Mental Health Social Work Research Articles

The Effects of Client Violences on the Turnover Intention of Mental Health Social Workers Working in Community Mental Health Centers : Focusing on the Mediating Effects of Job Stress

The Effects of Client Violences on the Turnover Intention of Mental Health Social Workers Working in Community Mental Health Centers : Focusing on the Mediating Effects of Job Stress

Developing a Health Inequalities Approach for Mental Health Social Work

Developing a Health Inequalities Approach for Mental Health Social Work

The Bermuda Triangle of child and adolescent mental health in remote regions

Introduction: Long waiting times and confusion about which service is appropriate, can mean that children and young people with mental health problems can become caught in the triangle of Child and Adolescent Mental Health Services (CAMHs), Paediatrics and Social Work Services. At worst this can be potentially damaging and at least, it causes frustration for families and service providers.Objective: To establish the utility of the DAWBA in the early assessment of children and young people.Methods: We recently introduced a pilot rapid diagnostic service. The service involves completion of the structured Developmental and Well-being Assessment (DAWBA) interview followed by a psychiatric assessment of the data and feedback to family doctors who can then make a more informed decision about which service is most appropriate. We think that children and adolescents may be less likely to get caught in the triangle if that happens.Results: As a result of this pilot work, we have reconfigured the pilot service to include the use of fully online DAWBA assessments and suggestions by psychiatrists about the likely best service for the family.Conclusions: The EU Northern Periphery and Arctic Programme is funding a multi-national randomised controlled trial of DAWBA. The challenges in ensuring appropriate and efficient referral to CAMHS and related services are international, and despite different service configurations in Sweden, Finland and Norway, colleagues from these countries are collaborating in this trial. Here we present the key issues which have emerged from the pilot and the early progress of the trial.This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.

Australian mental health professionals’ competencies for working with trans clients: a comparative study

Growing numbers of trans people require access to mental health services; however, previous research suggests that many trans clients have negative experiences with mental health professionals. This paper reports on an Australian survey of 304 counsellors, mental health nurses, psychiatrists, psychologists and social workers with regard to their clinical knowledge, comfort and confidence in working with trans clients. The findings suggest that training and previous experience in working with trans clients are related to increased levels of accurate clinical knowledge and confidence; that psychiatrists had the lowest levels of accurate knowledge; that female participants had higher levels of accurate knowledge than did male participants; that counsellors had the highest levels of confidence and that there was a negative relationship between religiosity and comfort in working with trans clients. The paper concludes by advocating for the development of more nuanced measures to assess the attitudes and skillsets of mental health professionals in regards to working with trans clients and the need for further upskilling of the Australian mental health workforce.

Patterns in Clinical Trial Enrollment and Supportive Care Services Provision Among Adolescents and Young Adults Diagnosed with Having Cancer During the Period 2000-2004 in Western Australia.

Support services provision and clinical trial enrollment were examined for a cohort of adolescent and young adults (AYAs) diagnosed with having cancer and treated at adult hospitals in Western Australia (WA). The sample was 383 AYAs aged 15-24 years diagnosed from 2000 to 2004, with follow-up until 2007. Sociodemographic, clinical trial participation, and health service data were obtained from Statewide administrative health data collections and patient medical records at hospitals in WA. Separate multivariate logistic regression models were used to identify which sociodemographic and treatment setting variables predicted whether a patient had formal contact with a mental health professional, social worker, or occupational therapist. Due to the small number of clinical trial enrollments in the sample (n = 5), modeling was not used to explore group differences in this outcome. Mental health professional, social worker, and occupational therapist consultations were received only by patients who attended a metropolitan hospital. Compared with patients treated at only tertiary centers, those treated at only nontertiary centers had lower odds of consulting with a mental health professional (OR = 0.12, 95% CI 0.03, 0.58) or occupational therapist (OR = 0.02, 95% CI 0.001, 0.23). Less than 2% of the cohort enrolled in a clinical trial. Access to clinical trials and support services by AYAs diagnosed with having cancer in WA was generally low, particularly outside the metropolitan area. Variations in accessibility across different treatment settings in WA warrant efforts for greater awareness of AYA needs and increased communication and collaboration between specialists and centers involved in the care of AYAs with cancer.

Being Seconded to a Mental Health Trust: The (In)Visibility of Mental Health Social Work

The paper explores the implications of being a social worker seconded to a Mental Health Trust based on narrative interviews with mental health social workers. As part of a wider study, thirteen mental health social workers from across England were interviewed individually about their experiences of being seconded to a Mental Health Trust. Building on the work of Andrew Pithouse, the findings reveal the (in)visibility of mental health social work. The social workers were isolated within Health Trusts with minimal links to their Local Authority employers. They struggled to articulate and define social work. Instead, social work was depicted as being indefinable, involving working in liminal spaces and as filling the gaps left by other professions. Furthermore, the social workers were unable to make social work visible as social work is not ‘seen’ by the other members of the team. Finally, the social workers were unable to make social visible through supervision if they did not have a social work manager. The paper ends with an unexpected outcome of the research: the notion of the research interview as surrogate supervision.

