Mental Health Social Work Research Articles

Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA. IMPLICATIONS Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates. Social work training is not preparing social workers for person-led, human-rights-based advocacy. Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

Identifying IBD Providers' Knowledge Gaps Using a Prospective Web-based Survey.

As treatments, management strategies, and the role of advanced practice providers (APPs) have evolved in recent years, the Crohn's & Colitis Foundation sought to understand the educational and resource needs of clinicians caring for patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe the self-identified IBD knowledge and resource gaps of clinicians to inform the development of future programming. A survey containing 19 questions created by the foundation's Professional Education Committee, a subset of its National Scientific Advisory Committee, was conducted from September 7, 2018 to October 15, 2018. Responses were included from providers if they were currently seeing any IBD patients in a clinical setting. The foundation distributed the survey by email and various social media channels to encourage a diverse response. The survey included questions on comfort levels around diagnosis, treatment, and management of patients with IBD, in addition to preferences and utilization of educational resources. The × 2 test was used to evaluate significant differences among respondents in the various domains surveyed. There were 197 eligible responses, of which 75% were from MD/Dos, followed by 25% APN/PA/RN/MSN/PhD/other; and 70% of respondents provide care for adult patients. The amount of time in practice was divided evenly among respondents. Fifty-seven percent of respondents practice in an academic/university setting, and approximately 75% indicated that ≥21% of their practice consisted of patients with IBD. Forty-four percent and 46% of respondents reported access to IBD based mental health providers and social workers in their practice, respectively. Seventy-two percent reported access to radiologists, 69% had access to dietitians, and 62% had access to advance practice providers. The areas of greatest educational need were prescribing medical cannabis (if approved locally) for pain management (62%); caring for patients with prior malignancy (35%); caring for pregnant patients and family planning (33%); caring for elderly patients (30%); and therapy decisions, including use of JAK inhibitors (29%), drug holidays (25%), and use of biosimilars (24%). More than 50% of respondents stated they do not participate in shared decision-making, citing time as the most common limiting factor. The majority of providers cited live education as their preferred learning format, and they wish to earn continuing medical education (CME) hours. This survey helped identify current IBD educational needs in our professional community. With a rapidly changing treatment landscape and an increase in the diversity of providers delivering care, additional opportunities to keep abreast of practice changes are critical to providing comprehensive, quality care in IBD. Our survey demonstrated that shared decision-making is underutilized in practice due to a need for resources that aid in its efficient integration into practice. Based on our results, a focus on creating live learning opportunities that offer CME are needed in the areas of therapeutic decision-making and treating IBD in special subsets (eg, prior malignancy, pregnancy, elderly).

Perspectives on social workers from within an integrated setting

PurposeThis research explores community professionals' opinions concerning social worker's roles and statutory functions. It explores the perspectives of professionals and their understanding of collaborative and cooperative work; experiences of professional support; opinions on the aspects of anti-oppressive practices in social work; views on social work identity within multidisciplinary team structures; and perceptions regarding the challenges of cultural and contextual drivers of social work practice.Design/methodology/approachThis study adopts an interpretivist paradigm and social constructionist epistemology in that there are multiple realities to be understood and different perspectives and perceptions to be explored. This study adopted a data collection approach of thematic analysis of semi-structured interviews.Setting and participantsSocial workers and nurses working within an integrated social care and health NHS trust.MethodsSix respondents volunteered for interviews in 2017. Data were coded as follows using a multistage approach: (1) coding of comments into general categories (e.g. culture, models of practice), (2) coding of subcategories within main categories (e.g. values, knowledge and skills), (3) cross-sectional analysis to identify themes cutting across categories and (4) mapping of categories/subcategories to corresponding comparable research for comparison.FindingsMost interviewees (5) were social workers, with one from the nursing field. Respondents provided comments that fell under four overarching themes: cultural theme, the impact of economic austerity, organisational structures and the political drivers of integration.Originality/valueThis study contributes to the evidence regarding the role of social workers within integrated health and adult social care organisations (as opposed to mental health social work) and also contributes to the evidence around social work in times of austerity.

International reflections on approaches to mental health social work Malcolm Golightley and Gloria Kirwan

International reflections on approaches to mental health social work <i>Malcolm Golightley and Gloria Kirwan</i>

Could educational programs in sexology have an influence on attitudes towards same-sex marriage and parenting?

