Navigating stormy waters: Challenges and opportunities for social work in mental health

The reforms driven by the National Mental Health Strategy have created both opportunities and challenges for social work as a profession. This paper examines the rapidly changing context for practice in mental health, including policy change, and developments in the education and training of the mental health workforce. Key practice issues identified for social work include: (i) the need to establish a viable paradigm for practice; (ii) a more positive response to the challenge of evidence-based practice models; (iii) a national agenda for education and training; and (iv) the importance of working collaboratively with consumers and families in a way that values their human rights and the lived experience of mental illness.     

The role of social work in the field of mental health: dual diagnoses as a challenge for social workers

This paper provides a discussion about the relevance of medical terminology within the social work context. The authors use the example of dual diagnoses to argue for less stigmatised attitudes toward people who become, in the process of help, labelled as people with dual diagnoses. It sets out that using medical terminology in the field of social work is more often a strategy to exclude people from the system of help than as a moment of providing adequate help. It is concluded that social workers do not need the knowledge about diagnoses – knowing the diagnosis is important only as information that illustrates users’ specific experience and perception of reality, the available resources and obstacles that people face in their everyday life. The planning of a social work intervention should be based on an operational definition of everyday life, e.g. how people live through the day, what are the important and valued roles they play in life, what are their wishes and needs.     

From past trauma to post-traumatic growth: The role of self in participants with serious mental illnesses

Studies have shown that people with serious mental illness are more likely to have experienced trauma compared to the general population. This qualitative study employed a grounded theory approach to explore how trauma histories influenced the process of triggering, developing, and recovering from serious mental illness. Findings based on in-depth interviews with 15 participants illustrated the intersection of trauma, serious mental illness, and post-traumatic growth. Experiencing trauma compromised participants’ self-functioning, causing issues such as affect dysregulation, distorted self- and other- concepts and relationship difficulties, meaninglessness, and existential fears, all of which negatively impacted participants’ mental health and behavior. At the same time, participants with serious mental illness were able to achieve post-traumatic growth with the “transformed-self” via self-acceptance, self-exploration, self-worth, and self-fulfillment. Findings of this study have useful implications for trauma-informed care in mental health treatment. Mental health professionals should address clients’ trauma histories to prevent re-traumatization and design trauma-informed programs that use and build clients’ inner resources and strengths to promote post-traumatic growth.     

Mental illness etiology beliefs among African American men with serious mental illness and their social support networks

Semi-structured qualitative interviews were conducted with 26 African American men with serious mental illness who were consumers of community mental health services and 26 members of their social support networks. All participants were asked what they believed had caused the consumers’ mental illness. Consumer participants most commonly identified chronic life stressors as a causal factor, while social supports most often identified intrinsic factors such as genetics or biology as causes of mental illness. Some support participants believed that unintentional drug use had precipitated the onset of mental illness or had no causal theories. The fact that some support participants could not identify a causal explanation may indicate failure on the part of mental health care systems to engage with consumers’ social support networks and provide education about mental illness and its causes. The implications of etiology beliefs on mental health service utilization are discussed.     

An investigation of mental health and personality in Swedish social work students upon entry to university training

The aims were to describe Swedish social work students' personality characteristics upon entry to their training and to analyze relationships between personality traits, mental health, and some sociodemographic variables. One hundred and twenty-one female social work students completed a sociodemographic form, the Temperament and Character Inventory, and the Symptom Checklist. They scored significantly higher on harm avoidance, reward dependence, and self-transcendence and reported more somatization, obsessive compulsive, and phobic-anxious symptoms, and less hostility, than Swedish individuals from the general population of the same age. Personality traits significantly predicted the various mental symptom scores. It is recommended to implement modules or training courses within social work training in Sweden that bring an improvement of self-directedness and cooperativeness character trait into focus.     

