Examining Direct Service Worker Turnover in Three Long-Term Care Industries in Ohio

This is the first study to examine direct service worker turnover and its predictors across three provider types: nursing homes, home health agencies, and providers of services for the developmentally disabled. Stratified random sampling procedures were used to select provider types across five geographic regions in Ohio. Data were collected from administrative staff. Findings indicated that annual direct service worker turnover did not significantly vary by provider type (mean = 33%). Predictors of turnover related to job burnout, negative social support, and region. Policymakers can promote practices to lower direct service worker turnover such as addressing burnout and increasing support.     

Devils and deep blue seas: the social worker in-between

This paper examines the role of the approved social worker, as defined by s.114 of the Mental Health Act 1983, with particular regard to ethical dilemmas in crisis intervention. Issues of management accountability, health and safety are set against the approved social worker's statutory responsibility to assess people experiencing mental health problems and, where necessary, admit to psychiatric hospital under compulsion. Consideration is given to the impact of this work upon the worker, on whom extreme and sometimes conflicting demands are made. An attempt is made to integrate these viewpoints within a fundamentally psychodynamic perspective.     

A case for psychodynamic social work

Abstract

Psychodynamic casework is not as popular in social work theory and practice as it once was. It is considered by some to be impractical, unscientific, and not suitable for those customarily receiving a social work service. Task-centred casework, behavioural approaches, the newer psychotherapies, and family therapy have all taken over as major paradigms of social work method. This is especially so, I think, for the social worker working in a psychiatric setting, where many clients stay only for a short time and where emphasis is placed on assessment and short-term intervention.

In this paper I shall argue that a psychodynamic approach in social work is still relevant; that it is important for its humanizing qualities, for understanding and working with people with severe problems and for, perhaps, helping us to locate the position of social work vis-a-vis other mental health professions. I shall do this by focusing on a particular case I had as a social work student on placement in a psychiatric day hospital.     

A review of the empirical status of tranditional modes of interpersonal helping: Implications for social work practice

The empirical status of traditional modes of interpersonal helping are reviewed in terms of client deterioration, spontaneous remission, and immediate and long-term effects. Necessary therapeutic conditions for client change, such as genuineness, nonpossessive warmth, and accurate empathic understanding, are discussed. Variables contributing to the ineffectiveness of traditional modes of interpersonal helping are elaborated in terms of the following: the medical model of mental disease, behavior as symptoms, diagnosis and treatment, labeling and stigmatization, the training of clinical social workers, conflict models of human behavior, academic achievement and fieldwork practice, criteria for the selection of theories of human behavior and induced change, and the relationship between academic performance and effectiveness in the field of clinical practice. The rationale is presented for a new type of social worker, the behavioral social worker, whose profile is reviewed in terms of knowledge base, behavioral skills, and value base.     

Psychiatry in the age of neuroscience: the impact on clinical practice and lives of patients

Due to the progress being made in the neurosciences, higher expectations for the use of medication, even against the patient’s will, are arising in mental hospitals. In this article, we will discuss whether the neurosciences and new psychopharmacological solutions really support patients who suffer from mental illnesses. To answer this question, we will focus on the perspective of patients and their experiences with psychiatric (coercive) treatments. The analysis of one person’s story shows that other issues besides appropriate medication are important for recovery from a mental illness. In daily life, issues such as coping, rehabilitation and social support are of major importance for a patient suffering from psychiatric disease. Thus, although progress in the neurosciences is a positive development for clinical practice, it does not mean that (coercive) medication alone will carry a patient into recovery. A patient’s recovery is dependent, not only upon the process of finding the appropriate medication and trust between the psychiatrist and the patient, but also upon relational aspects, such as being recognised as a person, belonging, accepting responsibilities, developing friendships and trusting others. These findings lead to the conclusion that dealing with psychiatric diseases is more complex than what the biomedical model of neuroscience suggests and that one should include the social context of the patient in the recovery process.     

Well‐being among adolescent boys

Most studies on mental health in the adult population have found a significant relationship between mental health and social class. No study has thoroughly examined this relationship in the adolescent population. This article, based on the Bachman, O'Malley, and Johnston “Youth in Transition” data set, tests the social class/mental state relationship among adolescents. Three separate measures—well‐being, psychiatric symptoms, and depression—are used to indicate mental state. Social class is based on a composite measure of socioeconomic level that exists within the “Youth in Transition” data set. Surprisingly, no relationship was found. These results persisted even when more traditional measures of social class based on parents’ education and the Duncan ranking of the fathers’ occupations were substituted for socioeconomic level. An alternative explanation supporting social stress is discussed in light of Thornberry's developmental hypothesis.     

