A gender-informed model to train community health workers in maternal mental health

The New Haven Mental Health Outreach for MotherS (MOMS) Partnership is a community-academic partnership that works to develop public health approaches to ensure that pregnant and parenting women living in the City of New Haven achieve the highest possible level of mental health. The MOMS Partnership developed a training model for community health workers specializing in maternal mental health. Six community health workers (termed Community Mental Health Ambassadors or CMHAs) were trained on key topics in this gender-informed maternal mental health curriculum. Pre- and post-test questionnaires assessed changes in attitudes, perceived self-efficacy and control using standardized scales. The results indicated preliminary acceptability of the training curriculum in transforming knowledge and attitudes about maternal mental health among community health workers.     

Report on the implementation and evaluation of an interprofessional learning programme for inter‐agency child protection teams

Effective collaborative working between the different professions and agencies working to safeguard children is essential. Lack of knowledge of others' roles, perceived differences in status and expertise, and negative stereotypes are examples of why this can be difficult to achieve. A facilitated interprofessional learning (IPL) programme was implemented to assess if such an intervention could overcome some of the barriers to effective interprofessional and inter‐agency team working. Six teams based in primary and secondary care trusts took part with participants from health, education, police and social services. Quantitative and qualitative data were collected from individual participants using a pre‐validated team climate inventory and reflective statements. Findings from this study demonstrate statistically significant changes in five out of six categories in the inventory. Reflective statements suggested that overall the programme offered a positive learning experience at both an individual and team level. The importance of outside facilitation to maintain the team's momentum was acknowledged, as was the difficulty of maintaining a good level of activity once the programme had ended. Nevertheless, the IPL programme provided a timely opportunity to reflect upon the interprofessional and inter‐agency team working needed within Children's Trusts and the implications for staff involved with regard to skills development. Copyright © 2009 John Wiley & Sons, Ltd.     

Learning to be interprofessional through the use of reflective portfolios?

Learning portfolios are used extensively in health and social care. There is evidence of their value as a tool to consolidate learning although limited information is available regarding their use in social work education. This study explores the use of a portfolio to encourage social work students to reflect on their interprofessional learning (IPL). The portfolio offers a means of demonstrating professionalism concerning knowledge, skills and attitudes in the context of collaborative practice. The findings of this research suggest that qualifying students were largely capable of reflecting on their development of interprofessional competence after attending specific IPL events, which were part of a wider programme. Social work students found reflective writing difficult, although this improved over time. In particular students struggled to write about skills and attitudes. Students perceived the portfolio to be a good way to assess their progress and believed this helped them to engage with their learning and make meaning through reflection and analysis. They appreciated that IPL and feedback from their assessments had advanced their abilities for self-analysis; despite needing help with reflective writing, they felt better prepared for ongoing use of reflection in their professional development, and in ‘working together’.     

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.     

Community mental health and mass media preventive education: the alternatives project.

An innovative mental health preventive education and public information program employing mass media was conducted in the Louisville, Kentucky, metropolitan area. Social work and mental health concepts of prevention were applied as a framework for developing project goals. Systematic evaluation, based on data from client-initiated telephone contacts and surveys of the community, demonstrated project success in increasing awareness and utilization of community mental health resources. The overall impact on assessment attitudes was positive; changes in resolution attitudes were not statistically significant. Implications for mass media utilization in mental health prevention are discussed.     

Promoting an endogenous approach to education at the local community level

A major postulate of this paper is that education is a subordinate component in a larger system of societies’ development. This means that any educational policy for any country should stem from a long‐term strategy to support this aim. The main focus of the study that this paper is based on is to develop a theoretical framework that identifies an educational model which would support endogenous development at the local community level. This framework is ‘indigenous community‐based education’. It is analysed in terms of its indigenous features and sharing applications, with reference to actual experiences of communities who have undertaken this type of programme.     

