The Attitudes of Social Work Students and Practicing Psychiatric Social Workers Toward the Inclusion in the Community of People with Mental Illness

Abstract

This study measured and compared the attitudes of social work students and practicing psychiatric social workers to the inclusion in the community of people with mental illness. The Community Living Attitude Scale Mental Illness (comprising the four subscales of Empowerment, Exclusion, Sheltering, and Similarity) was administered to a random sample of 68 Israeli BA social work students (first year: n = 35; third year: n = 33) and 28 practicing psychiatric social workers. Overall, the participants endorsed Empowerment and perceived the Similarity of persons with mental illness to themselves more than they agreed with the Exclusion attitude of segregating those persons from community life. First-year students rated Empowerment and Similarity significantly lower than did the third-year students and rated Sheltering significantly higher than did psychiatric social workers. Psychiatric social workers did not differ from third-year students and did not have stronger attitudinal commitment to the inclusion paradigm. They differed from first-year students only in the sheltering attitude; they showed lower support for sheltering people with mental illness.     

Social work in mental health services: A survey of the field

Abstract

A survey of social workers employed in mental health services was conducted in Victoria in mid-1997. Approximately 300 social workers were identified as working in the sector. About half were employed in adult clinical services, 23% in psychiatric disability services, 12.4% in Child and Adolescent Mental Health Services, and the rest in a range of other services. More than 90% worked in a community based service or team. The number of entry-level (SW I) positions in clinical services was found to have declined over the last ten years from 61 to 14, resulting in a lack of opportunities for social workers to gain experience in base grade positions, and difficulty in recruiting to SW II positions. Major issues of concern reported by social workers included: the lack of accommodation and other community resources for consumers; diminished opportunities for professional development, supervision, and discipline-specific training; lack of professional recognition; increasing workloads; and organisational emphasis on throughput rather than quality.     

Schizophrenia,Community Integration,and Recovery

Abstract

Rooted in deinstitutionalization policy, the community inclusion required by the Olmstead case, and the grass roots recovery movement, community integration for those who have diagnoses of serious mental illnesses has become an increasingly important policy goal. The purpose of this project was to examine empirical evidence describing experiences with social or community integration for people with psychiatric disabilities, with a particular interest in the schizophrenias. Studies chosen for review all involved direct survey or interview data from people with psychiatric disabilities and examined subjective experiences with social relationships or linked social participation with clinical, functional, or quality of life outcomes. Experiences involving the dynamics of social stigma, the achievement of personal agency, and innovative pathways to satisfying social inclusion are core themes found that are highly relevant for practitioners. Social work, with its ecological perspective, is well suited to address the complexities of conflicting interests and objectives that have arisen in mental health care in the pursuit of community integration. Suggestions for fruitful responses are presented.     

Community orientation of services for persons with a psychiatric disability. Comparison between Estonia,Hungary and the Netherlands

This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the Netherlands) confirms the findings of other studies that – regardless of geographical location – people with a psychiatric disability have difficulty fulfilling social roles in the community. They are often faced with fewer opportunities than other citizens, due to their health problems, stigma, discrimination and poverty [World Health Organisation. (2011). World report on disability. Geneva: WHO]. An important objective of social work is to help people find their way in society. Surprisingly enough, in all three countries, most social workers are mainly focused on solving individual problems, and not on community participation. Shifting the focus starts by having a clear awareness of the notion of community participation. Social workers have to work both on supporting individuals to find their way in the community (individual support), and on supporting social networks in the community to accommodate persons with a disability on the basis of equal and valued citizenship (community support).     

Understanding engagement in the Program of Assertive Community Treatment (PACT) from the perspectives of individuals receiving treatment

ABSTRACT

Engagement of individuals with serious mental illnesses in community mental health services is a significant challenge. The Program of Assertive Community Treatment (PACT) is an individual-centered and self-contained mental health program that provides psychiatric treatment, rehabilitation, and support services to persons with serious mental illness who have a history of or likelihood of disengagement with services. Understanding what helps and hinders consumers’ involvement in PACT services may provide information on how to tailor engagement strategies to individuals based on their treatment needs and preferences. The current study builds on existing studies by exploring factors that help and hinder engagement in PACT services from the perspectives of individuals receiving treatment. We conducted open-ended, semi-structured interviews with 17 individuals receiving PACT services. Nine themes were identified through thematic analysis: Desirable qualities of PACT, Focusing on positive outcomes, PACT as a safety net, Recovery orientation, Practical barriers, Conflictual relationships, and Medication side-effects. We conclude that the development of a trusting, therapeutic relationship that is collaborative and person-centered and that is facilitated by both practical and emotional support is critical to engaging individuals in treatment and maximizing positive outcomes.     

Lesbian,Gay, Bisexual,Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary

Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.     

