This study examined whether the concept of desired outcome in community programs serving adults with psychiatric disorders was a unitary or multifaceted concept and whether, if multifaceted, subject stakeholder group membership or variables of sex, education, age or attitudes were related to subject preferences for types of outcome. A literature review and focus groups were used to establish a broad range of potential outcomes and 47 subjects from six stakeholder groups (clients, family members, direct care staff, directors of programs serving clients with serious psychiatric disorders, DMH personnel who made service funding decisions, and taxpayers) sorted the 82 outcomes in order of their perceived importance. Subject responses were factor analyzed and a five factor solution was interpreted as indicating concerns for (1) increased client self determination, (2) risk reduction and stability, (3) provision for basic needs, (4) increasingly responsible and integrated community living, and (5) increased autonomy through skill development and symptom reduction. Stakeholder group membership was the only subject variable significantly correlated with subject differences in loading on the five identified factors. It was concluded that these differences had important implications for the ability of stakeholder groups to interact productively. That is, if individuals with differing views on the proper goals of the community mental health system fail to understand the nature of their differences conflict and distrust will continue and a coherent sense of mission for the community system will be impossible to attain. The author asserts that it is important for stakeholders to recognize the legitimacy of, and basis for, the views of others with whom they are attempting to work. Steps recommended to use these findings to improve the quality of practice in the field include: acknowledgment of conflicts inherent in differing points of view, clarifying the extent to which custodial care and social control of those with psychiatric disorders are primary functions of the community system, resolution of legal and ethical issues inherent in "ensuring" the care and safety (as defined by others) of those with psychiatric disorders, specification by funders of outcome priorities, and greater use of outcome measurement in program evaluation.

Yes / Despite increasing evidence of the impact of health inequalities on mental health (Pickett and Wilkinson, 2015) there is only limited recognition of the potential role for mental health social work in addressing ‘upstream’ as well as ‘downstream’ challenges of poverty, disadvantage and oppression affecting many people experiencing mental health difficulties. This paper presents some of the current evidence concerning mental health inequalities and the opportunities for mental health social workers to promote wellbeing. A theme throughout the paper is the need to avoid the many examples of dichotomous thinking that frequently characterise thinking about mental health and mental health practice. Additionally the limitations of an individualised recovery discourse are acknowledged. Drawing on Krieger’s (2011) ecosocial model, the social determinants of mental health are considered and the concept of embodiment is examined for its contribution to a more nuanced understanding of the relationship between inequality and health. Finally, the paper offers a version of mental health social work that ‘faces both ways’, involving issues at both the individual and the wider societal level. This includes developing and extending partnerships with service users and carers and with other professional and agencies.

Yes / This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based 'business champions' to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the 'business champion' emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments. / This work was supported as part of the evaluation of the Altogether Better programme, which is funded through the UK BIG Lottery fund and aims to empower people across the Yorkshire and Humber region of the UK to lead healthier lives.

<p> This mixed method study investigated what providers who work with school-age children identify as the continued needs among children of Minnesota National Guard service members who are currently or have been deployed since 9/11. Key informants with National Guard (n=8) and educational affiliations (n=8) participated in semi-structured interviews that helped inform survey content for school social workers (n=105) that completed online surveys. Results from this study demonstrate that needs among children of deployed service members are being addressed on many fronts. Yet in light of the transitions the families of these youth experience, they remain vulnerable and in need of school based support that makes use of relationship support at school and promotes their resilience. Results from this study also reveal that developing further supports&mdash;particularly through clinical, tertiary-level interventions&mdash;within school settings is an ongoing challenge to which school social workers are encouraged to respond. Future research would benefit from a study of clinical school social work interventions for children of deployed service members that are age-appropriate, multi-theoretical in nature, and address mental health needs within school settings.</p>

<p> The needs of homeless students are significant and varied. The McKinney-Vento Homeless Assistance Act helps ensure homeless students can access a quality education. One of the key provisions is the requirement that all LEAs identify a liaison to be in charge of meeting the needs of homeless students. The purpose of this study was to understand the perceptions of district liaisons in regard to the needs of the homeless students they serve and the factors that facilitate and hinder their ability to meet these needs. The study was designed as a qualitative study relying primarily on interviews with 20 liaisons from a representative sample of districts in the state of Ohio. </p><p> The findings indicate that homeless students face a number of needs, including access to basic necessities like food, clothing, shelter, and transportation, and to social services including mental health services and drug treatment centers. Liaisons indicated that they played a less direct role in supporting students&rsquo; academic needs, instead relying on school-based staff members to support homeless students&rsquo; academic needs. </p><p> Liaisons identified a number of factors that facilitate and hinder their ability to meet the needs of their homeless students. The availability or lack of district resources like funding and personnel were especially important. In some districts, superintendents had prioritized hiring additional social or community workers. Liaisons indicated they relied a great deal on the support of these personnel. Further, the availability (or lack) of community-based service agencies greatly impacted liaisons&rsquo; work. </p><p> Finally, liaisons faced a number of competing demands that made their roles challenging. The vast majority of liaisons held another full-time role in the district, meaning they had limited time to devote to the role of liaison. Liaisons also indicated that navigating both community perceptions of homelessness (whether identified families were &ldquo;truly&rdquo; homeless or deserving of support) and the proper role of the school in the community were added challenges. </p><p> These findings suggest that additional personnel to help meet the needs of homeless students and greater coordination between schools and social service agencies would benefit both liaisons and the homeless students they serve. </p>

