Meeting the social and behavioral health needs of students: rethinking the relationship between teachers and school social workers

BACKGROUND: While school‐based mental health professionals obviously must provide mental health services to students directly, the literature is increasingly identifying an empowerment role for these professionals, whereby they support teachers as primary service providers. The purpose of this study was to identify subtypes of school social workers within the context of collaborative practice, and to identify individual and contextual factors associated with these classifications as well as overall levels of collaboration. METHODS: Latent class analysis, conducted using data collected as part of the National School Social Work Survey 2008 (N = 1639), was employed to examine underlying subtypes of school social work practitioners in relation to collaborative practices and to examine predictors of collaborative practice. RESULTS: Four broad categories of school social workers were identified, including (1) noncollaborators, (2) system‐level specialists, (3) consultants, and (4) well‐balanced collaborators. These classes were associated with the number of schools served, grade level, education, and clinical licensure status; level of administrative responsibility was not associated with class membership. CONCLUSION: While school social workers varied in collaborative practices, opportunities exist to enhance their role in educating and supporting teachers to serve as primary providers to students with social, mental health, and behavioral needs. The implications for school‐based mental health providers, teachers, administrators, policymakers, and researchers are discussed.     

医院社会工作者的战略地位和卫生经济学贡献

医院社会工作者是跨学科、跨专业、跨领域医疗团队的重要成员,在卫生保健体系和医院质量管理中处于战略地位。更为重要的是,医院社会工作者通过健康教育宣传、社会资源动员、预防和缓解医疗纠纷等专业服务,可为医院做出难以估量的卫生经济学贡献。     

The impact of 'statutory duties' on mental health social workers in the UK

In the UK, applications for involuntary admission to psychiatric units are made mainly by specially trained approved social workers (ASWs). Proposed changes in the legislation will permit other professionals to undertake these statutory duties. This study aimed to examine how ASW status impacts upon work pattern and workload stresses by comparing ASWs with other mental health social workers who did not carry statutory responsibilities. A multimethod design was adopted that included a cross-sectional national survey of mental health social workers (n=237, including 162 ASWs), and a telephone survey of mental health service managers (n=60). Data were collected using a semistructured questionnaire and diary, the content of which was derived from focus-group work and standard measures. Features of job content, working patterns and conditions were described and their association with stress, burnout and job satisfaction examined. ASWs were older and had been qualified longer than non-ASWs. The working patterns and conditions of the two groups did not differ, although ASWs did more hours on duty. ASWs received less support at work, particularly from supervisors and their role afforded less decision latitude than that of non-ASWs. ASW status was related to an elevated GHQ score, particularly among males. Emotional exhaustion was very high (over two-thirds in both groups) but ASWs and non-ASWs did not differ in this or any other feature of burnout, only 8% of the sample were actually 'burnt-out', being more common among ASWs. ASWs were more dissatisfied and were more likely than non-ASWs to want to leave their job. Given that ASW status increased stress and job dissatisfaction, especially for men, and was related to a desire to leave one's current job, it seems likely that extending statutory duties to other professionals will increase levels of stress, burnout and dissatisfaction in these groups also. In turn, this might have consequences for staff recruitment and retention.     

Complex families,the social determinants of health and psychosocial interventions: Deconstruction of a day in the life of hospital social workers

The roles of hospital social workers are delineated in the literature; however, their daily interventions have only been described anecdotally. This study analyzes the daily work of social workers in a pediatric hospital through a survey completed which examined factors related to interventions utilized and time spent per case over a 1-day period. Length and types of interventions were associated with the social determinants of health, time since diagnosis, biopsychosocial issues, and perception of complexity. The study offers a snapshot of the personalized expertise, provided by social workers that addresses complex contextual and biopsychosocial concerns of patient and families     

Health challenges of mothers with special needs children in Pakistan and the importance of integrating health social workers

ABSTRACT

There is concern that mothers of special needs children in developing countries like Pakistan are neglected populations facing hidden health challenges. The aim of this study was to investigate the kinds of health challenges mothers experience and to highlight the role of health social workers in supporting the needs of mothers. Twenty-one mothers were sampled across three cities and findings were analyzed through a thematic content analysis approach. Findings revealed that mothers faced significant and salient challenges under eight sub-categories of mental health and six sub-categories of physical health. We recommend that health social workers collaborate with healthcare practitioners to improve health services for mothers and also coordinate with other social workers, community members, and policymakers for improving both social and structural support for special needs families.     

