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Home Courses I teach Social Work Program
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 |