Discussion 2: Emerging Issues in Mental Health Care

Like so many areas of practice in social work, mental health is dynamic and ever-evolving. Research continues to provide new information about how the brain functions, the role of genetics in mental health, and evidence to support new possibilities for treatment. Keeping up with these developments might seem impossible. However, being aware of and responsive to these developments and incorporating them into both your practice and social policy is essential to changing the lives of individuals and families who live with a mental health diagnosis and the impact it brings to their daily lives.

For this Discussion, review this week’s resources. Search the Walden Library and other reputable online sources for emerging issues in the mental health care arena. Think about the issues that are being addressed by social policy and those that are in need of policy advocacy and why that might be the case. Then, consider what social workers can do to ensure that clients/populations receive necessary mental health services. Also, think about the ethical responsibility related to mental health care social workers must uphold in host settings when they encounter conflicts in administration and home values. Finally, search your state government sites for the mental health commitment standards in your state and reflect on the mental health services covered under your state’s Medicaid program.

By Day 4

Post an explanation of those emerging issues in the mental health care arena that the policymakers address and those that are in need of policy advocacy and why. Then, explain what strategies social workers might use to ensure that clients/populations receive necessary mental health services. Finally, explain the mental health commitment standards and mental health services in your state. In your explanation, refer to the services covered under your state’s Medicaid program.

Support your post with specific references to the resources. Be sure to provide full APA citations for your references.

Consider the company that you currently work for or one for which you have been employed previously. Describe the pay structure of the company, and discuss whether or not you feel it is/was fair to the employees. What, if anything, could be or could have been improved about the pay structure?

Your journal entry must be at least 200 words. No references or citations are necessary.

 Textbook:

Martocchio, J. J. (2017). Strategic compensation: A human resource management approach (9th ed.). Hoboken, NJ: Pearson.

Tools for Practice

As an intern, even in your concentration year, it is common and expected to be nervous and unsure when you begin to work with clients. Working one-on-one with a client requires many skills that take years to learn and a feeling of mastery over these skills is a misguided goal. As a social work professional, even after you graduate, you will learn many lessons from your clients. You will consistently be challenged to obtain new skills and knowledge to best assist your clientele. Further, you will constantly be asked to look at yourself and your own reactions when providing care to your clients. The use of self-reflection and self-awareness is required of a good social worker who recognizes his or her own potential biases and personal experiences in and out of the room. This week you will consider some potential barriers to successfully working with a client and some potential strategies to address them.

Learning Objectives

Students will:

• Explain the importance of identifying internal and external barriers
• Analyze barriers to a therapeutic relationship
• Apply self-disclosure as an intervention strategy

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Drinane, J. M., Owen, J., & Tao, K. W. (2018). Cultural concealment and therapy outcomes. Journal Of Counseling Psychology, 65(2), 239-246.

Geller, S. M., & Greenberg, L. S. (2012). Challenges to therapeutic presence. In Therapeutic presence: A mindful approach to effective therapy (pp. 143–159). Washington, DC: American Psychological Association.

McTighe, J. P. (2011). Teaching the use of self through the process of clinical supervision. Clinical Social Work Journal, 39(3), 301–307.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014a). Sessions: case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].
The Petrakis Family (pp. 20–22)

Required Media

Laureate Education (Producer). (2013c). Petrakis family: Episode 3 [Video file]. Retrieved from https://class.waldenu.edu
Accessible player –Downloads–Download Video w/CCDownload AudioDownload TranscriptCredit: Provided courtesy of the Laureate International Network of Universities.

Singer, J. B. (Host). (2007, March 1). Developing treatment plans: The basics [Episode 10]. Social Work Podcast. Podcast retrieved from http://socialworkpodcast.com/2007/03/developing-treatment-plans-basics.html

Optional Resources

Use this link to access the MSW home page, which provides resources for your social work program.

