Navigating stormy waters: Challenges and opportunities for social work in mental health

The reforms driven by the National Mental Health Strategy have created both opportunities and challenges for social work as a profession. This paper examines the rapidly changing context for practice in mental health, including policy change, and developments in the education and training of the mental health workforce. Key practice issues identified for social work include: (i) the need to establish a viable paradigm for practice; (ii) a more positive response to the challenge of evidence-based practice models; (iii) a national agenda for education and training; and (iv) the importance of working collaboratively with consumers and families in a way that values their human rights and the lived experience of mental illness.     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.     

Combat Social Work During the Surge in Iraq

The military has long recognized the short-term psychiatric effects of war upon soldiers, a significant factor for combat operational readiness and strength (NATO, 2008). Currently referred to as combat stress reaction or combat operational stress reaction (COSR), the condition has debilitating, immediate effects as well as long-term consequences for soldiers and military units. For the wars in Iraq and Afghanistan, commanders expected psychiatric casualties rates equaling physical ones, stemming from the intensity and duration of these conflicts, nonlinear nature of the battlefields, unit morale, and soldier experiences and preparedness. For these recent wars, the concept of behavioral health, combat stress, and its military importance has dramatically changed, as have the protocols dictating the delivery of preventive and restorative combat behavioral health care. This article outlines the conceptual foundation of modern combat stress control, protocols, and the efforts of one social worker–led combat stress prevention team, forward deployed to a small base in a volatile area of Baghdad during the height of the surge in 2006–2007.     

Shared decision making from the service users’ perspective: A narrative study from community mental health centers in northern Norway

This article aims to contribute to the understanding of shared decision making as an important aspect of user involvement in mental health care from the perspectives of service users. A thematic analysis of interviews with 25 individual service users in three different community mental health centers in Norway identified different understandings of shared decision making. Shared decision making was identified as essential in four contexts: 1) during admission, 2) in individualized treatment, 3) in different treatment contexts, and 4) in user-professional relationships. We consider shared decision making to be intertwined with treatment from the service user perspective.     

Collaborative care for individuals with bipolar disorder or schizophrenia and co-occurring physical health conditions: A systematic review

While rates of chronic physical health conditions are increasing for the general population, individuals with severe mental illness are at greater risk. Co-occurring mental and physical health conditions are associated with poor health care utilization, socioeconomic, and patient-reported health status outcomes. This study used systematic review procedures to investigate the effectiveness of collaborative care models for improving the health of adults with bipolar disorder or schizophrenia and co-occurring chronic physical health conditions. Six studies met inclusion criteria, and included outcomes related to quality of life, physical health, and mental health. Collective and study-level results are reported and discussed, including implications for social work practice and research.     

Concept of ‘personality disorder’ and its relationship to social work

Abstract

Inherently difficult to define and apply in a valid and reliable way, the concept of ‘personality disorder’ is, nonetheless, a very important psychological construct in the assessment and treatment of clients. This paper discusses the nature and limitations of personality disorder diagnoses. It also refers to data suggesting a paucity of formal training and research on personality disorders, and mental health in general, within Australian social work. The authors call for greater research, analysis and debate by social work educators and the profession on these issues.     

Mental health practitioners’ strategies in equine-assisted psychotherapy: implications for social work

Equine-assisted psychotherapy (EAP), in this study, which included a mental health practitioner, an equine specialist, at least one horse, and a client in therapy sessions, is emerging in social work practice, education, and research. The purpose of this paper was to explore experienced EAP mental health practitioners’ cognitive activities and strategies to inform the social work profession.

Utilizing a constructive narrative approach, eight experienced EAP mental health practitioners participated. Two semi-structured, face-to face, individual interviews were used to gain their perspectives. Qualitative software assisted thematic analysis. The findings included a main theme identified as participants’ concrete strategies used in EAP with two subthemes. The second main theme identified abstract strategies with six subthemes.

EAP provides a holistic framework as social workers incorporate horses and natural environments in practice, which is consistent with systems theory. The findings inform experienced mental health practitioners to be effective therapists and educators, as well as to instill confidence in novices. Recommendations for the application of the findings in social work practice, education, and research are explained.     

Reflecting on partdime private practice: Is it worth it?

Abstract

Gradual, but not so subtle, changes in Australia's political and welfare cultures have meant that over the past I0 years social workers have been showing a greater interest in private practice as a legitimate aspect of the profession. This paper presents some of the major practical considerations required for a part-time practice to be successfully initiated and maintained. The author uses her own experience as an example and explores the personal, professional and commercial decisions she has made in such a practice over the past 16 years.     

The Impact of Social Capital on Men's Mental Health from the Perspective of Social Support Theory

This study examines the effects of social capital as it affects men's mental health in the context of work–family balance. Multivariate analyses of data from National Family Research of Japan 2008 have revealed the following. First, the social capital that men receive from their spouses was found to have a direct effect on their distress. The effect of social capital from family other than a spouse does not have a direct effect on men's mental health. Second, only social capital from a spouse was observed to provide a buffering effect. This result implies that, in contemporary Japan, social capital derived from the spouse functions satisfactorily as a bulwark to mitigate the negative effects that the experience of role conflict between work and family has on men's mental health. Finally, the study examines the effect of social capital with reference to social support theory. Subsequent research might usefully focus on varieties of social capital other than those covered in the current study, which will leverage the unique potential of social capital by examining techniques and units of analysis.     