A mixed-method exploratory study of interprofessional education in social work at historically Black colleges and universities: A faculty perspective

ABSTRACT

A mixed-method approach was used to capture social work faculty experiences in integrating interprofessional education (IPE) in the social work curriculum at historically Black colleges and universities (HBCUs). Questions measured attitudes, needs, preparation, and readiness of HBCU faculty to participate in preprofessional and graduate IPE courses. Both quantitative and qualitative analyses were used. The 23 participants indicated that there was strong interest and endorsement for participation in IPE as an educational tool to improve interdisciplinary team work and social care outcomes. However, faculty had limited previous involvement with IPE courses. Many partners were identified for IPE courses with almost all endorsing alcohol and substance abuse counseling, mental health counseling, public health, early childhood education, nursing, rehabilitation counseling, school of divinity, and school of psychology. The following IPE teaching methods were endorsed by almost all of the faculty: seminars, IPE common tools, case analysis, collaborative assessment, role playing, and experiential activities. Qualitative analysis of the open-ended questions yielded five themes: designing/evaluating IPE programs, embedding IPE courses in the social work curriculum, facilitating trust among faculty, removing negative IPE stereotypes, and IPE courses sustainability. The study contributes vital information about an important group of stakeholders whose participation in IPE, heretofore not mentioned in the IPE literature, needs to be integrated. We recommend that the IPE higher education community work with HBCUs to implement IPE.     

Social Work and Interprofessional Education in Health Care: A Call for Continued Leadership

A report from the Interprofessional Education Collaborative and another from the Institute of Medicine cite working as part of interdisciplinary teams as a core proficiency area for improving health care. This article discusses the core competencies of interprofessional education and the essential role for social workers as leaders and facilitators of this practice. Educators will learn how to help students discover the knowledge, skills, and attitudes for successful interprofessional work. Specifically, this article has the following objectives:

1. Discuss essential elements of effective interprofessional practice;

2. Present exemplars of interprofessional education involving social work;

3. Identify the roles for social work in leadership, education, and practice in interprofessional education.

     

Evaluating a community based mental health programme in West Bengal,India: Description of the methodology and lessons learned

Mental disorders impose an enormous burden on society. In developing countries like India, there is a lack of adequate number of trained mental health professionals to provide specialized care and 75–85 % of affected individuals do not have access to appropriate mental health services. The National Mental Health Programme (NMHP) is being implemented by the Government of India to support state governments in providing mental health services in the country. The Urban Mental Health Programme (UMHP) is a pilot initiative that has attempted the integration of mental health services in primary health care settings in two municipal wards in Kolkata, West Bengal, India. The overarching aim of this paper is to describe the methodology used for the evaluation of the community based mental health programme and to understand the processes of the programme in terms of barriers and facilitators. The current evaluation is based on a concurrent nested design, where qualitative and quantitative data are both collected at the same time but analysed separately and priority was given to qualitative data. This experience will contribute in helping other researchers to make some evaluations more effective, useful and manageable. Ethics approval was obtained from an institutional ethics committee of an organization (Ekjut) based in Ranchi, Jharkhand, India. The evaluation was undertaken by the George Institute for Global Health, New Delhi from February- June 2016.     

Young Adult Carers: The Impact of Caring on Health and Education

Research has shown that young people who care for parents and relatives (young carers and young adult carers) are at greater risk of mental and emotional difficulties and are more likely to do badly at school or college. To explore the difficulties faced by young adult carers (aged 14–25) in the UK, an online survey was conducted. Almost half (45%) of the 295 respondents reported having a mental health problem. The relationship between the extent of caring and perceived mental health problems and the impact of caring responsibilities on work and education were investigated.     

Whose ‘Ordinary Life’ Is It Anyway?