Building Community Capacity to Help Persons with Mental Illness

Abstract

In a time of crisis, persons with mental illness who encounter the police are often sent to jail or are involuntarily committed for psychiatric evaluation when mental health services are not readily available. To better serve these persons and the community, law enforcement and mental health professionals in one Iowa county joined together to ensure these individuals received the assessment and treatment needed. The results of a mixed methods program evaluation are detailed and suggest that the process to develop the program was as critical as the conduct of the program itself. Implications for program development are discussed.     

Reaching Out

Abstract

This article describes how a state health authority capitalized on the increased popularity of the Internet among consumers by launching a website devoted to improving communication among persons interested in children with disabilities and their families. The health authority collaborated with a local school of social work to redesign the website using the family-centered paradigm and evaluate its effectiveness. A sample of 51 respondents participated in the web-based survey. The article describes the process and methods of evaluation as well as the results of the survey to enhance feedback for the website's further development. Lessons learned for the design, development, and marketing of future websites are also covered.     

The Impact of Internships on Recruiting and Retaining Mental Health Workers: Views From Students and Their Supervisors

ABSTRACT

In 2015, 81% of counties in Texas were designated as full or partial Mental Health Professional Shortage Areas. To address this problem, we worked with a community-based association of mental health practitioners, using the social theory of career selection, to explore factors that influence students to join the mental health field. Our goal was to better understand how to recruit and retain mental health-trained students. We interviewed bachelor and master-level mental health interns in social work, counseling, and psychiatric nursing and field instructors using semistructured, open-ended interviews. Five themes emerged from the interviews: 1) attraction to mental health; 2) professional experience; 3) impact capacity; 4) develop social work skills; and 5) intern preparedness.     

Practice Wisdom on Custodial Parenting with Mental Illness: A Strengths View

ABSTRACT

Social work principles of strengths, empowerment, and consumer-centered care for persons with mental illness are currently being adapted to broader contexts. This article presents study findings on practice wisdom about custodial parents with mental illness, a potentially increasing group of consumers in light of mental health reform. The research team organized thirty-six professionals with practice experience into five focus groups. Findings reflect strengths perspective categories of resilience, social support, family functioning, self-care, and parents' positive experience of their symptoms. Implications discuss how providers who work with custodial parents and their children can apply these findings in assessments and interventions.     

Individualization and Prevention

SUMMARY

In 1905, Massachusetts General Hospital initiated the first medical social work program in the United States. Based on the writings of its leaders, this paper presents the early history of medical social work in the United States. Inspired by developments in European health care that emphasized the community context of disease, medical social work pioneers saw a need to individualize the patient while also promoting public health measures in the community, improving the patient's environment to eliminate the causes of disease. In addition, since they served patients because of their diseases rather than their poverty, medical social workers were among the first to provide social work services to the non-poor. In spite of their emphasis on environmental change, many of early medical social work leaders had an anti-institutional bias; they were suspicious of large-scale solutions for what they saw as fundamentally individual problems. Consequently, methods for promoting individual adaptation developed more rapidly than methods for promoting environmental change. Ironically, the medicalization of social problems in contemporary times has resulted in a focus on individual pathology rather than social and lifestyle causation in health, even as the rising cost and complexity of the system challenges health care consumers in the United States. Reaffirming the environmental emphasis of medical social work pioneers provides a way for today's health care social workers to incorporate environmental modification into their practice and promote the health of all citizens.     

Awareness and attitude of medical personnel in Kerala,India to transgender persons

IntroductionBeing one of the first Indian states to come out with a transgender bill in 2015, Kerala's Social Justice Department also implemented various health-based provisions for transgender individuals catering to their physical, mental, and gender-based health. Many of these are still in the process of being set up and transgender individuals will have to wait for smoother access to healthcare.AimThis study aims to assess the awareness regarding general transgender issues and health as well as the attitude towards transgender persons among the medical community- especially medical students and doctors who are a critical link for the integration of the transgender community into society.MethodResponses were collected from 452 medical doctors and students from Kerala through scales that measured awareness level and attitude, including transphobia. The relation of gender, age, years of experience, and specialty of medical personnel to the level of transphobia and awareness about transgender issues was also analyzed using statistical methods.Result and DiscussionTransphobia levels were moderate in the sample. Women and medical students had lower levels of transphobia than men and practicing doctors respectively. Awareness levels were average for general information about the transgender community, such as its core features and difference from other similar categories but were low on health-related aspects of transgender persons (such as their physical and mental health issues, healthcare provisions, and knowledge on gender affirmation surgery).ConclusionMore inclusive actions are needed in medical education, legislative actions, advocacy groups, and the formation of multidisciplinary surgical teams to further the cause of the transgender community.     