Factors associated with the recruitment and retention of social workers in Wales: employer and employee perspectives

Despite acute staffing shortages in social work, workforce planning within the UK social care sector is compromised by poor workforce intelligence. This study aimed to inform the evidence base providing new data on recruitment and retention in Wales, examining what personal and organizational characteristics are associated with intentions to leave, and what initiatives or incentives might mediate that effect. A multi‐method design facilitated comparisons between two data sources – a census of all 22 Welsh local authority employers about recruitment and retention practices and a survey of all social workers and senior practitioners employed in social services (n = 998; response rate 45.9%) about demography, workforce characteristics, working patterns, morale and plans and reasons for leaving one's job. Vacancy (mean 14.4%) and turnover (mean 15%) rates were statistically significantly higher in children's services than in adult services; vacancy rates were also higher in authorities that offered higher starting salaries. The provision of certain types of traineeship might also be associated with higher vacancy rates but these results should be treated with some caution. There was little evidence that recruitment and retention initiatives were associated with lower vacancy or turnover rates, despite employers’ perceptions about their effectiveness. Social workers derived a lot of satisfaction from their work, but more than a quarter wanted to leave their job within 6 months, and almost as many were actively seeking alternative employment. Intention to leave was explained by job and employer satisfaction, and negative feelings about pay. Senior practitioners and staff members with longer lengths of service were less likely to want to leave, even if they were dissatisfied with their job or employer. Job and employer dissatisfaction was associated with retention initiatives related to facilities, good caseload management and home‐working, suggesting that dissatisfied staff might remain in employment for longer if these initiatives were in place.     

Health social workers sources of knowledge for decision making in practice

This article presents findings from research examining knowledge social workers in a health network in Victoria, Australia identified as informing their decision-making. Data for 13 patients, and in-depth interviews with six social workers who worked with these patients, were studied. A thematic analysis of interviews revealed that participants identified reliance on past experience and contextual/situational information as underpinning their decisions, demonstrating their commitment to person-in-environment perspectives. However, despite the availability of a repository of empirical evidence, no respondent made use of this. This study provided insight into health practitioners’ sources of knowledge, highlighting gaps and areas for further exploration.     

SESAMI study of employment support for people with severe mental health problems: 12-month outcomes

In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group. One hundred and fifty-five users of six English agencies were followed up for 1 year (2005-2006). Information was collected about their employment status, job-seeking behaviour, perceived obstacles to work, self-esteem and hope, and the employment support received. Eighty-two per cent of those working at baseline were still in work a year later. The support agencies helped 25% of unemployed clients into work, a statistically significant increase in the proportion of clients in employment. Gaining employment was associated with improvements in financial satisfaction and self-esteem. There was a trend towards working half time. People who had been out of work longer were less likely to secure employment. No significant associations were found between getting a job and personal characteristics, the quantity of employment support given, nor the recipient's rating of the support offered. The odds of moving into work were nearly four times higher for those people who visited a job centre prior to the start of the study. Clients of specialist agencies rated their provision more highly than clients of pan-disability agencies. These results demonstrate the benefits of working for this group and support the development of employment services with an individualised, rapid placement approach, linked to job centre advice and expert mental health service input. This is consistent with the Individual Placement and Support model, and highlights in addition the importance of job centres for its implementation in England.     

The role of social workers in addressing nonmedical needs in primary health care

Nonmedical needs are intricately linked to health. Unaddressed nonmedical needs often result in poorer health and increased healthcare costs. Although social workers are well positioned to address nonmedical needs, their role in healthcare environments to address nonmedical needs is limited. The limited role relates to a lack of reimbursement streams, which stems from poor articulation about their unique contributions. An analysis of a case study in which a social worker using AIMS, a protocolized care coordination model, was undertaken to highlight specific activities performed by social workers. Implications for patient health outcomes and healthcare costs are discussed.     

