Perceived self-stigma in the utilization of mental health services in foster care and post foster care among foster care alumni

Foster youth experience higher rates of mental health disorders and receive higher rates of mental health services in comparison to the general population. Yet, upon foster care exit, mental health service use drastically declines. Little is known as to the reasons for mental health service decline after foster care exit. However, research studies in the mental health literature have consistently shown that self-stigma and public stigma are significant in mental health service receipt. Studies have also shown that self-stigma affects an adolescent's self-identity, self-efficacy, and interpersonal relationships, which impact self-sufficiency once youth leave foster care. This study explores self-stigma in the utilization of mental health services while in foster care, and whether the stigma developed while in foster care impacts mental health service use upon foster care exit. The role of public stigma in the utilization of mental health services post foster care is also examined. Thirteen former foster youth with a mental health treatment history while in foster care were interviewed. Results show that foster youth experienced self-stigma, which increased the negative impact of mental health service receipt while in foster care. After foster care exit, youth who identified experiencing self-stigma while in foster care tended to discontinue mental health services after foster care exit. In contrast, foster youth who did not identify self-stigma in the receipt of mental health services while in foster care continued accessing services upon foster care exit. Public stigma was not identified as influencing mental health service use post foster care, but was coupled with negative labels, stereotypes, and negative perceptions. Implications for preventive and intervention measures are also discussed/proposed.     

Does self-help increase rates of help seeking for student mental health problems by minimizing stigma as a barrier?

Objective: This study examined whether self-help (books, websites, mobile apps) increases help seeking for mental health problems among college students by minimizing stigma as a barrier. Participants and Methods: A survey was conducted with 200 college students reporting elevated distress from February to April 2017. Results: Intentions to use self-help were low, but a significant portion of students unwilling to see mental health professionals intended to use self-help. Greater self-stigma related to lower intentions to seek professional help, but was unrelated to seeking self-help. Similarly, students who only used self-help in the past reported higher self-stigma than those who sought professional treatment in the past. Although stigma was not a barrier for self-help, alternate barriers were identified. Conclusions: Offering self-help may increase rates of students receiving help for mental health problems, possibly by offering an alternative for students unwilling to seek in-person therapy due to stigma concerns.     

The Influence of Managed Care on Job-Related Attitudes of Social Workers

This study explores the relationships between the levels of conflict that social workers experience when interfacing with managed care organizations and outcome variables including job satisfaction, organizational commitment, emotional exhaustion, and turnover intentions. A total of 591 social workers practicing in mental health agencies in New York State completed self-administered and anonymous questionnaire packets that included several measures: Level of conflict that workers experience when interfacing with managed care organizations (CMC), job satisfaction, organizational commitment, emotional exhaustion, and turnover intentions. Results showed that CMC had statistically significant correlations with organizational commitment and with emotional exhaustion. The author discusses the role of social work schools and agencies in offering new educational opportunities and training in order to improve workers' skills, which are necessary for communicating and negotiating with managed care organizations.     

Job burnout and affective wellbeing: A longitudinal study of burnout and job satisfaction among public child welfare workers

Workplace experiences that threaten the affective well-being of child welfare workers pose a hazard to child protection organizations as a whole. This study tests a series of proposed interrelationships of workplace demands and resources as predictors of burnout development and the subsequent impact of burnout on affective worker well-being (e.g. job satisfaction) using longitudinal data collected from a sample of public child welfare workers. This study uses multi-group path models to test hypotheses about the temporal order of the relationships between work demands and resources, burnout, and job satisfaction. The hypothesized models were tested individually by social support in the workplace and specialized child welfare training. The overall theory-driven conceptual model tested performed as was hypothesized with some noteworthy exceptions. Findings from the multi-group path models suggest that the type and level of job resource moderate the relationship between job demands, burnout and job satisfaction. Job demands had diverging effects on several relationships in the model with the exception of two relationships. The relationships between emotional exhaustion and depersonalization and emotional exhaustion and job satisfaction were consistent across all groups and models. This finding suggests that regardless of social support and specialized training, emotional exhaustion is positively related to depersonalization and negatively related to job satisfaction. All models demonstrated good model fit. This article describes the implications of study findings on future research and workforce management practices in child welfare organizations.     

