Mental Health Social Work Research Articles

An Update on Resources, Procedures and Healthcare Provision in Pain Units: A Survey of Spanish Practitioners.

Multidisciplinary pain treatment units are recommended to provide comprehensive diagnosis and treatment of chronic pain, a complex clinical syndrome and one of the leading causes of disability worldwide. The objective of this study was to provide updated results on the situation of pain treatment units in Spain and to determine compliance with recommendations proposed by de Spanish Ministry of Health (SMH). A cross-sectional, prospective, multicenter survey was performed, collecting data on resources, procedures and healthcare provision. Between March and May 2019, the Spanish Pain Society sent an invitation letter to 183 pain units with a link to the questionnaire. Sixty-nine units from 13 regions agreed to participate. According to the International Association for the Study of Pain criteria, only 12 units were classified as multidisciplinary pain centers. Most (95.7%) were in hospitals, 82.6% from the public sector, and 46.4% had protocols to coordinate with primary care. Interviewees rated the adequacy of facilities at 6.3 (from 0 to 10). Moreover, 67% of interviewees found that there were insufficient staff, with no mental health professionals, physical therapists or social workers in 49.3%, 87.0% and 97.1% units, respectively. Only 24 pain units had a day hospital, 44.9% offered psychological interventions, and 79.7% supported teaching and research activities. Results suggest that a small proportion of Spanish pain units meet the national standards for multidisciplinary pain units proposed by the SMH.

Mental health needs of the COVID-19 patients and staff in the Fangcang shelter hospital: a qualitative research in Wuhan, China.

During the coronavirus disease 2019 (COVID-19) pandemic, Fangcang shelter hospitals were opened in Wuhan, China, to isolate and care for patients with mild or moderate symptoms. The patients and staff in the hospitals faced mental health challenges. This paper reports the experiences and mental health needs from them. Following the qualitative design, semi-structured interviews were conducted in the EastWest Lake Fangcang Shelter Hospital, Wuhan on March 2020. Data collection and analysis was based on grounded theory. Open coding was adapted and a structured codebook was developed through coding seminars. The themes and subthemes were then confirmed through thematic analysis. The findings were further explained and integrated in a theoretical framework. A total of 10 COVID-19 patients and 13 staff, including doctors, nurses, psychiatrists, and policemen participated in the interviews. They have common needs, as well as their own needs. The perspectives from the staff also did complement for needs of the patients. The mental health needs were generalized into four themes, that is, basic needs, information and communication, emotional needs, and social support, each with several subthemes. In addition, there were some external factors that regulated the internal needs, which were summarized in a theoretical framework. The study indicates the directions on hospital management, mental health services, policy making, and social work to meet the mental health needs of the inpatients and staff from temporary shelter hospitals like Fangcang in Wuhan during the COVID-19 pandemic.

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.

“Pull;” the Active Use of Dissonance. An IPA Pearl to Show Emotion Management in Action

This article explores emotion management of mental health social workers when undertaking a statutory function. Using data from a larger study of the Approved Mental Health Professional (AMHP), its aim is to explore a role that embodies a policy (both literally and metaphorically) concerning the distribution of professional responsibilities. Using the methodological approach Interpretative Phenomenological Analysis (IPA), this article explores the psychological and emotional experiences of participants from their own perspective. Data were collected from twelve AMHPs of three different non-medical backgrounds through a semi-structured interview that included the opportunity for each participant to draw and describe a Rich Picture of their experiences as AMHPs. Through one pearl, a small piece of data emerging form the larger corpus, AMHP work is shown to involve an active use of dissonance providing new insights into the enactment of mental health work and the role played by emotion. “Pull”, refers to the active use of dissonance; the recognition and use of seemingly contradictory emotions that, crucially, co-exist. This article argues that current dialogue ignores the advanced management of emotion in role accomplishment and the value of AMHPs. The use of drawing alongside discussion of it, underpinned by IPA, has given rise to the pearl, “Pull”, and its interpretation the active use of dissonance.

