Social workers’ perspectives on the recovery-oriented mental health practice in Tshwane,South Africa

The challenge facing the mental health field today is the lack of knowledge related to interventions and services that will help people recover from severe mental health problems. In addition, the reluctance of social workers to embrace the recovery-oriented mental health practice is attributed to their lack of knowledge. Hence, they regard recovery in mental health as misleading and unrealistic.The article provides the findings on the social workers’ lack of knowledge and understanding of the recovery-oriented mental health practice. The social workers are based in non-governmental organizations in Tshwane, South Africa. Semi-structured interviews were conducted to gather data from social workers. Findings confirmed the lack of knowledge regarding the recovery-oriented approach, which has not yet been implemented in South Africa. Mental health services continue to be informed by the traditional medical model.     

Another face of health care disparity: stigma of mental illness

In many everyday situations, individuals with mental illness face stigma that leads to discrimination. A growing body of evidence suggests that those with mental illness experience disparities in health care and that their medical needs are often overlooked. The purpose of this article is to increase awareness to this problem. Fictional vignettes in which individuals with mental illness seek medical care are presented, followed by discussion on the role discrimination may play in the level of care these patients received. To help alleviate disparities, nurses are encouraged to advocate and speak out when they suspect discrimination is affecting the quality of care of those with mental illness.     

What Adolescents Can Tell Us: Technology and the Future of Social Work Education

The use and usefulness of Information Technology (IT) is rapidly growing around the world, especially among the youth. IT has been shown to impact learning styles, communication, and social relationships in many ways. Recently, significant discussion has arisen around the importance of IT in higher education and more specifically, social work education. This study qualitatively assesses 128 youth aged 13–14 years to understand their access to and use of IT as well as the way it impacts their psychosocial development to provide clues that will help inform the design of social work education for the future. Youth in four school districts reported unanimous access to computers and television and a majority of students used other technologies. Adolescents reported increased ease of communication and ability to get information as well as enhanced social relationships connected to their use of IT. Discussion and implications suggest that in the future, social work education will have to implement IT into its curriculum in order to attract students and provide the best possible learning environment for the next generation, which has included technology in every aspect of their lives.     

Teaching and Providing Recovery-oriented Care Through Problem-posing Dialogue

As the recovery paradigm proliferates throughout systems of mental health care, social workers are being required to provide recovery-oriented services. Yet there has been little discussion about what changes need to be made in social work education to produce recovery-oriented social workers. This article uses Paulo Freire's theory of pedagogy to help social work educators understand how they can develop problem-posing relationships with their students in order to teach students about the relationships that social workers ought to have with people in recovery.     

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.     

What is DIstinctive about Mediation? Experience and Expertise in Media

If great material resources and specialist technical knowledge are no longer required for individuals to act as mass communicators, what resources are required? This paper reviews social theories of production that can help to shed light on the matter. It explores the nature of knowledge required in the production of content meant for a mass audience, and the manner of its validation. The paper progressively conceptualizes mass communication or mediation in terms of ‘media experience and expertise.’ It begins by framing the discussion of media production in terms of mediation and symbolic/media power, and teasing out knowledge and competence as problems that merit special attention. It then draws on two parallel areas of scholarship to think through the blurring of formerly neat boundaries between interpersonal and mass communication; producer and audience; and expert and layperson. First, the renewed interest in the lived experience of professional producers that is spurred by media production ethnographers. Second, ongoing debates in Science and Technology Studies (STS) around knowledge production and public participation. The paper concludes with a discussion of outstanding issues with respect to media theory and proposals for future work.     

What mental health professionals in Israel know and think about adolescent problem gambling

Mental health professionals are well versed in addressing multiple adolescent risky behaviours and play a primary role in the identification of and referral process and service provision for young people who engage in such behaviours. Given their ‘person-in-environment’ approach, training in multi-sectoral collaboration, and awareness of social policies, social workers are especially equipped to provide needed mental health services to young people. The aim of the current study was to examine Israeli mental health professionals’ awareness of and attitudes towards adolescent high-risk behaviours, including gambling. Child psychologists, social workers and school counsellors (N = 273) completed an online survey addressing concerns related to high-risk behaviours. Findings revealed that social workers perceived gambling as being among one of the least concerning adolescent mental health issues and reported feeling the least confident in their abilities to provide services to young people with gambling problems. The results suggest the importance of youth gambling addictions being incorporated into social work training curricula.     

