Family Social Networks and Recovery From Severe Mental Illness of Clubhouse Members

This study examined the contribution of family social network variables to recovery among Clubhouse members. A random sample of 118 members from one Clubhouse was recruited for this cross-sectional study. Among all respondents, greater overall family support and better relationship quality with the most supportive network member were correlated with greater levels of recovery. Clubhouse members perceived higher quantity and quality of support and more criticalness from their most supportive network members, principally family members, compared to the rest of their family members. Longitudinal studies are needed to further investigate the relationship between family support and recovery.     

Differential Labeling of Mental Illness Revisited: Patterns Before and After the Rise of Managed Care

With the National Comorbidity Survey of the early 1990s, Thoits (2005) recently showed that lower-status mentally ill individuals were not more often hospitalized or pressured into psychiatric treatment than comparably ill persons of higher status, disconfirming a central hypothesis of labeling theory. However, that finding may have been due to changes in the mental health treatment system introduced by the spread of managed care. The differential labeling hypothesis is reexamined here with data from the Epidemiological Catchment Area Studies (ECA) collected in the early 1980s before managed-care plans began to dominate the insurance marketplace and from the National Comorbidity Survey Replication conducted in the early 2000s when managed care had saturated the market. Little systematic support for the differential labeling hypothesis was found in the three studies, although, over time, the higher rates of mental hospitalization among less educated and low-income individuals found in the ECA survey disappeared. Trends across the studies suggest that educated and affluent persons with psychiatric problems more frequently sought hospital care. These findings further undermine the validity of the differential labeling hypothesis and suggest that service utilization or treatment-seeking factors may help explain mental hospitalization rates.     

Evaluation,Accountability and Clinical Expertise in Managed Mental Health Care

In this article, the author identifies a number of policies and practices of managed mental health care organizations that, if allowed to continue unchecked, will have deleterious effects upon the American family. Since this industry is not regulated by either state or federal statutes, managed care organizations have had free reign to disallow coverage for a variety of DSM-III-R diagnostic categories and V-Code conditions. Some organizations severely limit the number of collateral contacts their therapists can schedule with clients' family members and others prohibit their therapists from working with more than one family member at any given time. The author also highlights the complex relationship that exists among insurance companies, managed care organizations, the medical profession and the pharmaceutical industry. He then offers some hypotheses about the nature of these relationships and the reasons for their existence. Finally, the author calls for social work to take an active role in bringing these issues to public awareness and suggests that social workers become advocates for the American family in this era of managed care.     

论我国当前加强和改善社会组织建设的关键环节

社会组织的发展及其功能的充分发挥对于我国社会主义和谐社会建设具有重要作用,应大力促进社会组织的发展。但我国社会组织发展还存在很多不足和问题,主要问题一方面是其内部资源能力不足,另一方面是其管理和监督机制不完善。为了促进社会组织的发展,应进一步厘清对社会组织的认识,转变对社会组织态度,并抓住重点大力推动社会组织的建设与发展。为此,从四个方面讨论了当前大力发展社会组织的意义,提出了应该从四个方面进一步转变对发展社会组织的态度和观念,在此基础上提出并论证了当前我国应如何在体制机制建设、能力建设和管理体系建设三个重要方面加强和改善社会组织建设。     

Perspectives on How Social Business Can Engender Work Identity Among People with Mental Illness

ABSTRACT

Social businesses use market strategies to advance the employment and economic situation of people with mental illness who have experienced high levels of social marginalization. They have the potential to achieve these goals by fostering the work identity of the workers within the business, and to themselves acquire an identity as a viable commercial entity that contributes to the prosperity and social fabric of the local community. This study used in-depth case study methods enhanced by comparisons with international social businesses to understand the processes by which social businesses influence work identity. Six business processes that are salient to the development of a strong work identity were identified. Eight propositions for how work identity can be supported by social businesses are offered. The propositions may be useful as a guide for the development of social businesses that are organized and implemented to positively develop work identity, regardless of the nature of the business model.     

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.     

Socioeconomic Status and Mental Illness in Japan*

Abstract Since the pioneering work of Faris and Dunham (1938), a number of studies in the United States have documented an inverse association between socioeconomic status (SES) and mental illness both at the aggregate and the individual levels, and both for the treated and the general population. However, there are few studies of whether this relationship holds in other countries. This study examines socioeconomic characteristics and mental illness in Japan, which has a very different social stratification system from that of the United States. It was found that, at the aggregate level, the “inverse” association between socioeconomic characteristics and the rate of treated mental illness does not hold in Japan. Instead, the relationship is curvilinear: mental illness is higher in districts with large numbers of blue collar and upper white collar workers than in districts with large numbers of lower white collar workers. The effect of SES on mental illness operates through economic stress embedded in the macro social context. Because different social structures lead to different patterns of economic stress, the inverse relationship between socioeconomic status and mental health cannot be assumed to hold in all countries.     

The Social Construction of Social Work Ethics: Politicizing and Broadening the Lens

Structural barriers and the intrinsic paradoxes of practice often lead to a discrepancy between what a social worker would like to do and what that individual actually implements, resulting in ethical tensions. However, the canonical approach to ethics has had a narrow perspective on what constitutes ethics and has tended to treat these issues as peripheral rather than central to the social construction of ethics. This essay provides an explanation of how the construction of ethics evolved and what interests are served by this viewpoint, thereby illuminating the political ramifications of the current social construction. The author suggests ways to broaden the lens of focus.     

