Adult children of parents with mental illness: navigating stigma

The experiences of children who live with parental mental illness are becoming increasingly recognized. However, there remains a limited body of knowledge in relation to an individual's longer term experiences. This study sought adult children's experiences of childhood parental mental illness. It generated reflections of 13 adult children who had lived with parents with mental illness during their childhood. The narrative design of the study facilitated a voice for participants. The paper presents one main theme of the findings. The findings offer a unique insight into childhood awareness of social stigmas and children's behavioural changes to avoid disclosure of parental mental illness. Participants noted that they were aware of social stigmas associated with mental illness during their childhood. This contributed to their fear of disclosure to others that fuelled a culture of familial secrecy, reinforcing the children's own sense of difference. Further work is required to enhance community understanding about the familial journeys of parental mental illness and the impact of negative‐natured stigmas.     

The Significance of the Early Stage of Illness as a Focus for Social Work Help

Summary This paper considers the experience of illness as a series ofinterrelated phases, in which the beginning phase which is thetransition from health to illness is shown to have special significance.The common responses to this stage of illness are denial, welcomeor inertia, each of which may give some forewarning of problemsthat may be encountered later in the illness. Traditionallysocial work help has focused onto the acute or convalescentstages, but it is suggested here that the beginning phase ofillness offers a rewarding point for intervention, not onlywhen opening new cases, but also among clients who are alreadyknown and where health problems may interact with other problems.The implications of this are explored both for agency policyas well as an added dimension of diagnostic understanding ofindividual clients no matter what the agency     

INDIVIDUALS WITH INTELLECTUAL DISABILITY AND MENTAL ILLNESS: A LITERATURE REVIEW

This review highlights the urgency for a seamless and co‐ordinated approach to service delivery for people with intellectual disability and mental illness. There is emerging evidence of the high prevalence of mental illness in persons with intellectual disability. The notion that people with intellectual disability can have mental illness has only been recently acknowledged. Furthermore, people with intellectual disability also experience a wide range of psychiatric disorders often seen in the general population. Despite of recent developments in treatment options for these people, many of them continue to experience barriers in accessing mental health services.     

Wage compensation for job-related illness: Evidence from a matched employer and employee survey in the UK

Despite voluminous studies on compensating wage differentials for job-related fatal or non-fatal injuries, there remain few published studies confirming the existence of compensating wage differentials for job-related illness. This study utilizes a recently completed UK employer-employee survey to look at this specific issue. I find there is strong evidence of wage compensation for job-related illness risk for both male and female employees in the UK. The estimated wage compensation for one job-related illness episode per year ranges from 27% to 140% of annual earnings depending on gender and estimation approaches.     

Gaining knowledge about parental mental illness: how does it empower children?

This study examined the utility of a digital video disc (DVD) intervention, designed to educate children, whose parents have depression and/or anxiety. Twenty‐nine children completed pre‐ and post‐DVD exposure questionnaires, on mental health knowledge and help seeking, and 18 were interviewed about their experiences and use of the DVD. Post‐DVD, children's knowledge of mental illness improved. The DVD also challenged mental illness misconceptions. Most children preferred watching the DVD with a parent. The study explains how children utilize information about mental illness.     

Integrating Mental Health Parity for Homebound Older Adults Under the Medicare Home Health Care Benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Integrating mental health parity for homebound older adults under the medicare home health care benefit

Despite high rates of mental illness, very few homebound older adults receive treatment. Comorbid mental illness exacerbates physical health conditions, reduces treatment adherence, and increases dependency and medical costs. Although effective treatments exist, many home health agencies lack capacity to effectively detect and treat mental illness. This article critically analyzes barriers within the Medicare home health benefit that impede access to mental health treatment. Policy, practice, and research recommendations are made to integrate mental health parity in home health care. In particular, creative use of medical social work can improve detection and treatment of mental illness for homebound older adults.     