Summary Research on LGBT health services is urgent as well as effective actions. Some studies investigating the attitudes of mental Health Care Professionals (HCPs), social workers, medical trainees and professionals, students, and resident assistants towards Lesbian and Gay (LG) people showed a significant negative role of sexism affecting attitudes towards LGBT people, marriage and parenting. This study aimed to investigate the influence of Educational Programs in Sexology (EPS) on sexism, homophobia, and attitudes towards same-sex marriage and parenting. Data were collected on 552 Health Care Professionals (HCPs). The EPS group was composed by professionals who attended an accredited training in sexology, while the control group by HCPs without a specific formation on sexual issues. The EPS group reported lower levels of sexism and homophobia and more positive attitudes toward same-sex families (adoption for homosexual couples, artificial insemination and in vitro fertilization for lesbians). Having a specific training on sexology appeared to be associated to more positive attitudes based on equal rights. Healthcare system should be prepared to meet sexual minorities needs. Having a specific training on LGBT issues appears to be functional to a better patients’ taking care. Professionals who attended EPS seem to be the best references (for their formation and their personal attitudes) for sexual education programs, as well as for clinical work with homosexual patients complaining about sexual, marital, and/or parenting problems. Implications for research, clinical and health promotion are discussed.

Behavior Disorders: knowledge and actions of health professionals and social work.

to identify the knowledge of professionals of mental health services and social work on Behavior Disorders (BD) in childhood and adolescence, and to analyze their actions in care for children and adolescents with such disorders. a qualitative, descriptive-exploratory study with 13 professionals from two mental health services and two tutorial councils. The data were collected in interviews and submitted to thematic content analysis. three categories emerged from the interviews: "Knowledge about behavior disorders", which defines BD as deviations from normality and lack of limits. "Integrated and group care", which explains the integrated, multidisciplinary and group actions. "Specialized and legal care", which explains the actions through specialized, medical and judicial care. the results point out weaknesses and knowledge gaps of professionals, causing potential harm in the programming of effective actions, such as identification, referral and therapeutic planning.

Study Of The Functioning Level In People Having Psychosocial Disabilities

Introduction: Mental health is state of wellbeing in which as individual realizes in his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO, 2004). Schizophrenia is a significantly disabling disease that affects social family psychological, vocational and occupational functioning (Lyngdoth, L. et al, 2016). Depressive disorders often start at a young age; they reduce people’s functioning and often are recurring (Marcus et al., 2012). Studies have shown decreased functioning ability in people having mental illness in Nepal. This study was done to explore the impact of mental illness in their daily functioning abilities. &#x0D; Material And Method: A cross-sectional survey was conducted among 120 people suffering from mental illness (psychosocial disabilities) for more than six months. Mental health social workers who were facilitating mental health self-help group of treatment seeking mental health patients in the health facilities were trained and supervised during data collection. Selected participants were informed about research objectives and received consent for the study. Nepali adopted WHO-DAS-2 (Thapa et al, 2005) was used to collect both demographic and functioning abilities of research participants. Data were analysed using SPSS 20th version mainly for descriptive statistics. &#x0D; Results: Participants' age ranged from 18-60 years with mean age 29.53 (SD±10.8), with gender distribution 58.3% female and 41.7% male. People with psychosocial disabilities experienced in an average 9.45 days difficulty, average 6.95 days they couldn't do daily work and minimized work for average 3.55 days in the month. Female with mental health problems experienced more difficulties in daily life functioning (S1-S12 items in WHO-DAS) where moderate to severe level difficulties observed than male with mental health problems. Emotional effect due to health problems, talking with unknown people, difficulties in friendship area and doing daily activities were affected significantly statistically (p=0.01, 0.05, 0.04 and 0.02). Ethnicity and gender is significantly correlated with total affected days (r=.221, -.180 p= 0.05, table 3). Gender and total affected working days is correlated but not significant statistically. &#x0D; Conclusion: Level of functioning is affected significantly in people having psychosocial disabilities; impairment is higher in female, people suffering with severe form of mental illness. Findings indicate need of awareness in mental health. Further research is necessary in larger and representative population including care-taker of mentally ill person.

