The Mental Health Social Worker

An NIMH-funded program already shown to reduce risky sexual and substance abuse behavior among HIV-infected adults also appears to be effective in improving the lives of HIV-infected homeless or near-homeless adults, according to a new report. The study was published in the November 2008 issue of the American Journal of Public Health.

Background

Mary Jane Rotheram-Borus, Ph.D., of the University of California, Los Angeles, and colleagues examined the effectiveness of the NIMH-funded Healthy Living Program among a subgroup of HIV-positive adults. The program was designed for HIV-infected adults in general who continued to engage in risky behavior after learning of their infection. It consists of three intervention modules of five sessions each, designed to help participants reduce risky sexual behavior and drug use, improve their quality of life and stick to healthy behaviors.

A previous trial with 737 HIV-infected adults found the program to be effective in reducing risky behaviors. For this study, the authors analyzed data from 270 participants who were homeless or had been homeless in the three years prior to and during the study.

Results of the Study

Compared with a control group who did not receive the Healthy Living intervention, the authors found a significant reduction of risky sexual behavior among the subgroup. Up to 34 percent fewer risky sexual acts took place, and 72 percent fewer sexual encounters occurred with partners who were HIV negative or of unknown HIV status. In addition, individuals in the subgroup experienced up to 26 percent fewer days of alcohol, marijuana and hard drug use.

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Arlington, VA – Calling the NBC Show, The Baby Borrowers, exploitive and harmful to young children and families mental health, the American Psychiatric Association is urging NBC to provide a better review process of its programming in the future and to take into consideration the serious mental health implications shows such as the Baby Borrowers can have on individuals. The APA is calling on NBC to end this type of misuse of children used in order to secure ratings. (more…)

Statement by David Shern, Ph.D., President and CEO of Mental Health America

ALEXANDRIA, VA. (July 1, 2008)-The reports today of the death of a mental health patient in the Kings County Hospital psychiatric emergency room are deeply troubling and demand further investigation to determine the root cause of this incident.  Given the problems that were first raised in a federal lawsuit filed a year ago, it should also spur greater scrutiny of the hospital’s administration and practices.

Mental Health America’s fear is that this incident reflects a broader public attitude that devalues individuals with severe mental health conditions who are served in public systems.   We call on people who share our abhorrence at these acts to continue to combat the ignorance and discrimination that still exists toward people with mental illnesses.  If appropriately treated people, even with the most severe illnesses, can and will recover.  Hope and respect are central components of this treatment.  Devaluing people further prolongs their disability and likely contributes to the 25 years of lost life for persons with severe mental illnesses that are served in public systems. 

This incident is also a tragic illustration of systemic problems in public mental health, where needed mental health care is too often provided as a last resort instead of a first response, and where medical problems too often go unrecognized and untreated.   

Those systemic problems go far deeper than breakdowns in psychiatric emergency services.  By their very nature, emergency services are not adequate alternatives for the many people whose illness could be managed before it becomes a crisis

Rather, this tragic incident underscores a real crisis in mental health service-delivery – the failure to invest adequately in early-intervention and other community-based services and supports, even as hospitals have reduced psychiatric bed capacity.  The facts are that over two-thirds of adults and over half of children with a diagnosable mental health condition do not receive the mental health treatment and services they need.  At the same time, people with serious mental illnesses served in the public system die, on average, 25 years early from preventable health problems such as heart disease and diabetes. 

As we discuss and debate “health care reform,” these shocking data highlight the importance of making mental health reform a key component of needed health reform. 

Mental Health America is the country’s leading nonprofit dedicated to helping all people live mentally healthier lives.  With our more than 320 affiliates nationwide, we represent a growing movement of Americans who promote mental wellness for the health and well-being of the nation – everyday and in times of crisis.

Contact: Steve Vetzner (703) 797-2588 or svetzner@mentalhealthamerica.net

ARLINGTON, Va.-The reported death of a woman at King’s County Hospital in Brooklyn, N.Y., illustrates the dire need for more public services for individuals with mental illness, according to the American Psychiatric Association.

