Educating for mental health practice: Results of a survey of mental health content in Bachelor of Social Work curricula in Australian schools of social work

Health problems are amongst the most pressing encountered by social workers in practice. Health policy, largely through deinstitutionalisation, has placed mental health problems in the mainstream of health practice. One in 25 Australians will require professional assistance with mental health problems. Moreover, other professions are increasingly claiming that mental health is their area of expertise. Social work needs to reclaim this area as their own and hence it is incumbent on social work education to prepare students to practise in this area. As the second of a two-part survey of health and mental health curricula in Australian schools of social work, the findings of the survey on mental health curricula conducted in 1997 are presented in this article. Based on responses from 95% of the schools, nine of the 20 respondent schools were found to offer a separate mental health unit. The remaining 11 schools' coverage ranged from no coverage at all through to considerable integration in other subjects. Overall it was concluded that the majority of students received a significant amount of input on mental health. A number of recommendations are made to improve mental health input including more skill development, greater local contextualisation, more attention to an anti-oppressive agenda, and more explicit links to field education.     

Youth with Serious Mental Health Disorders: Wraparound as a Promising Intervention in New Zealand

Youth with serious mental health disorders present with a complexity of challenges for the mental health system, schools, youth justice, care and protection, and their communities. Research shows their needs are best achieved by providing coordinated intensive, multidisciplinary, and individualised services. This article outlines the prevalence and characteristics of youth with serious mental health disorders. It also discusses community‐based interventions used in New Zealand and their limitations. It introduces Wraparound, an intensive individualised coordination and care planning process as a promising practice for youth with serious mental health disorders and their families. Key principles and phases underpinning the Wraparound process are presented along with a case vignette to exemplify the process. Its theory of change, the challenges experienced in practice, and a brief overview of the evidence‐base are also discussed.     

The Use of Social Theory in Reflecting on Anti-Oppressive Practice with Final Year BSc Social Work Students

This article explores the relevance of social theory for social work teaching and learning about anti-oppressive practice. Use of theory in social work practice is discussed. It is argued that social theory is a toolbox from which social workers can draw eclectically in order to enhance their ability to practise anti-oppressively. A course/module which focuses on theory to understand and support anti-oppressive practice is described. The main aspects of social theory addressed in this module are outlined. These areas are firstly, human rights; secondly, traditional, modern and postmodern discourses or ‘ways of knowing’; thirdly, essentialism vis-à-vis the social construction of identity; and fourthly, an analysis of power in personal/professional relationships. The use of case studies or scenarios is discussed in relation to facilitating students' application of theory to practice. Extracts from a student essay demonstrate how one student applied social theory to a comparison of two case studies leading to strategies to empower the individuals in each scenario. The value of using social theory to reflect on and enhance anti-oppressive practice is discussed.     

Resisting Neoliberalism from within the Academy: Subversion through an Activist Pedagogy

Teaching and learning in the neoliberal academy means that educators in non-market-oriented departments, such as social work, face several constraints and challenges when trying to implement an anti-oppressive, social justice focused curriculum. This article considers challenges that can arise with an introductory social work course in the current context of neoliberalism, especially when open to both social work and non-social work students. With a particular focus on larger class sizes, the use of precarious labour and the depoliticization of the classroom, the authors use an inductive, reflective approach to analyse observations made about shifts in the behaviour and engagement of students in the course. The authors surmise possible explanations for these shifts, considering changes made to the substantive content and pedagogical practices of the course. Through this process the authors propose that these changes represent an ‘activist pedagogy’ which may offer potential for anti-oppressive education with students both inside and outside social work. As such, the authors propose ‘activist pedagogy’ as a possible way to resist and subvert the neoliberal educational paradigm and to better integrate the principles and practices of social justice and anti-oppressive social work into the classroom.     

Integrating cultural competency and empirically-based practices in child welfare services: A model based on community psychiatry field principles of health

Acknowledging the existence of racism in our society is crucial to understanding the need for a culturally competent approach to developing empirically-based practices in child welfare, thereby providing a foundation for evidence-based practice in the field. Advancements have already been made in mental health to address cultural competence and evidence-based practice. This article presents a model of seven field principles of health promotion successfully used in the mental health services. Examples of the use of the model in various settings and evaluation projects are provided. Each of the seven principles – rebuilding/supporting the village; providing access to health care; improving bonding, attachment and connectedness; improving self-esteem; increasing social skills of target recipients; reestablishing/strengthening the adult protective shield; and minimizing residual effects of trauma (Bell et al., 2002) – is elaborated. The model's critical role in establishing culturally competent evidence-based practice is further outlined for application in the field of child welfare.     