Managing physical and mental health conditions: Consumer perspectives on integrated care

Despite the growing trend of integrating primary care and mental health services, little research has documented how consumers with severe mental illnesses (SMI) manage comorbid conditions or view integrated services. We sought to better understand how consumers perceive and manage both mental and physical health conditions and their views of integrated services. We conducted semi-structured interviews with consumers receiving primary care services integrated in a community mental health setting. Consumers described a range of strategies to deal with physical health conditions and generally viewed mental and physical health conditions as impacting one another. Consumers viewed integration of primary care and mental health services favorably, specifically its convenience, friendliness, and knowledge of providers, and collaboration between providers. Although integration was viewed positively, consumers with SMI may need a myriad of strategies and supports to both initiate and sustain lifestyle changes that address common physical health problems.     

Children of adult consumers of mental health services: Towards principles of practice

Abstract

This paper discusses the development of a peer support and advocacy Network, Young Mothers for Young Women. The Network evolved through a participatory action research project into young mothers experiences of violence. Through the Network, young women participate in a community development approach to violence reduction. As part of the Network, young women offer peer support to other young women. Network members also engage in ongoing community education and advocacy about issues, such as poverty, isolation and sexism which increase young womens vulnerability to violence. An important aim of this paper is to make visible the dialogue between social workers and young women on which the Network relies. This paper is motivated by the concern that as social work enters an era of increasing accountability it is critical that workers articulate the often invisible role they play in facilitating participatory processes.     

The family caregiving context among adults with disabilities: A review of the research on developmental disabilities,serious mental illness,and traumatic brain injury

ABSTRACT

A majority of adults with serious disabilities are cared for in the home by family members. Guided by an ecological framework, this article presents the findings of a literature review of research on family caregiving and family support for adults with disabilities. This review included 33 research studies published between 2000 and 2015 focused on three disabilities: Developmental disabilities, serious mental illnesses, and traumatic brain injury. A synthesis of the findings underscores the critical role that family caregivers occupy in addressing the needs of their loved one with a disability; however, the needs of the caregiver are insufficiently met by existing service approaches. A better understanding of the unique needs and strengths of the family support context of caregivers and care recipients is needed, giving greater attention to ethnic, racial, and cultural considerations in future research.     

Bipolar disorder and the college student: A review and implications for universities

Abstract

Objective: This brief report provides a review of the prevalence and expression of bipolar disorder in the college student population. Implications for college teachers and universities working with students with bipolar disorder are presented. Methods: Responses from the National College Health Assessment (2009–2017) reference groups were collated to estimate whether the prevalence of students with bipolar disorder has been increasing over time. Results: Data indicate that although overall prevalence is low, the presence of students with bipolar disorder has increased over the past decade. Conclusions: To help students with serious mental illness, including bipolar disorder, succeed in higher education, practices consistent with the philosophy of supported education should be adopted. Special attention will need to be paid to students’ financial and academic challenges.     

‘Recovery work’ and ‘magic’ among long‐term mental health service‐users

Based on an extended period of qualitative research with mental health service‐users in north‐east England, this article considers the various forms of ‘magical work’ and ‘recovery work’ that emerge in the lives of people living with severe mental health problems. Given the now sizeable body of literature which seeks to problematize traditional conceptual boundaries of work, the article asks to what extent these hidden and unusual work‐forms might also be considered legitimate members of the category. Rather than argue for the expansion of the construct to accommodate these activities, the paper attempts simply to problematize the extent to which so‐called ‘mad’ forms of work are irresolvably different to more conventional forms of occupation. In challenging notions of the psychiatric patient as inevitably inactive, new vocabularies for service‐user work are explored. Concluding remarks are also directed to recent policy debates concerning ‘back‐to‐work’ welfare reform for long‐term out of work service‐users.     

