Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

Clinical Social Worker as Patient Advocate in a Community Mental Health Center

As a profession, social work has always advocated for clients. Yet clinical social work settings often ignore this important aspect of practice. For mental health services in public agencies, patient advocacy is a particularly vital element because these systems are not always responsive to the individual client. The clinical social worker, trained in advocacy, systemic intervention, and psychotherapy, is the professional most qualified to fill this role. The author summarizes the history of advocacy, provides a conceptual framework for the clinical social work advocate, and provides examples from 20 years of experience as a patient advocate in community mental health.

Power,participation and post modernism: User and practitioner participation in mental health social work education

The focus of this paper is service user and social work practitioner participation in the teaching for the mental health social work course. A review of the programme seeks to illuminate the value and significance of participation. The obstacles exposed through interviews and a collective workshop suggest a blocking opposition between idealistic education and ‘the reality of practice’. However this opposition is challenged by user and black advocacy participation. The value of participation appears in terms of anti-discrimination and extended possibilities to bring about change. Theory and practice divides are also dissolved. Participation is connected to power and modern and post modern approaches to education provide the theoretical framework.     

Self-esteem,Self-focused Attention,and the Mediating Role of Fear of Negative Evaluation in College Students With and Without Asthma

Abstract

Objective: The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Participants: Young adults with (n = 148) and without (n = 530) childhood-onset asthma were recruited from a college student population. Methods: Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Results: Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Conclusions: Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of self-esteem regarding participation in social activities among college students appears warranted.     

Adoption of an Outdoor Residential Hall Smoking Policy in a California Public University: A Case Study

Abstract

Objective: Because secondhand smoke is a public health concern, many colleges have adopted bans to ensure healthier environments. This study demonstrates how outdoor smoking policy change can be accomplished at a large public university. Participants: The participants were 1,537 students housed in residential communities at the University of California, Berkeley, who completed an online survey. Methods: A proposal for smoke-free residential communities that included student resident survey data was prepared. Results: The survey data indicated that most students (77%) were bothered by secondhand smoke, and most (66%) favored smoke-free environments. The data were used to advocate for a change in the residential community smoking policy. Conclusion: The survey data and institutional comparisons played a key role in administrators’ decision-making about campus smoking policy. Despite administrators’ concerns about students’ safety and freedom of choice, student-led advocacy was able to influence policy change.     

Balm for The Soul: Immigrant Religion and Emotional Well‐Being

Immigrants can face insurmountable odds in their acculturation to the new society, and subsequently suffer from poor emotional/mental health. Using immigrant data from the United States, Australia, and Western Europe, this paper tests the relationship between immigrant religious involvement and emotional well‐being. Results demonstrate that regular religious participation is associated with better emotional/mental health outcomes. Conversely, non‐religious group involvement (i.e., ethnic associations, leisure groups, work groups) do not have as equally a positive association with emotional well‐being. This pattern is consistent across all countries examined in this study, suggesting that religion has a unique relationship with immigrant emotional well‐being regardless of national context. Therefore, it is posited that in easing the emotional/mental adjustment of immigrants, religion is not an artifact of context or of a particular religious group, but a generality of immigrant adaptation. Policy implications for the study’s findings are discussed. Yet to him, in his troubled state, Christianity brought also the miracle of redemption. Poor thing that he was, his soul was yet a matter of consequence. For him the whole drama of salvation had been enacted: God had come to earth, had suffered as a man to make for all men a place in a life everlasting. Through that sacrifice had been created a community of all those who had faith, a kind of solidarity that would redress all grievances and right all wrongs, if not now, then in the far more important aftermath to life. ( Handlin, 1973 [1951]:93 )     

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.     

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.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

Acceptance of Online Health Services for Self-Help in the Context of Mental Health: Understanding Young Adults’ Experiences

ABSTRACT

This article explores the understanding of the acceptance of online health services from a self-help perspective in the context of mental health. By examining the experiences of young adults, this article develops a framework to leverage the current understanding of the factors that would support the acceptance and use of these types of services. To this end, a multidisciplinary perspective incorporating knowledge from the service marketing, health, and information systems literature is used. The results suggest that the production of online services that are meant for self-help purposes necessitates a focus on the acceptance of technology and, more importantly, instrumental value creation, as the purpose of using these types of services should be better understood and supported by technological solutions. This study also identifies several technological features supporting both the acceptance of technology and users’ ability to achieve well-being. Furthermore, when developing services for health self-help purposes, the issue of branding to increase acceptance should be assessed. From a user perspective, there appears to be a difference regarding whether the services are positioned as health services or as wellness services.     

Mental Health Workers Negotiating Risk on the Frontline

Abstract

Following deinstitutionalisation and the shift to models of community care, mental health practice has become increasingly focused on managing the risks posed by service users. However, the effects of risk management on workers’ professional identities have not been investigated empirically in Australia. Drawing on in-depth interviews with mental health workers from Victoria, Australia, this paper explores the diverse ways in which these workers adapted the formal technologies of risk management (e.g., the completion of risk assessment screens) to their professional identities. Some workers experienced risk management technologies as constraining their interventions with clients, while others saw these technologies as providing opportunities to strengthen and enhance their professional skills. Pondering these differences, the author speculates on the emergence of a new form of professional identity in the broader context of contemporary community mental health care.     

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.     

