Work, employment, and mental illness: expanding the domain of Canadian social work

Despite established evidence that work and employment are an important component of recovery for people who experience mental illness, social work education in Canada seldom offers graduate training or courses on the significance of work in peoples' lives or on the practices involved in helping to gain and retain employment for these individuals. In this article the authors argue that the high levels of unemployment among people who experience mental illness, and the rising incidence of mental health and addictions issues in workplaces, offer the opportunity, as well as the mandate, for social work educators to provide professional education in the area of employment support and assistance.     

My Recovery Story

This is an autobiographical story in which Charles Feldman grows up absurd, wants to be a hippie, is briefly involved in a socialist organization, comes down with schizophrenia, doesn't realize at first that he has an illness, suffers at the hands of an incompetent psychiatrist, gets better treatment with new providers, comes to terms with the illness, advocates on behalf of people living with mental illness, and resolves his existential identity crisis by finding a spiritual home in the Vedanta movement, which provides the culmination of his recovery.     

Children and Young People Living Through a Serious Family Illness: Structural,Interpersonal and Personal Perspectives

This study explores the experiences of children and young people in Britain living through a serious family illness. The study considers the interplay between social structures, social relationships and individual agency. We draw on data from the Millennium Cohort Study to estimate the number of children and young people affected nationally and on seven in‐depth interviews to understand young people’s experiences and the effects on their daily lives. Living through a serious family illness impacts on young people’s educational achievements, mental health and social relationships over long periods. Policy and service responses are suggested.     

Enabling careers, autonomy, and prosperity: Using community organizing and building approaches to improve the educational outcomes of people with mental illness

Objectives: The objective of this regional initiative was to develop access to educational opportunities for people with mental illness with a view to ultimately advancing their career prospects. Participants: The initiative engaged a broad range of community stakeholders including people with mental illness, their families, educators, mental health service providers and, policy analysts. Methods: The initiative used community organizing and development strategies to develop solutions to problems related to access to education. Results: The initiative was successful in mobilizing community participation, identifying priorities, and translating these priorities into action plans. Working groups of community stakeholders engaged in initiatives related to improving access to resources to support education, developing training for teachers in secondary schools, creating peer support systems, and developing a pilot supported education program as a partnership between a college and mental health service. Conclusion: Organized community building provided a foundation for a broad range of initiatives meant to improve access to educational opportunities for people with mental illness. Evaluation efforts will need to focus on the extent to which these initiatives ultimately ledto positive changes in the careers of people with mental illness.     

Parental Grief and Serious Mental Illness: A Narrative

Serious mental illness is associated with substantial personal and interpersonal distress and life disruption for the sufferer and for his/her family. A common response to having and caring for a family member with a serious mental illness is feeling loss and grief. This paper presents a representative narrative that attempts to capture the essence of the experience as conveyed by 22 parents of adult children with a serious mental illness. The implication of the narrative is examined.     

A new heart in the face of old ethical problems.

A heart-transplant patient, historian, and minister, Robert Clouse tells the story of his illness, his decision to undergo surgery, and his recovery, reflecting on the larger meaning of that experience.     

Online Peer Support Programs for Young People with a Parent Who has a Mental Illness: Service Providers’ Perspectives

Young people with a parent or parents who have mental illness are at a higher-than-average risk of experiencing emotional and behavioural difficulties. Notwithstanding the difficulties experienced by these young people, opportunities to interact with and obtain support from peers living in similar families can be beneficial. While young people face several barriers to participating in face-to-face peer support programs, online approaches potentially provide a different way of obtaining peer support. This paper aims to explore service providers’ perspectives on current Victorian peer support programs, as well as the strengths and weaknesses of online approaches to peer support. Semistructured interviews were conducted with 17 mental health professionals who work with families affected by parental mental illness. Participants recognised that many young people miss out on face-to-face peer support programs, and were highly supportive of the idea of online programs. This study suggests that online peer support programs for young people could occupy an important position in the evolving suite of services for Australian families affected by mental illness.     

The variation in family background amongst young homeless shelter users in Denmark

This article analyses variation in the family background of young homeless people in a cohort of young Danes. The study is based on administrative data for individuals who were 18 years old in 2007 and their parents. Homelessness is measured by shelter use over a five-year period. Data also cover education, employment, mental illness, substance abuse problems and placement outside home in childhood for the young persons, and education, employment, civil status, mental illness and substance abuse problems for their parents. A cluster analysis identifies two groups, each comprising half of the young shelter users. In the first group, social marginalisation is transmitted between generations, as most parents have low education and mental illness or substance abuse problems, and are unemployed. In contrast, the young people in the second group come from wider socioeconomic backgrounds, with few of their parents having mental illness or substance abuse problems. These young people develop psychosocial problems and become homeless without strong predictors from their family background. Amongst the young shelter users from families with severe social problems a higher share are in the Not in Education, Employment or Training group. They also have more shelter stays, compared to young shelter users from families with fewer social problems.     