Caring for Persons with Serious Mental Illness

Abstract

This article places evidenced-based knowledge of practice within the social context of care and proposes five policy objectives and specific policy and program changes to address care needs of people with serious mental illness. In spite of demonstration programs that provide the basis for proposed policy initiatives throughout the United States, treatment provision for this population remains inadequate and their safety and well-being continues to be at risk. The authors suggest that treatment initiatives need to be tied to stable policies protecting the mentally ill from adverse social context changes. The authors conclude that policies are needed that will enhance housing assistance, independent social functioning, personal empowerment, and treatment engagement. In addition, efforts are needed to make better use of inpatient hospital care, to better understand the role of assisted treatment, and to better develop consistent long-term fiscal support for the seriously mentally ill. They offer specific policy recommendations for changes in HUD programs, Medicaid and Medicare funding, and treatment programming that address these needs.     

Protection and Advocacy for Individuals with Mental Illness Act

Abstract

This study explored the perceptions of one state's policy stakeholders toward the implementation of the Protection and Advocacy for Individuals with Mental Illness Act (PAIMI Act). This congressional act established state programs authorized to investigate abuse, neglect, and civil rights violations against individuals with mental illness in residential facilities. A qualitative case study approach was selected to study the perceptions of the impact of this law. Participants were chosen using a maximum variation sampling of four diverse stakeholder groups. In-depth interview responses were developed into a series of proposed assertions regarding the impact of the PAIMI Act.     

The Social Construction of Marital Commitment

This paper articulates a theoretical framework for understanding how individuals orient themselves toward marital commitment. Using a life history interview methodology and interpretive framework, it examines the orientations toward marital commitment for a sample of women and men, single and married, between the ages of 28 and 35 (N = 75). Specifically, it elaborates a multidimensional view of marital commitment with attention to two multifaceted components, one value rational and the other practical. Borrowing concepts from exchange and identity models of commitment, it analyzes interpretive processes involved in their construction. Some preliminary comments on the role social position plays in shaping constructions of marital commitment are articulated and the implications of this model discussed.     

A Psychosocial View of Mental Illness: An Introduction

Abstract

Bullying presents a significant social distress for students, families and schools. Concerned practitioners and researchers are invested in developing interventions to decrease the frequency and negative impact of bullying. To do so, however, understanding the cast of characters in the bullying drama is critical. This paper reviews selected research on characteristics of bullies, victims and bystanders from a variety of theoretical and methodological approaches. The implications of these characteristics for effective interventions is considered. The role of socio-economic factors is presented, and their relevance for communities and policy makers discussed.     

Kinship Care for Children of a Parent With a Mental Illness

Little is known about “hidden” kinship caregivers of children of a parent with a mental illness (COPMI). An exploratory study surveyed 56 COPMI caregiver members of a kinship center administered by a school of social work in a large public university. The COPMI sample was a subset of a larger kinship caregiver study. Nearly one in four caregivers was providing COPMI kinship care. The COPMI caregivers reported numerous child behavioral crises and decreased caregiver physical and emotional health since they began providing care. Practice, policy, and research require development to increase support for COPMI caregivers and their families.     

Social Enterprise in Mental Health: An Overview

ABSTRACT

This article provides an overview of the models and concepts of social enterprise utilized for and by people with serious mental illness histories. Although social enterprise in mental health is not new, the naming of it as social enterprise and the attention these efforts have garnered is new. This article will provide a brief history of social enterprise in formal social services; review some conceptual issues and differences between social enterprise in Europe and North America—the two major current centers of its activity; and conclude with some observations of the ways in which mental health social enterprises are developing.     

Social Networks,Substance Use,and Mental Health in College Students

Abstract

Objectives: The relationship between social network risk (alcohol-using close friends), perceived peer closeness, substance use, and psychiatric symptoms was examined to identify risk and protective features of college students’ social context. Participants: Six hundred and seventy undergraduate students enrolled in a large southeastern university. Methods: An online survey was administered to consenting students. Results: Students with risky networks were at a 10-fold increase of hazardous drinking, 6-fold increase for weekly marijuana use, and 3-fold increase for weekly tobacco use. College students’ who feel very close to their peers were protected against psychiatric symptoms yet were at increased risk for marijuana use. Perceived closeness of peers was highly protective against psychiatric symptoms, adding a natural preventive effect for a population at great risk for mental illness. Conclusions: Results support targeting college students through network-oriented preventive interventions to address substance use as well as mental health.     

Recovery,Managed Care,and the Reflective Practitioner

ABSTRACT

Conflicting priorities between the recovery movement among consumers of mental health services and managed behavioral health care planners result in turbulence and ambiguity in the service delivery system. Based upon information from both published and unpublished written sources, areas of strain are described. The utility of a reflective practice model, as conceptualized by Schon (1983), for addressing a recovery vision within a managed care environment is explored.     

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.     

Mental Illness in Assisted Living: Challenges for Quality of Life and Care

ABSTRACT

An unknown number of mentally ill elders in the United States receive care in assisted living, along with persons facing physical or cognitive challenges. While dementia is familiar in assisted living, our data indicate that neither staff nor residents are prepared to work or live with the mentally ill. Challenges are created for professionals, since these residents bring diverse needs. Daily interresident interactions are also disrupted or stressful. Qualitative data describe the impacts on quality of resident life as well as care and management dilemmas identified within five assisted-living settings having varying presence of mental illness among residents.