Social Inclusion as an Agenda for Mental Health Social Work

Summary

Following New Labour's election to office in the UK in 1997, policy initiatives have proliferated relating to mental health. Much of this policy innovation emphasises the social dimensions of mental health and distress, with an emphasis on employment and social inclusion. Paradoxically, this modernization of the mental health agenda comes at a time when mental health social work is struggling to establish its role and contribution within recently integrated health and social services. The paper considers whether New Labour's flagship programme, Mental Health and Social Exclusion, constitutes a “New Deal” for mental health, and whether it provides a perspective that will help mental health social work to define its distinctive contribution to integrated services.     

The Need for Web-Based Cognitive Behavior Therapy Among University Students

ABSTRACT

This study investigates students' need for a web-based cognitive-behavior therapy (CBT) intervention program for preventing depression, the mental health status of those who felt a need for such a program, and underlying factors of the intention to use web-based self-help. A conceptual model for explaining intention to use web-based self-help is proposed. Nearly half of the participants reported a need for help with psychological problems, but only a third of these actually sought help from traditional mental health services. In conclusion, there is a need for web-based self-help, and web-based CBT has the potential to attract a group of students who, so far, have not been reached by traditional mental health services.     

Psychological Distress and Related Factors in Female College Students

Abstract

Objective: This study assessed the psychological distress in Spanish college women and analyzed it in relation to sociodemographic and academic factors. Participants and Methods: The authors selected a stratified random sampling of 1,043 college women (average age of 22.2 years). Sociodemographic and academic information were collected, and psychological distress was assessed with the Symptom Checklist-90–Revised. Results: This sample of college women scored the highest on the depression dimension and the lowest on the phobic anxiety dimension. The sample scored higher than women of the general population on the dimensions of obsessive-compulsive, interpersonal sensitivity, paranoid ideation, psychoticism, and on the Global Severity Index. Scores in the sample significantly differed based on age, relationship status, financial independence, year of study, and area of study. Conclusion: The results indicated an elevated level of psychological distress among college women, and therefore college health services need to devote more attention to their mental health.     

Exploring Knowledge through Peer Tutoring in a Transitional Learning Community: An Alternative Way of Teaching Counseling Skills to Students in Social Work Education

This article is a critical review of Crossing Bridges, a Department of Health training pack for those working with 'mentally ill' parents and their children. The author argues, on the basis of both personal and professional experience, that although the pack pays lip-service to the significance of structural factors, the training resources are primarily rooted in an individual and family-focused pathology model of mental illness. Three arguments are put forward for the necessity of a wider framework: the significance of shame and stigma to those experiencing mental distress and their families; the predominance of understandings of mental illness that translate social phenomena into individualised problems, notably genetic explanations and attributions of risk and dangerousness; and the contribution of motherhood to the experiencing of mental distress in women. Initiatives within the mental health survivor movement are highlighted as examples promoting positive images of mental distress, and the implications of the issues raised for social work education are considered. The article concludes that efforts to help the children of 'mentally ill' parents, not to mention the parents themselves, must incorporate wider strategies to promote openness, respect, acceptance and ultimately, social inclusion, of those who experience mental distress.     

The Psychology of the Psychopharmacology Triangle

Abstract

The psychopharmacological triangle generated by recent changes in mental health practices requires social workers to deepen their understanding of the psychological meanings of such treatment. Many clients receive concurrent psychotherapeutic and psychopharmacological interventions from different providers, creating a triangular treatment relationship. To facilitate a successful outcome, social workers will need to understand how meaning, transference and countertransference are stimulated by this arrangement. The literature on these issues as well as clinical experience will highlight specific issues requiring attention. By attending to these dynamics, the social worker can maximize the chances for a successful treatment outcome.     

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.     

Is an Independent Self a Requisite for Asian Immigrants' Psychological Well-Being in the U.S.? The Case of Korean Americans

Summary

This study examined the effect of both independent and interdependent self-construals on Asian immigrants' psychological well-being in the U.S., using a community sample of adult Koreans. Given that society rewards certain behaviors and attitudes that are consistent with the valued social norms, an independent view of self that matches the expectation of American society was hypothesized to promote Korean immigrants' psychological well-being. Hierarchical regression analyses revealed that Korean immigrants with a highly independent self-construal expressed significantly less depressive symptoms and significantly more life satisfaction than those with a less independent self-construal. Furthermore, as was also expected, an interdependent view of self that is valued in many Asian cultures did not hinder Korean immigrants' psychological well-being, controlling for the correlates of these immigrants' mental health and self-construals. The results underscore the importance of self-conceptions in cross-cultural adaptation, and suggest the need of future research focusing on the potential benefits of both types of self-construal for Asian immigrants in the U.S.     

