Empowering Alliances in Pursuit of Social Justice: Social Workers Supporting Psychiatric-Survivor Movements

This article reviews historical and current examples of harmful and forced treatments as well as scientific discrimination that have been applied to people diagnosed with mental illness. It discusses anti-psychiatric social action in North America from 1970 to the present. A review of social work's foundations in social justice, empowerment, and person-in-the-environment perspectives highlights the congruencies and communal benefits for both the social work profession and psychiatric-survivor movements. Through this discussion, it is apparent that the professed values of the social work profession are actually more compatible with psychiatric-survivor movements than with any allegiances to the biomedical model of psychiatry.     

Reclaiming Self

In this article I use performance poetry pieces to reflect upon my experiences of living with a disability as a person of color, a woman, and an immigrant. It is my firm contention that, although listening to the stories of the clients we meet on our journeys is integral to creating individual and structural changes and raising awareness of mental health issues, as social workers it is just as important to share our own personal and collective stories of mental health, stigma, and recovery. As helpers and change makers, it is unlikely that we can influence mental health policy purely from behind the wall of positivism. Stories of clients as well as stories of our lived experiences are critical to challenging the strong divide that characterizes the social work academy: the us/them, service provider/service user, and the expert/client. Furthermore, my hope is that this article will add to the literature concerning the traumas experienced by immigrant women in their private domains.     

African American Stepfather–Stepchild Relationships,Marital Quality,and Mental Health

ABSTRACT

This study examined associations between stepfather–stepchild relationship quality, stepfathers’ depressive symptoms, and two aspects of marriage: marital quality and positive marital interactions. Marital quality was assessed in terms of commitment, trust, passionate and friendship-based love, and happiness. Marital interactions were assessed in terms of intimacy, shared activities, and verbal communication. Using data collected from 149 recently married African American stepfathers, structural equation modeling revealed that when stepfathers reported more positive relationships with their stepchildren, they also reported more positive marital quality and a higher frequency of positive marital interactions (relationship-solidifying activities), and that, in turn, was associated with stepfathers experiencing fewer depressive symptoms.     

Understanding Parental Grief as a Response to Mental Illness: Implications for Practice

ABSTRACT

Parents who are raising children with mental illness struggle with feelings of grief and loss. Kubler-Ross' (1969 Kubler-Ross , E. ( 1969 ). On death and dying . New York : Scribner . [Google Scholar]) stages of grieving (denial, anger, bargaining, depression, and acceptance) are examined as experienced by parents raising children with chronic mental illness. Practice implications for social workers who are working with children and their parents are discussed. Acknowledging and understanding parental grief, while providing emotional support, leads to a more effective working partnership. This collaboration of parents and social worker can result in more effective treatment for the child with mental illness. Examples from one of the co-author's personal experiences are included.     

Wraparound Services: An Effective Intervention for Families Impacted by Severe Mental Illness

ABSTRACT

Children and families impacted by severe mental illness (SMI) have multiple strains that effect family functioning, child safety, and parental rights. Traditional services for children and families struggling with severe mental illness have not achieved success in improving family functioning and keeping families intact. Wraparound is a philosophy and a system of care with a promising evidence base that could enhance collaboration of child welfare, mental health, and community services to work more effectively with families impacted by SMI.     

Supporting Vulnerable Families Through School-Based Mental Health Services: Results of Caregiver and Teacher Focus Groups

Family perspectives facilitate participation and positive outcomes in child mental health treatment. In schools, families and teachers must cooperate to best meet children's mental health needs, also making teacher perspectives important. In this study, caregivers and teachers participated in focus groups following the pilot year of a school-based mental health (SBMH) project. Participants noted successes and challenges of the project and suggested improvements. Although this study focuses on the SBMH project, many of the study implications are applicable to other school mental health programs and may be of value to school and community practitioners.     

Prevalence and correlates of diabetes mellitus among homeless veterans nationally in the Veterans Health Administration

Abstract

Background: Homeless people are at high risk for many chronic medical conditions although their risk of diabetes has not been well studied. Current epidemiological studies of diabetes prevalence among homeless adults have been based mostly on self-report data not supported by clinical assessments.

Objectives: To determine the prevalence and risk factors for diabetes mellitus (DM) among homeless veterans in the Veteran Health Administration (VHA).

Methods: The sample included 3?464?364 veterans with documented body mass indexes (BMI), 137?720 (4%) of whom had been homeless. Logistic regression models were used to determine the odds of having DM among homeless veterans compared to non-homeless veterans. Bivariate and multi-variate analyses were then used to identify potential risk factors for DM among homeless veterans.

Results: The prevalence of DM in homeless veterans was 19%. Homeless veterans with DM, compared to those without it were older, more likely to have a BMI?>?40 and more likely to have DM-related co-morbidities.

Conclusions: There is a high prevalence of DM among homeless veterans in the VHA compared to previous reports for homeless adults (8%). Tailored approaches to improve access to DM screening, prevention, and treatment could benefit homeless veterans.     

Correlates of Sexual Abuse in a Sample of Adolescent Girls Admitted to Psychiatric Inpatient Care

We examined correlations of child sexual abuse among 300 adolescent girls in psychiatric inpatient treatment. Diagnostic and Statistical Manual of Mental Disorders (4th ed.)-based psychiatric diagnoses were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children—Present and Lifetime and from data on family and behavioral characteristics from the European Addiction Severity Index (EuropASI). A total of 79 girls (26.3%) had experienced child sexual abuse during their lifetime. Child sexual abuse was associated with an adolescent’s home environment, sibling status, smoking, posttraumatic stress disorder diagnosis, self-mutilating behavior, and suicidal behavior. At least 62% of the perpetrators were acquaintances of the victims. Correlates of child sexual abuse can be used to identify child sexual abuse victims and persons at heightened risk for child sexual abuse.     

Exploring Mental Health Adjustment of Children Post Sexual Assault in South Africa

Large numbers of children are affected by child sexual abuse in South Africa. This study aimed to assess psychological adjustment of children post sexual assault. In-depth, semistructured interviews were conducted with caretakers, and structured interviews using mental health assessment screening tools were given to children at three intervals over a five-month period after presentation at a sexual assault center. Almost half of the children met clinical criteria for anxiety, and two-thirds met criteria for full symptom post-traumatic stress disorder two to four weeks post disclosure. With standard care, we observed some recovery; 43.3% of children still met full symptom post-traumatic stress disorder nearly six months postdisclosure. Our findings indicate that current practice in South Africa does not promote adequate recovery for children.