RELEASING POTENTIAL — THE FUTURE OF SOCIAL WORK AND CAMHS

Several recent UK government initiatives are set to have an impact on child and adolescent mental health services. As a result new primary mental health worker and similar posts are being established. These jobs are proving attractive to social workers seeking to develop their special interest in child and adolescent mental health. This article sets out some of the problems and prospects for social workers undertaking them seeking to develop a modern psycho‐social practice using psychodynamic skills.     

The Social Process Behind Inequalities in Children's Mental Health: Incorporating an Illness Career Framework

More advantaged children (both in terms of social class and racial/ethnic membership) appear protected from symptoms of mental health problem, but a pattern has emerged in which these children who tend to have better mental health are more likely to be diagnosed with certain mental health disorders. These patterns have led some researchers and professionals to wonder if the qualifications for diagnosis are culturally biased or might unfairly favor the mental health needs of more advantaged individuals in society. Evidence that White and middle‐class children are more likely to be diagnosed with certain mental health disorders raises important and legitimate concerns about the mental health profession, but this problem of social advantage leading to mental health diagnosis has often overlooked the role of social process in how children become diagnosed. Mental health diagnoses represent the culmination of a process that involves several stages and requires initiation and (often times) persistence on the part of the individual being diagnosed. This idea of process has previously been referred to as the “illness career,” and applying this logic to the study of children opens the door for renewed inquiry into understanding who is and who is not diagnosed with a mental health problem.     

Ergonomics of bridge employment

In many countries of the world, retirement is mandatory at the age at which persons who hold certain jobs or offices are required by employment law to leave their employment, or retire (60 to 65 years). Typically, this is justified by the argument that certain occupations are either too dangerous or require high levels of physical skills and mental work. Every worker has to leave the workforce at that age. However, starting from the last two decades of the last century, it is observed that retirees live more years in retirement than ever before. This relatively long retirement as well as retirees' body fitness made many of them engage in new jobs which are either similar to their career jobs, or completely different from them. In this new type of employment which is called "bridge employment', the retired worker may spend more than ten years. But, to what extent these new jobs are fitted to the aged worker? Considering that experiencing any type of event increases the risk of worse health outcomes over time, bridge employment should be ergonomically designed if it is to fit the aged worker characteristics (physical, mental and affective).     

Experience in developing a Transitional Employment Program (TEP) for the psychiatric patients in an acute general hospital in Hong Kong

This paper describes the application of a transitional employment program (TEP) for psychiatric patients in Hong Kong. The TEP and its values in psychiatric rehabilitation are introduced. The differences between TEP and Supported Employment (SE) were also highlighted. A TEP for psychiatric patients in an acute general hospital is outlined. Interviews of employer and trainees showed that, apart from increasing income, qualitative changes in the trainees were observed such as increased self-confidence, improved assertive and social skills, and increased work tolerance. Ongoing objective measurement should be conducted to demonstrate its effectiveness. TEP could be considered as a feasible alternative of vocational rehabilitation for patients with mental illness.     

A case study

The relationship between social isolation and mental illness has given rise to several hypotheses, particularly those of the “drift” and “breeder” type. The present study is concerned with the relationship between separation from family and admission to a psychiatric hospital, and explores some aspects (area of admission, type of accommodation, readmission, diagnosis and age) of this relationship. Some implications for preventive planning are drawn from the findings.     

Translating collaborative models of mental health care for older adults: using Iowa's experience to inform national efforts

The Patient Protection and Affordable Care Act supports the translation of collaborative models of mental health care, but how the act will affect older adults remains unclear. The authors examined a sample of older Medicare beneficiaries and evaluated how individual characteristics, local service supplies, and other contextual features corresponded with the identification of older persons with psychiatric diagnoses and their access to specialty mental health care providers. Older adults presented a variety of psychiatric disorders, and their access and use of specialty mental health care related to age; sex; diagnosis; supply of mental health, health, and long-term care providers; and whether an older person lived in a rural area. Translation of collaborative models should consider a range of psychiatric conditions, adjust for varying local provider supplies, and consider the challenges in establishing collaborative care within rural areas.     

Social Work Registration: Another Opportunity for Discussion

ABSTRACT

The Social Workers Registration Bill 2018 is before the Parliament of South Australia. It makes provision to establish a social worker registration board with powers to investigate complaints and enforce penalties for breach of competency and ethical standards. This paper presents an argument for the national registration of social workers; and in addition, outlines key considerations for thinking about risk, protection, safeguarding, and implementation that comes with registration.