Managing Risk in the Pro-Empowerment Era of Mental Health Care: A Cross-Cultural Study of Social Work Perspectives in Hong Kong and Sydney

Abstract Risk management and empowerment have become key features of social work practice. Despite their increasing salience, relatively little is known about the perspectives of mental health social workers regarding how they navigate competing risk management approaches in modern practice that supports empowerment. The socio-cultural influences on risk management have also received insufficient attention in social work research. Focusing on these issues, this paper explored the perspectives of social workers in two geographically and culturally distinctive settings (i.e., Hong Kong and Sydney). Data were collected through semi-structured interviews with frontline social workers and were analysed using thematic analysis. Similar views were expressed by participants in both settings regarding assessment of clients’ readiness for risk-taking. Differences were identified in their practices of negotiating the perspectives of other key stakeholders and can be attributed to the influences of distinctive cultural and socio-political contexts. These insights may contribute to the development of more systematic, localised and practice-based risk assessment guidelines for mental health practitioners working towards the empowerment of clients.

Family Caregiver Assessment in Primary Care: A Nationwide Survey

Family caregivers play an important role in the healthcare of older adults, but their circumstances, needs, and risks are often unknown to medical professionals. Standardizing how caregivers’ needs are assessed in healthcare delivery can help clinicians design care plans that take caregivers’ capabilities into account and provide targeted recommendations for caregiver support. Despite the potential of caregiver assessment, little is known about its use in primary care practice. The present study surveyed a national random sample of 1,000 U.S. primary care clinicians (physicians, nurses, social workers) to characterize current practices, barriers, and facilitators of caregiver assessment. A total of 231 completed responses were received. A minority of respondents (11%) reported that their practice or clinic had a standardized procedure for caregiver assessment; one in ten (10%) reported that they had personally conducted a caregiver assessment using a standardized instrument in the past year. The most common barriers to caregiver assessment were lack of time (65%), inability to have private discussions with caregivers (36%), lack of access to referral options (30%), inadequate reimbursement (30%), and reluctance of caregivers to discuss their needs (30%). The most frequently endorsed facilitators to aid future implementation included better availability of referral options (77%), easier referral mechanisms (67%), co-location of mental health specialists, care managers, or social workers (65%), and training in how to address caregiver issues (61%). Findings are discussed within the context of emerging healthcare policies and practice initiatives designed to promote caregiver assessment in health care settings.

‘Maybe a Maverick, Maybe a Parent, but Definitely Not an Honorary Nurse’: Social Worker Perspectives on the Role and Nature of Social Work in Mental Health Care

Abstract In many places in the UK, social work is integral to mental health service delivery. Significant role erosion, however, has left the profession unclear about where it fits within modern mental health services. The 2016 Social Work for Better Mental Health initiative outlines five key mental health roles and has been adopted into national policy in England to combat this uncertainty, but the influence of this has not been explored. This study aimed to develop an understanding of how mental health social workers perceive and explain their role. Semi-structured interviews were undertaken with seven social workers based within one English National Health Service mental health trust covering a large geographical area and their responses analysed using Ritchie, Spencer and O’Connor’s Framework thematic model. Findings indicated that social workers only superficially engaged with the aspirational policy roles, instead presenting their own framework for what makes mental health social work distinctive. This was constructed around the context and intentions of practice, rather than around proscribed tasks and responsibilities. This study has significance for individual social workers and for organisations providing and planning mental health services in the UK and beyond, given the influence that practitioner perceptions can have on how they undertake their roles.

SOCIAL WORK IN MENTAL HEALTH IN UKRAINE: CURRENT CHALLENGES

The importance of mental health social work is rationalized as well as its introducing into public institutions across Ukraine. Core challenges for mental health social work in Ukraine are described, namely: lack of coordination mechanism for professional activities of medical and non-medical staff which are subordinates to different ministries, lack of appropriate specific professional training on mental health social work, lack of clinical social work specialization, lack of certification and licensing for social work in Ukraine to ensure quality in social services provision and others. Lack of shared understanding of the core of mental health social work as well as its role and functions, is identified to be the key challenge for its development in Ukraine. The analysis is made based on classification of social work professions by the National Classifier for Occupations in Ukraine DК 003:2010. The latter ensures availability of a range of social work professions at different levels, which, however, sometimes have similar requirements in terms of education needed and functions performed. This leads to narrowing the social work profession understanding at the levels of community, clients, employees, policy makers. That creates obstacles for the profession development in Ukraine, as in most cases such perception of the profession is limited to individual care provided to elderly and disabled people. Also, the international approaches towards classification of social work occupations were presented by analysis of the three core groups of professions described in ISCO 08, including: 2635 Social Work and Counseling Professionals, 3412 Social Work Associate Professionals, 1344 Social Welfare Managers, as well as the relevant functions they perform. The need to review and to adjust the National Classifier for Occupations in Ukraine DК 003:2010 to the International Standard Classification of Occupations 08 is rationalized to address the above discrepancies on social workers’ functions in Ukraine.

