Work organization, well-being and health in geriatric care

The objective of the present study was to explore the connection between the organization of work in geriatric care and factors which have been connected to job stress and burnout, i.e. exhaustion, mental workload, job satisfaction and communication. We also analyzed how these factors were related to employee visits to doctors during the previous 12 months due to various medical conditions. The study was a cross-sectional questionnaire distributed to all employees within nursing homes and geriatric hospital wards with 10 employees or more throughout Iceland. The total response rate was 80%. The majority of respondents, or 96%, were women (n = 1432), and the results are based on their answers. Our data show that there is a high correlation between mental exhaustion and the unsatisfactory organization of work. Mental exhaustion upon completing work shifts was more closely connected to the health outcomes studied than were the other work-related factors studied. This is especially true for chronic fatigue, depression and sleeping disorders. It is important that employers and managers notice the mismatches between work and workers that this study manifests. Employers and managers must also consider the organizational factors that are influential.     

Children’s Mental Health Providers’ Perceptions of Mental Health Literacy Among Parents and Caregivers

Mental health disorders are prevalent among children, yet many do not receive treatment. Parents and caregivers play a vital role in recognizing mental health disorders in children and accessing treatment. But a substantial number of parents lack essential knowledge of children’s mental health disorders, including risk factors, symptom recognition, and treatment options. Little focus has been given to parents in the children’s mental health literacy literature. The purpose of this article is to begin filling that gap by using a survey to describe the perceptions of child and family mental health providers’ perceptions regarding the amount, accuracy, and origin of mental health literacy in the parents of the children they treat. The impact of those perceptions on the work of providers is also explored. Eighty-seven mental health providers completed a survey to assess their perceptions of parent mental health literacy in the area of children’s mental health. Providers perceived parent mental health literacy as low, inaccurate, and inconsistent. In addition, providers indicated that parents rely on informal sources of support, such as friends and family for information about children’s mental health. Implications for social work researchers, practitioners, and the children and families they serve are discussed.     

Treatment of late-life mental disorders in primary care: we can do a better job

Health care services provided to older adults today are not as effective as they should be. The quality of care for late-life mental disorders often falls short of desired standards. The growth of the elderly population makes it imperative for the health care system to address late-life mental disorders more effectively. Intervention strategies based in primary care settings show the most promise, but effectiveness will depend on solving the geriatric psychiatry workforce crisis. Collaborative care is one promising model for improving geriatric mental health care delivery in primary care. Diffusion of collaborative care into the health care system and integrating geriatric psychiatry into other models such as geriatric medical homes will require redesign of the organization and financing of primary care and psychiatry to overcome current barriers. Public policy should reflect the essential role of psychiatry in geriatrics and promote the integration of geriatric psychiatry with primary care.     

Tracing disorder across theories of autism,empathy, and mental health care

Abstract

Categories of mental disorders are generally understood through a biomedical paradigm of clinical research, diagnosis, and intervention. Here, diagnoses operate as professional tools, facilitating care organization and information exchange across diverse social contexts. In this article, I focus on how the diagnosis of autism-spectrum disorder operates in this manner. Autism conceived as a biomedical disorder is then contrasted with proposals by the neurodiversity movement, who understand core qualities of autism as alternative expressions of otherwise normal processes of brain development. Finally, I supplement these conversations with insights from Gerald Edelman’s theory of neural plasticity and Felix Guattari’s paradigm of ethico-aesthetic care. Understood together, these allow mental disorders and community care generally to be reconceived in terms of networks of expressive, embodied, and dynamically embedded rhythms that transcend individual persons. This serves, additionally, to illustrate a concept of empathy that traverses neurological, psychological, and sociocultural domains.     

Mental health and substance use disorders among foster youth transitioning to adulthood: Past research and future directions

At a time when there is increasing attention being given to systematically integrating the well-being of children with the goals of safety and permanence in child welfare, little is known about the psychosocial functioning of foster youth transitioning to adulthood from substitute care. This article systematically reviews 16 peer-reviewed articles and/or research reports to identify lifetime and past year prevalence rates of mental health disorders and service utilization. At ages 17 or 18, foster youth are 2 to 4 times more likely to suffer from lifetime and/or past year mental health disorders compared to transition aged youth in the general population. Findings show that mental health service use declines at ages when the prevalence rate of mental health disorders is peaking. The findings of this review suggest the need to focus future efforts in three main areas: 1) setting a common research agenda for the study of mental health and service use; 2) routine screening and empirically supported treatments; and 3) integration and planning between child and adult mental health service systems.     