According to news reports, a woman who was suffering from agitation and psychosis, was kept waiting in the emergency room for almost 24 hours because the hospital reportedly did not have a bed available for psychiatric patients. She collapsed onto the floor and then lay there for approximately one hour before emergency room personnel tried to revive her. Tragically, the woman died of causes that have yet to be determined. (more…)

Washington—Today, the U.S. Supreme Court issued a precedent-setting 5-4 decision, reversing a May 2007 ruling of the Supreme Court of Louisiana, and holding that the imposition of the death penalty for child rape violates the Eighth Amendment’s prohibition against cruel and unusual punishment. 

The National Association of Social Workers (NASW) and its Louisiana Chapter filed an amicus curiae brief in Kennedy v. Louisiana (https://www.socialworkers.org/assets/secured/
documents/ldf/briefDocuments/Kennedy%20v.%20Louisiana.pdf)  arguing that the death penalty for child rape harms the victims it is intended to help.  The Court adopted the reasoning in NASW’s brief as support for its conclusion that the death penalty is a disproportionate consequence for a crime that does not result in the death of the victim.  NASW was joined on the brief by several coalitions of sexual assault treatment providers from across the nation.  (more…)

Research conducted by the Gay, Lesbian and Straight Education Network has found harassment and bullying as a result of family structure to be a significant concern for children in lesbian, gay, bisexual and transgender (LGBT) families. The report, “Gay…Families and Education,” also suggests that LGBT parents exhibit a greater involvement in their children’s education.

Details…

The majority of Hurricane Katrina survivors who developed mental disorders after the disaster are not receiving the mental health services they need, and many who were receiving mental health care prior to the hurricane were not able to continue with treatment, according to an NIMH-funded study published online ahead of print December 17, 2007, in the American Journal of Psychiatry.

Philip Wang, M.D., Dr.P.H., formerly of Harvard University, and now director of the NIMH Division of Services and Intervention Research, and colleagues conducted telephone surveys in early 2006 with 1,043 adults who had been affected by the hurricane in Alabama, Mississippi and the New Orleans metropolitan area. Respondents were asked if they had a diagnosed mental disorder, such as depression or anxiety, prior to the hurricane for which they received professional treatment. Those who did not have a pre-existing disorder were asked if they had developed and been treated for a mental disorder since the hurricane struck. Treatment included medication and/or psychotherapy from mental health professionals, general medical providers, religious or spiritual advisors, or complementary and alternative medicine professionals. (more…)

Arlington, Va. – The American Psychiatric Association (APA) applauds recent Congressional efforts to acknowledge and improve treatment for the large number of people with mental illnesses and substance use disorders who are currently incarcerated in U.S. jails and prisons.

According to a 2006 report by the United States Department of Justice (DOJ), entitled “Mental Health Problems of Prison and Jail Inmates,” more than half of the population incarcerated in U.S. prisons and jails – including 56 percent of state prisoners, 45 percent of federal prisoners and 64 percent of local jail inmates – were found to have a mental illness. Many of these inmates suffer from treatable disorders such as major depression, bipolar disorder and substance use disorder. (more…)

NASW signs on to Amicus Brief with other human rights organizations

Washington – Upholding the profession of social work’s commitment to human rights and social justice, the National Association of Social Workers (NASW) supports the ability of Guantanamo detainees to challenge their detention through our Constitutional system of  government checks and balances.

The cases, Boumediene v. Bush and Al Odah v. U.S., represent a clear violation of the rights of these detainees to gain access to the courts and to question the legality of their detention.  The cases do not directly address the innocence or guilt of the detainees, but rather the circumstances in which they are being held and their access to independent judicial review.

”Social workers uphold the key tenents of the profession – social justice and human rights — by taking a stand  against the unchecked use of power by the executive branch,” said Dr. Elvira Craig de Silva, NASW president.  “We serve as advocates so that everyone may have access to justice and basic legal rights under our Constitutional system of government.”

The NASW Code of Ethics notes that one of the core values of the profession is social justice.  To achieve social justice, governments must be able to guarantee  access to due process of law.

Habeas corpus is one of the fundamental elements of the U.S. legal system.  To strip courts of jurisdiction to review the legality of the detention overrides the detainees’ human rights.  Social workers’ abiding concern for social justice and human rights underlies our vision of equal access to justice for all people, regardless of where they are detained and for what reason.

The Amicus Brief was filed by The Constitution Project, Human Rights First, Human Rights Watch and The Rutherford Institute through the efforts of a pro bono legal team from Fulbright & Jaworski in Washington, DC.  NASW, along with a coalition of other non-governmental organizations, signed on to the brief, which was filed August 24, 2007.