Self-Stigma of seeking help and job burnout in mental health care providers: the comparative study of Lithuanian and the USA samples

This study aimed to explore the correlation between job burnout and self-stigma of seeking help among nonmedical mental health care providers (psychologists, social workers, and counselors) in two countries – Lithuania and the US. The study included 234 professionals (111 social workers and 123 psychologists) from Lithuania and 93 professionals (33 counselors, 23 social workers, and 37 psychologists) from the US on a voluntary basis (93% females, mean age – 39.81?years). They completed a self-reported questionnaire with the Self-Stigma of Seeking Help Scale (SSOSH) and the Maslach Burnout Inventory-General Survey (MBI-GS). The results revealed a statistically significant positive correlation between self-stigmatization and burnout in the Lithuanian sample, but only weak positive correlation between depersonalization and self-stigma of seeking help in the US sample. The relationship between the self-stigma of seeking help and burnout was stronger in the Lithuanian sample of professionals when compared to their colleagues in the US.     

Women Vietnam veterans. A comparison of studies

There is strong evidence that many women exposed to war stress have suffered mental health problems related to their experience, and a substantial number continue to have serious emotional, psychosocial, and other readjustment problems that affect their current level of functioning and life satisfaction. The consistent exposure to severe combat casualties, death and dying, workload extremes, personal deprivation, loss, and danger all take a significant emotional toll. These studies underscore the need for affected women to explore their war experiences and associated feelings with mental health professionals, as well as the need for those professionals to develop an awareness and understanding of the impact of specific war-related stress on women.     

An equality of condition framework for user involvement in mental health policy and planning: evidence from participatory action research

Discussions about user involvement in the mental health services tend to throw up four major areas of concern: the capacity of service users to participate, their lack of participation skills, the need for a positive organisational culture and the need for arenas of participation. This article presents evidence from participatory action research with Irish mental health service users which explored how they could more equally participate in advisory committees. Participants identified barriers to their equal participation due to unequal cultural, physical, mental and economic resources, time, power, ‘stigma’(prejudice) and lack of respect for their experiential knowledge and emotional expression. These barriers fall within the ‘equality of condition framework’ developed by Baker and colleagues. Enabling equal user involvement in strategic decision‐making requires more than arenas of participation – it requires comprehensively addressing service users’ structural disadvantages throughout the process of involvement.     

A bit more understanding: Young adults' views of mental health services in care in Ireland

Children and young people in the care system typically experience very high levels of mental health difficulties, yet their views of these difficulties and of mental health services have rarely been explored. For this qualitative study we spoke with eight young adults aged 18 to 27 years with experience of the care system in Ireland about mental health challenges, service experiences, and how they felt mental health services needed to improve. Themes from the interviews illuminated young adults' views of their emotional well-being while in care, and the double stigma of being in care and mental health difficulties. In terms of services, young adults wanted these to be flexible and sensitive to level of need; to offer choice and more congenial environments; to provide more creative routes to engaging young people; and to offer honest, reciprocal, caring communication — treating children in care as one would any child. Recommendations highlight three key needs: an ethic of care in services as well as an ethic of justice; mental health training for all professionals in contact with children in care; and the need to listen, hear and act on what children and young people say.     

Double trouble: work–family conflict and well-being for second job holders

The purpose of this study was to provide an initial investigation into the work–family conflict (WFC) experiences of individuals who hold a second job. Specifically, we proposed two opposing theoretical arguments regarding the relationship between WFC and four measures of well-being: life satisfaction, physical health, emotional exhaustion, and exercise for individuals who hold two jobs. In a sample of individuals working two jobs, we tested whether the effects of WFC arising from the first job and from the second job exerted an additive or interactive effect on employee well-being. Our results indicated that for emotional exhaustion, physical symptoms, and life satisfaction, the effects of WFC from two jobs are interactive; but that for exercise, the effects of WFC from two jobs are additive. In both cases, the additional WFC experienced as a result of working a second job contributed to the prediction of employee well-being over and above WFC from the first job. Results are discussed within the context of relevant theory, and suggestions are made for future research.     

Promoting public/academic linkage.

1. Collaborative linkages between public mental health/mental retardation service systems and academic institutions have evolved in response to several problems: increasing numbers of individuals requiring long-term mental health care; the nursing shortage; and a decline in enrollment and students graduating from psychiatric mental health nursing programs. 2. Evidence suggests that a public/academic linkage in the form of a multidisciplinary training course in the care of seriously mentally ill patients promotes a recruitment of mental health professionals to work with these patients. 3. The establishment of academic/health care system linkages can enhance client care, expand and improve clinical experiences and education for students, and provide opportunities for collaborative research among clinical staff, faculty members, and graduate students.     