This paper offers a feminist critique of current community care policy and of the normalisation ideology which underpins it. Drawing on experience in services for people with learning difficulties and people who use mental health services, the authors draw a series of parallels between 'clients' and women in our society. They discuss the mechanisms whereby groups of people are accorded second class status and the ways in which such oppression is experienced. Strategies for change are discussed with reference to feminist scholarship and the development of the women's movement. The prevailing philosophy of normalisation, which is both apolitical and highly individualistic, is challenged to take more account of collective and communal ways forward and to acknowledge the interdependence of people who need care and their carers. Despite the rhetoric of community care, the work of carers (most of whom are women) is undervalued and unsupported. Mainstream values such as competitiveness and self-reliance are incompatible with the integration of people with disabilities and a theoretical framework which confronts such conflicts of interest is required.     

Labeling theory and community care of the mentally ill in California: the relationship of social theory and ideology to public policy

The practical merit of a labeling theory approach to mental illness is examined and assessed through an exploration of its application in terms of public policy, i.e., community mental health policy in the state of California since 1968. Primary focus is placed on the impact of the deinstitutionalization of mental health services in that state, and the release of former mental patients into the community. Similarities in the fundamental ideological underpinnings of labeling theory, an associated conspiratorial model of mental illness, and contemporary California mental health policy, are presented and examples of policy input by labeling theorists and researchers are detailed. The impact of the California policy on the mentally ill is generally negatively assessed in terms of three major criteria: (1) rehabilitation; (2) reintegration; and (3) quality and continuity of care. The "translation" of several theoretical misconceptions regarding mental illness, caused by putting labeling theory into official policy, is suggested to lie at the root of many of the policy's implementation problems. The uses of social science theory and research are discussed, and caution is advised in the translation and application of social scientific theory and research to public policy proposals and programs.     

An interprofessional internship model for training master’s level social work and counseling students in higher education settings

ABSTRACT

The mental health needs of college students are steadily on the rise, which compels mental health service providers and educators to explore innovative ways to provide more collaborative, supportive, and interdisciplinary service models of practice and professional training. Graduate programs in social work and counseling are at the crux of producing internship training programs to help accommodate the influx of students with persistent mental health concerns across a variety of needs and cultures. This article describes an interprofessional internship program structured and designed to meet the clinical training needs of master’s level students matriculating in social work and counseling who aspire to provide mental health services in higher education settings. The interprofessional internship training model proposes an innovative interdisciplinary approach to field education which may result in positive training outcomes and learning experiences for social work and counseling students. This paper discusses the model’s emphasis on individual and interdisciplinary group supervision, objectives of the internship experience, internship site criteria, and professional and personal benefits to pre-service social workers and counselors. Recommendations for training and limitations of the model are provided.     

Mental Health Workers Negotiating Risk on the Frontline

Abstract

Following deinstitutionalisation and the shift to models of community care, mental health practice has become increasingly focused on managing the risks posed by service users. However, the effects of risk management on workers’ professional identities have not been investigated empirically in Australia. Drawing on in-depth interviews with mental health workers from Victoria, Australia, this paper explores the diverse ways in which these workers adapted the formal technologies of risk management (e.g., the completion of risk assessment screens) to their professional identities. Some workers experienced risk management technologies as constraining their interventions with clients, while others saw these technologies as providing opportunities to strengthen and enhance their professional skills. Pondering these differences, the author speculates on the emergence of a new form of professional identity in the broader context of contemporary community mental health care.     

Policy networks and the implementation of community care policy for people with mental handicaps

Although community care has been the professed policy of successive governments over three decades, according to the Prime Minister's own adviser, Sir Roy Griffiths, 'in few areas can the gap between political rhetoric and policy on the one hand or between policy and reality in the field on the other hand have been so great'. This paper examines the extent and causes of this 'implementation gap' in respect of services for people with mental handicaps--a consistent priority group for national policymakers. We examine centre-periphery relations in the health and personal social services in the light of Rhodes' power-dependence framework and his concepts of policy networks and policy communities. The NHS has been described as the archetypal professionalised policy network but we conclude that it is possible to account for implementation failures in community care only partly in terms of the dominance of the medical professions' values and interests and the deficiencies of accountability and control due to clinical autonomy. Such failures are due also to the inherently limited power of the centre. Sub-central units are not merely its meek agents. Moreover, the centre must explicitly structure local environments by itself providing a coherent framework of service and resource policies compatible with the national objectives it is seeking to achieve.     