<p> Diagnosis of cancer found in a child impacts not only the child being diagnosed, but the siblings, parents, and family as a whole. The purpose of this thesis project was to write a grant in order to fund the development and implementation of a support group for parents who have children with cancer. In partnership with Camp Ronald McDonald for Good Times, the program would create a 6 week long support group that would provide parents with skills, resources, and interventions needed to parent a child diagnosed with cancer. The W.K. Kellogg Foundation was selected as a funder because of the foundation's dedication to promote the health, happiness and well-being of children. This grant reviews the challenges parents have as well as the positive impact this program could have on the parents and their children. Submission and funding of this grant were not requirements of successful completion of this project. </p>

<p> This project served to locate a potential funding source and write a grant to secure funding for a program that provides mental health and psychological treatments, resources and information, and ultimately empowers Latina domestic workers who have survived trauma within and outside their scope of work. The program will be implemented by an MSW with Promotora community leadership. The program consists of a trauma focused intervention group with culturally sensitive and empirically supported curriculum as well as crisis mobilization services for female Latina domestic workers in the city of Los Angeles. If funded, this program will enable social workers and others to be able to advocate successfully and be informed about Latina domestic workers who face specific challenges in their work, including physical and mental health concerns, safety issues, a lack of labor protections, and overall health. Submitting this proposal for funding was not required to successfully complete this project.</p>

<p> Community mental health centers are actively pursuing evidence-based practices to help serve adolescents with serious emotional disturbances (Painter, 2012) and maintain adolescents in their homes who are at-risk for placement in residential care facilities (Copp, Bordnick, Traylor, &amp; Thyer, 2007). Family preservation programs attempt to improve family functioning and dissuade future out-of-home placement (Diamond &amp; Morris, 2011). The purpose of this study is to understand the relationship between the characteristics and outcomes of at-risk adolescents through secondary data. This study used a theoretical approach of the social learning theory developed by Albert Bandura (1973). The overall research question was as follows: Is there a significant difference between age, gender, and the length of treatment among adolescents in family preservation services? The study sampled 79 completed records of adolescents, age 1117, who received family preservation services in a Southeastern state over a five-year period and discharged from January 1, 2009 through December 31, 2014. The quantitative research design was intended to examine the relationship between age, gender, length of treatment, and treatment outcomes of at-risk adolescents using archived data from the Child Behavior Checklist and the Global Assessment Functioning. The results of this study were shared with the administrators of the community mental health center. Excerpts of the written report of this study were discussed in detail with the administrators. This study has demonstrated that the participants of family preservation services experience significant differences in treatment outcomes of length of treatment, but not in age and gender. Implications for service delivery, especially successful completion of services, were discussed. Recommendations for future research are suggested at the conclusion of this study.</p>