Examining professional competencies for emerging and novice social workers in health care

This participatory project identified competencies of social workers in health care, with a focus on entry to the field. Findings reflected discussion groups with n = 24 social workers in health care settings. Identified core competencies were: (a) a core base of knowledge specific to social work in health care, (b) understanding of the health care system and implications for practice, (c) a strong work ethic and confidence working with limited supervision, (d) interpersonal skills for multi-disciplinary teamwork, (e) understanding about complex role and power dynamics, (f) accountability for one’s own work/practice and commitment to professional development, (g) reflectiveness on practice, and (h) an organizational commitment to capacity building.     

Enhancing social networks: a qualitative study of health and social care practice in UK mental health services

People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual's social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over‐arching themes – worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub‐themes which were identified included worker attitudes; person‐centred approach; equality of worker–individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals’ access to social capital within networks.     

下岗职工精神健康及其社会支持和应付方式的调查

目的 了解社会支持和应付方式与下岗职工精神健康的关系。方法 对468名下岗职工以及512名在岗职工进行症状自评量表(SCL-90)、社会支持评定量表、应付方式评定量表测定，比较其心理健康水平、应付方式和社会支持强度。结果 大约有61．32％的下岗职工存在不同程度的心理健康问题，主要症状为躯体化、焦虑、抑郁等。与对照组职工相比，下岗组职工多采用回避、幻想等消极的应付方式，而且其客观支持、主观支持以及对社会支持的利用程度均低于对照组。同时，女性下岗职工的精神健康水平低于男性下岗职工，而且其应付方式以及社会支持量表的评分也低于同组男性职工。结论 如果缺乏适当的应付措施和社会支持，下岗可能导致比较强烈的心理应激反应，从而损害下岗职工的身心健康。     

大庆油田员工心理健康促进方案构建的研究

目的探讨适用于油田企业的员工心理健康促进方案的运作模式及其内容,了解员工生活与心理压力的来源与类型,规划构建有关心理健康教育课程。方法采用问卷调查方法,自行设计调查问卷,在大庆油田有限责任公司员工内采用分层抽样方法抽取3 000人作为调查对象。收集调查对象对心理健康促进的看法及需求并对资料进行统计分析。结果有效问卷2 760份,全体研究对象都认为现代企业关注员工心理健康很重要;受调查对象压力总体感觉比较大及以上者占33.59%,员工压力来源的排序依次为经济压力、生活压力、人际关系压力、职业发展压力、婚姻情感压力及内部竞争压力;员工需要获得的专业帮助依次为情绪管理、压力管理、有效沟通技巧、适应技巧、子女教育与亲子关系、心理调整技巧及职业规划设计;大庆油田员工心理健康促进方案以员工心理健康评价、心理卫生教育训练为主,辅以员工个别心理咨询。结论对大庆石油员工进行心理卫生教育是必要的。     

Help seeking and barriers to utilisation of medical and health social work services among ageing immigrants to Israel from the former Soviet Union

The study aimed to examine utilisation of medical and health social work services among ageing recent and long-term immigrants, to identify barriers to service utilisation, and to examine factors related to utilisation. Participants (n = 402) recruited from a random community sample of immigrants from the former Soviet Union in Israel, aged 55 and over, residing in urban areas throughout the country were interviewed by telephone. Using an expanded framework of Andersen's behavioural model, the independent variables included predisposing, enabling and need variables, and additional variables--barriers to utilisation or difficulties encountered during utilisation of services. For multivariate analyses of the dependent variables, a linear multiple regression model was employed for utilisation of medical services and a logistic regression model for utilisation of social work services. The main findings show that utilisation rates were high for medical services, but low for social work services. Recent immigrants had similar utilisation rates of medical services but utilised more social work services than long-term immigrants. There were few barriers but numerous difficulties in utilisation of medical services, while there were barriers but negligible difficulties in utilisation of social work services. Predisposing and need variables explained utilisation of medical services, whereas a combination of predisposing, enabling and need variables explained utilisation of social work services. The findings suggest that different factors are associated with the use of non-discretionary versus discretionary (social work) services. There is a need to reduce difficulties in utilisation of medical services and to enhance awareness about health social work services among the immigrants.     