Impact of Client Suicide on Mental Health Social Workers

Impact of Client Suicide on Mental Health Social Workers

정신건강사회복지사의 임파워먼트 실천에 관한 질적 연구: 이론과 실천의 딜레마를 중심으로

본 연구는 연구참여자들이 정신건강사회복지사로서 임파워먼트 이론을 실천에 적용하면서 무엇을 경험하고, 이론과 실천 간에서 어떠한 어려움을 경험하는지를 확인하고자 한 연구이다. 이를 위해 일반적 질적 연구 방법으로 정신건강사회복지사 4명을 심층면접 하여 6개의 주제, 26개의 하위주제, 49개의 의미단위를 도출하였다. 연구결과는 6개의 주제와 관련이 있는데, 첫째, 참여자들은 임파워먼트 이론을 실천하면서, ‘임파워먼트 실천을 위한 원칙’, ‘임파워먼트 실천과정에서의 자각’, ‘임파워먼트 실천과정을 통한 성장’ 등을 경험하였다. 둘째, 참여자들은 임파워먼트 이론을 실천하는 과정에서 ‘임파워먼트 실천과정에서의 딜레마’, ‘임파워먼트 실천과정에서 경험하는 개인적 어려움’, ‘소진의 경험과 대처’ 와 같은 어려움을 경험하였다. 본 연구의 결과를 토대로, 임파워먼트의 이론과 실천과정에서의 괴리를 최소화하려는 노력, 정신건강사회복지사의 소진예방을 위한 시도와 역량 강화를 통한 성취감 제고를 위한 제도적인 시도를 제언하였다.

What Do Service Users Want from Mental Health Social Work? A Best–Worst Scaling Analysis

Abstract Despite being a profession dedicated to the empowerment of service users, empirical study of mental health social work appears dominated by the perspectives of social workers themselves. What service users value is less often reported. This study, authored by a mix of academics and service users/carers, reports a Best–Worst Scaling analysis of ten social worker ‘qualities’, representing both those highly specialist to social work and those generic to other mental health professionals. Fieldwork was undertaken during 2018 with 144 working-age service users, living at home, in five regions of England. Of specialist social work qualities, service users rated ‘[the social worker] thinks about my whole life, not just my illness’ particularly highly, indicating that person-centred approaches drawing on the social model of mental health are crucial to defining social work. However, service users did not value help accessing other community resources, particularly those who had spent the longest time within mental health services. Continuity of care was the most highly valued of all, although this is arguably a system-level feature of support. The research can assist the profession to promote the added value of their work, focusing on their expertise in person-centred care and the social model of mental health.

Navigating the ‘shadow of loss’ in mental health social work

ABSTRACTThe human experience of loss has been at the centre of psychoanalytic understandings of the human condition since Freud’s first writings on ‘melancholia’. This essay draws on psychodynamic theory to show how workers who are attuned to the experience of loss in service users can shape their interventions accordingly. By reflecting on how a diagnosis of ‘depression’ might better be understood as the rippling wave of past grief, professionals can utilise the dynamics of projection, transference and containment to help understand the emotional pain of individuals they support. But this essay also suggests that the use of psychodynamic practice works best when it is bolstered by other frameworks – in this case an understanding of systems theory. When the two traditions are utilised together, they provide an understanding of psychic phenomena which can enable social workers to build a basis for effective interventions with service users experiencing mental distress.

정신건강사회복지사의 자기돌봄에 대한 인식과 경험

정신건강사회복지사의 자기돌봄에 대한 인식과 경험

정신병원에 종사하는 정신건강사회복지사의 클라이언트로부터의 폭력피해경험에 관한 질적 연구

본 연구는 정신병원에 종사하는 정신건강사회복지사의 클라이언트로부터의 폭력피해경험을 심층적이고 다면적으로 이해하고자 질적 연구를 수행하였다. 5년 이상 정신병원에서 근무하고 있는 8명의 1급 정신건강사회복지사를 대상으로 포커스그룹인터뷰를 실시하였다. 연구결과 4개의 주제, 15개의 하위주제, 68개의 의미 있는 개념을 도출하였다. 4개의 주제는 심각한 폭력피해와 고통, 폭력 후 깊어지는 상처, 폭력으로 인한 고통에서 벗어나기, 후유증 그리고 성장으로 구성되었다. 연구결과를 토대로 정신건강사회복지사의 클라이언트로부터의 폭력피해에 대처하기 위한 교육 강화와 사후대처에 대한 실천적 지원, 제도적 장치 구축, 법적 기반 강화 등 실천적 ·정책적 측면에서의 대처방안을 제안하였다.

Mental health social work in multidisciplinary community teams: An analysis of a national service user survey

Summary The article addresses the continued lack of clarity about the role of the mental health social worker within community mental health teams for working age adults and particularly the limited evidence regarding this from the perspective of service users. It compares findings from the literature, found to originate from a predominantly professional viewpoint, with secondary analysis of a national survey of service users to assess their views. Findings Three particular aspects of mental health social workers’ role identified in the literature were, to some extent, also located within the national survey and can be summarised as: approaches to practice, nature of involvement, and scope of support. The presence of these features was largely not substantiated by the survey results, with few differences evident between service users’ experiences of mental health social workers compared with other mental health staff. When nurses and social workers were compared, results were either the same for both professions or favoured nurses. The findings point both to the difficulty of articulating the social work contribution and to the limitations of the secondary data. Application The findings are a useful benchmark, highlighting the limited evidence base and the need for further research to improve both the understanding of the mental health social work role and how it is experienced by service users. The profession is keen to emphasise its specific contribution. Research evidence is required to underscore this and to ensure that the role is not subsumed within generic practice.