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Baseado na convicção de que trabalhar é gerir fruto das pesquisas com a perspectiva da Ergologia , procura-se nesta tese pensar gestão como um conceito ampliado, algo que todos os humanos operam ao trabalhar, e não somente como uma função exclusiva de administradores, no sentido restrito do termo (referido apenas aos chefes, diretores, etc.). Tendo como campo empírico o Sistema Único de Saúde (SUS) e investigando-se as proposições de alguns dos principais autores sobre o tema da Gestão e Planejamento em Saúde, verificou-se que uma exaustiva busca vem sendo empreendida por diversos agentes do campo da Saúde e por pesquisadores para aproximarem-se, compreenderem e desenvolverem melhor as habilidades, os conhecimentos, as competências e os dispositivos que permitiriam uma gestão mais eficiente do SUS e, mais especificamente, no âmbito de uma Unidade de Saúde Pública no Brasil. Estiveram em análise as práticas de gestão desenvolvidas em um Centro Municipal de Saúde do estado do Rio de Janeiro (Brasil), no qual o autor da tese, além das atividades de pesquisa, exercia a função de diretor geral. A tese teve como objetivo principal analisar, do ponto de vista da atividade, a dimensão gestionária do trabalho na Unidade de Saúde citada, a fim de discutir a viabilidade naquele local e, possivelmente em outras Unidades de Saúde do exercício de uma ergogestão, isto é, uma gestão com base nos princípios propostos pela Ergologia quando o ponto de vista da atividade tem cidadania no meio de trabalho. O referencial teórico constituiu-se de algumas abordagens clínicas do trabalho (Ergonomia da Atividade, Psicopatologia do Trabalho, Psicodinâmica do Trabalho e Clínica da Atividade, esta última em menor proporção) com elementos das contribuições do educador brasileiro Paulo Freire, do psicanalista inglês Donald Winnicott e do biólogo chileno Humberto Maturana, todas colocadas em sinergia dialética sob a orientação da perspectiva ergológica. No curso da investigação foram utilizados métodos e técnicas pertinentes a este quadro e que objetivaram possibilitar a aproximação e o diálogo com os protagonistas da atividade na Unidade de Saúde em análise. Destacam-se as influências da pesquisa-intervenção e da pesquisa etnográfica, sendo o principal dispositivo técnico utilizado aquele denominado Encontros sobre o Trabalho. A pesquisa empreendida, conjuntamente com a experiência concreta de gerenciamento (como diretor geral), permitiu concluir que o esforço de implantação da modalidade que se denomina ergogestão, privilegiando o ponto de vista da atividade, pôde colaborar para promover transformações positivas no cotidiano da Unidade posta em análise. Contudo, sua aceitação por um maior número de atores e seu desenvolvimento dependem do atendimento de algumas necessidades, apontadas pelo coletivo de trabalho como entraves a superar. Os achados aqui presentes podem contribuir para a construção de um patrimônio de informações acerca da Unidade. A partir desse patrimônio outras experiências de gerenciamento podem vir a se desenvolver, obtendo-se assim, cada vez maior êxito na gestão do processo de trabalho e na melhoria das condições do atendimento oferecido aos usuários. / Grounded in the conviction that working to manage,- results of the research on the ergological perspective -, we think management as an extended concept, something that all the human beings operate when working, and not only as an exclusive function of administrators, this term used in a restricted way (referred only to the board of directors, etc.). The field analysis consisted of the Sistema Único de Saúde (SUS) in accordance with the proposals of main authors in the area of health planning and management. It was verified that an exhausting search that is being undertaken as for some actors/agents of the field of health as for researchers to understand and to develop the abilities, the knowledge, the devices that would allow management more efficient of a Public Health in Brazil and the possibilities of some of these findings to be applicable to the Sistema Único de Saúde (SUS). It had been analysed the management practices developed in a Municipal Health Centre located in a city in the State of Rio de Janeiro (Brazil), where the author of the thesis, beyond the activities of research, exerted the function of general manager. This thesis had as a main objective to analyse, of the point of view activity, the gestionary dimension of the work in a Municipal Health Centre, in order to discuss the viability in that place - and, possibly in other Health Centre - of the exercise of the ergomanagement that is a management on the basis of the principles concern the Ergology - when the point of view activity has citizenship in the way of work. The theoretical referential consisted of some clinical boardings of work (psychopathology of work, psychodynamic of work, ergonomics of activity, and clinic of activity) in accordance with the work of the Brazilian educator Paulo Freire, the English psychoanalyst Donald Winnicott and the Chilean biologist Humberto Maturana, all applied the Synergy under the orientation of ergological perspective. During the work had been used pertinent methods and techniques that had objectified to make possible the approach and the dialogue with the protagonists of activity in the Municipal Health Centre in analysis. The reference method was the research-intervention and the ethnographic research, being used the main device technician Meeting on Work. The undertaken research, jointly with the concrete experience of management (as general manager), allowed to conclude that the effort of implantation of the modality ergomanagement, privileging the point of view activity, could collaborate to promote positive transformations in the daily of the Municipal Health Centre in analysis. However, its acceptance for a significant number of subjects and its development depends on the attendance of some necessities, pointed for the collective work as impediments to surpass. Thus the findings can contribute for the construction of a patrimony of information concerning the Municipal Health Centre. From this patrimony other experiences of management can be developed, getting great results from the management of the work process and in the improvement of the conditions of the attendance offered to the subjects.

<p> The purpose of this project was to develop a program to assist parents and caregivers of youth experiencing schizophrenia to address the needs and challenges of this population. The function of this grant proposal was to target a funding resource in order to implement a psychoeducational support group at The Guidance Center in Long Beach. The presence of schizophrenia symptoms in youth can create additional challenges to parenting and thus has a recognizable impact on families. The goal of this proposed program is to provide social support, education, coping skills, and decrease the stress of parents and caregivers of youth with schizophrenia to ultimately improve the lives of impacted youth and their families. The California Wellness Foundation was identified as a potential funder for this proposed program. The actual submission and/or funding of this grant proposal were not a requirement for the successful completion of this project.</p>