A Critical Analysis of the Social Work Literature on Disabilities

Abstract

The principles of empowerment and demedicalization have been central to the formulations of rehabilitation and social service practices as well as case management, a core community support service provided to people with psychiatric disabilities. This study describes empowering and demedicalized practices in mental health case management. Semi-structured interviews were conducted with thirty leaders in the mental health consumer movement and five professionals. Twenty-five categories of such practices were developed and are presented. Findings have implications for both the nature of the interaction between case manager and client and for program structures, activities, and missions.     

Peer Support Among Consumers of Professional Mental Health Services

ABSTRACT

Peer-support services have become increasingly prevalent in mental health; consumers now deliver many services once provided by professional mental health providers. Recognizing this key asset in mental health consumers' service environment is critical for social workers. This exploratory study examines differences among 311 consumers of professional mental health services, half of whom also used peer-support services. The two groups (peer support compared with non-peer-support) were compared on a number of dimensions related to their utilization of and satisfaction with professional mental health services. Users of peer-support services perceived greater availability of professional services and used more professional services, but found professional services to be less useful than those not participating in peer support. No differences between the two groups were found for overall satisfaction with professional services. Findings related to policy, practice, and research are discussed.     

Diversity Within Diversity

Summary

Asian American elderly form a heterogeneous group with respect to immigration history, ethnic/cultural background, socioeconomic position, and health and mental health status. This paper provides an overview of the internal heterogeneity within the Asian American elderly population and identifies those who experience multiple stressors affecting their quality of life. Then it discusses barriers to formal service utilization as well as strengths and deficits of informal support systems. To better serve Asian American elders with their multiple needs for health, mental health, and social services, increased funding is recommended for research on this group, diversification of social service programs in coethnic communities, and increased cultural competence in non-Asian social service agencies.     

Role Conflict and Ambiguity

Abstract

This study explores the relationship between role conflict and role ambiguity, and burnout of mental health service providers. The study used a sample of 259 mental health service providers who completed a questionnaire that included several measures: role conflict and ambiguity scales, the Maslach Burnout Inventory, social support scales and an involvement scale. Results showed that role conflict and role ambiguity had statistically significant correlations with several of the burnout dimensions. The author discusses the potential implications for increasing workers' quality of work life.     

Medicare Funded Mental Health Social Work: Better Access to What?

ABSTRACT

Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Scheme initiative (Better Access), is an Australian Federal Government scheme aiming to improve access to mental health services. Accredited mental health social workers have been involved in the delivery of services under Better Access for more than a decade. In this time, there have been significant changes in the field of mental health services, with consequent increases in size and costs for Better Access. Better Access now represents public spending of more than one billion dollars per annum, yet there is no ongoing account of its impact. In this paper we consider the policy chronology and evaluation of the program, using current available data to question the impact of Better Access on both the service system and the nature of mental health social work practice. This case highlights the importance of a clear articulation of the scope of mental health social work, and ongoing monitoring of the impact of policy in a policy environment increasingly characterised by individualised funding and service delivery structured according to the principles of New Public Management.

IMPLICATIONS

• Social workers' increasing involvement with Better Access has reshaped the scope of mental health social work practice.

• The impact of Better Access on outcomes for service users and mental health social work is not currently a focus of research attention.

• Better Access is a case study illustrating the potential of the policy context to directly shape social work practice, therefore critical engagement with the impact of Better Access is an essential professional imperative.

     

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.     

The accommodation and support needs of people with a mental illness: A process and framework for action

Abstract

This paper reports the results of a consumer-focused assessment of the accommodation and support needs of people with a mental illness living in a regional city. The study utilises a 'pathway to stability' approach to assess the phase-contingent accommodation and support needs of mental health consumers through interviews and focus groups with consumers, carers and service providers. The study identifies five broad phases of the life course impacted by mental illness—beginnings, long-term needs become clearer, instability as needs evolve, finding stability and ongoing. Five key issues—information, self-competence, comorbidity, coordination and flexibility were expanded upon in focus groups. Principles for planning future service delivery are identified. The implications of the findings and research methodology for social work practice and research are discussed.     

Boundary-Spanning

SUMMARY

A boundary-spanning approach to practice traverses barriers to give social workers greater understanding of context, more latitude in interventions, and increased access to systems. This broad-based approach helps social workers work in large, complex systems of care that demand more creativity and advocacy from practitioners in less time with less support. It draws from direct social work practice, program planning and management, social work administration, and business/organizational management. Spanned boundaries include those restricting knowledge bases and definitions of setting, those separating health from mental health, those that isolate systems of service delivery and levels and modalities of practice.     

An Evaluation of Mental Health Services for the Culturally Diverse

ABSTRACT

The purpose of this project was to examine the needs of multicultural populations in the mental health system, and see how these needs get addressed in current policies. As a social worker in the mental health system, I wanted to investigate the strengths and weaknesses of service providers in their ability to meet the needs of diverse populations. In doing this research, I hoped to make a space for people whose families have had to deal with mental health services, and explore the experiences of those who have not had the opportunity to discuss them. In addition, the purpose of this paper is to contribute to a body of increased knowledge on how the mental health system treats people who belong to a cultural minority.     

Translating knowledge into practice: using simulation to enhance mental health competence through social work education

ABSTRACT

Simulation-based learning (SBL) is an innovative experiential teaching method where students and instructors interact with a simulated client to foster students’ holistic competence in practice. Considering the context of North America where social workers are the largest service provider in the field of mental health, it is critical for educators to enhance competencies in students during the social work program. Guided by competency- and simulation-based, adult learning frameworks, this paper illustrates the development and integration of a range of educational activities into a treatment-focused advanced mental health course in the social work curriculum. We conclude by discussing how SBL enhances students’ mental health competence and provide recommendations when developing SBL in the mental health curriculum in social work education.     