Community Integration of Older People with Developmental Disabilities in Hong Kong

ABSTRACT

To understand the community integration of adults with developmental disabilities in Hong Kong, a comprehensive measure includes four dimensions, pertaining to social activity, social services, interpersonal behavior, and people involved in social interaction. Applying this measure to 692 adults (aged 15–62), the territory-wide study finds that these adults lack company for out-of-home activities and community activities despite their higher knowledge, assertiveness, social interaction, and feeling accepted in the community. With the strengthening of many conditions (including knowledge and community support) for community integration, the adults tend to have greater need for empowerment to enhance their active participation in community activities.     

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.

     

A Critical Review of Family Caregiving of Mental Health Consumers in Hong Kong

ABSTRACT

This paper is a critical review on the family caregiving of mental health consumers in Hong Kong. The writer has a brief review on related studies of family caregiving of mental health consumers. In comparing with those in the U.K. and the U.S.A., family caregivers of mental health consumers in Hong Kong are lonely, stigmatized and unsupported by mental health services and members in the community.     

The dynamics of multicultural values of Banuroja community in building social integration a socio-cultural ethnographic study in Gorontalo

ABSTRACT

This research is prompted by the researchers’ concern with the problems of this nation that seem to have no end, as can be seen in the various social conflicts related to ethnicity, religion, and race, due to intolerance to the diversity of society. Therefore, it is important to build social integration in this multicultural society through the preservation of cultural values, as has been practiced by the community of Banuroja. This research aims to describe the dynamics of the multicultural values of Banuroja people in building social integration in their community. The research approach is qualitative by using ethnographic study method. The results illustrate that the dynamics of the multicultural values of Banuroja community can build social integration in society in terms of: 1) Emphasizing the identity of cultural diversity; 2) Accepting and understanding the cultural diversity; and 3) Applying the principles in a multicultural social life, e.g., sensitivity and equality.     

Mental Illness,Social Construction,and Managed Care

Abstract

Managed care is creating a social reality that affects the lives of millions. Mental health coverage under health care plans is a function of how mental illness and its proper treatment are defined. These definitions are shaped by social actors competitively seeking to satisfy their particular interests. This paper examines the influence of privatized managed behavioral health care on these evolving social definitions, as evidenced in published works, written reports, and legal actions. It is written from the perspective of social workers as providers of services and advocates for social justice. Options for social work responses to managed behavioral health care are explored.     

The question of community attachment revisited

In this paper we compare the relative effects of satisfaction with specific community (neighborhood) attributes and social integration into the community on community attachment. Previous research on community attachment has not assessed the importance of satisfaction with specific attributes as a determinant of attachment. Instead, this research has focussed on integration into the social life of a community as the primary source of community attachment. We find that although social integration has the more important effect on attachment, satisfaction with specific community attributes also has a statistically significant effect. People who are satisfied with the general physical appearance, the noise level, and the quality of neighbors in their communities tend to be more attached to them than those who are less satisfied. We address the theoretical and policy implications of this finding. In short, this finding implies, contrary to previous thought, that it is possible for there to be higher levels of attachment to communities that appear to be lacking a well‐developed social life. It also implies that levels of attachment to communities could be enhanced by programs that improve certain features of the physical environment which are seen as indicative of the quality of communities as good places to live.     

Mens Sana: The Growth of Mental Health in the American College Health Association

Abstract

In 1910, the first college mental health service sought to help college students with personality development and building a healthy mind. In 1920, the meeting that founded the American College Health Association (ACHA) identified “mental hygiene” as important, although a separate Mental Health Section was not established in ACHA until 1957. Between 1920 and 1960, a series of national meetings helped define the role and functioning of college mental health and counseling services. Most colleges employed a multidisciplinary staff of psychologists, psychiatric social workers, and psychiatrists to provide clinical services for students and consultation and education for faculty and staff. Mental health services on college campuses grew rapidly in the 1960s and 1970s, leading to discussions in the late 20th century of the use of brief psychotherapies, prevention and treatment of drug and alcohol abuse, prevention of suicide and homicide, the use of psychotropic medications, and effective campus interventions.     

Video conferencing applications in social work: Work locally,think globally

Abstract

Video conferencing is a technology that facilitates the provision of high quality education, health-care and consultation to clients and families served by rural area health professionals via visual and audio transmissions. It also plays an important role in the education, and training of rural health professionals and the development of a multidisciplinary team dialogue between rural and metropolitan partners. This paper describes our experience of a video conferencing program conducted at the Goulburn Valley Mental Health Service and St George's Older Persons Mental Health Service. We have found a number of benefits of this technology for clients, their families and for health professionals themselves. The development of expertise in the use of video conferencing technology has empowered social workers in their work places. Video conferencing has been extended to other aspects of social work practice. A pertinent example of this is the use of video conferencing in Guardianship and Administration hearings for patients who would otherwise be unable to attend because of health problems (physical, mental and mobility).