One Hundred Years of College Mental Health

Abstract

Although the first student health service is credited to Amherst College in 1861, almost 50 years passed before Princeton University established the first mental health service in 1910. At that time, a psychiatrist was hired to help with student personality development. Although other schools subsequently established such services, the first 50 years of college mental health were marked by a series of national conferences. At the American Student Health Association's annual meeting in 1920, “mental hygiene” was identified as critical for college campuses to assist students to reach their highest potential. However, it took another 40 years before mental health and psychological counseling services became common on college and university campuses. The American College Health Association formed a Mental Health Section to serve mental health professionals in 1957, and most colleges and universities have now developed mental health and counseling programs commensurate with the size of their student bodies.     

Factors Associated With the Psychological Well-Being and Distress of University Students

Objective: Because of the serious nature of psychiatric illness and related problems, the authors attempted to identify demographic, individual, and behavioral factors linked to university students' psychological health. Participants: They surveyed 353 (60.9% female) predominately Caucasian (88.7%) university students attending a large public university. Methods: The authors used a self-report questionnaire including valid and reliable psychometric instruments for all study variables. They conducted multiple regression analyses to examine associations among study variables using a cross-sectional design. Results: More favorable health states (ie, greater psychological well-being and less distress) were positively associated with optimism, health values, and religiousness and were negatively associated with spirituality and number of sexual partners. Conclusions: Results demonstrated that multiple protective and risk factors contribute to the psychological well-being and distress of university students. Health promotion practitioners should adopt strategies that strengthen the personality characteristics and values associated with university students' psychological health.     

Ethical Issues in Child Custody and Dependency Cases

Abstract

The emotional and psychological risks to children of high conflict divorce have led to the increased involvement of mental health professionals in child custody cases. Numerous service models (Greenberg & Gould, 2001; Johnston, 2000; Johnston & Roseby, 1997) have been developed to assist divorcing families in minimizing family conflict and supporting children'S needs. This underscores the need for judges and attorneys to understand the ethical and professional standards that underlie competent mental health practice in forensic cases. The practices of mental health professionals providing court-related services may have a substantial impact on the validity of their professional opinions, the effectiveness of services provided to children and families, and children'S development and adjustment. The authors suggest core ethical and clinical issues to be considered by all psychologists who work in the context of custody disputes. It is hoped that these professional practice suggestions will also be useful to attorneys and judicial officers in assessing the quality of mental health professionals' opinions.     

A multimodal intervention for grandparents raising grandchildren: results of an exploratory study

This article describes the results of an exploratory study of a multimodal, home-based intervention designed to reduce psychological stress, improve physical and mental health, and strengthen the social support and resources of grandparents raising grandchildren. The six-month intervention included home visits by registered nurses, social workers, and legal assistants; the services of an attorney; and monthly support group meetings. The intervention resulted in improved mental health scores, decreased psychological distress scores, and increased social support scores. Participants also experienced improvement in the level of public benefits received and in their legal relationships with their grandchildren. Implications of these findings for practice are highlighted.     

A Student-to-Student Dental Outreach Program

Abstract

Objective: This study investigates the individual, interpersonal, and institutional level factors that are associated with overall mental health among college students. Participants: Data are from an online cross-sectional survey of 2,203 students currently enrolled at a large public university. Methods: Mental health was ascertained using a subcomponent of the RAND Medical Outcomes Study functioning and well-being measures developed by the RAND corporation. Stepwise regression was used to determine if self-reported measures of individual (ie, coping abilities), interpersonal (ie, intergroup awareness), and institutional (ie, campus climate/tension) level factors were associated with overall mental health, after controlling for demographic characteristics. Results: The combined effects of both individual and institutional level measures were associated with student mental health. In particular, limited coping abilities and a perceived racially tense campus climate contributed to the psychological distress of college students. Conclusions: Simultaneously addressing the individual and institutional level influences on mental health offers the most promising help for students.     

Predicting help-seeking behavior: The impact of knowing someone close who has sought help

ABSTRACT

Objectives: This study sought to replicate and extend research on social facilitators of college student's help seeking for psychological problems. Participants: We collected data on 420 ethnically diverse college students at a large public university (September 2008–May 2010). Methods: Students completed a cross-sectional online survey. Results: We found that students who were aware of close others' (eg, family, friends) help seeking were two times more likely to have sought formal (eg, psychologist) and informal (eg, clergy) help themselves. Tests of moderation revealed the incremental effect (ie, controlling for help-seeking attitudes, internalizing symptoms, cultural demographics) of close others' formal help seeking was strong and significant for men (R² = 0.112), while it was negligible and nonsignificant for women (R² = .002). Conclusions: We discuss the importance for students—particularly men—to learn about close others' help seeking for facilitating their own help seeking during times of distress.     