Discussion 1: Self-Reflection and Awareness

Exploring the reasons for wanting to be in social work and examining your motives for choosing a career of helping others is very important. Your background, including childhood experiences, may be instrumental in bringing you into the field of social work. Understanding the possible connection and working to resolve any underlying unresolved issues is essential to becoming an effective social worker. While working with a client, you must strive to be objective, but in the end we are all human with past hurtful experiences that can impact our ability to effectively work with clients. While complete objectivity is impossible and not expected, it is necessary to self-reflect and become aware of when a situation or a certain personality type causes you to react in an unprofessional manner. Understanding potential internal and external barriers you and your client bring to the room will assist you in balancing an appropriate empathetic response with proper objectivity.

For this Discussion, review the Geller & Greenberg (2012) article and the program case study for the Petrakis family, and view the corresponding video.

By Day 3

Post your explanation of the importance of identifying internal and external barriers of the client and social worker. Then describe the barriers experienced by Helen and the social work intern. Finally, suggest ways the intern could overcome these barriers.

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

By Day 5

Respond to at least two colleagues and suggest alternate ways the intern might overcome barriers.

Support your responses with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

Submission and Grading Information

Grading Criteria

To access your rubric:
Week 7 Discussion 1 Rubric

Post by Day 3 and Respond by Day 5

To participate in this Discussion:
Week 7 Discussion 1

Discussion 2: Self-Disclosure

Knowing that clients might react negatively to your work with them may cause anxiety, frustration, and even anger. It is inevitable that you will work with a client who expresses anger or disappointment over working with you. This does happen in the social work field and is to be expected over time. Understanding how you might react to allegations of incompetence or anger over incomplete goals is essential to managing this type of exchange. While a negative interaction may be justified if either person did not fulfill responsibilities, often it is a result of the client’s personal reaction to the situation. The best response is to use these interactions to build the therapeutic bond and to assist clients in learning more about themselves. Stepping back to analyze why the client is reacting and addressing the concern will help you and the client learn from the experience.

For this Discussion, review the program case study for the Petrakis family.

By Day 4

Post a description of ways, as Helen’s social worker, you might address Helen’s anger and accusations against you. How might you feel at that moment, and how would you maintain a professional demeanor? Finally, how might you use self-disclosure as a strategy in working with Helen?

Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

Having multiple levels of governmental hierarchy as well as various public agencies that are interrelated creates intergovernmental relationships (IGR). IGR can be extremely challenging for public administrators.

Chose one of the issues below. Write 750 – 1000 words explaining why intergovernmental relations (IGR) are so challenging, especially when dealing with the chosen issue.

1.  Illegal Immigration

2.  Homeland Security

3.  Education

Be sure to include the various agencies that contribute to the complexity and the advantages and disadvantages of each of the agencies involved.

Use APA formatting and cite a minimum of three credible sources, such as recent news stories from The New York Times, The Wall Street Journal, CNN, NPR, etc.

400 words not including title & Ref min 3 APA

Be on time, Original work

Data Manipulation

Because your secondary data may have been collected for a different purpose, you may not have the exact variables you need for your research. Data manipulation gives you the opportunity to move or rearrange your data without fundamentally changing it (Baty, 2009). Different variables or records are collected from a variety of data sets. Then, you need to combine these data sets to conduct your analysis. This process is called a data merge or append.

For example, if the age for a given person is stored in one data set, whereas the gender for that same person is stored in a different data set, you would need to merge the two data sets in order to have both variables in one place. At other times, you may need to split data into two and then merge them into one to meet the analysis requirements. For example, if you want to calculate the change from baseline, you would need to have the baseline for every record. Then, you would need to split baseline data and then merge them back to the main data. The process of data manipulation can be challenging, especially when you are working with a large volume of data, but it can be used to answer very specific research questions.

 Post a brief explanation of the concept of splitting data sets. Then, explain the basic elements for splitting data sets. Finally, provide two examples for when splitting data sets data sets may be appropriate. Support your response 

Assignment Details

Scenario: You are a team leader in a clinic inside of a medium-security state prison. Many of the inmates have been diagnosed with brain disorders, and the attending prison physicians have indicated medications that the prisoners must take while incarcerated in the facility. A state legislator visiting the prison has been advised of this program forcing inmates to take medications to treat their mental illnesses and is concerned about the reasons this is being done against the inmates’ will. The legislator asks for a meeting with members of the prison clinic, and you are tasked to explain the reasoning for the forced medication program. The following are questions being asked by the legislator that need to be addressed:

• Why are diagnosed mental health problem inmates being held in a jail-type facility?
• What is the reason the inmates are being given the drugs?
• How can the prison clinic be forcing inmates to take the drugs against their will?