Impact of coronavirus disease 2019 (COVID-19) pandemic on attitude, behavior, and mental health of patients with rheumatic diseases

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has become a global health, social, and economic crisis. Healthcare professionals, patients, healthy individuals, and the whole community are under inevitable psychological pressure which may cause different psychological problems as fear, anxiety, depression, and insomnia. The aim was to assess the impact of the COVID19 pandemic on the attitude, behavior, and mental health of rheumatic patients and to compare them with healthy individuals. This is a case-control study, 360 participants were included and divided into a patient group composed of 180 patients with rheumatic diseases, and a control group composed of 180 healthy people. Data were collected via a self-administered structured questionnaire designed on Google forms. It was sent to participants via social networks and emails to different rheumatic patients and healthy individuals. Mental health was measured by the 5-item Brief Symptom Rating Scale (BSRS-5).ResultsThe mean age of cases and control were (35.05 ± 8.79 vs 34.56 ± 9.06) years. In comparing attitudes and behavior toward COVID 19, there was a statistically significant difference (p ≤ 0.05) between both groups regarding washing hands, going outdoors, wearing masks and gloves outdoors, and staying in their rooms. Patients depended mainly on telehealth more than usual where about 50% used either phone calls, internet or sent their relatives to their physicians; moreover, 20% did not contact their physicians at all the past few months. There was a statistically significant difference (p ≤ 0.05) between both groups regarding feeling angry/irritated, inferior and insomniac. The BSRS-5 total score and being defined as a psychiatric case (according to the BSRS-5 scale) also differed significantly between patients and controls. Systemic lupus erythematosus (SLE) patients showed more adherence to their medications and stayed mostly at home and they have higher BSRS scores.ConclusionPatients with rheumatic diseases show comparable degrees of anxiety and depression to healthy individuals, but higher distress symptoms and panic in the form of anger, irritability, and insomnia. They have a significantly higher sense of inferiority and a higher total BSRS compared to controls. SLE patients show more adherence to their medications and stay mostly at home as a reflection of feeling more vulnerable. Moreover, they have higher degrees of psychological affection in the form of higher BSRS scores. Abandoning drug purchasing without medical prescription is necessary in Egypt to protect our patients from unnecessary drug shortages adding to their fear and anxiety. Mental health should be addressed in the same manner we deal with the infectious disease itself, being of no less importance. Mental health professionals, social workers, and support groups need to provide psychological support to vulnerable populations, including patients with rheumatic diseases. Rheumatologists should be aware of the need for psychiatric consultation for their patients whenever necessary.

Parenting-Related Exhaustion During the Italian COVID-19 Lockdown.

ObjectiveWorldwide, the coronavirus disease 2019 (COVID-19) pandemic has generated significant worry, uncertainty, anxiety, sadness, and loneliness. In Italy, these effects have been particularly pronounced. While research on the COVID-19 outbreak has mainly focused on the clinical features of infected patients and the psychological impact on the general population and health professionals, no investigation has yet assessed the psychological impact of the pandemic on parents. In the present research, we conducted a web-based survey of Italian parents to examine the prevalence of parenting-related exhaustion—and to identify its associated risk and protective factors—4 weeks into the lockdown.MethodsA total of 1,226 parents provided their consent to participate in the study and completed a demographic questionnaire, information relating to particular COVID-19 experiences, and measures of emotional exhaustion, parental resilience, social connections, and psychological distress during the lockdown.ResultsSeventeen percent of our sample experienced significant parenting-related exhaustion, with mothers more severely affected. Multiple regression analyses showed that greater parenting-related exhaustion was predicted by psychological distress, lower parental resilience, motherhood, fewer perceived social connections, and being single, as well as having a child with special needs, having a large number of children, and having younger children.ConclusionThe findings add further support to the call for preventive programs to support parents throughout the COVID-19 pandemic. Mental health professionals and social workers should be warned of the effects of lockdown and social distancing on parenting and, consequently, the well-being of children.