What Conferences Accomplish for Social Change Organizations

ABSTRACT

Conferences allow activists and their supporters to share information, seek out technical help and create supportive networks. At conferences, participants discuss the values that guide their work and by doing so agree on a shared meaning of their social change organizations. Conferences are focusing events that help create a social movement.     

Recovery Lessons Learned from Individuals with Psychiatric Disabilities

ABSTRACT

Over a long career in the public mental health system, the author has seen the progress in the service delivery that has given consumers more independence and ownership of their recovery. Until another breakthrough in brain science improves the outlook for prevention and treatment of brain disorders, the push to improve expectations with supports to manage their recovery needs to continue. The author describes Harbor City Services, Inc, a market-based social enterprise that creates jobs offering security against losing a job because of reappearing symptoms, including some jobs with the potential for growth beyond entry level. The growth of this business over 25 years shows the highs and lows of moving from public funding and charity to a self-supporting business. The author encourages the use of business strategies to improve the vocational opportunities that help sustain recovery and offers tips on employment and business.     

Jerk: A Tic-Inspired View of the Self-Determination Paradox in Our Mental Health System

Historically, the mental health field has been dominated by the medical model, placing the “patient” into the backseat of their own treatment. Sometimes this aspect of being controlled can be as hurtful as the out-of-control experience individuals with mental health conditions often face. In recent years, a number of people with mental health conditions have stepped up, showing not only that they can recover but also that they can lead the way in recovery-oriented mental health services. This article provides a commentary on this form of input that is rooted in the author's personal experiences with the system of care.     

The Power of Peer Support: The Development of the Empowerment Center

ABSTRACT

This article discusses the events and influences that led to the author’s contribution to the development of a mental health consumer-run organization, The Empowerment Center in Mount Vernon, NY. The author traces some events that influenced him personally and the evolution of the Empowerment Center from an organization that provided advocacy services (to those with mental health problems who were hospitalized) and community-based support services to people in mental health recovery, to an organization focusing on economic empowerment and economic development for the community of those in recovery. The transition of the Empowerment Center into an organization focused on economic empowerment underscores the importance of economic independence for people in recovery and the consumer-run organizations that support them. The Empowerment Center endeavors to demonstrate that mental health consumer-survivors can take control of their economic health as well as their physical and mental health.     

Symptoms of Mental Health Problems: Children’s and Adolescents’ Understandings and Implications for Gender Differences in Help Seeking

Amidst concerns that young people’s mental health is deteriorating, it is important to explore their understandings of symptoms of mental health problems and beliefs around help seeking. Drawing on focus group data from Scottish school pupils, we demonstrate how they understood symptoms of mental health problems and how their characterisations of these symptoms as ‘rare’ and ‘weird’ informed participants’ perceptions that peers, teachers and parents would respond to disclosure in stigmatising ways. Consequently, participants suggested that they would delay or avoid disclosing symptoms of mental health problems. We highlight subtle gender and age differences and outline implications for policy and practice.     

On Accepting Relationships between People with Mental Retardation and Non-disabled People: Towards an Understanding of Acceptance

This article outlines the “sociology of acceptance” as a theoretical framework for understanding relationships between people with mental retardation and typical people. As a point of departure, the authors review sociocultural perspectives on deviance and explore their contribution to the study of mental retardation. Based on qualitative research on community programs for people with severe disabilities, the authors next examine the nature of accepting relationships and describe four sentiments expressed by typical people who form relationships with people with mental retardation: family; religious commitment; humanitarian sentiments; and feelings of friendship. The article concludes with a brief discussion of the implications of a sociology of acceptance for the field of mental retardation.     