Family-centered care in adults’ mental health: Challenges in clinical social work practice

ABSTRACTThis article presents findings from an exploratory study to examine mental health social workers’ perspectives on factors that impede the implementation of family-centered care to adult mental health practice in Hong Kong. Seven mental health social workers were interviewed. The analysis identified a paradigm shift from a biomedical to a family-centered and strengths-based perspective; a paradigm shift from risk control to proactive case management, and a paradigm shift from management accountability to professional empowerment as affecting the frontline practitioners in applying a family-centered approach to mental health care. Recommendations for clinical social work practice at individual, organizational, and policy levels are outlined.

‘So I Feel Like I'm Getting It and Then Sometimes I Think OK, No I'm Not’: Couple and Family Therapists Learning an Evidence‐Based Practice

This research concerns itself with the experiences of couple and family therapists (CFTs) learning about and using an evidence‐based practice (EBP). The engagement with EBP is growing across many aspects of the mental health and health care systems. The EBP model is now being applied in a broad range of health and human service systems, including mental and behavioural health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence‐based approaches in the practice of CFT and research literature is also evolving (Sexton et al., 2011; Sprenkle ). Interestingly, while the research delves into what are the best approaches with different populations and presenting issues, little research has explored the experience of CFTs themselves, particularly while learning an EBP. Using a phenomenological approach called interpretive phenomenological analysis (Smith, Flowers & Larkin, 2009), this research explores the experiences of CFTs learning and using an EBP. The paper reports on key issues, challenges, and areas for CFTs, educators, and supervisors. As researchers, educators, administrators, policy makers, and CFTs struggle with what works best with which populations and how best to allocate resources, this research contributes to dialogues about how best to educate and support CFTs, and the complexity of doing research in real‐life settings.

Risk, Recovery and Capacity: Competing or Complementary Approaches to Mental Health Social Work

ABSTRACTMental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination, and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. Therefore it is argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery-based approaches, which promote supported decision-making and inclusion; and the assessment of a person's ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.

The Effect of a Dedicated Psychiatric Team to Pediatric Emergency Mental Health Care

BackgroundPediatric emergency department (PED) visits among children and adolescents with acute mental health needs have increased over the past decade with long wait times in the PED awaiting disposition. ObjectiveThe objective of this study was to evaluate the effect of a new pediatric mental health liaison program with the hypothesis that this model reduces length of stay (LOS) and hospitalization rates among pediatric mental health patients. MethodsThis was a pre- and postintervention retrospective study of the year prior to (June 2012–June 2013) and the year after (October 2013–October 2014) implementation of a new PED psychiatric team. All patients aged 1–18 years with a mental health International Classification of Diseases-9th Revision code were included. Patients who did not receive a Psychiatry consult in the PED were excluded. ResultsThere were 83 encounters in the year prior to and 129 encounters in the year after the implementation of the liaison program. There was an increase in the suicidality of mental health patients during this time. There was a significant decrease in mean PED LOS of 27% (95% confidence interval [CI] 0–46%; p = 0.05) from pre- to postintervention period. The decrease in the proportion of patients admitted/transferred to an inpatient psychiatric facility in the postintervention year was statistically significant (odds ratio 0.35; 95% CI 0.17–0.71; p < 0.01). ConclusionsThe use of a dedicated child psychiatrist and mental health social worker to the PED results in significantly decreased LOS and need for admission without any change in return visit rate. Larger, multicenter studies are needed to confirm these findings.

Contemporary Formulation-based Assessment and Treatment: A Framework for Clinical Discourse

With the relentless push for efficient and effective mental health treatment, service delivery has evolved from inpatient and outpatient therapy to multi-component interventions provided collaboratively across a continuum of treatment settings by a range of disparate disciplines, including mental health providers, medical providers, case managers, social workers, residential and social service providers, and managed care stakeholders. This new paradigm for mental health treatment calls for a need to modify traditional psychodynamic case formulation approaches, which have focused primarily on synthesizing clinical data to inform predominantly long term psychodynamic therapy. This paper details a new approach to clinical formulation that allows for the provision of targeted, optimal, efficient, and effective care by linking a biopsychosocialspiritual understanding to a biopsychosocialspiritual suite of interventions executed by a coordinated, multidisciplinary team of service providers. Finally, the paper concludes with a discussion of strategies for implementing formulation-based assessments and treatment plans.

