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Service users with mental health problems can present social workers with their own unique challenges; by exploring these challenges it is possible to gain a greater understanding of the role of the social worker. It is intended to look at the desired outcomes from Social Work intervention and the processes that a Social Worker can use to facilitate these outcomes.
Prevention-Work with groups at risk of mental health problems to promote positive mental health -work with individuals and families – reduce the negative effects of institutionalisation and to promote social integration. (DAVIES, 2008)pp260
Multidisciplinary Teams-medicine- Psychiatrist-nurses-psychologist-occupational therapists-social worker
All Social Workers, not just Mental Health Social Workers, need to be aware of the multitude of mental health conditions that exist. Whilst it is not the role of a Social worker to diagnose a mental illness; it is important for Social Workers to recognize that a client may have a mental health problem and be able to refer the client to a medical professional. Mental Health issues are present across all areas of social work including, child protection, older people, criminal justice and physical illness. (Manktelow, 2008) It is also important that Social Workers understand the various causes and contributing factors that can lead to the onset of mental health problems.
It is widely agreed among health professionals that the causes of mental illness can be physical, psychological, social and environmental or more usually a combination of these factors.
Physical- Genetic, brain injury, illness, pre birth factors such as maternal substance abuse or maternal illness during pregnancy
Psychological- Abuse or trauma, bereavement or divorce
Social and environmental factors- Lack of support network, stressful job, unemployment, living in a deprived or high crime area, poor accommodation, and lack of privacy. (www.rethink.org)
http://www.rethink.org/about_mental_illness/what_causes_mental_illness/index.html [accessed 23/11/2010]
Whilst physical causes can generally be put purely in the realm of the medical professionals; some issues such as substance abuse during pregnancy are a social work issue and whilst it is intended to concentrate on the work of the social worker within the bounds of mental health it is important to remember that many of the agreed causes of mental health problems are also social work issues and that early intervention in these areas can prevent future problems.
The Social Worker’s role is especially important for service users with a dual diagnosis i.e. schizophrenia and substance dependence as the two conditions tend to be managed by different agencies; add to that issues with housing and benefits and it can be seen that effective communication as facilitated by the Social Worker is paramount (Parrish, 2010)
The ultimate role of intervention is to improve the quality of life for the service user, their families, carers and all concerned. Cite Perhaps now would be a good time to look at what a person requires to feel that they have a good quality of life and the negative effect that a mental health problem could have on these requirements. Maslow with his “Hierarchy of Needs” tells us that to achieve a good quality of life we need firstly, the basic requirements of life without which a person will die then next in the hierarchy is the need for safety followed by Love and belonging, esteem and finally self actualization. Whilst the theory has its’ critics; most of the criticisms are aimed at the hierarchal nature of the theory. When the theory is applied to a specific population as in Majercsik’s study of the needs of geriatric patients it can be seen that the hierarchy can be skewed.(Majercsik, 2005) It is generally agreed that if these needs are not met then this will have a negative effect on quality of life.
E. Majercsik. (2005). Hierarchy of Needs of Geriatric Patients. Gerontology, 51(3), 170-3. Retrieved November 26, 2010, from ProQuest Nursing & Allied Health Source. (Document ID: 823764721).
The initial concerns during assessment and intervention are to ensure that the basic needs of the individual are being met and that they can continue to be met either by the individual or if necessary by a care plan. As well protecting the client from harm Service users with mental health problems my present a safety risk to themselves or others and it is important that these risks be assessed and if necessary steps taken to reduce these risks. If a client is deemed to be a risk to themselves or others they may be detained for treatment under the Mental Health Act (1983). This process requires an Approved Mental Health Professional (AMHP) to make an application for admission to hospital for assessment or treatment. Deprivation of liberty is a serious matter and as such it is covered by strict laws and guidelines. It is important for a Social worker working in the field of mental health to know the laws and procedures involved with compulsory detention. (Golightley, 2008)
Mental illness can be caused by abuse but also having a mental illness can leave a person vulnerable to abuse. Individuals with mental health problems are vulnerable to abuse in many forms, physical, sexual, psychological, financial, discrimanatary and neglectful. This abuse can come from many sources, friends, family, neighbours, strangers and even care proffessionals. This abuse can be intentional or unintentional. Working with vulnerable people puts a Social Worker in a position of power both real and percieved and it is important that this position of power is not abused. The GSCC Codes of Practice state that as a Social Worker you should recognise and use resposibly the power that comes from your work with service users and carers (GSCC 2002). The use of anti oppressive, anti discriminatory and reflective practices is therefore essential to good practice. Working in partnership with clients, setting the client realistic goals and the use of a person centered approach all serve to redress this balance of power. Recognizing how one’s own emotions, circumstances and values effect the way in which a person or situation is percieved is an important factor in being non-judgemental. A Holistic approach, taking into account, race, culture, social standing can help prevent discrimination.
It is important to appreciate that any care plan should meet the needs of the individual and to ensure that the family/carers are also supported. Caring for a family member with a mental health problem can have many negative effects on the carer. The family may suffer financial hardship, social stigma and isolation. Children may feel or even be neglected due to the demands of caring placed on a family; this can lead to attention seeking behaviour, missing school, poor hygene, poor health or criminal activity. They may feel fear or intimidated by the unusual behaviour exhibited in some forms of mental illness. Carers may feel helpless, overwhelmed, tired, socialy deprived and may neglect their own care in favour of that of the ill family member; this can lead to physical or mental illness for the carer. If the carer can no longer cope with the caring role then the individual can be neglected. It is essential then that the family/carers receive support in their role. The Social Worker must develop a care plan that helps the family cope with their role as carers; this may include carer support groups, coping strategies for dealing with aggressive behaviour or hallucinations, advice on benefits, bringing in outside carers and explainations of treatments and illnesses. An effective care plan can improve the quality of life for the service user and their family and this in turn reduces the need for hospitalization and can prevent a host of future problems.
Service users who require hospitalization for long periods of time can present different problems. They can become institutionalized and require a lot of work when the time comes that they are ready to re enter society.
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