An investigation of mental health and personality in Swedish social work students upon entry to university training

The aims were to describe Swedish social work students' personality characteristics upon entry to their training and to analyze relationships between personality traits, mental health, and some sociodemographic variables. One hundred and twenty-one female social work students completed a sociodemographic form, the Temperament and Character Inventory, and the Symptom Checklist. They scored significantly higher on harm avoidance, reward dependence, and self-transcendence and reported more somatization, obsessive compulsive, and phobic-anxious symptoms, and less hostility, than Swedish individuals from the general population of the same age. Personality traits significantly predicted the various mental symptom scores. It is recommended to implement modules or training courses within social work training in Sweden that bring an improvement of self-directedness and cooperativeness character trait into focus.     

Consensus or contention: an exploration of multidisciplinary team functioning in an Irish mental health context

Multidisciplinary teams (MDTs) are conventionally recommended in mental health care literature as an important way to offer holistic treatment provision to patients. This study aims to explore multidisciplinary teamwork in contemporary mental health settings, particularly what aids and hinders the process of multidisciplinary teamworking, and the social work contribution in such teams. In order to attain an in-depth exploration of these phenomena, a single case study design was employed. Within this design, data were generated through semi-structured interviews and structured observation of a mental health MDT in Ireland. These data were analysed using interpretative phenomenological analysis. The research highlights how the concept of mental illness is contested within this MDT, with the medical model dominant within an environment of fluid working arrangements. Professional role blurring and stereotyping were found to impact the division of labour on this team, with role negotiation found to be an integral part of retaining a professional's practice identity. This research raises concerns for social work's capacity to function within mental health MDTs in Ireland, and highlights ways in which social work educators might respond in order to empower Irish social workers to meet the challenges of mental health multidisciplinary teamworking.     

The utility of the DSM-5 Z-codes for clinical social work diagnosis

ABSTRACT

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard reference text used by social workers for diagnosing mental disorders. The social work profession has always had an uneasy relationship with the DSM, but for 33 years there was an opportunity to note a client’s psychosocial stressors on Axis IV. With the publication of the DSM-5, however, the multiaxial diagnostic system was abandoned, and many social workers are concerned that this change limits their ability to provide comprehensive diagnoses. The purpose of this article is to consider an expanded use of Z-codes as one way to continue including social work’s psychosocial perspective on human functioning in the diagnostic process.     

Community orientation of services for persons with a psychiatric disability. Comparison between Estonia,Hungary and the Netherlands

This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the Netherlands) confirms the findings of other studies that – regardless of geographical location – people with a psychiatric disability have difficulty fulfilling social roles in the community. They are often faced with fewer opportunities than other citizens, due to their health problems, stigma, discrimination and poverty [World Health Organisation. (2011). World report on disability. Geneva: WHO]. An important objective of social work is to help people find their way in society. Surprisingly enough, in all three countries, most social workers are mainly focused on solving individual problems, and not on community participation. Shifting the focus starts by having a clear awareness of the notion of community participation. Social workers have to work both on supporting individuals to find their way in the community (individual support), and on supporting social networks in the community to accommodate persons with a disability on the basis of equal and valued citizenship (community support).     

Young people and social networking sites: exploring the views and training opportunities of CAMHS social workers in Ireland

ABSTRACT

Social Networking Sites (SNS) (e.g. Facebook, Instagram) have become a fundamental part of the daily lives of many young people. SNS engagement has been associated with a number of risks and benefits, some of which are particularly relevant to young people who access child and adolescent mental health services (CAMHS). Consequently, understanding how and why young people engage with SNS, and the associated risks and benefits, may become an increasingly important part of CAMHS social work.

This small-scale study (n = 15) utilised an online survey to explore the importance that a sample of Irish CAMHS social workers attribute to maintaining an awareness of how young people use SNS, whether they, in their professional lives, have been offered the opportunity to learn about SNS engagement among young people, and whether they have taken it upon themselves to learn about this topic.

Findings suggest that participants consider an understanding of SNS to be an important part of CAMHS practice. However, participants report that they do not feel sufficiently aware of SNS trends among young people, suggesting that there is scope for SNS-focused training/learning opportunities among this sample of CAMHS social workers. Implications for practice and suggestions for future research are outlined.     

Practice experience and social work education

Abstract

This paper examines the arguments that are often put in favour of social work academics having direct practice experience in order to enhance their teaching effectiveness. The paper looks at the number of ways that social work academics can gain up to date knowledge of practice developments and explores what constitutes an effective teacher. It concludes that recent direct practice experience will be of limited use in assisting social work academics to become effective teachers and that there are other ways that academics can become aware of practice developments that are in line with the other professional requirements on academics such as research and knowledge generation.     

Introduction: Safe Passage

Adolescence is a period fraught with developmental challenges for all individuals. Those encountered by gay, lesbian, bisexual, and other sexual minority youth are particularity difficult. The Knowledge that they are “different” show how, although not yet necessarily full aware of how they are different, leaves many isolated and unable to work thought some typical developmental issues having to do with establishing romantic relationships and learning diverse social skills. Such teens may develop a host of coping mechanisms to ease the dissonance experienced when their forming identities are in conflict with peer, parental or, more broadly, societal expectation.