Making people feel good: Workers' constructions of meaning in interactive service jobs

This paper analyses the experiences of women who work in residential real estate sales, to identify the factors that lead women to choose and keep this occupation. In-depth interviews provide the data for a case study of the importance of various job traits in determining job satisfaction for a specific category of workers. The more general question concerns workers' constructions of the emotional labor involved in interactive service work. Within a general queueing model, this paper focuses on job queues. Specifically, I examine workers' preferences for jobs and the factors that contribute to positive ranking of the job after workers' initial experiences with it. Findings show that although the women's experiences on the job have disappointed their expectations, most remain satisfied with their work and plan to stay in the field. The reasons for this high level of satisfaction are related to characteristics of the workers—the women's educational and skill levels, and the limited alternatives that they perceive for themselves, and characteristics of the job—its autonomous nature and the emotional labor it entails.     

Organizational values,job experiences and satisfactions among female and male psychologists1

This study examined the relationship of managerial and professional women's and men's perceptions of organizational values supportive of work–personal life integration and their job experiences, work and non-work satisfactions and psychological well-being. Data were collected from 324 women and 128 men psychologists in Australia using anonymous questionnaires. Both women and men reported benefits from such values. Women psychologists reporting organizational values more supportive of work–personal life integration also reported working fewer hours and extra-hours worked per week, greater job and career satisfaction, more optimistic career prospects, less time to job and less work stress, greater friends satisfaction, and more positive emotional and physical well-being. Men psychologists reporting organizational values more supportive of work–personal life integration also reported less job stress, greater joy in work, lower intentions to quit, greater job and career satisfaction, more optimistic career prospects, fewer psychosomatic symptoms and more positive emotional and physical well-being. Multiple regression analyses indicated more independent and significant correlates of organizational values supporting work–personal life integration among women than among men. Possible explanations for why women might benefit more from such organizational values are offered.     

Are we doing enough? Stigma,discrimination and human rights violations of people living with schizophrenia in India: Implications for social work practice

ABSTRACT

In India, the human rights of people living with mental illness (PLMI) are poorly articulated and hence less researched. Using in-depth and focus group interviews, this study explores multiple perspectives on stigma, discrimination, and human rights violations of people living with schizophrenia (PLS) within their web of relationships in the city of Mumbai, India. Thematic analysis shows that abusive experiences at home, stigma associated with mental health services and barriers to meaningful employment contribute to human rights violations. Implications for strengthening the role of mental health professionals including social workers to promote, protect and actualize the rights of PLS are stressed.     

Reclaiming Self

In this article I use performance poetry pieces to reflect upon my experiences of living with a disability as a person of color, a woman, and an immigrant. It is my firm contention that, although listening to the stories of the clients we meet on our journeys is integral to creating individual and structural changes and raising awareness of mental health issues, as social workers it is just as important to share our own personal and collective stories of mental health, stigma, and recovery. As helpers and change makers, it is unlikely that we can influence mental health policy purely from behind the wall of positivism. Stories of clients as well as stories of our lived experiences are critical to challenging the strong divide that characterizes the social work academy: the us/them, service provider/service user, and the expert/client. Furthermore, my hope is that this article will add to the literature concerning the traumas experienced by immigrant women in their private domains.     

Direct What? The Untapped Potential of Direct Payments to Mental Health Service Users

This article describes research carried out for the Central Research Unit of the Scottish Executive about Direct Payments to mental health service users including people with dementia. Previous research had found that Direct Payments were not often, if at all, offered to mental health service users. Using focus groups, interviews and a telephone survey, Scottish Health Feedback explored the extent of implementation of Direct Payments across Scotland, and the views of mental health service users, carers and professionals about the idea of Direct Payments, the potential obstacles, and the support that would be needed. Awareness of Direct Payments was low, even among professionals. Many were hearing about this option for the first time through this research and a common reaction to the research questions was 'Direct what?' The study found that in order to make Direct Payments work for mental health service users, what was needed was 'person-centred' assessment, access to proper support, advice and training, and Direct Payment schemes that were flexible to allow for different arrangements and for transitions.     