Pengetahuan dan Skil Pekerja Sosial Kesihatan Mental di Malaysia

Knowledges and skills in providing documentation, client assessment and problems solving based on theories and relevance methods are essential roles in the social work profession. The ability to conduct psychosocial assessment among clinical social workers are particularly important in mental health for social work to help clients to overcome their problems. Face to face interviews were conducted with respondents working in mental health setting. Semi- structured interview was utilised to identify the knowledge and skills required for a mental health social worker. Respondents’ transcription were analysed using thematic analysis based on the research objectives. Findings showed that elements of knowledges and skills required by social workers in mental health setting could be categorized into four components: (i) knowledge in doing assessment; (ii) knowledge about mental health and the competencies in relevant theories; (iii) knowledge on academic qualification and advanced social work training and (iv) additional skills as a social worker in a mental health setting.

Cooperating system building in the process of social work intervention: „We try that client doesn‘t go to nowhere“

Straipsnyje aptariama, kaip stacionarioje psichikos sveikatos įstaigoje dirbantys socialiniai darbuotojai reflektuodami savo profesinę patirtį apibūdina bendradarbiavimo sistemos kūrimą socialinio darbo intervencijos procese. Tyrimas atskleidė, kad stacionarioje psichikos sveikatos priežiūros įstaigoje dirbantys socialiniai darbuotojai reflektuodami savo profesinę patirtį bendradarbiavimo sistemos kūrimą socialinio darbo intervencijos procese apibūdina kaip šeimos įtraukimą į pagalbos procesą ir socialinio pagalbos tinklo organizavimą.

Recovery-Oriented Mental Health Practice: A Social Work Perspective

This paper explores the concept of recovery-oriented social work practice in mental health settings as it is understood and practised by social workers. The authors describe an investigation of the implementation of mental health reforms in Quebec. This study explored the gap between the reforms' philosophical orientations of mental health recovery and its practical realisation. Specifically, we will discuss the ways in which the social work field encompasses approaches that potentially espouse contradictory understandings of recovery. The study highlights the external and internal obstacles and facilitators to recovery-oriented social work practice. This qualitative research project used semi-structured interviews with eleven primary care mental health social workers in two health care agencies to better understand how they situate themselves with respect to the recovery orientation. The findings illustrate the impact of organisational constraints on social workers' attempts to practise from a recovery-oriented perspective. Specifically, they show that (i) managerial orientations espoused by the reforms have paradoxically led to systemic barriers to recovery-oriented practice and (ii) recovery practice by social workers is facilitated in part by their understanding of this philosophy and by leadership on the part of their managers. This paper will allow for a better understanding of social work perspectives and practical frustrations regarding current primary care mental health practice.

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.

Challenges Highlighted During Peer Supervision by Mental Health Nurses and Social Workers Recently Trained as Case Managers in Sweden

This study looked at 13 mental health nurses and social workers who were recently trained as case managers (CMs) and the work-related challenges they faced in community mental health services. Data were collected during ten peer supervisions sessions. Participants expressed pride and enthusiasm about their new function as CMs, but they also acknowledged that their new position meant they had to confront existing systems and posed several challenges, including organizational hindrances, economic prerequisites, nominated administrators, role function, and model fidelity. We conclude that the existing organizations seemed to be unprepared to hold and facilitate more person-centered approaches, such as designating CMs. The model fidelity is important, but has to be flexible according to clients’ daily state.

Religion and Spirituality as Troublesome Knowledge: The Views and Experiences of Mental Health Social Workers in Northern Ireland

Religion and Spirituality as Troublesome Knowledge: The Views and Experiences of Mental Health Social Workers in Northern Ireland

Towards a socially just social work practice: the liberation health model

This article discusses the ‘liberation health’ model for social work practice and explores how this model may be used to bring conversations about race and class into the therapy room. It begins with a review of mental health social work teaching in the United States and moves on to demonstrate differences between traditional and liberatory practice methodologies. The term ‘liberatory’ is used in this article to refer to a variety of anti-oppressive theoretical frameworks, with an emphasis on the work of Paulo Freire and Ignacio Martín-Baró. Additionally, the author demonstrates interviewing strategies for bringing conversations about intersectionality into the therapy context.

Attitudes Toward Seeking Help Among College Students Enrolled in Helping Profession Courses: A Comparative Study Between Clinical Mental Health Counselors, Social Workers, and Psychologists

This study used the Inventory of Attitudes Toward Seeking Mental Health Services to measure and compare college students’ attitudes toward seeking mental health services from professional clinical mental health counselors, social workers, psychologists, and mental health providers with a neutral identity. The participants’ (n = 131) attitudes toward seeking mental health services did not vary statistically among any of these four groups, even when participants’ academic majors and past experience with mental health services were covaried.

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.