Support for and From Aging Mothers Whose Adult Daughters are Seriously Mentally Ill

This article discusses, from the grandmother’s perspective, the ways in which support is exchanged in families coping with serious mental illness. A strengths perspective was utilized to identify ways in which family members help each other. Employing a qualitative approach, this study focuses on interviews obtained from a sample of 22 aging mothers, aged 52–90, who are in contact with their daughters who have a mental illness. Grandmothers provided several kinds of support to their mentally ill adult daughters and to their grandchildren, who also supported the aging mother in numerous ways. As social workers seek to assist individuals with mental illness, it is important to assess the existing strengths of their intergenerational family context.     

Practical considerations for maintaining independence among individuals with functional impairment

Social workers, gerontologists, and related health professionals must learn to recognize how aging, disability, and chronic illness affects individuals and their families' physical, psychological, and social functioning in order to develop effective interventions for their clients. This article discusses prevention strategies to help facilitate functional consequences of aging, including chronic illness and disease and offers suggestions for assisting clients to cope and manage the consequences of illness in frail elder adults.     

Coping with Chronic Renal Failure

Summary This paper presents the findings of a small-scale study in whichtwenty renal patients on home dialysis were interviewed. Thedata are analysed in relation to coping strategies, coping stylesand illness roles. Some implications for theories of coping,illness roles and social work are examined.     

A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.     

Unemployment as Illness: An Exploration of Accounts Voiced by the Unemployed in Aotearoa/New Zealand

In Aotearoa/New Zealand unemployment is a continuing social concern that has been linked to a range of negative consequences, including various psychological and physical ailments. Whereas findings linking unemployment to such conse-quences are highly prevalent, few studies have explored people's experiences of unemployment. This article presents an analysis of 26 semistructured individual interviews with unemployed people in order to explore the social construction of unemployment. It is argued that the meaning of unemployment is in many respects analogous to what previous research on lay health beliefs has found regarding the meaning of illness. Prominent themes from literature on the meaning of illness are used to inform an analysis of the meaning of unemployment. The implications of constructing unemployment as an illness are explored in relation to the assignment of cause and responsibility and to the ways the unemployed are socially positioned. Tactics used by participants to preserve a sense of moral worth in response to the stigma of unemployment provide a key focal point for this article.     

Practice challenges at the intersection of child protection and mental health

This paper examines the complexity of collaboration between child protection and mental health services, where a parent has a mental illness and there are protection concerns for children. The paper reports on data from focused in‐depth interviews with 36 child protection workers, adult mental health workers and child and youth mental health workers. Data were analysed thematically, using NVivo to facilitate data management and analysis. Two dimensions were identified. The first, the process of collaboration, relates to four factors that assisted the collaborative process: communication, knowledge, role clarity and resources. The second dimension considers the challenges presented to collaborative work when a parent has a mental illness and a child is in need of protection, and identifies issues that are inherent in cases of this kind. Two types of challenge were identified. The first related to characteristics of mental illness, and included the episodic and/or unpredictable nature of mental illness, incorporating information from psychiatric and parenting capacity assessments, and the provision of ongoing support. The second type of challenge concerned the tension between the conflicting needs of parents and their children, and how this was viewed from both the adult mental health and the child protection perspective. Implications for policy and practice are identified in relation to the need for service models that provide ongoing, flexible support that can be intensified or held back as needed.     

Ethnicity, migration and health: A population-based study of 338 refugees from Latin America, 396 nonrefugee immigrants from Finland and 161 from southern Europe and 996 age-, sex- and education-matched controls from Sweden

This article shows the influence of being a refugee from Latin America or a nonrefugee immigrant from southern Europe or Finland on self-reported illness, controlling for social factors and lifestyle. The study population consisted of 338 Latin American refugees, a random sample of 396 Finnish and 161 southern European immigrants and 996 age-, sex- and education-matched Swedish controls. The data were analysed unmatched with logistic regression (multivariate analysis) in main effect models. The strongest independent risk indicator for long-term illness was being a Latin American refugee (estimated odds ratio (OR)=2.96, 95% confidence interval (CI)=2.19–3.82). There was a significant association between being a Latin American refugee and period prevalence, ill health and unsatisfied need for care. Being a southern European or Finnish immigrant was a risk indicator of ill health but was not associated with the other dependent factors. Not feeling secure in daily life was a strong risk indicator for long-term illness and ill health (estimated OR=1.89, 95% CI=1.26–2.76 and OR=3.04, 95% CI= 1.97–4.48) respectively). Being a Latin American refugee was equal in importance to traditional risk factors such as overweight and not taking regular exercise for long-term illness and ill health.     