Predicting job satisfaction of mental health peer support workers (PSWs)

ABSTRACT

The Mental Health Recovery Model is an empowering service philosophy which has been transforming the field of mental health. An important service approach to actualizing this model is hiring peer support workers (PSWs) who are peers advanced in recovery and employed to assist other peers in their recovery process. This study reports on factors hypothesized to affect PSW job satisfaction. Using multiple regression analyses, organizational culture and relationship with peers predicted 29% of job satisfaction. Based on these findings, suggestions are offered to assist social work administrators in effectively integrating and supporting PSWs in the workplace.     

Responding to the Mental Health and Grief Concerns of Homeless HIV-Infected Gay Men

Summary

Aging, homeless HIV-infected gay men confront multiple bereavement and mental health issues. Needs assessment interviews with this population in the streets of New York City facilitate the initial review and provision of clinically and culturally appropriate service delivery strategies for these disenfranchised gay men to access bereavement support and mental health care systems.     

Cultural Change and Chinese Immigrants' Distress and Help-Seeking in Hong Kong

Abstract

The study examined, within a stress-coping paradigm, the contribution of acculturation, enculturation, and acculturative stress to distress and help-seeking among Mainland Chinese immigrants in Hong Kong. One hundred and thirty-one female immigrants were recruited from community service centers. Hierarchical regression results showed that general stress and acculturative stress were linked to distress. Social support did not play a buffering role on distress. Whereas length of residence and social support were strongly related to informal helpseeking, acculturation, along with age and social support, were related to professional help-seeking. Given the differential effects of various cultural change variables, the importance of independently assessing their influence on immigrant mental health and help-seeking is warranted.     

Predictors of well-being in the lives of student service members and veterans

Objective: The current study examined predictors of well-being, including quality of life and academic engagement, in a sample of student service members and veteran college students. Methods: Eighty-seven student service members/veterans (SSM/V) completed an online survey containing questions about post-deployment social support, emotion regulation skills, psychological distress, academic engagement, quality of life, and demographics. Participants were recruited from September 2012 through May 2014. Results: Results provided partial support for the proposed bi-directional mediational relations between post-deployment social support and emotion regulation predicting to quality of life and academic engagement. Path models indicated that both post-deployment social support and emotion regulation skills partially mediated the relation with quality of life while accounting for the effect of psychological distress, and that emotion regulation skills fully mediated the relation between social support and academic engagement. Conclusions: These findings suggest that both social support and emotion regulation skills may be useful targets for health promotion and intervention efforts for this population. Limitations and clinical implications for the development of on-campus SSM/V focused health promotion services are discussed.     

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.     

Cyber Counseling for Queer Clients and Clinicians

Abstract

As the Internet grows, so does its use by mental health professionals and by clients seeking mental health services. Drawing on his own experience as an example, the author describes how the Internet can enhance clinical practice. Social service professionals can utilize the Internet to provide a supportive forum for patients grappling with issues of self-identity; facilitate communication between therapist and client; provide community education about mental health issues; provide referrals to local social service professionals; market a private psychotherapy practice; and provide patient billing, scheduling, and record keeping.     

Responsive engagement in mental health services for foster youth transitioning to adulthood

ABSTRACT

As youth near the transition to adulthood and aging out of the foster care system, exposure to stress increases, especially for youth who have less-than-adequate support systems. Although mental health problems among foster youth often continue into adulthood, service use decreases dramatically within a year of turning age 18. Understanding how foster youth experience mental health services as they transition from care provides social workers and other mental health professionals important insight that can lead to specific, targetable strategies. This study sought to explore what situations were helpful in supporting mental health as foster youth transitioned to adulthood. Focus groups and interviews with former foster youth and professionals informed the development of a quantitative instrument, which was used to identify the most supportive and frequently encountered situations former foster youth experienced. Findings indicate the most helpful situations were those in which professionals and mentors were flexible and responsive to their individual needs and trusted their ability to make decisions. Supportive adults who honored their choices and collaborated in decision-making were also helpful. Engaging, empowering, and partnering with transition-age youth may increase the likelihood of positive mental health outcomes for this population, offering implications for family-centered, strengths-based practice.     

Implementation of a Mental Health Task Force in a collegiate-based emergency medical services organization

Abstract

Objective: A Mental Health Task Force (MHTF) was implemented in 2016 by a collegiate-based emergency medical services (CBEMS) organization to (1) improve mental health emergency response and to (2) address concerns for the mental health of CBEMS providers. Participants: Skidmore College EMS is a Basic Life Support First Response service staffed by volunteer undergraduate students. Methods: In coordination with faculty and staff, students in the MHTF developed trainings, peer support structures, community events, policies, and informational resources. Results: Sixteen students joined the MHTF within 1 year. Over 35 Skidmore College EMS members received training on mental health emergency response, peer-support, and self-care. Debriefing programs, mindfulness-based events, shift-length limitations, and access to informational resources promoted the mental health of Skidmore College EMS members. Conclusions: Implementing an MHTF is an innovative, student-led approach to coupling education on emergency response with programming that supports the mental health of CBEMS providers.     

‘I am not your nutter’: a personal reflection on commodification and comradeship in service user and survivor research

Abstract

This article offers some personal reflections from a mental health service user/survivor researcher working in English academia. It is a critical examination of what mainstream clinical mental health researchers and funders appear to need us to be, and what some in the service user and survivor movement perceive us to be. The discussion examines questions about commodification and public and patient involvement and contemporary challenges for service user and survivor research as a separate discipline operating within and beyond academia in England. The article concludes by exploring potential strategies for collaborative activism for service user and survivor researchers in academia based on the concepts of social capital and situated solidarity.