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 Need for Web-Based Cognitive Behavior Therapy Among University Students

ABSTRACT

This study investigates students' need for a web-based cognitive-behavior therapy (CBT) intervention program for preventing depression, the mental health status of those who felt a need for such a program, and underlying factors of the intention to use web-based self-help. A conceptual model for explaining intention to use web-based self-help is proposed. Nearly half of the participants reported a need for help with psychological problems, but only a third of these actually sought help from traditional mental health services. In conclusion, there is a need for web-based self-help, and web-based CBT has the potential to attract a group of students who, so far, have not been reached by traditional mental health services.     

Theoretical and Practical Imperatives for Reflective Social Work Organizations in Health and Mental Health

Summary

This article describes the common challenges to health and mental health organizations that require these agencies to become more “reflective” in their culture and structures. This necessitates integrating practice and research at all organizational levels. Schon's concept of reflective practice to health and mental health organizations is extended to develop the construct of a reflective organization, in which direct practitioners are integral to organizational learning through ongoing service evaluation and redesign. The theoretical and practical reasons why social work administrators and clinicians alike are obliged to integrate practice and research are discussed. University-based models of practice-research integration impede this process; Epstein's Practice-Based Research approach facilitates it.     

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.

     

What Do Social Workers Need to Know About Mental Health Courts?

Abstract

Mental health courts are an emerging strategy to engage mentally ill offenders in treatment and to avoid unnecessary incarceration. These courts began in 1997 based upon the drug court model; there are currently over 70 courts nationwide. These courts are heterogeneous in structure, work with interdisciplinary teams, and seek to engage the consumer in treatment rather than use judicial sanctions. Social workers are integral members of these teams; yet, no research has been published in social work journals on mental health courts. This article explains the background and context of the courts, describes their features, discusses what social workers need to know about mental health courts, and concludes with ideas for how social workers may work effectively with mental health courts.     

Translating knowledge into practice: using simulation to enhance mental health competence through social work education

ABSTRACT

Simulation-based learning (SBL) is an innovative experiential teaching method where students and instructors interact with a simulated client to foster students’ holistic competence in practice. Considering the context of North America where social workers are the largest service provider in the field of mental health, it is critical for educators to enhance competencies in students during the social work program. Guided by competency- and simulation-based, adult learning frameworks, this paper illustrates the development and integration of a range of educational activities into a treatment-focused advanced mental health course in the social work curriculum. We conclude by discussing how SBL enhances students’ mental health competence and provide recommendations when developing SBL in the mental health curriculum in social work education.     

An interprofessional internship model for training master’s level social work and counseling students in higher education settings

ABSTRACT

The mental health needs of college students are steadily on the rise, which compels mental health service providers and educators to explore innovative ways to provide more collaborative, supportive, and interdisciplinary service models of practice and professional training. Graduate programs in social work and counseling are at the crux of producing internship training programs to help accommodate the influx of students with persistent mental health concerns across a variety of needs and cultures. This article describes an interprofessional internship program structured and designed to meet the clinical training needs of master’s level students matriculating in social work and counseling who aspire to provide mental health services in higher education settings. The interprofessional internship training model proposes an innovative interdisciplinary approach to field education which may result in positive training outcomes and learning experiences for social work and counseling students. This paper discusses the model’s emphasis on individual and interdisciplinary group supervision, objectives of the internship experience, internship site criteria, and professional and personal benefits to pre-service social workers and counselors. Recommendations for training and limitations of the model are provided.     

A journey of embedding mental health lived experience in social work education

Abstract

The value of learning from mental health lived experience is widely acknowledged, however, the nature of lived experience involvement in Australian social work education seldom extends beyond guest lecturing. Further, few opportunities exist that build the capacity of people with lived experience to become educators within tertiary settings. In this paper we present the Valuing Lived Experience Project (VLEP), an initiative led by a Lived Experience Academic (LEA) that seeks to systematically and meaningfully embed lived experience into the social work curriculum at a Western Australian university by providing significant opportunities for the capacity building of both individuals with mental health lived experience and academics. Given the relative infancy of service user involvement in Australian social work education, the VLEP offers a number of opportunities for reflection and consideration. A long-standing partnership between a LEA and Social Work Academic is described, the activities and key learnings of the VLEP to date are outlined, and we offer our reflections on challenges encountered throughout the journey. We hope that our experiences and learnings can be drawn upon to progress lived experience participation in tertiary settings and further legitimise lived experience involvement in the education of social workers.     

Wo'Lakol Kiciyapi

ABSTRACT

This pilot study hypothesized that the ancient traditions of help and healing among traditional Lakota people represent an alternative or complementary model for understanding a distinctive approach to American social work theory and practice which includes “shamanic” or spirit healing as a constituent part of the help and healing process. Thirty-two individuals, Including traditional Lakota elders, educators, leaders, and mental health providers, were interviewed about their views on traditional ideas of help and healing and about social work and social service practices. The findings show that there were distinctive approaches to ensure social health and well-being among pre-reservation Lakota peoples, and that the traditions of help and healing are intimately linked to the “natural law” and to the ceremonial life of the tribe. The findings show a resurgence of traditional healing practices among the Lakota with important implications for Social Work theory and practice.     

