Educating for mental health practice: Results of a survey of mental health content in Bachelor of Social Work curricula in Australian schools of social work

Health problems are amongst the most pressing encountered by social workers in practice. Health policy, largely through deinstitutionalisation, has placed mental health problems in the mainstream of health practice. One in 25 Australians will require professional assistance with mental health problems. Moreover, other professions are increasingly claiming that mental health is their area of expertise. Social work needs to reclaim this area as their own and hence it is incumbent on social work education to prepare students to practise in this area. As the second of a two-part survey of health and mental health curricula in Australian schools of social work, the findings of the survey on mental health curricula conducted in 1997 are presented in this article. Based on responses from 95% of the schools, nine of the 20 respondent schools were found to offer a separate mental health unit. The remaining 11 schools' coverage ranged from no coverage at all through to considerable integration in other subjects. Overall it was concluded that the majority of students received a significant amount of input on mental health. A number of recommendations are made to improve mental health input including more skill development, greater local contextualisation, more attention to an anti-oppressive agenda, and more explicit links to field education.     

The Implementation of Mental Health Evidence Based Practices from the Educator,Clinician and Researcher Perspective

Within the different arenas of social work practice, community based mental health is among the most advanced in terms of defining a set of evidence based practices (EBPs). Social workers play a major role in the delivery of community based mental health and are at the forefront of efforts to implement these practices through state and federal initiatives. One such initiative is The New York Office of Mental Health Evidence Based Project, which is designed to increase the knowledge and skills related to evidence-based practice among New York’s mental health human services workforce. The project had a social work component, which trained students in implementing EBP’s through specially designed curricula and field placements. The students participating in the project encountered numerous challenges in the field including lack of agency “buy-in” and infrastructure support; inadequate training and resources; poor supervision; and provider resistance. From the multilevel perspectives of educator, clinician and researcher, this paper addresses these challenges and makes recommendations to facilitate the implementation of EBPs.     

The Evolution of Mental Health Care Policy and the Implications for Social Work

Abstract

The focus of this article is on the evolution of mental health care policy in the United States from the eighteenth century to the present. To the extent that social work practice enacts policy, this article focuses particularly on the ways 20th century social workers have reflected, interpreted, and forged mental health care initiatives and reforms. The article includes a discussion of how the cycles of mental health reform (moral treatment, mental hygiene, and community mental health) have influenced not only the roles but also the actual practices of social workers. The article concludes with a consideration of the impact of managed care on mental health policy and the implications for social work.     

An Experiment in Overseas Field Instruction

This paper reports on a study that examined the knowledge needed for practice in community mental health and the primary source for this knowledge. Differences were found in knowledge areas needed for practice in community mental health settings when contrasted with practice in more traditional mental health agencies. The most frequently indicated source of knowledge for social work roles in community mental health was on-the-job experience. Courses in social work schools were not a primary source of knowledge for the many nonclinical roles undertaken by social workers in community mental health.     

Utilization of the interprofessional education,practice, and research model in HBCU social work education

ABSTRACT

Historically Black colleges and universities (HBCUs) are often overlooked as a resource to address the need for a diverse healthcare workforce even though they are an essential component of ensuring diversity. In order to meet the needs of the current patient population, HBCUs’ social work programs must move from silo education, practice, and research pedagogy to inter-professional education (IPE), practice (IPP), and research (IPR) modalities when developing partnerships that promote the elimination of health disparities. This article discusses the contributions of a HBCU’s School of Social Work to the growth of IPE, IPP, and IPR utilizing the Ujima principle of Nguzo Saba. The projects developed were an attempt to provide meaningful and relevant education to social work students while exposing them to a collaborative inter-professional education, practice, and research experience. The three social work projects included intra-university and social community collaborations and exposing students to experiential inter-professional education, practice, and experimental learning. This is an opportunity for social work students to become involved in the evolving best practices pedagogy for inter-professional education, practice, and research which social work must embrace in order to fulfill the National Association of Social Workers imperative of preparing students to work in collaborative health care teams. The expected outcomes of these inter-professional ventures reflect a HBCU’s commitment to increasing the competency in inter-professional modalities aimed at supporting, empowering, and preparing high caliber diverse graduates who will grow the future and lead the world as a diverse healthcare workforce.     