Self-care behaviours and their relationship with Satisfaction and Compassion Fatigue levels among social workers

Compassion fatigue is a syndrome resulting from an empathic listening to the client’s distress. Social workers, by the relational nature of their task, can be at risk and may suffer from adverse health effects. This quantitative research (N = 270) aimed to assess the efficiency of social workers’ self-care practices. The conclusion is that personal and professional self-care practices reduce compassion fatigue levels as well as increase satisfaction levels. Promoting self-care practices will bring benefits for the professional and, therefore, in the client and the institution.     

大学生社交焦虑与压力和心理健康的关系

目的探讨大学生社交焦虑对压力源和心理健康关系的影响。方法选用经修订后的青少年生活事件量表(ASLEC)、社交焦虑量表和一般心理健康问卷(GHQ12),对1430名大学生进行调查。结果(1)社交焦虑对大学生压力源与心理健康之间的关系起部分中介作用。(2)女大学生更容易受丧失压力和人际关系压力的影响。(3)非独生子女比独生子女大学生的社交焦虑感更高,心理健康水平更差。结论对大学生的社交焦虑进行测查和干预有助于缓解大学生面对的生活事件压力,提高心理健康水平。     

Interprofessional collaboration and integration as experienced by social workers in health care

Interprofessional collaboration in health care is gaining popularity. This secondary analysis focuses on social workers’ experiences on interprofessional teams. The data revealed that social workers perceived overall collaboration as positive. However, concerns were made apparent regarding not having the opportunity to work to full scope and a lack of understanding of social work ideology from other professionals. Both factors seem to impede integration of and collaboration with social workers on health care teams. This study confirms the need to encourage and support health care providers to more fully understand the foundation, role, and efficacy of social work on interprofessional teams.     

Health care use associated with work-related musculoskeletal disorders among hospital workers

Introduction: The purpose of this study was to investigate if work-related musculoskeletal disorders (WMSDs) are associated with increased health care use, over and above workers’ compensation health care benefits, in the period prior to and following a workers’ compensation claim indicating gradual progression and declining function associated with musculoskeletal morbidity. Methods: This study employed secondary analysis of employment data, workers’ compensation claim data and provincial (universal) medical services data for a cohort of health care workers; and investigated rates of medical care contacts among injured workers with a WMSD claim (n=549) compared to a matched group of non-claim workers. Predictors of health care contacts were estimated using general linear regression. Results: WMSD injured workers had significantly higher rates of health care contacts associated with a claim compared to non-injured workers, over and above workers compensation health care benefits. In the final multi-variable model, a WMSD claim among injured workers was associated with an estimated 69% (95% CI, 1.50, 1.91) increase in health care use for the 12-month period immediately after the injury date compared to non injured workers. Conclusion: The pattern of visits for WMSDs suggests that workers visit general practitioners as part of an ongoing pattern of symptoms, resulting in frequent utilization of health services prior to work disability that is also reflected in health care contacts after return-to-work.     

Staff shortages in the mental health workforce: the case of the disappearing approved social worker

Approved social worker (ASW) numbers in England and Wales were compared on the basis of two national surveys conducted in 1992 and 2002. These data were supplemented by reports published by the Employers' Organisation in the intervening years. Although raw numbers suggested a modest absolute increase over this time, rates of ASW's per 100,000 population declined by over 50%. Possible explanations for this dramatic fall are explored. The authors conclude that specific and targeted action needs to be taken by the government and public sector employers to determine the numbers of mental health social workers needed in modernised community mental health services.     

Factors influencing the use of community health and social services by those aged 65 and over

Interview data collected in a 1990/91 health and life-style survey is used to investigate in those aged 65 years and over the relationship to the use of community health and social services of age, health status and social and economic factors. One thousand eight hundred and forty-one respondents were included in the study. Contacts with general practitioners (GPs), district nurses and home helps and use of “meals on wheels”, day centres for elderly people and lunch clubs were related to age, chronic illnesses, gender, mental well-being, living alone, income and social class. Age and chronic illness were strongly related to the use of all services. A distinctive pattern of service use was found for particular chronic illnesses. Musculoskeletal conditions were most strongly related. Significant relationships between mental well-being, living alone, gender, income and social class remained after the effects of age and chronic illness were removed. Consideration is given to the implications for those who plan community health and social services.