Mental Health Social Work Research Articles

Barriers to advocacy for recovery and wellbeing: a mixed methods study of challenges faced by mental health hospital social workers in Ontario, Canada

ABSTRACT Although advocacy is a key process in social work practice, there is a dearth of research on the constraints experienced in engaging in this process. Drawing on a larger project on frontline social workers’ advocacy practices, this paper focuses on barriers hospital mental health social workers face as they advocate against systemic inequity and support recovery for clients with serious mental illness. Using descriptive statistics and reflexive thematic analyses of an online survey (n = 43) and in-depth interviews (n = 12), this article presents the intertwined macro, mezzo, and micro-level barriers social workers encounter as they advocate to promote client, family, and community wellbeing.

‘Two sides of the one coin’: using reflection to examine co-production of human rights education within higher institutions in Ireland

ABSTRACT Encompassing human rights-based approaches within mental health service delivery is essential to supporting the recovery of service users, their family members/carers/supporters. This is being increasingly led by social workers due to their role in responding to psychosocial challenges. This is seen in today’s mental health services through their work in safeguarding service users and addressing familial concerns regarding all aspects of life. It is also evidenced in their openness to the concept of personal recovery—a movement aimed at defending and improving human rights for service users and their family members/carers/supporters through the recognition of international legislation. Recent debates within social work education have explored whether our critical and radical roots are declining or absent in practice. One argument for this has been the increasing pressures coming from neoliberal policies. This paper describes how both authors approached several co-produced sessions with social work students at an Irish university regarding mental health recovery and social work. The authors provide insight into this approach, including a description and exploration of a model of reflexivity used during this process which can be used by other educators, students, and practitioners [CS is an Assistant Professor of Social Work,MJN is a Consumer Academic].

Multifaceted personas in context: mental health social worker perspectives on the intersection of mental health, social work and professional identity in England and Wales

Mental health provision in England and Wales has fluctuated between promoting social work as a valued, distinct contributor and viewing it as an adjunct to a generic workforce. Perspectives are divided on whether the profession should emphasise social work, mental health work or a cross-disciplinary blend, and definitional attempts have proved challenging, with wide variation in practice. This article explores how mental health social workers view their professional identity across practice contexts. Using a mixed-methods approach, 248 mental health social workers completed an online survey, and 30 undertook a subsequent semi-structured interview. Survey data were statistically analysed using Kruskal–Wallis H-tests to explore differences across settings. Qualitative interview data were analysed using a framework thematic approach. Participants demonstrated a strong but flexible professional identity, adopting a multifaceted, fluid sense of self that prioritised the aspect of identity most relevant to the context. Contrary to narratives of poor articulation, this was framed within a specialist knowledge- and values-based perspective that influenced practice approaches and accommodated context without requiring external validation. This fluidity suggests a need to move away from restrictive task-based definitions of social work in order to actively engage the workforce in developing professional roles that embrace this flexibility to offer holistic services.

Clinician actions in response to Adverse Childhood Experience (ACE) screening

Background and ObjectiveAdverse Childhood Experiences(ACEs) have a powerful influence on mental health, physical health, and life expectancy. Screening for ACEs and the clinician response to ACEs are critical to addressing the health and well-being of children; however, little is known about the actions clinicians take in response to ACE screening. Therefore, we aimed to examine clinician responses to ACE screening at five California pediatric clinics in a large public health care system. MethodsPatient demographics, indicators of social and behavioral determinants of health (e.g., housing insecurity), the number of ACEs endorsed on a screening instrument, and the actions clinicians took in response to each ACE screen were collected. Data was collected from May to October 2021. These data were used to examine the association between number of ACEs reported and clinician response, controlling for patient demographics and their social and behavioral determinants of health using multiple logistic regression. ResultsFive participating pediatric clinics conducted 2,652 ACE screens in six-months. Clinicians documented an action twice as often when ACEs were present, after controlling for patient demographics and their social and behavioral determinants of health (odds ratio(OR) = 2.2, 95 % confidence interval(CI): 1.5–3.3, p-value < 0.0001). Clinicians were three times more likely to record referrals to mental health clinicians, social workers, and community organizations relative to anticipatory guidance when the number of ACEs increased from one to three to four or more (OR=3.2, 95 %CI: 1.6–6.5, p < 0.0001). ConclusionFindings provide early information that ACE screening results are associated with patient care.