Bachelor of Social Work Students and Mental Health Stigma: Understanding Student Attitudes

Bachelor-level social work students (n = 198) at a midsized Midwestern public university were surveyed to evaluate their attitudes toward those with mental health concerns. Additionally, students were surveyed regarding their willingness to seek treatment for their own mental health needs. Results of the analyses suggest that the majority of students do not hold stigmatizing attitudes toward mental illness. Students who believed mental health work is rewarding were less likely to be afraid or uncomfortable around people with mental illness. In addition, these students were more likely to report attitudes that acknowledge the capabilities of people with mental illness and were less concerned with others knowing their own mental health status. Implications for social work education and directions for future research are discussed.     

‘Actually There is a Brain in There’: Uncovering Complexity in Pathways Through Education for Young Adults Who Have Been in Care

Internationally, research has highlighted disruption to the educational trajectories of young people in care, documenting concern about upheaval and poor educational outcomes. We present findings from English data arising from qualitative longitudinal research with care experienced people (16–32 years) who were also in education, employment or training. The analysis extends understanding of the experiences of those who achieve educational ‘success’, including those who followed non‐linear trajectories. The need for a flexible education system, and leaving care entitlements, which take into account the disruption experienced by young people in care and the consequent possibility of delayed educational pathways, is discussed.     

A culture of education: Enhancing school performance of youth living in residential group care in Ontario

This article presents a synthesis of what is known about the educational experiences of youth living in residential group care based on a literature review that highlights both the experiences of the youth themselves and the operational context of residential group care in Ontario as it pertains to educational performance. The author argues that there is little emphasis on education within the residential group care sector in Ontario that could translate into more productive educational experiences for youth. The article then provides a framework for developing a culture of education for residential group care that can be acted upon expeditiously. Enhancing the educational performance of young people living in group care will require a cultural approach that provides for daily and pervasive education supports and encouragement, and aims to enhance the lived experience of young people pursuant to their education.     

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.     

Bathrooms,Boundaries, and Emotional Burdens: Cisgendering Interactions Through the Interpretation of Transgender Experience

Building on findings demonstrating that social institutions may cisgender realities by creating and enforcing binary notions of gender rooted in cisgender experience, this study examines the ways cisgender people reinforce cisnormative gender binaries in their ongoing interactions. Utilizing interviews with 99 cisgender people, I show how respondents react to a vignette about a gender nonconforming person seeking to use a public bathroom by “cisgendering interactions,” which I define as the process whereby people reassert binary understandings of gender to make sense of transgender experience while placing an unequal emotional burden on transgender and gender nonconforming people to mend the interactional disruption of the gender panic. Additionally, my analysis extends transgender scholarship by demonstrating some ways cisgender people make sense of transgender people in public spaces. In conclusion, I draw out insights for understanding (1) the ways people cisgender their realities in the face of conflicting stimuli, (2) the ways in which emotions are a mechanism of inequality reproduction, and (3) the consequences these actions have for the perpetuation of gender inequality.     

THE BODY, IDENTITY, AND SELF:

Serious chronic illness undermines the unity between body and self and forces identity changes. To explicate how the body, identity, and self intersect in illness, one mode of living with impairment, adapting, is explicated in this article. Adapting means altering life and self to accommodate to bodily losses and limits and resolving the lost unity between body and self. It means struggling with rather than against illness. The process of adapting consists of three major stages: (1) experiencing and defining impairment, (2) making bodily assessments and, subsequently, identity trade-offs, as ill people weigh their losses and gains and revise their identity goals, and (3) surrendering to the sick self by relinquishing control over illness and by flowing with the experience of it. Adapting seldom occurs only once. Rather chronically ill people are forced to adapt repeatedly as they experience new losses. The data consist of 115 interviews about experiencing chronic illness and 25 more focused interviews about the body in chronic illness. The strategies of grounded theory provided the methods for completing the analysis.     

Young consumer identity in a restrictive school environment — Addictive substances,symbolic goods and consumer skills

For young people, consuming is an act of constructing identity, where goods, services and styles are important parts of signifying who they are. Our study focuses on young people who are living in restrictive environments, such as special boarding schools. They have been placed there because of social and educational reasons. Although aspects of education and health of young people in out-of-home care have been studied, their consumer behavior has been given limited attention. Our study shows that young people openly report the use of addictive substances such as cigarettes, alcohol, drugs as well as gambling. They also build up their consumer identity by appreciating symbolic goods, such as clothes, music and sport. Spending on expensive clothes serves their favorable self-image. The fact that the schools provide all their essential needs makes the learning of consumer skills challenging although the schools reinforce management skills such as planning the use of money. Young people struggle with their identities at the borders of their school environment (i.e. education, school discipline) and the temptations of consumer culture. Even if they manage to break their damaging life path, they will be consumers throughout their life, meaning their consumer skills need to be strengthened by special education.     