Meaning-Making of War Experiences: Stories From Kosova

The research evidence shows that war had many detrimental effects on the mental health, wellbeing, and social functioning of the people of Kosova, which is similar to the findings in many other postconflict societies. However, there are few studies focusing on the process of meaning-making of war experiences and their impacts on resilience and growth. This phenomenological study aimed to explore the lived war experiences of citizens of Kosova from the perspectives of three generations (grandparents, parents and children) through semistructured interviews, which were conducted with 37 participants. Thematic analysis revealed that the journey of the meaning-making of war experiences in Kosova is rather dynamic and reflects the context in which each generational cohort lived and grew. The findings provide a deeper understanding of the strategies used by each generation for meaning-making and how these strategies contributed to resilience and growth. The implications for mental health counselors, social workers, and policymakers are discussed.

Toward coercion free, trauma-informed care in Australian adult mental health services: strategies for social workers

ABSTRACT Least restrictive practice is a key principle of mental health legislation. It seeks to minimize coercion and maximize the human rights of mental health service users. Coercive practice, with a focus on seclusion, is explored from a whole-of-mental-health-system perspective as distinct from the behavior of individual service users. Exemplar coercion-reducing strategies arising from the reviewed research and literature are outlined. The exemplars can strengthen the utility of the least restrictive principle by extending non-coercive practice options for mental health social workers. The strategies bring a focus to proactive trauma-informed systemic changes and community level alternatives to hospitalization, coercion and seclusion.

Social work and technology: Text mining three decades of scholarly literature (1985–2018)

Summary While the scholarly literature is abound with discussions of technology and its proliferation in different social work domains, evidence about what types of technologies are being used in various social work practice domains remains limited. The present study aimed to identify the larger trends in how technology has permeated the profession. The study sample comprised of 892 articles from a journal known for its contribution in publishing research on technology use in human services. Two methods were used—topic modeling and human-assisted analyses. Topic modeling was performed using MALLET, a machine learning tool which employs latent Dirichlet allocation over a fixed vocabulary for the corpus of text. Human-assisted analyses were performed using QDA Miner and MS-Excel to assist in the manual analyses. Findings In all, 29 topics in social work and 27 topics in technology domains were obtained. Social work education and mental health and clinical social work appeared as two of the top five social work domains in both topic modeling and human-assisted analyses. Management information system, communication technology, generic technology usage, and education technology were the top common topics in both types of analyses. Applications The present study findings have two applications. First, the descriptive analysis of technology adoption across diverse social work areas of research provides the first concrete evidence of how technology has been spread throughout social work. Second, the patterns of technology adoption across social work practice fields indicate some fields have limited research regarding technology.

Care, Convenience, Comfort, Confidentiality, and Contagion: The 5 C's that Will Shape the Future of Telemedicine.

The COVID-19 pandemic has driven rapid, widespread adoption of telemedicine. The distribution of clinicians, long travel distances, and disability all limit access to care, especially for persons with Parkinson's disease. Telemedicine is not a panacea for all of these challenges but does offer advantages. These advantages can be summarized as the 5 C's: accessible care, increased convenience, enhanced comfort, greater confidentiality to patients and families, and now reduced risk of contagion. Telemedicine also has its limitations, including the inability to perform parts of the physical examination and inequitable access to the Internet and related technologies. Future models will deliver care to patients from a diverse set of specialties. These will include mental health specialists, physiotherapists, neurosurgeons, speech-language therapists, dieticians, social workers, and exercise coaches. Along with these new care models, digital therapeutics, defined as treatments delivered through software programs, are emerging. Telemedicine is now being introduced as a bridge to restart clinical trials and will increasingly become a normal part of future research studies. From this pandemic will be a wealth of new telemedicine approaches which will fundamentally change and improve care as well as research for individuals with Parkinson's disease.