For more information about this and other briefs that NASW files on behalf of the social work profession, please visit the NASW Legal Defense Fund.

About the National Association of Social Workers
The National Association of Social Workers (NASW), in Washington, D.C., is the largest membership organization of professional social workers with 150,000 members.  It promotes, develops, and protects the practice of social work and social workers.  NASW also seeks to enhance the well-being of individuals, families, and communities through its advocacy.

By Elizabeth J. Clark, Ph.D., ACSW, MPH

Over the past two years, the concept of social work advocacy for social justice has been under attack. In 2005, the Chronicle of Higher Education published an article regarding a request from the National Association of Scholars asking the U.S. Department of Education to investigate the Council on Social Work Education for “politicized standards” — encouraging universities to evaluate students based on “their commitment to social justice.” Several social work groups responded to this challenge.

NASW responded by emphasizing that “professional education is the vehicle through which members of a discipline become acquainted with the theoretical foundation and the knowledge base of a profession. It is also the method for socializing new entrants about a profession’s values and ethical standards. Consequently, the social work profession has not only the right, but the responsibility of assuring that new professionals understand the profession’s ethical and philosophical underpinnings.”

Our response concluded by stating, “NASW proudly embraces and supports the guiding value of social work justice in social work education and practice.”

Also in 2005, social work advocacy came under public scrutiny. Emily Brooker, a social work student at Missouri State University, with the help of the conservative Alliance Defense Fund, sued the university in federal court for religious persecution. The suit was based on an assignment related to advocacy that Ms. Brooker claimed violated her Christian beliefs. She alleged that she was given a poor grade because of her refusal to sign a letter supporting adoptions by gay couples.

Ms. Brooker was enrolled in a course being taught by social work professor Frank Kauffman. The syllabus for the course indicated that the course included the advocacy element of social work.

The university settled the lawsuit out of court, so Ms. Brooker’s allegations were never proven or discounted. According to a recent article (March 2007) by Alan Cooperman in The Washington Post, both Kauffman and Brooker “insist they were misunderstood.” Kauffman, a former assistant pastor in the Assemblies of God church, maintains that in the classroom, he has always given equal time to everyone’s views.

Why is this issue still getting media attention in 2007? Partly this is due to the fact that in April 2007, the Missouri House of Representatives passed the Emily Brooker Intellectual Diversity Act with the goal of protecting students from “viewpoint discrimination.”

Also related to this issue, in March, Stanley Fish wrote an editorial titled “Advocacy and Teaching” for The New York Times in which he stated that “advocacy is just not what should be going on in a university.” NASW President Elvira Craig de Silva sent a letter to the editor of the Times in which she clarified that “social work requires its members to advocate for individual clients and for systemic reform that improves communities.”

As social workers, we all must stand to differ with individuals and groups such as Stanley Fish, the Alliance Defense Fund, the National Association of Scholars and the Missouri House of Representatives. We cannot allow other groups or individuals to define or limit our profession.

Advocacy is the cornerstone on which social work is built. It is so important that it is framed in three sections of our Code of Ethics. Advocacy for individuals, communities and systems is not just a suggested activity for social workers. It’s not a “do it if you have some extra time” or a “do it if the inequity and disparity are very great” activity. It is a requisite.

Most of us came to the profession of social work to make a difference, to bring about positive social change, to better society. We could have chosen other professions that focus mainly on the individual, on intrapsychic issues rather than on the person-in-the-environment. We could have chosen psychiatry, psychology, mental health counseling or psychiatric nursing. We didn’t.

We became social workers and committed our careers to working not just with, but on behalf of, others. We work towards ensuring healthy individuals, functioning communities and a better society. That’s where advocacy comes into the picture. The Social Work Dictionary defines “advocacy” as “the act of directly representing or defending others — of championing the rights of individuals or communities through direct interventions or through empowerment.”

If being a social worker means standing up for others — all others — and trying to better society, then our critics are correct. We are guilty as charged — and we are unapologetic. Without advocacy, there would be no social work profession. And without social workers, this country would be a much less hospitable and caring place.

To comment to Elizabeth J. Clark: newscolumn@naswdc.org