Social worker and immigrant client experiences in multicultural service provision: Educational implications

Social work education, while committed to preparing students for anti-oppressive practice with immigrants and refugees, has not always been successful in achieving this goal. Student knowledge about and interest in cross-cultural practice, as evidenced in Canadian and US studies, often remains superficial and marginalized. This may in part be due to a lack of inclusion of practice wisdom and lived experiences of front-line practitioners and their clients. To remedy this deficit, 13 Canadian social workers of varied cultural backgrounds providing services in inner-city schools and 19 immigrant clients were interviewed in-depth to ascertain their perceptions of central elements of anti-oppressive practice with immigrant populations. Results yielded two major themes: Multifaceted Perception of Self and Other , which pertained to a recognition that culture was multifaceted, complex, and defined interactively; and Proactive Service Delivery , which pertained to active worker involvement in cultural bridging, brokering and advocacy. Implications for anti-oppressive social work education include a focus on multifaceted definition of culture, and admissions policies that promote multilingual, multicultural competencies.     

Practice Wisdom on Custodial Parenting with Mental Illness: A Strengths View

ABSTRACT

Social work principles of strengths, empowerment, and consumer-centered care for persons with mental illness are currently being adapted to broader contexts. This article presents study findings on practice wisdom about custodial parents with mental illness, a potentially increasing group of consumers in light of mental health reform. The research team organized thirty-six professionals with practice experience into five focus groups. Findings reflect strengths perspective categories of resilience, social support, family functioning, self-care, and parents' positive experience of their symptoms. Implications discuss how providers who work with custodial parents and their children can apply these findings in assessments and interventions.     

The Four S Model in action for de-escalation. An innovative state hospital-university collaborative endeavor

In this article, the Four S Model is presented as a working clinical framework for generating structured nursing interventions and treatment plans. The de-escalation process, formalized by the De-escalation/Alternative to Restraint Flowsheet, is one way in which the model is being operationalized to reduce seclusion and restraints. As shown by the flowsheet, the model allows for integration of mental health and mental illness. It spans the scope of nursing practice at all levels, from para-professional to advanced practice nurse, by integrating the mental health concepts of communication, leadership, clinical judgement, critical thinking, and caring within its framework. Most important, the flexibility to individualize treatment that is built into the model allows for generalization to all psychiatric presentations.     

Psychodynamics and empowerment in community mental health

Abstract

This paper examines the relationship between empowerment philosophy and psychodynamic principles and practices, as it applies to community mental health work. It suggests that as empowerment philosophy is more a system of values than a model of mental health and illness, it cannot in itself act as a framework for understanding and working with disturbed people. I suggest ways of disentangling the often fraught relationship between the two frameworks by identifying the contribution I see each as able to make to the task of providing services which sustain people in the community, and attempt to articulate the elements of a practice model consistent with both sets of principles.     

Preparation for Practice: Can Philosophy Have a Place in Helping Students Incorporate the Social Model of Disability Within Their Praxis?

This short paper emerges from an engagement with the paper by Morgan in this special edition which argues that the social model of disability can be viewed as a threshold concept which students struggle to ‘get’. I suggest that introducing social work students to philosophical concepts such as recognition at an early stage of their learning about skills, values and anti-oppressive practice, could facilitate the transition over this disability studies threshold, reducing the potential for ritualised performance instead of true understanding. It will be argued that Honneth's account of recognition in particular can be helpful in reducing the risk of psycho-emotional disablism within professional relationships between social work students and disabled service users. However, I also suggest that encouraging students to engage with philosophical questions about personhood and humanity are crucial to maintaining true anti-oppressive practice at a time of financial cutbacks in social work services.     

Heterosexism and social work education: The invisible challenge

This paper is concerned with the new discourse in social work education with its emphasis on anti-discriminatory and anti-oppressive practice. This directive is examined critically in relation to sexual orientation, suggesting that the contemporary climate is confusing and far from straightforward. The ideological, theoretical and legislative contexts in which social work as a profession has developed are reviewed, and their heterosexist bias exposed. In contrast to developments in relation to racism and sexism, little attention has been given to heterosexism - yet the heterosexual hegemony needs challenging with urgency if we are to truly work in an anti-oppressive way with lesbians and gay men.     

