Psychiatric supervision for social work?

There are increasing efforts by psychiatrists and insurance companies to maintain psychiatric control in mental health settings and thus limit the autonomous functioning of clinical social workers. This paper presents facts indicating that psychiatrists actually are only peripherally involved in mental health facilities. Clinical social workers as autonomous professionals diagnose and treat mental disorders and often hold key positions in administration and in program and staff development. The attempt to maintain a facade of psychiatric control amounts to a distortion of the reality of professional roles and results in inefficiency, increased costs, and a lowering of the quality of care.     

Dementia Patients’ Transition to Residential Aged Care: Carers’ and Social Workers’ Experiences

Many people with dementia eventually require residential aged care, frequently preceded by a hospital admission. Family carers often find the process challenging and disempowering, as they are expected to move their family member to residential aged care quickly. This article reports on findings from a small Australian qualitative study focusing on the provision of information, support and resources, and discusses the findings in relation to person-centred care and critical social work. Social workers completed an online survey and participated in focus groups, and carers were interviewed. The research found that carers valued the information, support, and resources provided by social workers and other hospital staff. They needed time to adjust to the dementia diagnosis and wanted a supportive person to talk to about the written information. The social workers wanted an improved approach to the preparation and communication of information, and a more consistent approach to family meetings.     

Social Workers’ Observations of the Needs of the Total Military Community

Researchers surveyed licensed social workers from 5 Mid-Atlantic states to explore their perspectives on the current state of mental health and service delivery for military service workers, families, and contractors. Social workers identified needs in the following areas: mental health, physical health and wellness, social and environmental, interpersonal and family, and military-specific needs. The majority of needs were most critical during the postdeployment stage. Education related to the observed needs was reported; social workers were most interested in learning about military culture and how to coordinate resources within the community to support the total military community. Suggestions for social work education and future research are discussed.     

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.     

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.     

Mental Illness,Social Construction,and Managed Care

Abstract

Managed care is creating a social reality that affects the lives of millions. Mental health coverage under health care plans is a function of how mental illness and its proper treatment are defined. These definitions are shaped by social actors competitively seeking to satisfy their particular interests. This paper examines the influence of privatized managed behavioral health care on these evolving social definitions, as evidenced in published works, written reports, and legal actions. It is written from the perspective of social workers as providers of services and advocates for social justice. Options for social work responses to managed behavioral health care are explored.     

An Interview with Joyce Edward: Exemplary Clinician, Advocate, and Scholar

Over the years, noteworthy social workers have been interviewed for the Clinical Social Work Journal. This article features an interview with Joyce Edward who is recognized for her many extraordinary contributions to clinical social work. Joyce has co-written or co-edited three exceptional books for the social work clinician, she has been an esteemed teacher and a vocal activist for quality mental health care. In this interview Joyce reflects on family influences, her work as a social caseworker, the psychoanalytic luminaries with whom she trained, her concerns about the clinical education of today's social work students, and finally, her perspective on managed mental health care.     

Mental health social work in Northern Ireland and the Republic of Ireland: challenges and opportunities for developing practice

Drawing on their experience of mental health social work in Northern Ireland and the Republic of Ireland, the authors examine the impact of current legislative and policy change in both jurisdictions. The paper applies Lorenz's theoretical framework to develop a comparative analysis of how global and country specific variables have interacted in shaping mental health social work. The analysis identifies linkages between factors and indicates similarities and differences in mental health social work practice. The paper highlights emerging discourses in this field and explores the impact on practice of developments such as de-institutionalisation, community care, and ‘user rights’ versus ‘public protection’. The article concludes with a review of key challenges facing social workers in both jurisdictions and identifies opportunities for developing mental health social work in ways that can positively respond to change and effectively address the needs of mental health service users and their carers. The analysis provides an opportunity to evaluate Lorenz's theoretical framework and the paper includes a brief critical commentary on its utility as a conceptual tool in comparative social work.     

Intersections of Stigma,Mental Health,and Sex Work: How Canadian Men Engaged in Sex Work Navigate and Resist Stigma to Protect Their Mental Health

Men engaged in sex work experience significant stigma that can have devastating effects for their mental health. Little is known about how male sex workers experience stigma and its effects on mental health or their strategies to prevent its effects in the Canadian context. This study examined the interrelationships between stigma and mental health among 33 Canadian indoor, male sex workers with a specific goal of understanding how stigma affected men’s mental health and their protective strategies to mitigate against its effects. Men experienced significant enacted stigma that negatively affected their social supports and ability to develop and maintain noncommercial, romantic relationships. Men navigated stigma by avoidance and resisting internalization. Strategy effectiveness to promote mental health varied based on men’s perspectives of sex work as a career versus a forced source of income. Programming to promote men’s mental health must take into consideration men’s diverse strategies and serve to build social supports.     

The Lull of Tradition: A Grounded Theory Study of Television Violence, Children and Social Work

This article results from a study of television violence and social work practice with children. Twenty-one social workers who work primarily with children in schools, in community mental health agencies and in private practice were interviewed. A qualitative analysis using grounded theory indicates that social workers do little to elicit television content or information about children's television viewing. They do not believe that television experiences are central to their work. Although social workers express concern about the influence of television violence on children, their traditional beliefs in cause and effect, values neutrality, and gender lead many to minimize its importance.     

