Captured by the Game: Might a Focus on the ‘Therapeutic Relationship’ Diminish the Attention We Give to the Client's Intimate Network?

A recent project sought to clarify how psychotherapists and mental health workers understand psychosocial health and pathology. In this enquiry, I paid particular attention to the client's interpersonal networks: did the professionals actively consider, and if so to what extent, ‘intimate social and family relationships’ in constructing their understanding of the presenting problem and in the process they used for goal setting. Twenty‐two semi‐structured interviews were undertaken, eleven with psychotherapists and eleven with mental health workers. Across both groups, interviewees tended not to see their clients as embedded, relational entities, but primarily, often quite exclusively, as autonomous beings. Second, interviewees accorded a high value to the importance of ‘the therapeutic relationship’. Is it possible that the emphasis practitioners place on ‘the therapeutic relationship’ has the effect of marginalising the attention that is given to the client's significant‐other network?     

SAMHSA pushes back against ‘political ploy’ criticism

Last week, the Substance Abuse and Mental Health Services Administration (SAMHSA) struck back against “members of the media and even other federal agencies who purportedly exist to protect the health of Americans,” charging that children's mental health is the agency's main reason for promoting school reopenings. The Sept. 29 statement by SAMHSA ( https://www.samhsa.gov/newsroom/press‐announcements/202009290204 ) came the day after the New York Times article ( https://www.nytimes.com/2020/09/28/us/politics/white‐house‐cdc‐coronavirus‐schools.html ) revealing the federal Centers for Disease Control and Prevention's (CDC's) concerns about reopening schools.     

A Social Constructivist Perspective on the Potential Relevance of Selected DSM‐5 Disorders for South African Children and Youth

In South Africa, careless implementation of child psychiatry's biomedical model of ‘mental disorder’ could stigmatise children and youth who have been made vulnerable by the lingering effects of apartheid — poverty and malnutrition, violence and abuse, and the HIV/AIDS pandemic. A focus on DSM‐5 category changes — regarding post‐traumatic stress disorder and ADHD — demonstrates that these psychiatric labels are impracticable and irrelevant in a post‐colonial developing country, where mental health care is delivered in the context of scarce services and unequal access. A social constructivist perspective enables us to broaden policy decisions and suggest directions for research.     

Do Lets Work?

This study aims to uncover some of the reasons for differences in attitudes towards family‐friendly and equal opportunities (EO) policies for women between senior and junior staff and between male and female staff. This in‐depth case study of a multi‐national corporation in Hong Kong that included a survey questionnaire, interviews and participant observation suggests four categories of female employees according to their approach to EO: advocators, supporters, outsiders and rejecters. The approach adopted was dependent on the woman's level of empathy towards the situation of working women and the extent of her career ambition. Four categories of male employees can also be classified depending on their level of empathy towards women's situation (similar to women's case) and their extent of career satisfaction (in contrast to women's career ambition), namely, antagonists, outsiders, fence‐sitters and sympathizers. Women at higher levels were less supportive of EO than women at lower levels. No such clear relationship between organizational level and attitudes towards EO was observed among men. In Hong Kong, female managers had little expectation that their organization would be family‐friendly and women workers who consciously chose to balance work and family accepted that it meant fewer promotional chances. No such self‐adjusted depressed ambition was observed among men.     

HMOs and the Future of Student Mental Health Services

Abstract

The health maintenance organization (HMO) is likely to have a prominent position under national health insurance, which will have a strong systematizing effect on the nation's health services. Over the past two years the University of Massachusetts mental health services have provided benefits at both the university and a private medical group practice. Experience has shown that a university which already provides broad services to a large student population can extend itself to the university community including its faculty and staff. Several advantages of this development, as well as some significant problems, are discussed. As the HMO grew and quality services were established, it became feasible for the private medical group to develop its own mental health component. Based on this and other experiences in mental health delivery systems, certain conclusions are drawn about the ways universities can develop HMOs and some recommendations are made for national mental health planning.     

Who cares? A lack of self‐care for women in the non‐profit/non‐governmental sector

In this article I examine the lack of self‐care regimes for women working in the non‐profit/non‐governmental sector. While I draw on ethnographic research conducted in the Malaysian context of women's organizations, the issue of self‐care for activists and feminist activists is a global one that crosses borders and boundaries. I explore the gendered nature of care and care professions to demonstrate how women are predominantly affected in these working environments. To date, there has been little scholarship on self‐care and care in non‐profit/non‐governmental working environments. Using interviews with women working in the sector, I argue that women's emotional, mental and physical health comes at a cost in these hectic workplaces. This article contributes to the literature on gender, work and care in women's organizations by taking seriously women's concerns working in these spaces, where they experience self‐neglect and institutional barriers in care regimes.     

