D.Phil. (Social Work) / The research question answered in this thesis is: What is the place (role, attitude, aim) of medical social work as a component in the treatment of mental illness in a general hospital? Since the medical staff at a general hospital are primarily concerned with the treatment of physical illness, it is expected that the place and role of the medical social worker, as well as the mentally ill patient, create problems with role-functioning in this primary medical setting. In a general hospital, where life and death are vital issues, the doctor plays a major role in the treatment process and social workers and other persons, in ancilliary professions are expected to render a subordinate and secondary service. The patient's problems with role-functioning occur prior to admittance, during hospitalization and after discharge. In the process of becoming a patient the difference between the medical and psychiatric sick role is accentuated. Problems after discharge include unemployment and the fulfilment of roles such as marriage partner, roommate, neighbour, colleague and employer as determined by the social distance scale. Legislation, especially the Health Act (Act 63 of 1977) and the Mental Health Act (Act 18 of 1973) has made provision for psychiatric services to be incorporated in the general health services of the RSA and for the mentally ill to be treated in general hospitals. Despite the community-oriented approach, stigma is still attached to mental illness and the general public remains relatively ignorant regarding mental illness. One way of researching the influence of stigmatic labels in determining reactions to persons who are mentally ill is to investigate the attitudes of various sections of the community, including professionals in the health field. Attitudes towards mentally and public perception of the signs and symptoms of mental illness have for several years been the subject of considerable concern and research. The empirical data used in this study was obtained from collating the views of staff members attached to four training hospitals in South Africa. The investigation covered their knowledge of and attitude towards mental illness and the mentally ill patient. It al so determined whether respondents showed prejudice towards the treatment of the mentally ill patients in general hospitals. An analysis of the empirical data according to occupation indicates that professionals qualified in the human sciences comprise the smallest component of the personnel structure in hospitals. Compared to other personnel this group shows a more favourable attitude towards treatment of mentally ill patients in general hospitals and the acceptance and employment of mentally ill persons in the community. Although medical social work quantitatively form the smaller component in the treatment of mental illness in a general hospital it has a significant contribution to make with regard to the following aspects of social work service delivery: humanising the hospital system and the home environment of the mentally ill person; prouott ng mental health education; activating support systems; utilising social networks; enhancing effective role functioning; restoring social functioning as a facet of social health; preventing mental illness; promoting mental health and changing attitudes towards mental illness

The purpose of the present study has been to examine the referral system used by the doctors and others in making requests from Medical Social Services in Vancouver General Hospital. More specifically, the examination was confined to the present use by medical personnel of the referral form, (M 234). This pilot project has been undertaken to explore the referral system in relation to improvement of medical social services offered in the out-patient department. As background, the history of medical social work, standards of medical care, and a resume of Medical Social Service in the out-patient department of Vancouver General Hospital is reviewed. Basic information for the study was obtained through a survey of all requests made to medical social service from out-patient clinics during November, 1960. In addition to this, twenty-four doctors of the specialty clinics were canvassed through the medium of a questionnaire, and personal interviews, to ascertain their opinions on (a) most convenient methods of referral, (b) kinds of social information, (c) reasons for referral, (d) and suggestions for improving medical social services. The findings of the study indicate that slightly less than one-third of the new patients admitted to the out-patient department clinics for November, 1960, were referred for medical social services. There is evidence that a far higher percentage than this could benefit from such services. The Social Service Department has been aware of the possibilities for some time, and the present study was undertaken in order to gain facts, opinions, and clarification towards improving the referral system in the interests of more adequate standards of medical care. / Arts, Faculty of / Social Work, School of / Graduate