Qualitative Study on Burnout Experience of Mental Health Social Workers in Psychiatric Hospitals

Qualitative Study on Burnout Experience of Mental Health Social Workers in Psychiatric Hospitals

Educating for critical social work practice in mental health

ABSTRACT Practising critically in medically dominated settings has been identified as a radical challenge for social work. While commonly acknowledged that the biomedical model dominates most mental health settings, social workers continue to try to carve out a more distinctive role for our profession that aligns with the values of social justice. This paper explores how social work education (specifically critically reflective pedagogies and methodologies), can support transformative learning that, at least in this case, generated possibilities for critical practice in mental health. It articulates a co-constructed process in which the educator (Author One) and the student (Author Two) use critical reflection to unearth opportunities for mental health social workers to practise critically. This paper discusses the broader implications for social work education and practice, thus generating practice-based evidence that extends current theorising and social work practice in mental health.

Perceptions of the social worker role in adult community mental health teams in England

There is a growing recognition of the importance of the social work contribution within community mental health services. However, although many texts describe what the mental health social work contribution should be, little empirical evidence exists about their role in practice and the difference it might make to service users. This qualitative study sought to articulate this contribution through the voices of social workers and their multidisciplinary colleagues via focus group discussions across four English Mental Health Trusts. These considered the impact of the social worker on the service user. Thematic analysis resulted in the identification of three over-arching themes: social workers own perceptions of their contribution situated within the social model; the high value their colleagues placed on social work support and leadership in a range of situations and the concerns for service users if social workers were withdrawn from teams. Key findings were that social workers are the only professional group to lead on the social model; that this model enhances the whole teams’ practice and is required if service users are to be offered support that promotes long-term recovery and that without social workers, the community mental health team offer would be more transactional, less timely, with the potential for the loss of the service users’ voice. If social work is to make a full contribution to community mental health team practice, it must be clearly understood and provided with the support to enable social workers to operate to their full potential.

Framework for a psychosocial support structure for individuals during an Ebola virus disease outbreak: Lessons from Port Harcourt experience

Background: The Ebola virus epidemic was reported in Lagos, Nigeria, in July 2014; this further spread to Nigeria's Oil city of Port Harcourt in September 2014. Ebola virus disease (EVD) is highly infectious with high mortality rates reported. During such an outbreak, there is a tendency to neglect the psychosocial implications of this outbreak. This research sought to propose a psychosocial support framework during an EVD outbreak. Methods: This study was a qualitative study. It employed review of literature, individual- and group-interview sessions and one of the author's (CUO) experience and challenges as the lead of the psychosocial support group (PSG) during the 2014 EVD outbreak in Port Harcourt to develop a framework on psychosocial support for EVD. Data presentation involved tables, charts and GIS map. Results: There were a total of four cases of EVD and 526 contacts in the EVD outbreak in Port Harcourt. The framework comprises four components, namely PSG, set-up/location, protocol of care and services and mobility/other logistics. A multidisciplinary team comprising psychiatrists, clinical psychologists, mental health nurses, counsellors, social workers and religious carers makes up the PSG. Set-up/location refers to the PSG operation office. The protocol of care and services are the modalities of care related to the categories of individuals requiring psychosocial support in EVD response. Conclusion: It is imperative that the psychosocial needs of individuals affected by EVD outbreak are sufficiently met. The psychosocial support framework provides a well-coordinated and structured approach in ensuring the holistic care of these individuals.

How to increase the role of social workers in suicide preventive interventions.

Suicide is a serious public health issue that affects individuals, families and societies all over the world. International studies provide consistent evidence that the presence of psychiatrists in a region is associated with lesser suicide rates. However, many psychiatric patients including suicidal patients do not have access to psychiatrists. This indicates that mental health and non-mental health social workers need to be involved in suicide prevention efforts. This paper is the first comprehensive work that discusses how to increase the role of social workers in the area of suicide prevention. A review of the relevant literature. Increasing the role of social workers in suicide prevention efforts may reduce suicide risk in groups and people at elevated risk for suicide, as well as the general population. Recommendations are provided for how the social work profession can improve upon suicide prevention while incorporating universal, selective and indicated suicide preventive interventions. Social work research efforts should focus on how to increase the role of social workers in suicide prevention and the management of suicidal patients. Social work education programmes should modify their curricula and increase their attention on suicide prevention. Mental health social workers need to educate the patient and their family on suicide risk factors. Furthermore, mental health and non-mental health social workers need to educate the general public on suicide risk factors.

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.