Social Networks,Substance Use,and Mental Health in College Students

Abstract

Objectives: The relationship between social network risk (alcohol-using close friends), perceived peer closeness, substance use, and psychiatric symptoms was examined to identify risk and protective features of college students’ social context. Participants: Six hundred and seventy undergraduate students enrolled in a large southeastern university. Methods: An online survey was administered to consenting students. Results: Students with risky networks were at a 10-fold increase of hazardous drinking, 6-fold increase for weekly marijuana use, and 3-fold increase for weekly tobacco use. College students’ who feel very close to their peers were protected against psychiatric symptoms yet were at increased risk for marijuana use. Perceived closeness of peers was highly protective against psychiatric symptoms, adding a natural preventive effect for a population at great risk for mental illness. Conclusions: Results support targeting college students through network-oriented preventive interventions to address substance use as well as mental health.     

Role-played interviews with service users in preparation for social work practice: exploring students’ and service users’ experience of co-produced workshops

Abstract

Within a Theory and Practice of Social Work module, prior to embarking on practice placements, social work students practised professional communication skills with people who had used social work services. They undertook role-played interviews with service users about real issues, which had led individuals to seek assistance in the past. Using principles of co-production, the workshop was developed in partnership with members of the University’s social work service users and carers’ group. Care was taken to safeguard service users’ well-being, as well as developing an effective learning opportunity. Drawing on evaluations by students and feedback from service users, this paper discusses the process of planning and delivering the workshops, as well as perceived outcomes for both groups. Findings indicate that students valued the opportunity to engage with service users, gaining key learning about their own practice skills. Service users described a boost to self-esteem through contributing to students’ learning. The workshop provides an example of how service user involvement in social work education has evolved from a primary focus on sharing personal testimonies to active participation in student skill development. It underlines the importance of investment in service user involvement to achieve an appropriate context for such projects to develop.     

Flourishing: Exploring Predictors of Mental Health Within the College Environment

Abstract

Objective: To explore the predictive factors of student mental health within the college environment. Participants: Students enrolled at 7 unique universities during years 2008 (n = 1,161) and 2009 (n = 1,459). Methods: Participants completed survey measures of mental health, consequences of alcohol use, and engagement in the college environment. Results: In addition to replicating previous findings related to Keyes’ Mental Health Continuum, multiple regression analysis revealed several predictors of college student mental health, including supportive college environments, students’ sense of belonging, professional confidence, and civic engagement. However, multiple measures of engaged learning were not found to predict mental health. Conclusions: Results suggest that supportive college environments foster student flourishing. Implications for promoting mental health across campus are discussed. Future research should build on exploratory findings and test confirmatory models to better understand relationships between the college environment and student flourishing.     

A Strengths Perspective on Caregiving at the End-of-life

Abstract

The most recent version of the Australian Association of Social Workers Code of Ethics includes substantial reference to social workers’ professional responsibilities for environmental awareness and advocacy. This article reports on a qualitative study of 20 Australian environmentally-conscious social workers from a variety of fields of practice. The study found that while there was a high level of awareness of the relevance of environmental issues for social work practice, participants reported professional and organisational constraints, which prevented them from aligning their environmental concerns with their professional practice. The findings from this study suggest that proenvironmental views and actions may not yet be accepted as a legitimate aspect of social work practice, despite strong recognition of the links between social justice, human rights, social work, and the environment in the Australian Association of Social Workers Code of Ethics.     

Media advocates,Latino citizens and niche cable The limits of ‘no limits’ TV

In Shot in America, Chon Noriega calls for the study of media activism’s work ‘within the system’ of state institutions and for analysis of the relationships between media activism, the television industry and government policies. This article uses a cultural policy studies focus to answer this call and map the deregulated terrain upon which media advocacy groups must now operate. Liberal governance demands that media advocates find means other than state-directed appeals to advance their agendas. As such, this essay examines the efforts of several Latino advocacy groups to garner viewer support for a Latino-themed cable television show, Resurrection Boulevard, and to use the series as a vehicle for increased Latino participation in the television industry. This article focuses on the issue of access for Latinos to professional positions that affect television programming, and it presents tools for advocacy efforts within political spheres to achieve more socially equitable access to media technologies. First, the paper traces the regulatory history of the broadcasting and cable television industries to show how the federal government narrowly conceives of ‘the public interest’ as a specifically consumerist one. The article then analyses the structures that led to cable television’s ‘narrowcasting’ format, such as Showtime’s ‘No Limits’ programming, and argues that liberalism has created a context wherein several media advocates normalise the ‘citizen-consumer’ model. Having established this groundwork, the author then conducts a case study of the economic and social forces that shape Resurrection Boulevard, which is written, produced and acted by Latinos. Through this study, the author maintains that advocacy groups’ consumer-based appeals to Latinos as ‘citizen-consumers’ fail to serve as effective instruments for achieving increased minority representation in the television industry.     

Mental health professionals in children's advocacy centers: is there role conflict?

Two recent chapters in professional books have criticized children's advocacy centers for creating role conflict for mental health professionals because of their work with criminal justice and child protection professionals in children's advocacy centers as part of a coordinated response to child abuse. This article argues that these critiques misunderstand children's advocacy center practice and overestimate the risk of role conflict. Children's advocacy center standards set a boundary between forensic interviewing and therapy, which in most children's advocacy centers are done by separate professionals and never by the same professional for a given child. Many mental health professionals serve children's advocacy centers as consultants with no treatment role. Children's advocacy center therapists are rarely involved in investigation, and their participation in multidisciplinary teams focuses on children's interests and well-being.