The private practice of social work: Current trends and projected scenarios in a managed care environment

This article reviews the status of the social work labor force engaged in the private practice of social work based on data drawn from the full membership of the National Association of Social Workers. The demographics, areas of practice, income, and career development patterns of this sub-set of social workers are explored. These trends and issues are then discussed within the context of the realities of actual and potential changes in the mental health system of care in this society and their implications for private practice. Despite clear patterns which show a consistent upward trend in the proportion of social workers engaged in the private practice of social work, the current political and economic environment raises substantial questions about the nature and breadth of this component of social work practice in the future.     

The Contribution of Voluntary Organizations to the Care of Children with Life-limiting Incurable Disorders and their Families

A national postal survey of voluntay organizations providing for children with life-limiting incurable disorders (n = 147) is described. The majority of organizations originated from the motivation of parents or care workers in response to deficiencies in service provision from other agencies. A wide variety of services were available from the organizations with over half providing an information service, emotional support and counselling, patient and family support and a telephone helpline. The provision of some services, for example respite care, was, hoverer, associated with the size of annual budgets. Publicity, referral and funding arrangements are also discussed. The role of voluntary organizations as partners in care with statutory agencies is discussed in the light of instability of funding arrangements and the use of health and social work staff as the main source of information about voluntary services to parents. Areas of further research in this field are suggested.     

The Severely Disabled: Some Problems Associated with the Adjustment to Stress During the Rehabilitation Process

Modern methods of patient care are resulting in the discharge from hospitals and mental institutions of thousands of persons annually and increasingly large numbers are being referred to rehabilitation and other agency facilities for assistance in maintaining themselves in the community. For such persons, the requirement for medical care is minimal. However, these clients need relatively large amounts of assistance from social workers in readjusting to their families, in managing some kind of effective social existence, and in achieving some measure of economic independence.     

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns.MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained.ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation.ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.     

The use of mental health care,psychotropic drugs and social services by divorced people: does informal support matter?

This study compares the mental health care, psychotropic drugs and social service use of divorced people (re-partnered or single) with that of married people. This paper questions whether the availability of informal support facilitates or substitutes for formal care seeking. Data from the Divorce in Flanders survey of 2009–2010 are used. Logistic regression analyses are performed separately for women (N = 3450) and men (N = 3020). Greater use of mental health care, psychotropic drugs and social services by single divorced men is explained by their higher need for care, while divorced women (especially single divorced) more frequently contact a general practitioner (GP), a psychiatrist, or a psychologist, regardless of their mental health, socio-economic background and informal support. Women who have support from non-family members are more inclined to use social services and to contact a GP, while support from family members is only positively related to GP consultations. With regard to men, informal support from non-family members positively influences each type of formal care seeking. Our results suggest that non-family members (and only among women, family members as well) can provide help and advice about seeking professional mental health care and social services, but they do not have an influence on psychotropic drug use.     

Disability facilitators' views of their work with children/youth with disability in South Africa

Children and youth including those with impaired body function or structure, in under resourced areas, can be disadvantaged in terms of education and health care, and can experience social hardship. Within South Africa, personal, health and education support to individual children and their families in under-resourced areas is provided by care workers from the National Association of Child Care Workers. This organisation also provides training and support to their care workers to take on the role of Disability Facilitator, to extend their services to children with impaired body function or structure. This study established the views of Disability Facilitators about their work. Fourteen participants (aged 25–54 years) were individually interviewed at their own worksite. Two themes were identified from the data - Empowerment and Burden of responsibility.The theme of ‘Empowerment’ encapsulated how participants viewed disability more widely than as it relates to impaired body function and structure. Disability Facilitators empowered children and their families in a holistic way, and advocated within their community to address negative perceptions about disability. They supported the wellbeing and participation of children with disability within their local communities, and perceived their work as motivating and worthwhile. However, the second theme ‘Burden of responsibility’ encapsulated the challenges in feeling solely responsible for disability support in their community and in providing care and support for children living in dysfunctional families. They recommended all care workers receive training about disability issues to reduce the burden of responsibility on themselves. This study has demonstrated the worth of Disability Facilitators to address the challenges inherent in disabling environments. This approach to service provision offers useful insights that could be adapted into other countries and contexts.     

Being a service user and a social work academic: balancing expert identities

Abstract

I am a service user and academic working in a university social work department. My hybrid identity allows me to draw on different types of knowledge in all aspects of my work, including: academic, practice and experiential wisdom. Service user involvement is mandated across social work education but the scope and breadth of different kinds of participation is developed in diverse ways across university contexts. This article affirms the value of service user involvement in health and social care education, exploring its positive impact on students. When lecturers share personal experience of using services alongside practice and academic wisdom in the course of teaching, sometimes the value of experiential knowledge is doubted and its influence dismissed. I examine the importance of experiential wisdom in social work education, specifically when it is embedded in an academic role in a university social work department, and consider how it can be respected and valued. The parallel experiences of involving peer support workers in mental health services, who use their knowledge of recovery to mentor other service users, are then briefly examined, together with reflection of the concerns across mental health with professionals sharing their experiential wisdom with the people that they support.     

School Social Work in Australia

Abstract

This study explores the current state of social work services in Australian schools. A total of 65 social workers participated in the survey. The majority of respondents had permanent positions and over half of them were working part time. The number of schools serviced was wide ranging and the median was six schools. The major funding source was state governments, the primary referral sources were school staff, and the primary reasons for referral were behavioural and mental health problems. Respondents reported good support from employers and high levels of work efficacy and satisfaction. A large proportion of their hours were spent on counselling, paperwork, case management, and consultations. The major barriers to their work were lack of time, lack of resources, and lack of recognition given to social work perspectives and roles. Given the paucity of literature, findings from this study are expected to lay a foundation for future studies.