This research project aims to explore service user and mental health social workers’ (MHSW) perspectives and experiences of practice in the area of personality disorder. It seeks to answer three research questions: how service users and MHSWs understand personality disorder, how they understand MHSW practice and how practice in this area might be better informed. The study’s attention to the experiences and perspectives of both groups sets the research within the interpretivist paradigm and relies on a relativist ontology, subjectivist epistemology and inductive, qualitative methodology. The involvement of both groups means that this project makes an original contribution to MHSW research and practice. Constructivist grounded theory (CGT) has been used to generate a conceptual, theoretical analysis. The research was divided into two phases. Phase 1 involved ten semi-structured interviews with ten service users from a community service for people with personality disorder. This data was analysed before Phase 2 began, comprising twelve semi-structured interviews with twelve MHSWs from three regions of England. NVivo 7 was used to analyse the data in and across case. The analysis identified participants’ understanding of personality disorder, mental health social work practice and how this practice might be better informed. The analysis was supplemented by documentary analysis of policies relevant to personality disorder and MHSW. The findings suggest that traumatic experience impacts on the lens through which the person views self and others. Distress can be overwhelming, lead to extreme and unsafe behaviours, which reinforce disconnection from self and others. In supporting a relationship between personality disorder and traumatic experience, this study suggests the relevance of mental health social work (MHSW) to personality disorder. The findings suggest that more humane, empathic responses are required. Practice founded on understanding the impact of traumatic experience and the ways in which the individual might be trying to cope with their distress. The findings reveal the importance of MHSWs’ relational skills and interventions that offer practical support, encouragement and effective liaison with others. Through more caring, protective bonds and broad social supports MHSW might empower individuals’ response to traumatic experience. The findings raise implications for MHSW and mental health professionals more generally. The findings also indicate that practice would be better informed by greater knowledge and understanding of the person and the diagnosis; the provision of feedback to the person; modelling; greater transparency and consistency; support for the person’s social and family network, and more practical support. This project makes an original contribution to knowledge about personality disorder and to MHSW knowledge and practice in this area.

Indiana University-Purdue University Indianapolis (IUPUI) / The unnecessary medical care causes a heavy financial burden for the patients themselves and the society, and they also negatively impact the quality of medical care. An estimated 13% to 27% of ED visits in the United States could be managed in physician offices, clinics, and urgent care centers, saving $4.4 billion annually, and 26 percent of hospitalizations were potentially avoidable at a cost of $5.6 billion in 2005. If we can help people become more aware of health care services, it could be a potentially effective way to reduce emergency service overuse. we focused on mental health service and social work service as intervention variable, preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem as outcomes to determine the impact of specific social service on utilization of specific health care service adjusting for other characteristics of patients (demographic and utilization history information). The data which involved 24074 patients was provided from and managed by the Regenstrief Institute. The date of having the specific service and the frequency of using the specific health care service per year from 2011 to 2014 for each patient was recorded as well as the baseline information including gender, age, race, primary care visit per year before 2011, ACG risk score at 2011, ED visit per year before 2011. For each of preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem, we fitted a multiple linear regression model to ascertain the effects of mental health service and social work service adjusted for the baseline information. There was a significant relationship between preventable ED visit & mental health service, hospitalization due to mental health problems & mental health service, as well as hospitalization due to mental health problems & social work service. We found that in most situation, social services were positively associated with health care service. But in the second model which described the impact of mental health service on utilization of hospitalization due to mental health problem, receiving one mental health service can reduce the utilization of hospitalization due to mental health problem, which is as our expectation. According to our study, appropriate amount of services appears helpful on reducing the overuse of ED and hospitalization due to mental health problem. However, people who overused ED or hospitalization in the past were also more likely to be frequent service users, and they tended to continue overuse ED or Incur more hospitalization. There is a group of people who overuse ED or hospitalization without having any service. ED or hospitalization may be their first choice because of their financial condition or other factors, which makes them have no interest to take services.

Text in Afrikaans / Drug dependent adolescents do not display a clear understanding regarding the value of social work intervention during the process of rehabilation, causing them to not utilize the profession of social work effectively during drug rehabilitation. This study aimed to explore and describe the nature and contribution of social work service delivery to drug dependent adolescents from their own perspective. A qualitative research approach, an explorative research design, and a snowball sampling technique were implemented. The sample consisted of drug dependent adolescents from the Western Cape. Semi-structured interviews were executed determining the participant’s perception of the nature and contribution of social work service delivery. Amongst others, the findings indicate that: • social workers are not sufficiently prepared, trained or committed to render effective, professional services to drug dependent adolescents; • social workers need to continuously revisit their knowledge, skill and attitude regarding this specialised field of service rendering. / Social Work / M.A. (Maatskaplike Werk)

Text in Afrikaans / Drug dependent adolescents do not display a clear understanding regarding the value of social work intervention during the process of rehabilation, causing them to not utilize the profession of social work effectively during drug rehabilitation. This study aimed to explore and describe the nature and contribution of social work service delivery to drug dependent adolescents from their own perspective. A qualitative research approach, an explorative research design, and a snowball sampling technique were implemented. The sample consisted of drug dependent adolescents from the Western Cape. Semi-structured interviews were executed determining the participant’s perception of the nature and contribution of social work service delivery. Amongst others, the findings indicate that: • social workers are not sufficiently prepared, trained or committed to render effective, professional services to drug dependent adolescents; • social workers need to continuously revisit their knowledge, skill and attitude regarding this specialised field of service rendering. / Social Work / M.A. (Maatskaplike Werk)

Summaries in Afrikaans and English / Text in Afrikaans / Die teoretiese doelstellings van die ondersoek behels die verkenning van sommige maatskaplike behoeftes van Dowes, asook die aard van maatskaplikewerk-hulpverlening aan Dowes in Suid-Af rika. In die empiriese ondersoek word twee aspekte ondersoek, te wete: -Dowes se menings oor maatskaplike behoeftes van Dowes; -Maatskaplike werkers in Dowesorg se menings oor maatskaplike behoef tes van Dowes en die praktyk van maatskaplikewerkhulpverlening aan Dowes. / The theoretical goals of the study include the investigation of some of the social needs of deaf people, as well as the nature of social work services to the Deaf in South Africa. The empirical research focuses on the following two aspects: -Deaf people's opinions about their social needs; -Social workers in Deaf care's opinions about the social needs of deaf people and the practice of social work services to the Deaf. / Social Work / D. Diac. (Social Work)

Summaries in Afrikaans and English / Text in Afrikaans / Die teoretiese doelstellings van die ondersoek behels die verkenning van sommige maatskaplike behoeftes van Dowes, asook die aard van maatskaplikewerk-hulpverlening aan Dowes in Suid-Af rika. In die empiriese ondersoek word twee aspekte ondersoek, te wete: -Dowes se menings oor maatskaplike behoeftes van Dowes; -Maatskaplike werkers in Dowesorg se menings oor maatskaplike behoef tes van Dowes en die praktyk van maatskaplikewerkhulpverlening aan Dowes. / The theoretical goals of the study include the investigation of some of the social needs of deaf people, as well as the nature of social work services to the Deaf in South Africa. The empirical research focuses on the following two aspects: -Deaf people's opinions about their social needs; -Social workers in Deaf care's opinions about the social needs of deaf people and the practice of social work services to the Deaf. / Social Work / D. Diac. (Social Work)