The Clubhouse Model of Community Support for Adults with Mental Illness: An Emerging Opportunity for Social Work Education

The Clubhouse Model of community support is enjoying renewed interest among social workers and social work educators concerned with alternatives to traditional forms of community mental health treatment and rehabilitation. This article describes the model and its underlying congruence with social work theory and practice. Findings of the National Task Analysis Study of Social Work Practice are presented that suggest an increasingly important role for social workers and social work educators in the continued growth of this practice model.     

Mental health social work in Northern Ireland and the Republic of Ireland: challenges and opportunities for developing practice

Drawing on their experience of mental health social work in Northern Ireland and the Republic of Ireland, the authors examine the impact of current legislative and policy change in both jurisdictions. The paper applies Lorenz's theoretical framework to develop a comparative analysis of how global and country specific variables have interacted in shaping mental health social work. The analysis identifies linkages between factors and indicates similarities and differences in mental health social work practice. The paper highlights emerging discourses in this field and explores the impact on practice of developments such as de-institutionalisation, community care, and ‘user rights’ versus ‘public protection’. The article concludes with a review of key challenges facing social workers in both jurisdictions and identifies opportunities for developing mental health social work in ways that can positively respond to change and effectively address the needs of mental health service users and their carers. The analysis provides an opportunity to evaluate Lorenz's theoretical framework and the paper includes a brief critical commentary on its utility as a conceptual tool in comparative social work.     

Enhancing Competence in Health Social Work Education Through Simulation-Based Learning: Strategies From a Case Study of a Family Session

ABSTRACT

Simulation-based learning (SBL) is a powerful tool for social work education, preparing students to practice in integrated health care settings. In an educational environment addressing patient health using an integrated care model, there is growing emphasis on students developing clinical competencies prior to entering clinical placements or clinical practice settings. This article highlights the importance of SBL in the development of the clinical competencies of graduate social work students enrolled in a Social Work Practice in Health course. The development and implementation of an educational initiative using a family-based simulation scenario to enhance classroom learning for health social work practice is described, and recommendations for future educational initiatives using SBL are provided.     

Being a service user and a social work academic: balancing expert identities

Abstract

I am a service user and academic working in a university social work department. My hybrid identity allows me to draw on different types of knowledge in all aspects of my work, including: academic, practice and experiential wisdom. Service user involvement is mandated across social work education but the scope and breadth of different kinds of participation is developed in diverse ways across university contexts. This article affirms the value of service user involvement in health and social care education, exploring its positive impact on students. When lecturers share personal experience of using services alongside practice and academic wisdom in the course of teaching, sometimes the value of experiential knowledge is doubted and its influence dismissed. I examine the importance of experiential wisdom in social work education, specifically when it is embedded in an academic role in a university social work department, and consider how it can be respected and valued. The parallel experiences of involving peer support workers in mental health services, who use their knowledge of recovery to mentor other service users, are then briefly examined, together with reflection of the concerns across mental health with professionals sharing their experiential wisdom with the people that they support.     

Access barriers to mental health services for older adults from diverse populations: perspectives of leaders in mental health and aging

This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.     

Access Barriers to Mental Health Services for Older Adults from Diverse Populations: Perspectives of Leaders in Mental Health and Aging

This project is based on the results of telephone surveys with 52 local, state, and national informed respondents including policymakers, county leaders, planners, and advocates in mental health and aging with a particular focus on the states of California and Florida. This article addresses challenges to access to mental health services for diverse older adults including barriers related to race and ethnicity, socioeconomic status, location, age, gender, immigrant status, language, sexual orientation, and diagnosis. The article also highlights broad themes that emerged including (1) the importance of outreach and transportation tailored to diverse elders, and (2) recruitment of diverse staff and training related to diversity. The article concludes with policy and practice recommendations to reduce these disparities in access to mental health services for diverse populations of older adults.     

Learning from Mental Health Lived Experience and the Influence on Students’ Practice

This study explored how learning from mental health lived experience influenced Australian social work students’ practice during their first fieldwork placement. Involvement of mental health consumers in social work education is gaining momentum, yet little is known about how this type of learning informs students’ practice. Ten social work students participated in semistructured interviews and one focus group. Findings suggest that learning from lived experience promoted social work practice that honoured the expertise of mental health consumers and privileged personal recovery. Factors such as organisational culture and supervisor attitudes were found to mediate the students’ attempts to privilege lived experience.     