Primary care team characteristics associated with video use: a retrospective national study at the Veterans Health Administration

ObjectiveTo examine primary care (PC) team members’ characteristics associated with video use at the Veterans Health Administration (VA).MethodsVA electronic data were used to identify PC team characteristics associated with any video-based PC visit, during the three-year study period (3/15/2019-3/15/2022). Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD).Population54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs.ResultsThe mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18–29 years old) (example: 50–59 age group: OR = 1.12,95%CI:1.07–1.18). Women were more likely to use video (OR = 1.18, 95%CI:1.14–1.22) compared to men. MH specialists (OR = 7.87,95%CI:7.32–8.46), PharmDs (OR = 1.16,95%CI:1.09–1.25), and SWs (OR = 1.51,95%CI:1.41–1.61) were more likely, whereas nurses (OR = 0.65,95%CI:0.62–0.67) were less likely to use video compared to PCPs.ConclusionsThis study highlights more video use among MH specialists, SWs, and PharmDs, and less video use among nurses compared to PCPs. Older and women clinicians, regardless of their role, used more video. This study helps to inform the care coordination of video-based delivery among interdisciplinary PC team members.

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

Telehealth in Mental Health Social Work: Benefits and Limitations within Practice

ABSTRACT Telehealth is increasingly being adopted in mental health service delivery, particularly since the onset of COVID-19. However, the literature on the uses and applications of telehealth in mental health social work is still emerging, and a critical understanding of telehealth practice is vitally needed. This research explored how the use of telehealth impacts the practice of mental health social workers and what this means for service users. Ten semistructured interviews were undertaken with mental health social workers. It was found that although telehealth is becoming embedded into service delivery, there are implications for workload, training and support, and skills in reflexively adapting practice to ensure ethical practice when using telehealth technologies. Telehealth can align with the profession of social work if the practical benefits are clearly understood and the limitations of the approach are monitored and supported with adequate training and support. IMPLICATIONS Telehealth has many practical benefits for practice, but it presents a challenge for the relational skills social workers rely on for face-to-face practice. Social workers should be critically reflective on how telehealth can impact ethical practice. Training and support around the practical implications of telehealth for those implementing telehealth would be beneficial.

Research-related knowledge, understanding and practice in public mental health: the voices of social workers and occupational therapists

IntroductionPrevious studies have explored facilitators and barriers to research conducted by allied health professionals in general medical settings. Since the mental health system is acknowledged to be significantly under-funded and more poorly functioning than general medical services, it is unclear whether the published facilitators and barriers also apply to mental health settings. This study sought to explore the research-related knowledge, understanding and practices of allied mental health clinicians based in a large public mental health service.MethodsA mixed methods study recruited 59 occupational therapists and social workers working in a dedicated metropolitan public mental health service in Melbourne, Australia. Quantitative survey results are reported elsewhere. Semi-structured interviews were conducted with 16 survey responder volunteers. Thematic analysis was conducted on the qualitative survey and interview data.ResultsFour main themes were identified: research must connect with clinical practice; fragments of knowledge; research in practice; and research is not part of my professional identity. The third theme, research in practice, comprised four subthemes: no time for research in clinical roles, missing communication, lack of ownership, and what I need to do research.ConclusionsThis study found that research and research-related activities were not considered part of the mental health social workers and occupational therapists’ professional identities. Dealing with this issue may be instrumental to the realization of these clinicians’ professional peak-body associations’ code of practice and to government mandated practice standards. We provided several strategies to encourage both clinicians and services to view research-related activities as an everyday part of clinical roles. This is especially important if we think of allied health evidence-based practice requiring a reasonable level of research-related skills and/or competencies to appraise, practice, evaluate and adapt their evidence-based practice.

A Phenomenological Study on the Training Experience of Mental Health Social Workers

A Phenomenological Study on the Training Experience of Mental Health Social Workers

Care and Control in Mental Health Social Work: A Case Study

Whether to apply for involuntary treatment is challenging for social workers. The aim of this study is to explore the legal background of a mental health social work case in Scotland and at the same time pay attention to the ethical dilemmas during the intervention. The relationship-based practice was applied to develop trust between the social worker and the service user and to change negative behaviours, while some difficulties related to multi-agency work and self-determination of service users still existed.

To delay or not to delay: procrastination and suicide prevention

ABSTRACT When mental health professionals or social workers are confronted with a suicidal individual, one approach is to use all means to delay the act of suicide until the desire for death subsides. Encouraging someone to delay suicide while bypassing the individual’s practical reasons for suicide can lead to irrational postponement, which equates to procrastinating suicide. Causing someone to procrastinate in this manner poses a risk of disrespecting the person as a rational agent. However, is it even possible to irrationally delay one’s own act of suicide? Additionally, isn’t it beneficial to do so? The aim of the manuscript is to explore the possibility and value of using procrastination in managing suicidal individuals. First, I will argue that procrastination of a suicide intent is possible, which makes inducing this state of mind in people morally problematic. Second, I will argue that there is no intrinsic value in procrastination, although it does have instrumental value. Procrastination holds instrumental value for individuals who delay an irrational act of suicide. Furthermore, procrastination is valuable for clinical psychology, not by making people irrationally delay suicide but for assessing suicide risk.