Essentially, the subject of this thesis is the problem of multiple hospital admissions, and the possible psychosocial etiology of these admissions. Chronic readmissions to hospital are of concern to social workers, to hospital personnel, and to the wider community, in view of the numerous and varied concommitant problems which may involve not only the patient, but any number of other persons or projects in the community. A survey of the several hundred referrals made to the Medical Social Service Department at Shaughnessy Hospital, Vancouver, during the fiscal year studied (1952-53) points up the fact that more than half of this referral group constitutes patient readmissions, and that at least one-quarter of the readmitted group might be considered as having a chronic readmission pattern. The manner in which this present study is approached is through detailed examination of data on district office files and medical social service case records, relative to a group of fifty-one veteran patients with a chronic readmission pattern, referred to the Medical Social Service Department at Shaughnessy, for varied medical-social problems. Findings of this study indicate that psychosocial factors, at least among the group selected, weigh heavily in a pattern of chronic hospital readmissions. Judging from the retarded referrals, there does not seem to be a sufficient awareness, on the part of a number of hospital personnel, that the admission pattern of many veterans contains a substantial psychosocial element, and/or if such is realized, that medical social services might be beneficial in rehabilitating the patients concerned. The onus for remedying this situation lies not only with the staff of the Medical Social Service Department at Shaughnessy, but with administration, with the medical staff, and with all DVA personnel interested in helping the veteran to function adequately outside the hospital setting. / Arts, Faculty of / Social Work, School of / Graduate

The purpose of this project is to explore the field of hospital social work to see what, if any frustrations, problem areas, and/or dissatisfactions exist among those who work in this profession. In order to accomplish this task of exploration, the project is composed of three parts. The first segment is the literature review (Chapter II). It is divided into a brief history of hospital social work and other studies that have been done on hospital social workers. It is hoped that the combination of both of these components will reflect the struggles, strengths, and problems of the profession, therefore giving the reader a sense of the profession's background. Secondly, by attempting to capture some of the "roots" and research involving hospital social workers, hopefully, a context will be provided as the project takes a look at hospital social workers in Portland, Oregon. The second part of the project consists of a research study. It attempts to assess the attitudes of hospital social workers in Portland toward the environment in which they work. By doing this, the research portion will contribute, more specifically, to the overall purpose of the project. This section includes the design and methodology of the research (Chapter III) as well as the findings (Chapter IV). All of the eight hospitals in the Portland area having social service departments are involved in the study. In addition, the ten second year MSW students from Portland State University who were placed in hospital settings for their second year of field placement, are also included in the research segment of the project. The third part is comprised of the conclusions and recommendations. It is hoped that this section will bring together both the first and second parts of the project and in so doing, formulate the end results of the intended task, an exploration into the field of hospital social work. Finally, a short section will follow on recommendations for the future.

published_or_final_version / Social Work / Master / Master of Social Work

Thesis (M.S.)--Boston University

Careful review of the literature found prison programs having a positive impact on post-release outcomes in employment and lowered recidivism rates. Most of the literature reviewed found negative effects of mental illness on post-release success. This study expands the literature on prison programming and mental illness by examining the dynamics between mental illness, program completion, and post-release success. Furthermore, this research can be linked to Hirschi's social bond theory, which created a framework to view the relationship between prison programming and increased ties to conventional society through commitment, attachment, and involvement. This study examines the impact of mental illness and prison vocational and educational programming on reentry outcomes (employment rates, length of employment, enrollment in and completion of school, and recidivism) and the relationship between mental illness and program completion. Additionally, the study examines the interactions of mental illness and prison programming on reentry outcomes. The sample consists of male offenders released onto parole in the State of Iowa (N=3426). Vocational training had positive significant effects on employment rates and full-time employment. An additional analysis found a significant indirect relationship between vocational training and recidivism through employment. Mental illness had a negative significant impact on completion of vocational programming, GED classes, and employment outcomes. Furthermore, it was found that having a mental illness significantly increased the likelihood of recidivism. The interaction of mental illness and programming on reentry outcomes did not have a significant impact. However, the interaction of mental illness and vocational programming had a positive significant impact on full-time employment in the opposite direction of prediction. The results inform social work practice and policy on the benefits of prison programming and the negative impact of mental illness on participation in programs and reentry outcomes.

Thesis (M. Soc. Sc.)--University of Hong Kong, 2006.

Thesis (M.P.A.)--University of Hong Kong, 1995. / Includes bibliographical references (leaves 110-114).

Thesis (M.S.W.)--University of Hong Kong, 1999. / Includes bibliographical references (leaves 67-74).