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.     

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.     

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.     

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.     

Legal capacity and the mental health social worker role: an international comparison

ABSTRACT

New capacity laws have been introduced to many jurisdictions over the last decade. These laws have substantially changed the way in which mental health social workers and other professionals approach decisions about, and for, clients. Most notably, there is now an expectation that mental health social workers engage more in supported decision-making to prevent the need for substitute decision-making. This article describes the legal and policy drivers that have led to these changes in practice, with a particular emphasis on the significance of the United Nations Convention on the Rights of Persons with Disabilities (the UNCRPD) and the importance of recovery approaches in mental health services. It then uses selected literature to explore the efficacy of the laws and decision-making in this area. The second part of the article identifies the role that mental health social workers can play in supporting legal capacity, drawing from the authors’ experience and knowledge of mental health social work and law in four jurisdictions: Victoria, Australia; Ontario, Canada; England and Wales; and Northern Ireland. It is concluded that mental health and other social workers need to refine skills, knowledge and values to accommodate this paradigm shift in law, policy and practice.     

The role of social work in the field of mental health: dual diagnoses as a challenge for social workers

This paper provides a discussion about the relevance of medical terminology within the social work context. The authors use the example of dual diagnoses to argue for less stigmatised attitudes toward people who become, in the process of help, labelled as people with dual diagnoses. It sets out that using medical terminology in the field of social work is more often a strategy to exclude people from the system of help than as a moment of providing adequate help. It is concluded that social workers do not need the knowledge about diagnoses – knowing the diagnosis is important only as information that illustrates users’ specific experience and perception of reality, the available resources and obstacles that people face in their everyday life. The planning of a social work intervention should be based on an operational definition of everyday life, e.g. how people live through the day, what are the important and valued roles they play in life, what are their wishes and needs.     

Social workers: a new precariat? Precarity conditions of mental health social workers working in the non-profit sector in Greece

ABSTRACT

Traditionally, in western countries, the social work profession primarily has come into contact with issues of precarity through the lives of service users. This paper introduces precarity in the social work scholarly literature as a feature of social workers’ professional and personal lives. It draws from the findings of a qualitative small study of mental health social workers working in the non-profit sector in Greece. The findings reflect a picture of social workers experiencing precarious conditions as they have become part of the growing phenomenon of the working poor, surviving by loans, experiencing housing insecurity, reproductive insecurity, fuel poverty and unable to pay for their commuting expenses to and from work. Furthermore, the paper maintains that the expansion of the conditions of precarity to university-educated professionals, such as social workers, needs to be understood within an International Political Economy (IPE) perspective in order neoliberal capitalism which brings rising levels of inequalities to become a focus of intervention.     

Stigma as a barrier to engaging in mental health services among adolescents who survive natural disasters

Many barriers impact the utilization of mental health services among adolescents who survive natural disasters. Although stigma has been identified as one of these barriers, minimal work examines the etiological factors that impact stigma and how these factors operate in perpetuating stigma among adolescents after a disaster. Understanding the role that stigma plays is a critical step to raising awareness of the cognitive and behavioral processes that preserve adolescents’ well-being, timely attainment of developmental milestones, and the potential for engagement in meaningful opportunities. We modify an existing adolescent self-stigma model to better understand how youth might respond psychologically to natural disasters both immediately after the event as well as during the long-term recovery phase. Future empirical research should assess the validity of these barriers within the suggested temporal framework. If this proposed conceptual piece is validated, interventions could be designed that directly address the role of stigma.     

Conservation of Resources theory in the context of multiple roles: an analysis of within- and cross-role mediational pathways

Based on the Conservation of Resources theory, we used data from the National Survey of Midlife Development in the United States (MIDUS I, 1995–1996; N=1779) to estimate by covariance structure analysis the direct and indirect effects of work and family demands, resources, and support on psychological distress. In a new application of the theory, we estimated six within-role mediational pathways linking work-related predictors to psychological distress through work interfering with family (WIF) and family-related predictors to psychological distress through family interfering with work (FIW). Finally, in a departure from previous work–family research, we estimated six cross-role mediational pathways linking work-related predictors to psychological distress through FIW and family-related predictors to psychological distress through WIF. Ten of the 12 hypothesized mediational effects were significant and another was marginally significant, supporting the mediational role of work–family conflict within Conservation of Resources theory.     

Creation and evaluation of a maternal mental health course

Perinatal Mood and Anxiety Disorders (PMADs) engender significant and increasing personal, social, developmental, and economic burdens to women, children, families, and global public health. In the US, a Master of Social Work (MSW) elective course, Introduction to Maternal Mental Health, was created to prepare future social workers to better understand, detect, intervene, and advocate with women struggling with perinatal mental health concerns. A pilot study used pre–post-surveys (N = 10) and a focus group to examine students’ knowledge acquisition, course satisfaction, and perceived self-efficacy. A Wilcoxon signed-rank test showed a statistically significant difference between pre- and post-survey course content knowledge scores. Positive focus group feedback and survey outcomes suggest that students benefitted from the course in terms of increased learning and professional efficacy in maternal mental health; however, the study should be replicated using a larger sample and comparison group. The course outline provided may be used to develop a similar course or to infuse maternal mental health content into existing courses. The paper concludes with implications and recommendations for social work educators.     