Caring at a distance: Learning and practice issues

Emphasis on support for informal carers focuses on those who provide, in the words of the Carers (Recognition and Services) Act 1995, 'substantial' and 'regular' care. Following research and policy, professional education has also developed interest in those who live with the people they support, such as co-resident spouses and children of all ages. This article considers those who probably do not define themselves as carers and are usually referred to as 'relatives' or 'family', living at a distance from an older relative. It explores their possible need for support as well as the form and level of their involvement in relation to care managed services. It describes key areas or events to draw out practice issues and concludes with a discussion of the extent to which care management can work with such relatives. In many ways caring at a distance forces an examination of what is meant by 'care' and who can legitimately claim this as an emotion or status. The rationale for such interest is therefore three-fold. If social workers and social work educators restrict the meaning and their definitions of carers to those who provide 'hands on' services, as part of the care package, they risk alienating relatives from the learning experience of students. In doing so they may neglect these highly valued supports of older people and may leave relatives distressed and disempowered by anxiety over their contract with social work agencies.     

Normal life crises and insanity—mental illness contextualised

According to a 2005 survey, the people of Rosengård, a culturally heterogeneous borough of Malmö, Sweden, utilise considerably less mental health services in relation to their estimated needs than the rest of the city's population. A study based on interviews with people living or working in the area revealed several possible reasons. Most important was their perception of what constitutes mental illness. If the cause of one's disturbed mental state is viewed as a normal life crises rather than an illness, one does not seek medical treatment. The aim of this article is to illustrate how under-utilisation of mental health services by an immigrant population can be explained by their different perceptions of what constitutes mental illness. Interventions should add concerns regarding a client's socio-economic and psychosocial needs, rather than solely follow a medical model.     

Individual and environmental factors related to job satisfaction in people with severe mental illness employed in social enterprises

Objective: The purpose of this study was to enhance understanding of the impact of individual and environmental variables on job satisfaction among people with severe mental illness employed in social enterprises.Participants: A total of 248 individuals with severe mental illness employed by social enterprises agreed to take part in the study. Methods: We used logistic regression to analyse job satisfaction. A model with job satisfaction as the dependent variable, and both individual (occupational self-efficacy and severity of symptoms perceived) and environmental (workplace) factors (provision of workplace accommodations, social support from co-workers, organizational constraints) as well as external factors (family support) as predictors, was tested on the entire sample. Results: All findings across the study suggest a significant positive impact of both individual and environmental factors on job satisfaction. People with higher occupational self-efficacy who were provided with workplace accommodations and received greater social support were more likely to experience greater job satisfaction.Conclusions: These results suggest that certain features of social enterprises, such as workplace accommodations, are important in promoting job satisfaction in people with severe mental illness. Further studies are warranted to expand knowledge of the workplace features that support employees with severe mental illness in their work integration process.     

Helping partnerships that facilitate recovery from severe mental illness

The intent of this study was to learn how consumers experience helping partnerships that assist them in recovery to inform families, professionals, and peers about meaningful actions and strategies that promote the healing process. In-depth interviews were conducted with a purposeful sample of 10 individuals who had a self-reported diagnosis of severe mental illness. Using the phenomenological research process, helping partnerships and how they develop were described. Six key themes emerged from the data and included Networks of Helping Partnerships, Teaching-Learning, Spirituality, Creative Drive, Time, and Medication Adherence. Characteristics and behaviors of helping partners were identified, as well as structures that promoted their development. Educating the public, consumers, and mental health professionals about how to promote recovery, the role of spirituality and creativity, the benefits of medication and therapy, and the impact of learning on progressing through recovery can go a long way toward eliminating the mystery and fear associated with mental illness.     

Creative Solutions and Development for Social Workers Treating People with Serious Mental Illness - Contributions from Supervision

Social workers who are engaged in a therapeutic work with clients who have serious mental illness often face specific challenges and find themselves in crisis states in therapy, which stem from the return of the clients’ symptoms and their cognitive impairments as well as social stigma. These crisis states cause dramatic changes in the way social workers mentalize their clients and they are propelled to draw from covert, unformulated, and dissociated knowledge that they have about the client’s experience, which contributes to achieving new, surprising, and creative ways to mentalize the client. Such crisis resolutions enhance therapists’ personal and professional development and serve as an identification model for their clients.