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.

Factors Affecting the Mental Health of Youth After the Great Kahramanmaras Earthquake Disaster

This study aims to determine the extent of the psychological effects of the Kahramanmaraş earthquake disaster, which is widely regarded as one of the most significant disasters of the century, on young people based on their direct or indirect exposure and to investigate the impact of these issues on life satisfaction. Data were collected from 337 individuals who were continuing their advanced education at a state university in Turkey, using a demographic information form, life satisfaction scale and Depression Anxiety Stress Scales 21. In the analysis of the data, t-test, Pearson correlation test, ANOVA and multiple regression analysis were employed. The results of the analyses indicated that as the intensity of exposure to disaster news increased, the stress, depression, and anxiety levels of the participants also increased. Individuals who experienced the earthquake personally and participated in volunteer aid activities demonstrated higher depression and anxiety scores and DASS21 scale total scores than those who did not directly experience the earthquake but followed the news and those whose relatives experienced the earthquake. There was no significant difference in the intensity of following earthquake news between men and women among the participants. However, it was determined that the intensity of following earthquake news from media and social media tools positively and significantly predicted the life satisfaction of the participants. These findings provide insights for future mental health interventions and social work practices for young people affected by the earthquake.

The effectiveness of the mental health social worker-led multiprofessional program in preventing long-term hospitalization and readmission in acute psychiatric inpatients in Japan: A retrospective analysis.

The large number of new long-stay (NLS) patients and high readmission rates in psychiatric hospitals are longstanding concerns in Japan despite reforms to encourage multidisciplinary support of such patients. Staffing shortages of specialists, especially mental health social workers (MHSWs), may be one of the reasons for these problems to remain unsolved. The authors examined the effectiveness of the MHSW-centered multidisciplinary care model in preventing NLSs and rehospitalization in terms of both patient dynamics and cost by retrospective comparison of before and after program implementation. After our program was introduced, NLS was almost completely prevented. In addition, a significant decrease in readmissions of involuntarily admitted patients was also observed. On the other hand, the resulting decrease in treatment costs and hospital revenues was mismatched by an increase in personnel costs. While MHSW-centered multidisciplinary care is effective for the community integration of patients, there are cost challenges. State policy changes are needed to resolve staffing problems, along with the introduction of appropriate indicators of community integration.

What discourses shape and reshape men's experiences of accessing mental health support?

The research employs a single embodied case study design with the aim to examine the discourse of men accessing and receiving mental health support alongside those who are the providers of the support. Three groups of adults were interviewed: men who had experienced mental health problems and had attempted to access mental health support; lay people who supported them, such as partners and non-mental health professionals and professionals, such as mental health nurses, social workers, clinical psychologists and general practitioners. Critical discourse analysis (CDA) is used to identify discourses around three emergent themes: well-being, power and dominance and social capital. Participants seeking mental health support often referred to mental health services as not listening or that what was offered was not useful. A lack of belonging and community disconnectedness was apparent throughout all participant interviews. The study is reported according to the COREQ guidelines.

Association between mental health social worker staffing in psychiatric emergency wards and readmission outcomes: A nationwide survey in Japan.

The mental healthcare system in Japan is transitioning from institution-based to community-based treatment. To prevent prolonged hospitalization and community integration of psychiatric patients, mental health social workers (MHSWs) are pivotal in coordinating post-discharge arrangements for psychiatric inpatients. This study aimed to propose a care model to improve clinical outcomes in psychiatric emergency wards in Japan. We conducted a mail-in questionnaire survey targeting medical facilities with psychiatric emergency wards. We collected data of the psychiatric care system, including facility profiles, staffing conditions and caseloads, and the provided psychiatric services and treatment options. Using multiple regression analyses, we explored associations between these data and clinical outcomes, focusing on the average number of days for hospitalization and the integration of patients into a community. Data were collected from 82 facilities (response rate, 45.8%). The average number of days for hospitalization and community integration were 64.7 and 327.9 days, respectively. The caseloads for MHSWs were significantly associated with longer hospitalization (β = 0.31, p = 0.009) and shorter duration of community living (β = -0.28, p = 0.027). The clinical performance in psychiatric emergency wards surpassed the Japanese government's targets regarding these outcomes. We found that heavy caseloads on MHSWs were associated with worse clinical outcomes for patients in psychiatric emergency wards. These findings suggest that reducing MHSW caseloads (≤20 cases) may be a potential interventional strategy to prevent prolonged hospitalization and promote successful community integration of patients.