Psychological distress among mental health social workers

This study employs the General Health Questionnaire (GHQ-12) in order to examine psychological distress among Greek mental health social workers. The findings are examined in the light of the respondents' demographics, professional characteristics (educational background and work experience), work perspectives (job satisfaction and perceived work efficiency) and perceived financial strain. The study took place two years after austerity measures were imposed in the country. A self-addressed questionnaire employing 4-point Likert-type scale items was posted to 154 mental health social workers residing in an urban area in Greece. A statistical analysis of the 65 returned questionnaires identified frequencies and correlations in the corpus of the data. According to the findings, 15% of the practitioners were within the psychological distress range. When compared to their non-psychologically distressed counterparts, the psychologically distressed respondents were clearly differentiated according to their professional characteristics, work perspectives and perceived financial strain.     

Enabling social support and resilience: outcomes of Family Group Conferencing in public mental health care

Family Group Conferencing (FGC) is a decision-making model where clients with their social network formulate their own plan. There is little experience with FGC in mental health care. We studied the outcomes of 41 conferences in a public mental health setting in the north of the Netherlands. We interviewed 312 respondents out of a total of 473 conference participants. In 33 cases, it was possible to obtain scores from 245 respondents on scales ranging from 0 to 10 about the situation prior and after the conference on three outcome measures, namely the quality of: (1) social support, (2) resilience and (3) living conditions. In the 33 cases, t-tests and multilevel analyses indicate on all of the three outcomes measures significant positive changes after the conferences. On average, the scores on the quality of social support (5.04–6.73), resilience (4.09–6.32) and the living conditions (3.73–6.64) had been increased since the conferences were organised. The results are modest but remarkable. That the impact of FGC is not more substantial can be explained. The clients referred to a conference in this particular study, mostly had a limited network and few recourses from whom little support could be expected.     

The necessity of an attention to Eurocentrism and colonial technologies: an addition to critical mental health literature

Critical perspectives in mental health and the highly influential contributions of those who identify with and/or ally with the psychiatric-survivor, consumer-survivor, ex-patient, or mad movements have provoked an appreciation of the many exposed epistemological, methodological, and ethical issues that (re)produce violence within biomedical psychiatry. What is often left uninterrogated is the reliance on a Eurocentric conceptualization of history within articulations of struggle and when attending to the political and social contexts of critique. The effect of this enduring Eurocentrism is often an inattention to the complicit influences of colonial and imperial projects on the practices and technologies of dehumanization, taxonomization, and the establishment of human hierarchies to rationalize violence through the implementation of racial and eugenic rationale. The imperative of this attention to Eurocentrism is suggested from a synthesis of contributions from critical mental health, postcolonial, and critical race literature.     

Group work in the mental health field: researching outcome

This paper reviews outcome studies from groups facilitated for persons living with serious mental illness. Although the research base is limited (groups posing considerable methodological challenges), available studies show that, in general, group work is as effective as individual work, if not more so. This paper describes findings from studies of short-term, long-term and self-help groups dealing with mood disorders, schizophrenia, eating disorders and borderline personality disorders over the last 10 years. The concept of ‘time-effective’ group work is discussed as are the potentially harmful effects of group participation. The paper concludes by arguing that group work is an effective and less expensive treatment option that would benefit from further research to establish an evidence base, both for current practice and for the expansion of group work practice in the future.     

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.     

Improving mental health assessments in child protection through audit

Existing agency records, together with questionnaires completed by social services referrers and mental health providers, were used to identify problems in current arrangements for obtaining specialist mental health assessments in child protection cases. Standards were set and implemented through a multi‐agency steering group. The practice of referrers and providers was then reaudited. Sixty‐nine social workers, six mental health specialists and 27 child protection initial case conferences (involving 31 children) were involved in the reaudit over a 4‐month period. Initially, main problems concerned communications, unclear referral and access arrangements, waiting times and disagreements over prioritization. Standards concerned consultation and decision‐making arrangements within the child mental health service, the format of referral and reply letters, the sharing of information and the attendance of mental health professionals at child protection case conferences. There appeared to be improvements in all these areas at reaudit. In conclusion, some shared views of problems, additional support funding and the audit process appear to have helped to improve inter‐agency collaboration and develop more efficient referral and care arrangements. There is a need to maintain and further develop this work, and audit would again be a useful means. Copyright © 1999 John Wiley & Sons, Ltd.     

Oral health among student veterans: Effects on mental and physical health

Abstract

Objective: The purpose of this study was to explore differences in oral health among students by military service status in postsecondary settings. Participants: Secondary data were obtained from the American College Health Association’s 2011–2014 National College Health Assessment II. Method: Demographic characteristics of the study sample were explored by calculating frequencies and percentages by military service status. Research questions were explored with maximum likelihood multiple logistic regression. Results: Service member and veteran students are at greater risk for neglecting health behaviors associated with positive oral health, including that they were less likely to get dental exams and that those who deployed in the past were the least likely to be practicing good oral health. Conclusions: The results suggest that improving oral health will contribute to improving health and mental health outcomes in this population, and provide important information for health specialists working with service members and veterans on college campuses.