Work organization, well-being and health in geriatric care

The objective of the present study was to explore the connection between the organization of work in geriatric care and factors which have been connected to job stress and burnout, i.e. exhaustion, mental workload, job satisfaction and communication. We also analyzed how these factors were related to employee visits to doctors during the previous 12 months due to various medical conditions. The study was a cross-sectional questionnaire distributed to all employees within nursing homes and geriatric hospital wards with 10 employees or more throughout Iceland. The total response rate was 80%. The majority of respondents, or 96%, were women (n = 1432), and the results are based on their answers. Our data show that there is a high correlation between mental exhaustion and the unsatisfactory organization of work. Mental exhaustion upon completing work shifts was more closely connected to the health outcomes studied than were the other work-related factors studied. This is especially true for chronic fatigue, depression and sleeping disorders. It is important that employers and managers notice the mismatches between work and workers that this study manifests. Employers and managers must also consider the organizational factors that are influential.     

Understanding and influencing the stigma of mental illness

Life goals and the opportunities that define them are impaired by the stigma of mental illness. Three kinds of stigma may act as barriers to personal aspirations: public stigma, self-stigma, and label avoidance. Challenging mental illness stigm is essential in helping individuals accomplish recovery-related goals. Public stigma may be changed through protest, education, and contact. Self-stigma can be addressed by fostering group identity, changing the perceived legitimacy of stigma through cognitive rehabilitation, and making strategic decisions about disclosing one's mental health history. Stigma change for label avoidance is not as well understood but may include the education and contact approaches used for public stigma. Evidence-based approaches to stigma change need to be substantiated by rigorous investigations.     

Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems

Minimal research has investigated the stigma associated with problem gambling, despite its major hindrance to help-seeking and recovery. This study explored perceived stigma and self-stigma to examine stigmatizing beliefs held, how they may be internalized, coping mechanisms, and effects on help-seeking. In-depth interviews with 44 people experiencing gambling problems were analysed using interpretive phenomenology. Results revealed an overwhelming perception that problem gambling attracts acute public stigma and is publicly viewed as caused by personal failings. Participants had serious concerns about being viewed as ‘a problem gambler’, fearing demeaning stereotypes, social rejection, hostile responses and devaluing behaviours. Many participants internalized perceived stigma as self-stigma, with deleterious reported effects on self-esteem, self-efficacy, perceived social worth, and mental and physical health. Deep shame was a near universal emotion and exacerbated by relapse. Secrecy was the main coping mechanism used, with perceived and self-stigma found to act as major barriers to disclosure and help-seeking. The findings can inform the development of a valid understanding and conceptualization of problem gambling stigma. This is a prerequisite for effective stigma-reduction strategies to reduce public stigma and discrimination, and to lower perceived and self-stigma and increase the use of treatment services and other interventions by people with gambling problems.     

Peer Support Among Consumers of Professional Mental Health Services

ABSTRACT

Peer-support services have become increasingly prevalent in mental health; consumers now deliver many services once provided by professional mental health providers. Recognizing this key asset in mental health consumers' service environment is critical for social workers. This exploratory study examines differences among 311 consumers of professional mental health services, half of whom also used peer-support services. The two groups (peer support compared with non-peer-support) were compared on a number of dimensions related to their utilization of and satisfaction with professional mental health services. Users of peer-support services perceived greater availability of professional services and used more professional services, but found professional services to be less useful than those not participating in peer support. No differences between the two groups were found for overall satisfaction with professional services. Findings related to policy, practice, and research are discussed.     

Stigma as a barrier to engaging in mental health services among adolescents who survive natural disasters

Many barriers impact the utilization of mental health services among adolescents who survive natural disasters. Although stigma has been identified as one of these barriers, minimal work examines the etiological factors that impact stigma and how these factors operate in perpetuating stigma among adolescents after a disaster. Understanding the role that stigma plays is a critical step to raising awareness of the cognitive and behavioral processes that preserve adolescents’ well-being, timely attainment of developmental milestones, and the potential for engagement in meaningful opportunities. We modify an existing adolescent self-stigma model to better understand how youth might respond psychologically to natural disasters both immediately after the event as well as during the long-term recovery phase. Future empirical research should assess the validity of these barriers within the suggested temporal framework. If this proposed conceptual piece is validated, interventions could be designed that directly address the role of stigma.