Chap 6

SW 2300 Syllabus

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Social work and mental health

SW and Mental Health Care

•In-patient, out-patient, residential and community based treatment

• Team approach

• Case conferences, planning

• Case management

 

Roles of the BSW and MSW

•MSW performs therapy

• BSW is case manager, residential care counselor, crisis intervention worker, community based treatment coordinator, discharge planning

Historical development

•1841 - Dorthea Dix - mentally ill in prisons or poor house

• 1843 Report to Massachusetts legislature

• Development of institutions for mentally ill

• Women's issues in mental health in the Victorian Age - Hysteria

 

 

Historical development

•Mary Richmond - Social Diagnosis 1921

• Freud - recognition of unconscious, preconscious and conscious

– Typographical Model

•WWI - Shell shock VA services

• 1933 Jessie Taft - Psychologist First Book on Children's Mental Illness

• National Mental Health Act of 1946 - provided federal funds for research

Psychotropic Medications

•Antipsychotics (1955) - Haldol, Chrlorpromazine, Thorazine, Mellaril, Stelazine, Prolixin

• Antidepressants - Elavil, Tofranil, Prozac, Desiryl, Nortriptline, Sinequan

• Antimanic medications - Lithium

• Antianxiety medications - Benzodiazepines - Valium, Ativan, Xanax

• Hypnotics and Barbituates

DSM IV

•Dominant tool for diagnosis

• Psychosis

• Neurosis - anxiety disorder

• Mood disorder

• Personality Disorder

 

DSM IV

•Multiaxial assessment

• Axis I - clinical disorders

• Axis II - personality disorders

• Axis III - general medical conditions

• Axis IV - Psychosocial and environmental problems

Deinstitutionalization

•Community Mental Health Centers Construction Act of 1963 - Deinstitutionalization

• Least restrictive setting

• Community based treatment and planning

 

Rights of the mentally ill

•1970's - Rights of mentally ill. Modeled after the civil rights movements

• Right to informed consent

• Self determination

• Right to release

• Right to receive treatment

• Least restrictive care setting

 

Involuntary treatment

•Commitment

• Danger to self and others

• Unable to care for self

• Unable to understand the need for treatment

• Duty to warn

–breaks confidentiality when specific threat or target is identified

 

Current trends in mental health care

•Brief short term treatment

• Intermittent over lifetime

• Managed Care

• Community based treatment (ACT)

• Deinstitutionalization

• Medications

• Cognitive behavioral approaches