Improving Skills and Knowledge: Adapting a Core Competencies Suicide Risk Assessment Training Program to Support Mental Health Professionals in Hungary

Introduction Competency and skill-based education and assessment have become increasingly significant in mental health professional training. The conventional approach of acquiring knowledge is now being supplemented by emphasizing practical skills and implementing best practices that prove effective in the field. This emphasis on competencies is particularly apparent in the instruction regarding suicide risk evaluation and management. Cramer and colleagues have identified ten core competencies essential for working with patients at risk of suicide and developed a training material (Cramer et al. 2013, Train. Educ. Prof. Psychol; 1 1-11).Objectives We aim to tailor Cramer et al.’s training program to the Hungarian setting and assess its efficacy among mental health experts, including psychiatrists, clinical psychologists, and social workers. Additionally, we aim to validate the Suicide Prevention and Assessment - Competency Assessment Form (SCAF-R), which comprises a ten-item survey to measure the ten core competencies’ levels with Likert scales and textual ratings by observers. Through this training program, we aim to offer mental health professionals an educational framework to enhance their skills in evaluating and managing suicide risk. Our goal is to provide a comprehensive approach to suicide risk assessment and better equip professionals to handle this emotionally difficult clinical task.Methods We have created a Hungarian version of the core competencies training material tailored to the culture. We are assessing changes in attitudes towards suicide behavior and prevention by administering pre- and post-training psychometric measures, such as Willingness to Intervene against Suicide (WISE), Suicide Behavior Attitude Questionnaire (SBAQ), Attitudes Toward Suicide Prevention Scale (ASP), and Suicide Competency Assessment Form - Revised (SCAF-R). A quantitative analysis will be performed on the responses. The research was approved by Péterfy Hospital’s Institutional Review Board (IRB): approval number 07-2023.ResultsThe questionnaires’ results will be summarized with standard statistical methods.ConclusionsImproving mental health education in healthcare with up-to-date knowledge of evidence-based best practices is a top priority. Enhancing skills and knowledge can lower clinicians’ anxiety in this emotionally challenging and burdensome task. There is a high demand for mental health workshop training among healthcare workers in both undergraduate and post-graduate education. We expect positive changes in attitude and self-perceived competencies in participants.Disclosure of InterestNone Declared

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.

Mental Health Social Work Practitioner Research: A Narrative Review of Papers Published From One Academic Program

Purpose: This narrative review explores papers published in peer-reviewed journals reporting research from a practice research module of a qualifying program to examine their potential contribution to knowledge in mental health social work. Methods: A narrative review was undertaken according to the PRISMA extension for scoping reviews of papers published by the first three cohorts of a practice research module. Results: Eleven papers were included in the review which found, for example, some deficits in practitioners’ knowledge, confidence and understanding. The studies were modest and had some common limitations, but a high number of online views indicate that the papers have the potential to impact on practice. Conclusion: This review found that it is possible to use a practice research module of a qualifying program to train social workers to undertake and publish high-quality research which has the potential to influence policy or practice beyond a students’ own learning.

Developing a Suicide Crisis Response Team in America: An Islamic Perspective.

Suicide is a critical public health issue in the United States, recognized as the tenth leading cause of death across all age groups (Centers for Disease Control and Prevention, 2020). Despite the Islamic prohibition on suicide, suicidal ideation and suicide mortality persist among Muslim populations. Recent data suggest that U.S. Muslim adults are particularly vulnerable, with a higher attempt history compared to respondents from other faith traditions. While the underlying reasons for this vulnerability are unclear, it is evident that culturally and religiously congruent mental health services can be utilized to steer suicide prevention, intervention, and postvention in Muslim communities across the United States. However, the development of Suicide Response toolkits specific to Muslim populations is currently limited. As a result, Muslim communities lack a detailed framework to appropriately respond in the event of a suicide tragedy. This paper aims to fill this gap in the literature by providing structured guidelines for the formation of a Crisis Response Team (CRT) through an Islamic lens. The CRT comprises of a group of individuals who are strategically positioned to respond to a suicide tragedy. Ideally, the team will include religious leaders, mental health professionals, healthcare providers, social workers, and community leaders. The proposed guidelines are designed to be culturally and religiously congruent and take into account the unique cultural and religious factors that influence Muslim communities' responses to suicide. By equipping key personnel in Muslim communities with the resources to intervene in an emergent situation, provide support to those affected, and mobilize community members to assist in prevention efforts, this model can help save lives and prevent future suicide tragedies in Muslim communities across the United States.