One hundred years of college mental health

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, "mental hygiene" was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

Stepping Down and Stepping In: Youth's Perspectives on Making the Transition from Residential Treatment to Treatment Foster Care

Older youth preparing to emancipate from the foster care system are often served in residential treatment settings where they have limited opportunities to practice skills for independent living in a community setting. Stepping these youth down to less restrictive environments such as treatment foster care is a growing trend, especially for youth with mental health issues. Yet, few studies have explored the youth's perspective on making this transition. This study utilized qualitative interviews with youths who were participating in a treatment foster care intervention study (n = 8) to gain their perspectives on the process of transitioning from residential care. Youths were interviewed right before they exited residential care and two months after placement in the new foster home. Youths reported hopes for gaining family in the new home as well as fears of placement disruption. Findings point to the need to enlist youths in discussion and problem solving about difficulties they anticipate in the new home and expectations for their relationship with the new foster parents. In addition, the struggles described after two months in the home point to the need for youths to build specific skills to better manage ongoing relationships with foster parents and for foster parent training on how to help build these skills.     

What do teenagers want? What do teenagers need?

It is widely accepted that adolescence is a developmental phase fraught with challenges, yet in the 1990s, teenagers face unique demands and difficulties. Dilemmas such as increased violence, drug and alcohol use, sexual involvement and AIDS pose problems not only for the teens themselves, but also for their families, teachers, health care providers and other caregivers.This article reports on the qualitative findings extracted from a study of over 3,700 teenagers from urban, suburban, and small city settings, describing the array of difficulties teenagers face today. The themes which emerged from the students' comments offer a compelling portrait of life as a teenager in the 1990s and help shape an agenda for understanding and responding to these myriad needsThis research was supported by grants from the Ohio Department of Mental Health (#93,1058A), Treu-Mart Fund, Nord Family Foundation, and the University at Albany Faculty Research Awards Program.     

Social Comparisons of Psychological Distress by Boarding House Residents: Self-Evaluations of Mental Health and Healthcare Need

Abstract

Boarding house residents (BHRs), like the wider homeless population, are multiply disadvantaged and have disproportionately high levels of mental ill-health. Social comparison processes that involve comparing one's mental health to others, may lead BHRs to minimize their mental health problems and needs. This cross-sectional study examined BHRs' evaluations of their psychological distress compared to three social reference groups and the significance of these to their felt need for help with distress. Fifty-seven, mostly male, BHRs in New South Wales participated in structured face-to-face interviews that included an objective measure of distress (K10). There was no evidence that psychological distress was underestimated due to social comparison processes. Objective distress produced the strongest prediction of participants' desire for help. Participants reported substantially higher distress than the Australian normative sample and 58% had clinically significant distress. Of these BHRs, 42% indicated that they did not want any help for their distress, which highlights the need for strategies to better engage this group.     

What We Talk About When We Talk About Taxes

Taxes are a preeminent issue in domestic politics, but the prevalence, content, and shape of public discussion on taxation is often perplexing to social researchers. We argue that part of the confusion arises from the lack of qualitative data on the meanings Americans associate with taxation. In order to remedy this lack we conducted semi‐structured interviews with white, Southern, small business owners. In answering our questions, our respondents constructed narratives that connected taxation with exploitation and a loss of personal freedom. We propose that everyday fiscal discourse is morally charged and interconnected with boundary work and a sense of group position. Further, qualitative research into tax talk can help make sense of the current political and social landscape (e.g., the continued cultural saliency of the Tea Party).     

The professionalization of psychiatric nursing. From doctors' handmaidens to empowered professionals

The professionalization of psychiatric nursing in the United States has been subject to political, economic, and theoretical influences, and prominent individuals such as Florence Nightingale and Hildegard Peplau have caused changes over time. Throughout history, professional and societal beliefs about mental illness have affected the nature of psychiatric nursing. In colonial times, people with mental illnesses were considered to be either possessed by demons or inferior and treated as animals. Today, psychobiological causes of mental illness are better understood, and treatment is aimed at adjusting disordered physiology and implementing psychosocial interventions. Care of people with mental illnesses has echoed this shift with increasing professionalization of psychiatric nurses. Attention to the lessons of history can help psychiatric nurses identify current societal influences, act on them according to their own vision, and further increase their professionalism.