Motivations to Pursue Accreditation in Children's Mental Health Care: A Multiple Case Study

Accreditation is a growing, worldwide phenomenon that has spread to a range of industries and fields, including nonprofit social services and mental health care. Thousands of organizations are accredited, but it is not known what is driving the growth of this phenomenon. Using a multiple case study design, this exploratory study aimed to understand children's mental health agencies' motivations to pursue accreditation. In‐depth interviews, focus groups, document reviews, and limited observations were conducted at five children's mental health agencies that had recently undergone or were undergoing the Council on Accreditation process. Agencies were influenced by external factors, such as policies that require accreditation, wanting to assert their positions in the field, and the need to increase funding opportunities. Other factors were internal, related to agency leadership using accreditation as a platform for change and agencies' genuine intent to improve services. Implications for agencies, accreditors, and future research are offered.     

The Effects of United Way Membership on Employee Pay in Nonprofit Organizations

This research investigates the relationship between United Way membership and the compensation level of employees in nonprofit organizations. This study is based on questionnaires completed by 1,811 employees from sixty‐nine nonprofit agencies in a large metropolitan area. Managerial capitalism, agency theory, and United Way funding and governance roles were used to develop the hypotheses. We found that employees of organizations belonging to the United Way receive pay premiums, suggesting that the United Way member agencies are higher‐quality agencies that pay their employees higher wages.     

“A Geography of Disparate Spirits”: Pathology as Oppression in “A Woman is Talking to Death” and “Mental”

This article foregrounds Judy Grahn's commitment to social justice and chiefly considers her nine-part poems: “A Woman is Talking to Death” and “Mental.” These poems illuminate the socially constructed nature of mental illness and challenge readers to consider how and why the characters within them are deemed mentally ill. Little, if any, scholarship has been devoted to using Grahn's poetry, and particularly “Mental,” as a framework for analyzing the pathologization of people, especially women, relative to the system of mental health. Her work remains relevant to critical conversations that illuminate contemporary issues of oppression that still haunt us today.     

Exploring a model of servant leadership,empowerment, and commitment in nonprofit organizations

This study examined a model of servant leadership's relationship to organizational commitment through structural and psychological empowerment, focusing on leader–follower dyads in a nonprofit organization. Survey data was collected from 128 employees of a nonprofit organization in a northeastern U.S. city. After model re‐specification, a well‐fitting model emerged, indicating that structural empowerment mediates the relationship between servant leadership and organizational commitment. Moreover, the model suggests that structural empowerment's effect on organizational commitment is both direct and indirect—the latter occurring through the meaning dimension of psychological empowerment. This study provides initial support for structural empowerment being a mechanism through which servant leadership impacts organizational commitment in nonprofits. In addition, the role of meaningful work is highlighted as an antecedent to organizational commitment for nonprofit employees. Servant leaders are suggested to create structurally empowering working environments, which support employees' stronger commitment to the organization.     

The Power of Peer Support: The Development of the Empowerment Center

ABSTRACT

This article discusses the events and influences that led to the author’s contribution to the development of a mental health consumer-run organization, The Empowerment Center in Mount Vernon, NY. The author traces some events that influenced him personally and the evolution of the Empowerment Center from an organization that provided advocacy services (to those with mental health problems who were hospitalized) and community-based support services to people in mental health recovery, to an organization focusing on economic empowerment and economic development for the community of those in recovery. The transition of the Empowerment Center into an organization focused on economic empowerment underscores the importance of economic independence for people in recovery and the consumer-run organizations that support them. The Empowerment Center endeavors to demonstrate that mental health consumer-survivors can take control of their economic health as well as their physical and mental health.     

Case Studies of Federal Occupational Health's EAP Responses to Natural Disasters

Summary

Employee assistance professionals have increasingly been called upon to address the emotional and mental health needs of customer organizations and their employees in response to large-scale natural or man-made disasters. In doing so, employee assistance program (EAP) professionals must use a repertoire of responses that encompasses a broad range of interventions, generally anchored in an understanding of and focus on the organization and its culture, mission, management and labor concerns, and other critical characteristics. The EAP's fallback response to a crisis affecting the workplace is often a critical incident stress debriefing or close variant of it. However, EAPs can best serve their customers at all levels with interventions attuned to an understanding of the workplace culture gained through a consultative relationship with management, while factoring in the nature of the disaster, the length of time and characteristics of the disaster's aftermath, and the nuances of the employees' physical and emotional needs throughout the entire disaster response and recovery process.

This article highlights these issues through the presentation of two case studies, gained from the hurricane response activities of the Federal Occupational Health (FOH) EAP. FOH, a service unit within the U.S. Department of Health and Human Services' Program Support Center, has 60 years of experience working in partnership with its federal agency customers to deliver comprehensive occupational health services to improve the health, safety, and productivity of the federal workforce. FOH's EAP contracts with vendor organizations to provide direct employee assistance, work/life, and related services to more than 1.3 million federal employees. The first case study describes (from the first person perspective) an on-site, multi-focused EAP intervention at a federal facility. The second case study describes management consultation with the U.S. Postal Service in response to major hurricane activity.     

Volunteers' Power and Resistance in the Struggle for Shelter Animal Survival

This article presents an analysis of how volunteers use different forms of capital to resist the practices and discourses of the organization for which they volunteer. Volunteers at a large public animal shelter do not share the shelter's institutionally held belief that shelter death is an inevitable result of homelessness among companion animals; to reduce shelter death, they craft challenges to the shelter practice of putting dogs down and work to construct shelter death as an avoidable and problematic outcome. Their repertoire of resistance includes educational, health‐based, relational, moral, reputational, and legal strategies. The findings illuminate that volunteers’ social location outside of the shelter provides them with capital to engage in resistance within the shelter.     