Scenario: You are the Director of Mental Health at Halfway House, which deals with drug addicts who have brain disorders who have found their way into the criminal justice system. The patients in this program were diverted from incarceration into prison because a clear link was established between the drug offenses they committed and their mental illness. Mental illness is often a reason for an individual to turn to substance abuse.

The majority of your inmate/patient population requires medication to maintain a semblance of social function and to be allowed to leave the facility to work and see family members. You must continually evaluate the participants of the program utilizing the Axis criteria and the patient evaluation from the Global Assessment of Functioning (GAF) Scale (DSM-IV, 1994, p. 32). The GAF is broken into 10 groups from 0 to 100. A person in the category from 91–100 would be perfect mentally. This is not normally found with anyone. The person found in the category of 0–10, which is the opposite, would be a persistent danger to everyone around him or her, including him- or herself. This person would be completely dysfunctional socially and unable to work. As the director, you are required to use the GAF to evaluate the ability of your charges to remain in the program on a monthly basis.

The persons in this program must have successfully completed detoxification for the drugs they were abusing.

In addition to your required evaluations, you have a pharmacy on-site. The pharmacy issues medications and requires the participants to take the medication in front of health service professionals so that the medication prescribed is actually being used and not sold or thrown away. The following medications are being given:

• For participants suffering from schizophrenia, the drugs used are classed as antipsychotic drugs.
• For those being treated for depression, antidepressants used are also known as selective serotonin reuptake inhibitors (SSRIs).
• A common illness among inmates is bipolar disorder. This is treated with mood stabilizers that were originally developed to treat convulsions. For bipolar disorder, antipsychotics and antidepressants may also be used.
• Anxiety disorders are also common mental health concerns with inmates/patients. These include many commonly known mental health problems such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder, and social phobia. For treatment of such disorders, the most common drugs are antidepressants, anti-anxiety medications, and beta-blockers.

In a 10–12-page position paper, write up the problem you observed in the scenario, and answer the following questions:

• What level of inmate patient are you prepared to take into the program based on the five Axis of the DSM-IV and the associated GAF criteria for identifying function? Justify your reasoning.
• What are the main categories of mental illness that can be treated by pharmaceuticals?
• By category of illness, what corresponding type of drug should or could be prescribed to treat those illnesses?
• What are the side effects of the drugs you indicated in your report?
• How do you plan to convince the participants that they must maintain their drug treatment after they leave the program you are in charge of?
• How will these treatments allow the patient/inmate to reintegrate into family, social setting, work setting, and keep them from re-offending?
• What are the associated dangers of putting a person in a drug therapy program where they had previous chemical addictions?

For the Unit III Essay, imagine you are the lead trainer for a global organization. Through data analytics and observations, you have noticed that employees across the organization do not share their knowledge with one another, whether that be from skills trainings they recently completed to general knowledge that could enhance the capabilities of the organization. This is a big issue for the chief executive officer (CEO), and the head of human resources (HR) has asked you to come up with solutions to address the issue. Within your essay, provide the information below. 

• Give three reasons as to why employees do not share knowledge. 
• Give three solutions that your organization can incorporate to encourage knowledge sharing among employees. 
• Discuss the benefits that each solution offers and how each solution promotes knowledge sharing. 

For this essay, create a fictitious company name and location, and make your suggestions specific to that company. In the introduction, give the company name and location and some brief background information about the company and industry. Feel free to choose any industry (e.g., technology, manufacturing, or advertising) that interests you, and add any details that you think are necessary for your essay. 

Your essay must be at least two pages in length, not counting the title and reference pages. You are required to use at least one outside source to support your explanation. All sources used, including required unit resources, must be cited and referenced according to APA guidelines.

The Assignment

1. Analyze the subjective portion of the note. List additional information that should be included in the documentation.

2. Analyze the objective portion of the note. List additional information that should be included in the documentation.

3. Is the assessment supported by the subjective and objective information? Why or why not?

4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?

5. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.