Application of E-Therapy Programs to the Social Work Practice

The many applications of the use of e-therapy in social work practice are reviewed. Salient issues regarding technological interventions, including ethical dilemmas, are elucidated. Applications discussed include the use of this evidence-based technology in treatment of substance abuse, anxiety disorders, depression, and other mental health diagnoses. Most significantly, e-therapy provides means of reaching 85% of clients who need services yet do not receive them.     

Negotiating narratives surrounding children's mental health diagnoses: Children and their contribution to the discourse

Despite increasing numbers of children diagnosed with mental health disorders, there is limited research on how children come to understand these diagnoses in childhood. This study examines the retrospective accounts of emerging adults who were diagnosed with mental health disorders in childhood to better understand how they made sense of their diagnoses over time. In-depth, semi-structured interviews were conducted with 42 emerging adults (ages 18 to 22) who were diagnosed with attention deficit hyperactivity disorder (ADHD), depression, generalized anxiety disorder (GAD), and/or bipolar disorder in childhood. Interviews elicited participants' experiences learning about their diagnoses and suggestions for how diagnoses should best be explained to children. Findings demonstrate that participants actively sought and obtained information about their diagnoses over time. They negotiated narratives from several sources, including parents, teachers, mental health professionals, peers, siblings, the media, reading materials, and the Internet. Many of those who embraced medical accounts of their diagnoses did so as they obtained in-depth medical information over time. Meanwhile, those whose parents were open and communicative without using medical narratives suggest it is possible to share information with children without utilizing the terminology of “disorder.” Participants emphasize the importance of being open with children and providing them assurances, explaining that their problems are legitimate, common, and “not their fault.” Implications for social work practice are discussed.     

Group work in the mental health field: researching outcome

This paper reviews outcome studies from groups facilitated for persons living with serious mental illness. Although the research base is limited (groups posing considerable methodological challenges), available studies show that, in general, group work is as effective as individual work, if not more so. This paper describes findings from studies of short-term, long-term and self-help groups dealing with mood disorders, schizophrenia, eating disorders and borderline personality disorders over the last 10 years. The concept of ‘time-effective’ group work is discussed as are the potentially harmful effects of group participation. The paper concludes by arguing that group work is an effective and less expensive treatment option that would benefit from further research to establish an evidence base, both for current practice and for the expansion of group work practice in the future.     

Models of Family Structure and Functioning

Professional change-agents who are concerned with modifying individual behaviour are increasingly aware of the impact of the family in inducing and maintaining personality disorders. As far as the individual's mental health is concerned, the family is the critical social context which fosters personal growth or produces disturbed behaviour. Consequently, professional attention is moving from the study and treatment of individuals in isolation to a new emphasis on work with whole families.     

The psychosocial work environment in the Church of Sweden: An explorative study

This article offers a preliminary analysis of the work environment of the national Church of Sweden. Previous research on this topic has been limited and has focused on either structural problems or leadership. This explorative study examined psychosocial work environment factors (those related to the interplay of physical, mental, organizational, and social conditions in the workplace) in the Church of Sweden and used a top‐down perspective. Data including documents and interviews and were analyzed and categorized in order to identify patterns of relevance for the psychosocial work environment in the organization. The results show four themes: unclear organization structure, a sense of being different, stressful work conditions, and a destructive communication style. The psychosocial work environment within the church is complex, characterized by deep conflicts that are often not dealt with.     

From maximum security to secure treatment: organizational constraints

This study focuses on an organization at the interface of the criminal justice and mental health systems. The institution examined was a maximum security mental hospital, primarily for incompetent felony defendants, as it was attempting to change from a custodial to a treatment orientation. Interest centered on whether structural factors in this type of organization place significant constraints on the ability of the organization to change in the intended direction. Data were collected at five points in time over a two-year period to test the impact of three substantial modifications in the organizational setting on the level of treatment. The latter was measured by patient/inmate responses on Prisonization and Favorableness Scales. Supporting the research hypotheses, there were some initial fluctuations in scle scores, but during the two periods of organizational stability no significant changes in either scale were evident. These findings are discussed in the context of technological constraints facing organizations, especially those providing mental health services in the criminal justice system, with the dual goals of custody and treatment.     

The Costs of Thinking About Work and Family: Mental Labor,Work–Family Spillover,and Gender Inequality Among Parents in Dual‐Earner Families

One of the aspects unaccounted for in previous assessments of employed parents ‘distribution of time is the mental dimension of tasks and demands. This aspect, referred to as mental labor, is conceptualized as the planning, organization, and management of everyday activities. Using the experience sampling method, a unique form of time diary, and survey data from the 500 Family Study (N = 402 mothers with 16,451 signals and 291 fathers with 11,322 signals), this study examined the prevalence, context, and emotional correlates of mental labor among parents in dual‐earner families. Results show that fathers reported thinking more frequently about job‐related matters than mothers but these concerns did not spill over into unpaid work. By contrast, mothers’ job‐related thoughts tended to spill over into unpaid work and free‐time activities. When engaging in mental labor, mothers and fathers were equally likely to think about family matters, but these thoughts were only detrimental to emotional well‐being in mothers. Among both mothers and fathers, paid work was relatively insulated from thoughts about family matters. Overall, findings highlight mothers’ double burden and suggest that mental labor may contribute to mothers’ emotional stress and gender inequality among dual‐earner families.     