Culturally responsive social work practice with D/deaf clients

ABSTRACT

D/deaf individuals are often marginalized in our society. A lack of cultural understanding among social workers serving this population, coupled with communication barriers, inconsistent access to interpreters, or misperceptions of culture, adds to the potential for further marginalization. D/deaf individuals seeking mental health and social services live in a unique cultural context with which social workers may not be familiar and experience persistent issues surrounding access to mental health and social services. This article reviews some useful best practices, cultural points to be aware of, and suggests some strategies for providing culturally responsive social work when working D/deaf clients.     

Outcomes Measurement

SUMMARY

Outcomes measurement in health and mental health should be of vital concern to social workers since public support and financing will follow evidence of effectiveness. Social work in health and mental health requires a framework for conceptualizing outcomes measurement so that the profession can focus clearly on the work to be done in outcomes measurement. This framework should distinguish among the various ways that outcomes measurement can be used to advance policy, program and practice. This article discusses two applications of outcomes measurement, namely for improving policies and programs, and, second, for conducting outcomes research. Other dimensions that could be included in an outcomes measurement framework for social work in health and mental health are identified but not elaborated. The author's objective is to make a strong case for the role that outcomes measurement can play in both the improvement of social work policies and programs in health care, through performance measurement, as well as in advancing the healthcare knowledge base, through outcomes research.     

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.     

Reflective practice in a process for the re-approval of ASWs: An exploration of some inevitable resistance

In this article a mental health trainer and a group facilitator explore the background to developing a new protocol to manage the re-approval of mental health social workers in an inner London borough. The new procedure involved social workers attending a series of small group sessions in which they were invited to present and reflect on their work with clients. The dynamics of these sessions and particularly some of the transferential material between group members and facilitator are explored here. The significance for mental health social work, post-qualifying learning and the possibilities of reflective practice is considered.     

Social Inclusion as an Agenda for Mental Health Social Work

Summary

Following New Labour's election to office in the UK in 1997, policy initiatives have proliferated relating to mental health. Much of this policy innovation emphasises the social dimensions of mental health and distress, with an emphasis on employment and social inclusion. Paradoxically, this modernization of the mental health agenda comes at a time when mental health social work is struggling to establish its role and contribution within recently integrated health and social services. The paper considers whether New Labour's flagship programme, Mental Health and Social Exclusion, constitutes a “New Deal” for mental health, and whether it provides a perspective that will help mental health social work to define its distinctive contribution to integrated services.     

Facilitating the Welfare-to-Work Transition for Women with a Mental Health Work Barrier

SUMMARY

Since the 1996 PRWORA welfare reform act requiring workforce participation in order to receive services, evidence has emerged that many welfare recipients experience mental health work barriers. Yet, little is known about effective approaches for assisting women with a mental health work barrier in the welfare-to-work transition. This paper addresses this gap by first surveying the empirical research on mental health work barriers among welfare recipients. Second, I propose a comprehensive service provision model to identify and assist welfare recipients with a mental health barrier. Third, I review outcome data from several promising intervention strategies.     

Triage and Ethics: Social Workers on the Front Line

ABSTRACT

This article highlights the results of an international qualitative study examining the impact of terrorism and other disasters—both human-made and natural—on social work agencies and their labor force. The study was conducted with focus groups of social workers in health care and social service settings. The major research question concerned the impact of disaster—both natural and human-made—on agencies and social work practitioners. Focus was placed on the ethical dissonance experienced by social workers under pressure to prioritize how services and resources are distributed to those in need.     

Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.     

Medicare Funded Mental Health Social Work: Better Access to What?

ABSTRACT

Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Scheme initiative (Better Access), is an Australian Federal Government scheme aiming to improve access to mental health services. Accredited mental health social workers have been involved in the delivery of services under Better Access for more than a decade. In this time, there have been significant changes in the field of mental health services, with consequent increases in size and costs for Better Access. Better Access now represents public spending of more than one billion dollars per annum, yet there is no ongoing account of its impact. In this paper we consider the policy chronology and evaluation of the program, using current available data to question the impact of Better Access on both the service system and the nature of mental health social work practice. This case highlights the importance of a clear articulation of the scope of mental health social work, and ongoing monitoring of the impact of policy in a policy environment increasingly characterised by individualised funding and service delivery structured according to the principles of New Public Management.

IMPLICATIONS

• Social workers' increasing involvement with Better Access has reshaped the scope of mental health social work practice.

• The impact of Better Access on outcomes for service users and mental health social work is not currently a focus of research attention.

• Better Access is a case study illustrating the potential of the policy context to directly shape social work practice, therefore critical engagement with the impact of Better Access is an essential professional imperative.