The Sociology of Mental Health: A Brief Review of Major Approaches

The article emphasises the importance of making sense of the theoretical debate in the sociology of mental health in order to 'position' the wide range of studies that have contributed to this field within three main approaches. The article indicates ways in which various studies have proved highly influential and continue to form the basis for research, policy and practice. Sociological concepts such as stigma continue to resonate as they highlight the sense in which negative social attitudes often make life harder for those who are already experiencing distress. The politics of risk in mental health, which has become a particularly powerful force in recent years, has made the prevailing climate more and not less stigmatising for those identified with 'mental illness'. The article concludes by arguing that the sociology of mental health continues to offer the conceptual and theoretical foundation from which negative associations can be challenged and overturned.     

Juvenile Delinquency in Search of a Practice Model: Family Health,Differential Association,and Social Control

ABSTRACT

Historically, practice research on juvenile delinquency has often been guided by the theories of differential association and social control. However, current research indicates that no matter what theory of delinquency is pursued, it has had little effect on decreasing juvenile arrest and violent crime rates. This article will explore the dynamics of the theories of differential association and social control in relation to juvenile delinquency. These linear, normative, and deficit-based theories are then contrasted with family health practice, an alternative theory and intervention model which focuses on the multiple forms and needs of families and their strengths. Specific family health practice principles and interventions are suggested for practice with families in which juvenile delinquency occurs. Finally, a case example utilizing family health interventions is presented.     

How Psychological Telehealth Can Alleviate Society's Mental Health Burden: A Literature Review

Mental health professionals must establish new means to reach those in need that face obstacles related to geographical location, time limitations, and health. With the high incidence of mental illness, as well as the hypothesized increase in coming years, telehealth modalities propose a novel and far-reaching alternative to traditional therapy. This article outlines the positive aspects and interdisciplinary possibilities when telehealth is incorporated into mental health practice. Novel outlets including mHealth and the utilization of computer tablets as mental health facilitators are outlined. Considerations for practice including training are discussed, as well as potential future directions for the field. Available data supports telehealth as an effective mode for the treatment of clients who are unable to pursue mental health services in their current form. However, careful consideration and training for the mental health professional is needed if telehealth is to be effectively used to alleviate the mental health burden.     

Global Mental Health in Action: Reducing Disparities One Community at a Time

There are great disparities in mental health care around the world. Traditional approaches to mental health care have not been found to be transferrable to many parts of the world and are inadequate to address these disparities. Unconventional approaches are needed that match the traditions of care‐seeking and care‐giving within the communities where they are delivered. The authors review the global mental health literature and discuss how marriage and family therapists are in a particularly good position to have worldwide impact on mental health disparities. Five principles of global mental health are presented along with an example of how these principles are applied through the Reducing Mental Health Disparities One Community at a Time (RD1CT) model.     

Accredited Mental Health Social Work in Australia: A Reality Check

Abstract

Accredited mental health social workers (AMHSWs) have a great deal to offer the clients they see in their private practices, many of whom have complex needs. However, they are constrained by the inflated expectations Government has about evidence-based psychological interventions. The restrictions placed on the professional private practice of AMHSWs by Federal Government Medicare funding of a narrow set of psychological interventions ultimately limits the services received by clients. In this article, the findings of a survey of AMHSWs are presented, highlighting the tensions between individualised responses promoted by Medicare payments, and those premised on principles of social justice and social inclusion.     

Teaching Note—Integrating Prevention Content Into Clinical Social Work Practice Courses

Rapid changes in health care services and delivery suggest an upcoming paradigm shift in the field of mental health. Recent national reports, health care policy changes, and growing evidence support a shift toward prevention-focused mental health care. The social work profession is uniquely positioned to act as leaders in this shift as the profession’s values, goals, and hallmark practice approach are consistent with preventive care. Most social work students, however, do not receive training in prevention practice. The author’s development, implementation, and evaluation of a prevention-focused master of social work elective in the area of mental health is presented as an example of integrating prevention content into clinical social work practice courses. Implications for social work education are discussed.     

The Evolution of Community Mental Health Services in Asian American Communities

This paper explores the history of Asian immigration to the United States, and its intersections with the mental health system. As mental health care have evolved since the 1960s from institutions to the community, public mental health services for Asian Americans have become increasingly culturally relevant. Major policy shifts, trends in immigration, and mental health practice will be presented with a focus on the Bridge Program at the Charles B. Wang Community Health Center. Integrative practice and research models that extend evidence-based knowledge to Asian American communities and practice implications are discussed.