Attitudes to child care reform in Romania: Findings from a survey of Romanian social workers

This paper presents the findings of a survey of Romanian social workers' attitudes towards two key aspects of child and family social work in their country: namely, the development of foster care, and the regulation of inter-country adoption. Major changes to the law on these matters were introduced in Romania in 1997, and the paper links the research findings with discussion of the progress, and difficulties, of putting the new legislation into practice. The research was undertaken in spring 1999, by means of a self-completion questionnaire for social workers and workers in related occupations. Comparisons between the attitudes of the two groups, and analysis of differences within the social work group, generate insights into the ways in which the new approaches to child and family welfare are taking hold in Romania. The research highlights the wide range of opinions and beliefs within the social services workforce in Romania, and draws attention to the complex interaction of professional education, workplace culture, and government policy in shaping those attitudes. The conclusion offers some thoughts on ways forward for child care policy, practice, research, and training in Romania.     

Multiple Objectives In Undergraduate Social Welfare Programs

A three-year action-research project that placed social workers and graduate students in community police departments stimulated a rethinking of traditional social work attitudes and practices. Issues uncovered included: selection of staff and students, attitudes about the law, confidentiality, motivating the reluctant client, and sensitivity to police-social worker perceptions of each other. The process of achieving cooperation with police and community agencies is described. Social work education is challenged by the need to produce professionals who will be effective in police-social work interprofessional cooperation as well as offering useful social services to previously unserved populations.     

Supporting families with a mentally ill parent: European perspectives on interagency cooperation

This paper reports on the findings of a cross-country comparison of cooperation between services for community mental health and child protection in 11 states. The authors consider the implications of the findings for English practice. When children have a parent with mental health problems, they have needs over and above those of other children. Often these needs are met by the family, but this is not always possible. There are increasing numbers of these children, and they feature disproportionately in the case loads of child welfare professionals, health visitors and social workers. The cross-country comparisons demonstrate the ways in which differences in structures, resources, expectations and attitudes affect professional responses and the experiences of families. The findings provide information on several levels. A comparison of commonalities and differences highlights the problems that are shared across countries, and alternative ways of responding to them at ground level are discussed. The factors that facilitate a good outcome are analysed in relation to English practice and service structures. The research findings are relevant for British social welfare strategies, and the paper highlights the implications of the findings for policy and practice. Copyright © 2001 John Wiley & Sons, Ltd.     

Power,participation and post modernism: User and practitioner participation in mental health social work education

The focus of this paper is service user and social work practitioner participation in the teaching for the mental health social work course. A review of the programme seeks to illuminate the value and significance of participation. The obstacles exposed through interviews and a collective workshop suggest a blocking opposition between idealistic education and ‘the reality of practice’. However this opposition is challenged by user and black advocacy participation. The value of participation appears in terms of anti-discrimination and extended possibilities to bring about change. Theory and practice divides are also dissolved. Participation is connected to power and modern and post modern approaches to education provide the theoretical framework.     

Transgender Individuals' Perceptions of Maternal Support in Central Appalachia

The psychosocial experiences of transgender individuals are shaped by specific cultural beliefs and values that influence family and community interactions. Using a constant-comparative approach to thematic analysis, we analyzed in-depth interviews with 25 transgender-identified adults in Central Appalachia and discovered that their mothers play a crucial role in their social support experiences. Participants described supportive and unsupportive interactions with their mothers and how their mothers' attitudes and behaviors evolved in positive directions over time. They also perceived that their mothers played a key role in influencing how other family and community members behaved toward them. Participants gave meaning to their mothers' behaviors by placing them in the context of strong cultural values about distinct gender roles, family loyalty, religious conservatism, and pride of place. These findings serve as a reminder to family mental health practitioners and health service providers to directly assess family and community strengths and draw on these resources to facilitate the well-being of clients from stigmatized and under-resourced populations.