Service user involvement in social work education: experiences from Germany and implications for a European perspective

ABSTRACT

Service user involvement (SUI) in social work education has gained widespread attention in Europe and other continents. Nevertheless, experiences on including service users in social work education have not been reported from Germany or other German-speaking countries to date. This paper reports preliminary experiences with implementing SUI in a bachelor’s programme of social work in a German University of Applied Sciences. The main goals of the current paper are (1) to provide a background for implementing service user approaches in Germany by introducing the structure of social work education in Germany; (2) to report experiences from a weekend seminar where service users worked together with students of social work in the framework of a curriculum of a German University of Applied Sciences and (3) to formulate some implications of these experiences for SUI across Europe. The main results were that introducing service user involvement into a German curriculum of social work is possible but needs careful reflection and planning. Experiences gathered in the weekend seminar with service users were encouraging for service users, students and teachers. We conclude that systematically implementing SUI into German curricula of social work is important.     

Heterosexism,racism, and mental illness discrimination: Experiences of people with mental health conditions and their families

Experiencing discrimination related to race/ethnicity, sexual orientation, or having a mental health condition is associated with negative outcomes. Research comparing types of discrimination or considering intersectionalities is lacking. This study reports findings from interviews with people with mental illnesses (PWMI) or family members of PWMI; all study participants also are of color and/or lesbian, gay, or bisexual. Findings include the following: participants experienced multiple forms of discrimination, mental illness discrimination shares characteristics with racism and heterosexism, and heterosexuals and people of color reported more mental illness discrimination than their counterparts. Implications for change advocates, mental health providers, and researchers are offered.     

Social work in mental health services: A survey of the field

Abstract

A survey of social workers employed in mental health services was conducted in Victoria in mid-1997. Approximately 300 social workers were identified as working in the sector. About half were employed in adult clinical services, 23% in psychiatric disability services, 12.4% in Child and Adolescent Mental Health Services, and the rest in a range of other services. More than 90% worked in a community based service or team. The number of entry-level (SW I) positions in clinical services was found to have declined over the last ten years from 61 to 14, resulting in a lack of opportunities for social workers to gain experience in base grade positions, and difficulty in recruiting to SW II positions. Major issues of concern reported by social workers included: the lack of accommodation and other community resources for consumers; diminished opportunities for professional development, supervision, and discipline-specific training; lack of professional recognition; increasing workloads; and organisational emphasis on throughput rather than quality.     

Sense of community through supportive housing among formerly homeless individuals with serious mental illness

Much research documents the correlation between homelessness and mental illness. Often, existing research focuses on deficits that live at the intersection of these phenomena. The present study utilizes a sense of community (SOC) framework to interrogate the ways in which formerly homeless individuals with serious mental illness perceive and experience community in supportive housing. Through focus groups with 18 consumers, this study contextualizes dimensions of SOC (membership, emotional connection, needs fulfillment, and influence) for the aforementioned population. Analysis of focus group data produced 16 themes and subthemes that support and extend our understanding of SOC for a population often conceptualized as isolated and alone. Implications for policy and practice emphasize: (1) the importance of supportive housing communities and the call for policymakers to increase funding for such programing; and, (2) that practitioners facilitate housing members’ voices to effectuate change in supportive housing and increase SOC.     

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.     

Working on the edge: the meaning of work for people recovering from severe mental distress in Norway

Most citizens with long‐term mental distress want a real job, and both Norway and European policies agree that work is a crucial part of social inclusion goals. Yet we know little about the actual impact of work on the recovery process for people with severe and often enduring mental distress. This article reports findings from a qualitative study which used an everyday life orientation to explore what it means to have a job and be an employee in regular work settings and ways of integrating work into daily life. Thirteen Norwegian men and women with experience of long‐term mental distress were interviewed. The findings indicate some ways in which work supports the recovery process: having an active working role, being in ordinary work settings, balancing rest and activity and having a sympathetic work environment. Often what may seem trivial to others is crucial to individuals in recovery from mental distress, yet is turned into models and system level solutions, where the uniqueness of everyday life and ‘common sense’ approaches remain unrecognised.     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.