IMPLICATIONS

• Risk and protection need to be assessed as part of a more comprehensive regulatory framework in the debates of registration.

• If registration is to become part of the regulation of social work, a national approach to social worker registration is indicated, so that a person deregistered in one state cannot be employed as a social worker in another.

• Social worker registration is a potentially useful formal mechanism that offers both a protective safeguard (social worker status) and a corrective safeguard (limiting or de-registering).

     

The career of the mentally ill: an integration of psychiatric, labeling/social construction, and lay perspectives

This paper provides a new way of conceptualizing the career of the mentally ill. Most persons who experience an episode of a serious mental disturbance lead a normal life, while a few persons lead lifetimes that revolve around their mental disorders. The processes leading to either result can only be understood by integrating the traditional labeling and psychiatric perspectives with lay understandings of the concepts of "mental illness" and "nervous breakdowns." A selection of key concepts from these perspectives leads to a better understanding of the different paths persons take as they move through the pre-patient, inpatient, and post-patient phases of the "career of the mentally ill." This perspective makes understandable a number of counterintuitive relationships. For example, it explains why most hospitalized mental patients (1) have a negative stereotype of the "mentally ill," (2) do not perceive themselves as "mentally ill, yet (3) perceive themselves as benefiting from treatment, and (4) do not progress into a career of secondary deviance.     

Deinstitutionalization, social rejection, and the self-esteem of former mental patients

Modified labeling theorists have long argued that the stigma of mental illness has important consequences for the lives of people with mental illness. We propose that social rejection is an enduring force in the lives of people with mental illness and that these experiences are central to understanding the poor self-concepts described by many former psychiatric patients. We explore changes in a cohort of recently deinstitutionalized mental patients' (N = 88) self-esteem and experiences with social rejection using data from a three wave panel survey conducted while institutionalized and over a two-year period following the patients' discharge from a long-term state hospital. Our results indicate that social rejection is a persistent source of social stress for the discharged patients. Moreover, these experiences increase feelings of self-deprecation that, in turn, weaken their sense of mastery. Where the patients' received their follow-up care--whether in a community setting or in another state hospital--had little impact on their self-related feelings or on their experiences of social rejection. Our results provide further support for modified labeling theory and underscore the need to consider the dynamic relationship between stigmatizing experiences and self-related changes.     

Social work students’ professional and personal exposure to social work: an Australian experience

General career research suggests that many factors may influence how people select a career, including information about or exposure to the career. The focus of this paper is upon how exposure to a social worker personally (e.g. friend or family) or in a therapeutic capacity (e.g. received social work therapy) may influence the decision to become a social worker, when compared to other disciplines. The results showed that 63% of 64 social work students had personal and/or professional exposure to social work prior to making a career decision. When compared to other students (n?=?447) the social work students were significantly more likely to have accessed social work services (themselves or a family member). The influence of a friend who was a social worker and working with a social worker was noteworthy for mature-aged students. These results highlight that every interaction social workers have with the community provides valuable information about the profession and gives insight into social work as a career. Additionally, the results suggest that the increase in numbers of social workers and the influence of that exposure to a social worker have resulted in an increase in the use of social work services by students, and may continue to rise in the future.     

Using a Community Participatory Research Approach to Understand Satisfaction with Psychopharmacology Among Families of Children with Psychiatric Co-Morbidities

How do parents of children with psychiatric co-morbidities perceive their children’s use of psychiatric medications? To learn more, the Parent/Professional Advocacy League of Massachusetts (PAL), representing families of children with mental health needs, collaborated with researchers on a community-based participatory research (CBPR) study. A questionnaire assessed satisfaction with psychiatric medication as it pertained to children with psychiatric co-morbidities (n = 212). Satisfied parents were likely to employ alternative therapies and feel that prescribers had informed them about medication use and side effects. Results reinforce the need for prescribers to discuss psychopharmacology with families. CBPR improved study relevance and supported PAL’s advocacy efforts.     

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.     

Resource Scarcity in Mental Health: Crisis or Opportunity for Social Work Education?

This paper suggests that the funding crisis faced by mental health provides an opportunity for structural and policy changes that can benefit the entire system. The effect of increasing state control, trends in mental health treatment, new technologies, and changing higher education constituencies on social work education are examined. Stress is placed on the need for social worker educators to become more involved in the determination of state priorities and policies in order to shift the emphasis of mental health from institution to community, from medical model to psychosocial treatment, and from physician dominance to multidisciplinary control.     

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.