Managerial audit and community mental health: a study of rationalising practices in Finnish psychiatric outpatient clinics

In many European welfare states the reform of mental health services has been accompanied by the implementation of new forms of governance, including the introduction of managerial audit systems. While such systems have been developed for ‘good causes’, such as quality assurance, financial management and monitoring staff performance, they may simultaneously produce diverse and contradictory effects on practice. The aim of this article is to examine the role of one managerial audit system, introduced in psychiatric outpatient clinics in central Finland, and assess its impact on practice. Reference is made to modernising mental health policy in the UK as that has producedsimilar practics outcomes. The research was an empirical study of practice using a mixed-method case study design involving documentary research and semi-structured interviews. Insights from Mitchell Dean's notion of governmentalisation of government were utilised in the analysis. It was found that, although the audit system primarily served administrative needs, it began to reshape practice by reinforcing certain modes of working and excluding others. The analysis of community mental health work in Finland, with similar trends in the UK, highlights the connection between documentation, resource allocation and managerial priorities that reinforce particular styles of practice. In community mental health services it would appear that the problems of professional practice have become the problems of administration.     

Teaching Note—Meeting the Demand for Behavioral Health Clinicians: Innovative Training Through the GLOBE Project

ABSTRACT

The national move toward integrated mental health and substance abuse service delivery has a significant impact on social work education and necessitates changes in how we train students. To address this need, the Global Leaders of Behavioral Health Education (GLOBE) training project was developed. GLOBE is a student training and stipend program that prepares students for clinical behavioral health practice in integrated care. This teaching note describes GLOBE, reports challenges encountered in its implementation, and provides strategies for overcoming them. The challenges include assigning students to grant-compliant field placements, engaging other health care professionals in the educational efforts, and implementing curriculum changes. Suggestions for social work program administrators interested in integrated care training are provided.     

Passing a Mental Health Levy

ABSTRACT

The “devolution revolution” has decreased federal and state roles in the funding of social services and increased the burden on local sources, both public and private. This article describes how a community passed an initially unpopular property tax levy earmarked to support local drug, alcohol and mental health services. The article illustrates how social workers employing specific community practice knowledge provided leadership to the successful campaign. This example of community practice leadership includes building and maintaining coalitions, managing group tension and conflict and demonstrating fundamental social work values.     

Teaching Note—Integrating Prevention Content Into Clinical Social Work Practice Courses

Rapid changes in health care services and delivery suggest an upcoming paradigm shift in the field of mental health. Recent national reports, health care policy changes, and growing evidence support a shift toward prevention-focused mental health care. The social work profession is uniquely positioned to act as leaders in this shift as the profession’s values, goals, and hallmark practice approach are consistent with preventive care. Most social work students, however, do not receive training in prevention practice. The author’s development, implementation, and evaluation of a prevention-focused master of social work elective in the area of mental health is presented as an example of integrating prevention content into clinical social work practice courses. Implications for social work education are discussed.     

Should Dsm Be the Basis for Teaching Social Work Practice in Mental Health? Yes!

Abstract

Point/Counterpoint is a regular feature of the Journal of Social Work Education. Its purpose is to provide a vehicle for the expression of contrasting views on controversial topics in social work education. Our goal is to illuminate important debates and explore the diverse perspectives that are shaping social work education.

In each issue of the Journal several social work educators are invited to comment on a topic about which they have differing viewpoints. The commentators are given an opportunity to make a brief rebuttal. In this issue, Janet Williams (Professor, Columbia University College of Physicians and Surgeons), Robert Spitzer (Professor, Columbia University College of Physicians and Surgeons), Herb Kutchins (Professor, California State University, Sacramento), and Stuart Kirk (Professor, University of California, Los Angeles) address the question: Should DSM be the basis for teaching social work practice in mental health?     

Health Maintenance Organizations: Legislative and Training Implications

The Health Maintenance Organization Act of 1973 provides Americans with the opportunity to join prepaid group health plans. HMOs are not a panacea for the ills that beset our health delivery system but their emphasis on health maintenance and preventive interventions will provide new social work practice and student training opportunities. This article reviews and analyzes the major features of the HMO Act. Expanded roles for social work practitioners are discussed and suggestions are made for strengthening social work training programs in order to prepare social work professionals for practice in HMOs and in the health care field.