Organization Learning Disorders: Conceptual Model and Intervention Hypotheses

This paper presents a conceptual model thatproposes how organization learning disorders influenceorganization performance. The model suggests thatorganization knowledge mediates the relationship between learning disorders and performance. Specificorganization learning disorders are identified for eachof the four phases of organization learning: discovery,invention, production, and generalization. The effect of learning disorders on organizationknowledge is explored, and intervention hypotheses fortreating the disorders are presented.     

Multiple Co-occurring Behaviours among Gamblers in Treatment: Implications and Assessment

A substantial portion of gamblers in treatment may have co-occurring mental health disorders including substance use disorders, especially alcohol dependency, personality disorders, affective disorders, anxiety disorders and impulse control disorders. Co-occurring mental health disorders affect treatment seeking, the treatment process and its outcome, quality of life and functioning in many mental health disorders. Participants in this study were 78 adults enrolled in state-supported out-patient services for pathological gambling and current Gamblers Anonymous attendees. The majority of participants (76.6%) had co-occurring behaviours; 55.8% had multiple co-occurring behaviours. Participants with multiple co-occurring behaviours were more likely to report that a co-occurring behaviour increased the severity of their gambling symptoms. A dose/response relationship between number of co-occurring behaviours and severity of gambling problems was found. Co-occurring behaviours can interact with gambling behaviour. Brief, validated screening instruments are available for screening and diagnosing co-occurring behaviours among gamblers presenting for treatment.     

The Portrayal of Children's Mental Health and Developmental Issues from 1890 to 1920 in Mass Print Magazines in North America

Children's mental health and development issues are considered a significant concern today. A century and more ago children's mental health and developmental disorders were likely understood differently. This paper examines the portrayal of children's mental health and developmental disorders in all 41 accessible articles on the topic indexed in the Reader's Guide to Periodical Literature from 1890 to 1920. It focuses on these three decades as a time of fundamental economic, political and social transition before the first text in Child Psychiatry was published and the first professorship in the field established. It was also before the beginning of the influential child guidance movement. In particular, the research asks (i) what were the ‘disorders’ discussed and of what were they said to consist?, (ii) what was said to cause them? and (iii) what was thought best to be done about them?     

Autism Spectrum Disorder: The Impact of Stressful and Traumatic Life Events and Implications for Clinical Practice

Research findings suggest that behavioral interventions are effective in improving educational outcomes and fostering skill development in people with autism spectrum disorder (ASD). However, high rates of comorbidity between ASD and other psychological disorders, including depression and anxiety, indicate that standard behavioral approaches are not adequately addressing issues related to mental health in this population. Research emerging since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is advancing our understanding of the nature of childhood stress and trauma in people with ASD and its subsequent impact on mental health and wellbeing. Mounting evidence for stress and trauma as a risk factor for comorbidity and the worsening of core ASD symptoms may intimate a shift in the way clinical social workers and other clinical practitioners conceptualize and approach work with this population to include trauma-focused assessment strategies and clinical interventions. Future directions for research to better understand the nature of childhood stress and trauma and improve mental health in this population are also discussed.     

Peer Behaviors and Co-occurring Disorders Among Adolescents

The complexity of co-occurring substance use disorders and mental health problems among adolescents challenges both researchers and practitioners. The purpose of this study was to further disentangle those relationships and examine the role that peers who engage in deviant activities plays in that relationship. A subset of variables from a larger study of adolescents referred for substance use assessment was analyzed in this study. The results suggest that as the severity of substance use and mental health problems increases so does the number of peers who engage in deviant activities; peers partially mediates the relationship between those two variables. Implications for social work practice and other professionals are discussed.     

The interaction of co-occurring mental disorders and recovery management checkups on substance abuse treatment participation and recovery

This article examines the effectiveness of quarterly Recovery Management Checkups (RMCs) for people with substance disorders by level of co-occurring mental disorders (34% none, 27% internalizing disorders, and 39% internalizing and externalizing) across two randomized experiments with 92% to 97% follow-up. The 865 participants are 82% African American, 53% female, and age 37 on average. RMC involves identification of those in need of treatment, motivational interviews, and treatment linkage assistance. It is effective in linking participants in need to treatment, with equal or better outcomes among those with more mental disorders. The data support the utility of monitoring and re-intervention for clients with co-occurring disorders.