Talking or Keeping Silent About Parental Mental Health Problems—A Grounded Theory of Parents' Decision Making and Experiences with Their Children

This grounded theory study explored parents' experiences of responding to their children's need for understanding parental mental health concerns. Fifteen parents with severe and enduring mental health difficulties participated in the study. The findings suggest four main social processes that influence parents' talk with their children about parental mental health issues, namely “Protecting and being protected,” “Responding to children's search for understanding,” “Prioritizing family life,” and “Relating to others.” Implications of the findings for clinical practice and future research are considered. In particular, the need for more family‐orientated services where parents experience parental mental health problems is highlighted.     

Lesbian Health

ABSTRACT

Health care research suggests that lesbians may face unique physical and mental health risks, yet few studies make use of gender and sexuality theories to explain lesbian health. In this study, a social constructionist view of sexuality is used to examine the impact of lesbian identity on well-being. Drawing from nineteen intensive interviews with women who self-identify as lesbians, the results show that individuals' sexual identities change over time and are affected by their social environments. The data also demonstrate that sexual identity and social context have implications for well-being. Specifically, hostile environments, which are characterized by animosity toward gay men, lesbians, and others who do not conform to heteronormative gender expectations, are associated with distress over lesbian identity and with physical and mental health problems. By contrast, supportive environments, which many women report finding through feminism, facilitate the construction of a positive lesbian identity and enhance well-being.     

Mental Health Needs Assessment of a Major Urban University

Abstract

A questionnaire surveying mental health needs was administered in class to 1,412 Virginia Commonwealth University (VCU) students, and a service utilization questionnaire was administered to 154 students applying for mental health services at four campus-based agencies. The nature of the specific problems of concern to students tended to remain stable over the course of a semester. Study habits and grades was the most frequently cited problem area on the needs survey, though help was sought most frequently for physically oriented concerns. Students lacking important sources of social support reported the most difficulties. Students who sought help had more problems and higher levels of concern than those not seeking help. A comparison of the two data sources indicated a slight but significant tendency for agencies to deal with the greatest areas of need at the severity levels indicated in the needs survey.     

Social Exclusion and Psychosis

SUMMARY

This article considers aspects of the possible impact of social exclusion upon psychosis and the implications of this for mental health social work practice. Against a background of calls for evidence based practice, and increasing recognition of the significance of theories and understandings as the foundations of practice, the article will first explore current and historical ways of viewing and intervening with the relationship between social adversity and mental health. Then, alternative understandings of this relationship, supported by recent research regarding the impact of trauma and extreme social adversity upon physiological and physical processes implicated in mental ill-health, will be discussed. These approaches have major implications for social work practice with psychosis, suggesting that experiences of trauma and disadvantage, and interventions seeking to alleviate the inner and outer effects of these experiences-tasks central to the social work remit-can make a significant difference to mental health outcomes. However, this is not to advocate a simple (albeit under-resourced) 'social solution'! On the contrary, the understandings underpinning these approaches recognise biological processes play a role in mental and physical ill-health: importantly, however, they can be shown to question the stigma traditionally attached to the concept of biological disorder in mental health, thus pointing to the value of a truly biopsychosocial approach with psychosis, involving fully holistic interventions that differ from those currently dominant, and which carry implications for more egalitarian worker-user relationships.     

Understanding loss: The origins and value of current theories of loss

Abstract

This article discusses the origins of concepts concerning the nature of loss and its consequences for mental health. It suggests that, while the experience of loss is self-evidently of importance for individuals, the view that loss represents a major risk factor in mental health has led to unwarranted professional intervention in the belief that grief must be 'resolved' in order to prevent a negative psychological impact. It is suggested that this view has not been sufficiently explored theoretically and that professional helpers, such as social workers and counsellors, should use models which purport to facilitate mourning with some caution.     

Psychological Distress of Cuban Americans Affected by Restrictive U.S. Travel Policies

We describe the mental health consequences of United States travel policies affecting Cuban Americans (CAs) with relatives in Cuba and discuss these policies in the context of U.S. domestic politics and the Bush administration's desire for regime change in Cuba. Policies put into effect in 2004 restrict CAs from visiting relatives in Cuba more than once every 3 years, narrowly define family whom CAs can legally visit, and limit the assistance they can provide their Cuban relatives. We share case reports based on qualitative interviews with 53 Cuban Americans that illustrate travel-related psychological distress (TRPD) experienced by CAs in response to the restrictions. We note the difficulties CAs experience in coping with TRPD and the need for political and mental health interventions to address this condition. TRPD is directly related to the government's violation of the human and constitutional rights of CAs to travel freely. It is the responsibility of the state to restore those rights. Human services professionals should oppose TRPD as antithetical to family well-being.