes. Participant perceptions of the benefits of the MBSWSC programme on their well-being and social work practice are further explored via a thematic analysis of an open-ended questionnaire. Statistically significant changes in all variables were found post-programme except for depression and loss of empathy/depersonalisation, a facet of burnout. The qualitative data provided a deeper insight into the potential benefits of the programme for the enhancement of student well-being, mental health and anti-oppressive social work practice (AOP).

Engaging with Transformative Paradigms in Mental Health.

When graduates of Australian social work courses embark on a career in mental health, the systems they enter are complex, fragmented and evolving. Emerging practitioners will commonly be confronted by the loneliness, social exclusion, poverty and prejudice experienced by people living with mental distress; however, social work practice may not be focused on these factors. Instead, in accordance with the dominant biomedical perspective, symptom and risk management may predominate. Frustration with the limitations evident in this approach has seen the United Nations call for the transformation of mental health service delivery. Recognising paradigmatic influences on mental health social work may lead to a more considered enactment of person centred, recovery and rights-based approaches. This paper compares and contrasts influences of neo-liberalism, critical theory, human rights and post-structuralism on mental health social work practice. In preparing social work practitioners to recognise the influence of, and work more creatively with, intersecting paradigms, social work educators strive to foster a transformative approach to mental health practice that straddles discourses.

Centering Social Justice in Mental Health Practice: Epistemic Justice and Social Work Practice

This article examines how mental health social work practice can move outside the hegemony of the medical model using approaches that honor the centering of social justice. By using the philosophical analysis of epistemic injustice and the ethics of knowing, I move out of the traditional psychiatric and psychological conceptual frameworks and discuss new guiding principles for practice. In the context of the radical tradition in social work and the impetus to blend theory with practice, I consider the use of narrative and anti-oppressive approaches to center social justice principles in individual dyadic work as well as in wider systems family and community work and policy advocacy. I evaluate these approaches through the principles of epistemic justice and discuss the importance of a relational collaborative approach where honoring the client and exploring lived experience are central to both the concepts of testimonial justice, hermeneutic justice and anti-oppressive practice.

Relationship-building in recovery-oriented mental health practice: valuing the role of emotions

Despite increased interest in relationships and emotions in social work, not enough is known about the role of emotions in recovery-oriented mental health care settings. Reflecting on my graduate research, I explore the inconsistent understandings and comfort levels with emotions in mental health social work practice. I make connections with findings which show that uneven attempts at relationship-building lead to missed opportunities for connection, understanding, and supporting recovery. I discuss the tensions faced by mental health practitioners implementing recovery-oriented interventions within a new public management and risk reduction paradigm of care and the ways that attending to emotions might help critique or dismantle the status quo. These reflections suggest pathways to resist these tensions through realizing the potential of emotions as a source of knowledge in constructing recovery-oriented mental health care interventions.

Medicare Funded Mental Health Social Work: Better Access to What?

ABSTRACTBetter Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Scheme initiative (Better Access), is an Australian Federal Government scheme aiming to improve access to mental health services. Accredited mental health social workers have been involved in the delivery of services under Better Access for more than a decade. In this time, there have been significant changes in the field of mental health services, with consequent increases in size and costs for Better Access. Better Access now represents public spending of more than one billion dollars per annum, yet there is no ongoing account of its impact. In this paper we consider the policy chronology and evaluation of the program, using current available data to question the impact of Better Access on both the service system and the nature of mental health social work practice. This case highlights the importance of a clear articulation of the scope of mental health social work, and ongoing monitoring of the impact of policy in a policy environment increasingly characterised by individualised funding and service delivery structured according to the principles of New Public Management.IMPLICATIONSSocial workers' increasing involvement with Better Access has reshaped the scope of mental health social work practice.The impact of Better Access on outcomes for service users and mental health social work is not currently a focus of research attention.Better Access is a case study illustrating the potential of the policy context to directly shape social work practice, therefore critical engagement with the impact of Better Access is an essential professional imperative.

Mental Health Act Assessments – Professional Narratives on Alternatives to Hospital Admission

This article draws on themes derived from research conducted as part of a doctoral study, using Framework Analysis, in which fifteen mental health professionals were involved in nine Mental Health Act assessments in the UK. In this work, risk is explored in terms of the social context, using a social constructionist perspective, in which concepts of ‘social crisis/mental illness’, professional negotiations and social capital are explored. The key findings highlighted: the social constructions of service users’ worlds, as presented by the Approved Social Workers (ASWs) and Home Treatment Professionals (HTPs), were notably different; the negotiations between the ASWs and HTPs provided the ASWs with a number of roles including negotiator, deal-maker and decision-maker; and the service user’s social network and the provision of home treatment showed that the ‘treatments’ provided can be seen as a shared role. Finally, the implications for contemporary mental health social work practice are presented.

Evaluating the Effectiveness of the Reframing Technique in Psychodynamic Social Work Practice

ABSTRACTThis multiple case study responds to the need for process and effectiveness studies in mental health social work practice through providing an in-depth analysis of the operationalisation of the reframing technique from a psychodynamic perspective. The practitioner–researcher studies (1) the way reframing (theory) is applied in the work with the parents of six latency aged children suffering from child separation anxiety disorder (practice) and (2) the effects of the technique on the parents and their relationship with the child. Reframing provided relational meaning and accordingly modified the parental ambivalence to bring the child for assessment, the parental inability to set boundaries on child aggressive behaviours, the parental child overprotection behaviours, the separation anxiety symptoms of the child, the parental phobic anxiety, the emotionally painful parental psychosocial histories, and the parental couple relationship problems. The study establishes that the concept of reframing is worth further exploration in mental health social work practice.

Social Participation Interventions for Adults with Mental Health Problems: A Review and Narrative Synthesis

People with mental health problems remain a highly socially excluded group despite international efforts to facilitate their inclusion. Enhancing their social participation—building trusting relationships and engaging in community activities—is an important role for mental health social workers, but there is a lack of evidence-informed interventions to enable workers to achieve this goal. This article fills a gap in knowledge by systematically reviewing evidence of the effectiveness of interventions that aim to enhance the social participation of adults with mental health problems in their wider communities, outside of formal mental health services. A systematic review and modified narrative synthesis methodology was used. Sixteen articles reporting 14 unique interventions met the inclusion criteria, and findings across the studies were categorized by delivery mode and intervention strategy. Positive outcomes were found in asset-based approaches, social skills development, building trusting relationships between workers and service users, and resource finding to enhance community participation. However, only four studies were found to have a low overall risk of bias. The findings of this review suggest further evidence-informed interventions, and robust evaluations, are needed as current evidence is limited to inform mental health social work practice.

A Tricky Question: Spirituality and Mental Health Social Work Practice in Northern Ireland

The social work profession in the United Kingdom is criticized for its reluctance to engage with spirituality. Its absence in Northern Ireland is particularly significant given the role of religion in its political conflict. Drawing upon qualitative research with mental health service users and social workers about religion, spirituality, and mental distress, this article explores the ambivalence that exists around this subject in mental health social work practice. It appears that the political conflict continues to impact social work provision. Support is needed for practitioners and service users to give voice to this aspect of mental well-being. This study comprised one-to-one interviews with 12 mental health social workers and 12 mental health service users. Half of the participants from each group were invited to take part in a telephone interview. All of the participants were invited to bring an object which signified what religion and/or spirituality meant to them, to the interview.