小组工作在综合医院精神科精神疾病康复中的运用——以昆明M医院精神科“沟通小组”为例

随着精神疾病发病率的不断上升,精神疾病负担的不断加剧,精神健康与精神疾病越来越受到人们的普遍关注,众多学者也开始了对精神疾病康复模式的探索,笔者以社会工作专业视角,利用小组工作介入形式,为M医院精神科精神病人及其陪护开展"沟通小组"活动,开始了综合医院精神科精神疾病康复的探索与实践。     

Surviving Critical Illness: New Insights From Mixed-Methods Research

Current advanced medical technology allows survival of critical illness. However, the patient's psychological response to survival is relatively unexplored. Interviews with 32 older adult survivors, using the Hospital Anxiety and Depression Scale (HADS) and the Experience after Treatment in Intensive Care (ETIC-7) scale, Miller's Q-sort, and social work clinical wisdom, yielded unique and unexpected research results. Four response types were identified: avoiding, depressed, denial, and coping. Psychological agency during illness was found to be important. Participants did not reveal posttraumatic stress disorder–related phenomena predicted in previous literature but instead experienced posttraumatic growth. Hallucinatory experiences during illness were not traumatic, whereas social support emerged as a complicated concept. Participants unexpectedly revealed that childhood trauma was an important factor. Implications for clinical social work practice and research are outlined following the discussion of findings.     

Mother's Coming Home Today

Through use of hypothetical case material, this paper explores the social and emotional impact of discharge planning on an older patient, who has been in the hospital, and on her family. Three major areas are examined: mobolizing families through the crisis of illness; the need for early discharge planning to determine options and meet the federal-state regulations; and the potential for burn-out which exists in the discharge planner. The case material focuses on how a family experiences illness and responds to the discharge planning process.     

The Citizenship of Excluded Groups: Challenging the Consumerist Agenda

The language of consumerism suggests that through involvement in consumer processes, consumers can influence policy formation and service provision. This paper examines, as illustrative cases in Australia, how two groups of consumers, people with a mental illness and older people, engage with these consumer processes. It finds they critically evaluate the opportunity offered by consumer processes for inclusion in policy and programmes. Both people with a mental illness and interviewed older people indicated how they acted as "agents involved in interpreting their needs", despite finding that in consumer processes their needs were predefined. Rather than allowing themselves to be constructed as passive objects, they positioned themselves as active citizens, having agency not as individual consumers but through drawing on networks. The responses of both groups go some distance toward dismantling power differences between professionals and "consumers", suggesting that social policy and programmes for both people with mental illness and older people can and sometimes do develop in a context of greater inclusivity.     

Differences by Race in Social Work Students’ Social Distancing,Treatment Options,and Perceptions of Causes of Mental Illness

ABSTRACT

Research has shown that racial and cultural differences are related to the degree of social distancing associated with mental illness, beliefs about what causes mental illness, and what treatment options are best; however, there is little information on how this may manifest in social workers’ perceptions of these issues. This cross-sectional survey analyzed the differences in perceptions by race of 835 students enrolled in social work classes in the United States. Results indicated that individuals who self-identify as African American/Black expressed the greatest social distance concerning mental illness. Whites were most likely to endorse the use of medication and were least likely to normalize mental illness. The most frequently endorsed mental health provider varied according to racial/ethnic groups. Our findings show that future research may be needed to further investigate the conceptualization of the role of social work among different groups. The need for self-reflection and keeping biases in check are discussed as implications for social work practice and education. Suggestions for working with diverse clients, including religious diversity, are offered as well.