Against all odds: Revitalization of local self-help alternatives by longterm mental health consumers

The article presents a grounded theory case study of a consumer-run alternative services organization, operated by and for people labeled chronically mentally ill in Michigan. We analyze the organization's emergence and development as a process of revitalization through which participants mobilized to transform their private and public identities. Innovations, including self-disclosure rituals and advocacy strategies, were developed by the group's founder during a period of social dislocation following deinstitutionalization. Subsequently, through their advocacy efforts for and with other consumers, group members laid the foundation for a unique form of locally-based political activism, blending innovative self-advocacy strategies with a critique of conventional mental health care. Active participants' efforts have created a mental health consumer organization that members perceive as an empowering and sometimes rehabilitative alternative within Michigan's public mental health care system.     

The mental health problems of mothers experiencing the child protection system: identifying needs and appropriate responses

This article presents the findings of a small pilot study which examined the needs of 13 mothers with severe mental health problems whose children were involved in the child protection system. The use of the diagnosis of ‘personality disorder’ in relation to this group of women is discussed and the finding that all these women had experience of domestic violence is considered in the context of other research findings. The extent to which child protection social workers and mental health professionals worked together on these cases was explored and only limited evidence of good communication and collaboration was found. The need for effective inter‐professional and inter‐agency coordination is argued, but differing conceptions of maternal mental health problems and their relationship to children's needs may make for difficulties in professional communication and decision‐making. The article seeks to identify the differing approaches to maternal mental health problems which appear to be developing out of different groups of research studies and argues that practitioners need to be explicit in identifying their perspectives on the associated issues of maternal mental health problems and child protection. Copyright © 1999 John Wiley & Sons, Ltd.     

What Do Social Workers Need to Know About Mental Health Courts?

Abstract

Mental health courts are an emerging strategy to engage mentally ill offenders in treatment and to avoid unnecessary incarceration. These courts began in 1997 based upon the drug court model; there are currently over 70 courts nationwide. These courts are heterogeneous in structure, work with interdisciplinary teams, and seek to engage the consumer in treatment rather than use judicial sanctions. Social workers are integral members of these teams; yet, no research has been published in social work journals on mental health courts. This article explains the background and context of the courts, describes their features, discusses what social workers need to know about mental health courts, and concludes with ideas for how social workers may work effectively with mental health courts.     

Doing It Well

SUMMARY

Social workers are being challenged internationally to be accountable by defining competency standards at beginning and advanced levels. The study that is the subject of this article will develop the work of one of the authors, which involved a 5-year longitudinal study of beginning social workers and another of experienced social workers. These studies resulted in a book on professional expertise (Fook, Ryan, & Hawkins, 2000). The present study furthered that work and subjected this theory of professional expertise to further testing by examining the work of a sample of expert (rather than experienced) social workers in the mental health field in Melbourne, Australia. Data was collected from a selected sample of mental health social workers by the use of focus group interview. This article reports on the study's findings and discusses their significance and application.     

Well‐being among adolescent boys

Most studies on mental health in the adult population have found a significant relationship between mental health and social class. No study has thoroughly examined this relationship in the adolescent population. This article, based on the Bachman, O'Malley, and Johnston “Youth in Transition” data set, tests the social class/mental state relationship among adolescents. Three separate measures—well‐being, psychiatric symptoms, and depression—are used to indicate mental state. Social class is based on a composite measure of socioeconomic level that exists within the “Youth in Transition” data set. Surprisingly, no relationship was found. These results persisted even when more traditional measures of social class based on parents’ education and the Duncan ranking of the fathers’ occupations were substituted for socioeconomic level. An alternative explanation supporting social stress is discussed in light of Thornberry's developmental hypothesis.     

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.     

OUR Walmart: a case study of connective action

This article analyzes communication practices within networked social movements by exploring the network structure of an organization responsible for numerous labor actions and campaigns targeting the retail giant Walmart. This case study of the Organization United for Respect at Walmart (OUR Walmart) represents an initial attempt to map the network structure of an emergent form of labor organization. To better understand the relationship between communication and collective action, I utilize Bennett and Segerberg's [(2012). The logic of connective action: Digital media and the personalization of contentious politics. Information, Communication & Society, 15(5), 29] model of connective action to examine the organizational structure of OUR Walmart. I conducted semi-structured interviews with a dozen union representatives, OUR Walmart members, and current and former Walmart employees. My intention is to (1) delineate the network structure of a new and significant organizational form of class struggle and (2) consider the utility and validity of the logic of connective action. I conclude with a consideration of the limitations and affordances of the network structure of OUR Walmart for workers engaged in struggles for better working conditions and higher wages. This research finds support for Bennett and Segerberg's model of large-scale action networks. Moreover, this research suggests that organizationally enabled networks are an effective means of coordinating class struggle.