Confidentiality and Ethical Practice in Child and Adolescent Mental Health

ABSTRACTThis paper examines the concept of confidentiality and the quality of the relationship between young people experiencing mental health problems and social workers supporting them. The nature of a therapeutic intervention brings into focus the rigidities and complexities in adhering to agency and professional guidelines on confidentiality. The paper highlights the tensions and ethical dilemmas in making decisions about risk and whether, when, and how to breach confidentiality.

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.

Repositioning Social Work in Mental Health

This paper emerges in response to the recent initiative by the Australian Association of Social Workers (AASW) to mandate the inclusion of specific, clinically based mental health curriculum into qualifying social work programs across Australia. Whilst the authors affirm the importance of an emphasis of mental health in social work education, we further suggest that the professional repositioning of social work in mental health must be informed by critical/postmodern theoretical approaches. If social work is to engender and maintain its unique and vital role in problematising simplistic, depoliticised and individualising constructions of mental health and illness, we need to promote more contextualised and holistic understandings of people’s experiences. The paper concludes by offering an example of critical mental health curriculum.

"How Can We Help You": Mental Health Practitioners' Experiences of Service Provision in Northern Namibia.

Although 12-13% of Namibians are reported to struggle with psychological distress, very few practitioners are available to provide mental health services in Namibia. Those practitioners who are available are often trained from Western counseling and psychiatric perspectives that may not readily align to beliefs about illness held constructed in Namibian cultures. Institutional effort is invested in the education and use of mental health practitioners, including counselors, social workers, nurses, psychologists, and psychiatrists. However, little is known about the experiences of these providers. Therefore, this study, a grounded theory ethnography, was undertaken as part of broader ethnographic work to understand how mental health practitioners (N = 7) in Northern Namibia view their work with Aawambo Namibians given that Namibian mental health practitioners are few but embedded in the country's health care system. Four categories were identified in analyses: Provision of Mental Health Services in the North, Practitioners' Conceptualizations of Psychological Distress: Western and Aawambo Influences, Beliefs about Mental Health Services in the North, and Integration of Traditional Treatment and Counseling. Results are discussed with respect to cultural competence in Namibian mental health practice and potential for integrating traditional practices and mental health services.

정신건강사회복지사의 자살위기개입 업무수행 경험에 대한 연구

본 연구는 정신건강복지센터에 종사하는 정신건강사회복지사의 자살위기개입 업무 수행 경험을 심층적, 다면적으로 이해하고자 질적 연구를 수행하였다. 2년 이상 자살위기개입 경험이 있는 8명의 실무자들을 대상으로 심층면접을 실시하였으며, 수집한 자료는 현상학적 연구방법으로 분석하였다. 연구결과 3개의 주제묶음과 10개의 하위범주를 도출하였다. 3개의 주제묶음은 자살위기개입 업무로의 진입 경험을 나타내는 ‘‘자살’이라는 혼란에 내던져짐’, 업무수행 과정경험의 본질을 나타내는 ‘각자도생하며 발버둥치는 현실’, 자살위기개입 과정을 통한 인식변화와 성숙의 경험을 나타내는 ‘삶과 죽음에 대한 성찰과 성숙해져감’으로 구성되었다. 연구결과를 토대로 정신건강사회복지사의 소진 완화 대책, 교육훈련 강화라는 실천적 제안과 정신건강복지센터의 공적 권한 확대와 자살예방사업의 제도적 기반 강화라는 정책적 보완 필요성을 제안하였다.

North Carolina MH providers oppose BH EHR requirements

A group of mental health providers and social workers in North Carolina are requesting a delay on state requirements that promote behavioral health EHR use, according to North Carolina Health News, EHR Intelligence reported. Specifically, the care providers oppose state legislation that would require providers in behavioral healthcare settings to link with North Carolina's health information exchange (HIE) by June 1, 2019. According to testimony from bill sponsor Josh Dobson (R‐N.C.), many behavioral health providers are concerned that the high cost of connecting to the state's HIE may pose a challenge. North Carolina's HIE network — NC HealthConnex — was implemented to break down information silos between providers, improve patient health outcomes, and streamline state‐funded programs such as Medicaid. The bill proposed by Dobson and others would push the deadline for providers to participate in NC HealthConnex to June 2021. Proponents of the bill agree requiring behavioral health providers to connect to the state HIE would be beneficial in the long‐term for payers, patients, and providers. Incentivizing EHR adoption among behavioral healthcare providers may help to close the digital divide between primary and specialty care.