Steven P. Segal and Leah A. Jacobs
The deinstitutionalization policy sought to prevent unnecessary admission and retention in institutions for six populations: elderly people, children, people with mental illness or developmental disabilities, criminal offenders, and, more recently, the homeless. It also sought to develop community alternatives for housing, treating, and habilitating or rehabilitating these groups. U.S. institutional populations, however, have increased since the policy’s inception by 212%. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house these groups, often referred to as transinstitutionalization. This entry considers how this shift has affected the care and control of such individuals from political, economic, legal, and social perspectives, as well as suggestions for a truer implementation of deinstitutionalization.
Lisa S. Patchner and Kevin L. DeWeaver
The multiplicity of disability definitions can be attributed to the heterogeneity of disability, its multifactoral nature, and its effects across the life span. Of particular concern to the social work profession are those persons with neurocognitive disabilities. Neurocognitive disabilities are ones where a problem with the brain or neural pathways causes a condition (or conditions) that impairs learning or mental/physical functioning or both. Some examples are intellectual disabilities, autism spectrum disorders, and savant syndrome. Neurocognitive disabilities are the most difficult to diagnose often times because of their invisibility. Providing services for people with neurocognitive disabilities is very difficult, and people with these disabilities are among the most vulnerable populations in today's society. This entry discusses neurocognitive disabilities and current and future trends in social work disability practice.
Romel W. Mackelprang
Characteristics that we contemporarily define as disabilities have existed in the human population from earliest recorded history. Societal explanations for disability have varied greatly by time and populations in which disabilities have occurred. At various times in history, disability has been viewed as a blessing from deity or the deities, a punishment for sin, or a medical problem. Social workers have worked with persons with disabilities from the inception of the profession, and in recent years, social work has begun to embrace the concept of disability as diversity and to treat disability as diversity and welcome disabled persons as fully participating members of society. Social work has begun welcoming persons with disabilities as fully participating members of society, including valuable members of the profession.
Mary Ann Clute
Physical disability is traditionally defined by society's view of atypical function. The medical model offers information on factors contributing to physical disability, including genetics, injury, and disease. The social model of disability, however, defines the societal responses, not the physical differences, as disabling. People with physical disabilities have unique characteristics and experiences that fall into the broad range of human diversity. They belong as full participants in society. Social workers must focus on working in respectful partnerships with people with physical disabilities to change environments and attitudes. This will help build a just society that honors diversity.
This entry addresses multiple factors that cause disability, from genetics to environment, as viewed through the medical model. The social model view of “the problem” is offered in comparison. It also introduces the wide diversity of people with physical disability. The entry discusses two major societal responses to physical disability. Environmental modification is one approach. A more recent approach, Universal Access, involves upfront design of environments to meet diverse needs. The final sections explain implications for social workers and lays groundwork for action. Creating access and respectful partnerships are foundations of the work ahead.
It is difficult to define physical disability without situating the discussion in the model used to view and deal with human diversity. This discussion is based on the social model of disability, a view of disability that sees the environment as disabling, not the individual condition. Discussion of the medical model is offered as a contrast. (For a more complete discussion of disability models, see Mackelprang's Disability: An Overview in this publication.)
W. Patrick Sullivan
The psychosocial catastrophe that accompanies serious mental illness negatively impacts individual performance and success in all key life domains. A person-in-environment perspective, and with a traditional and inherent interest in consumer and community strengths, is well positioned to address psychiatric disabilities. This entry describes a select set of habilitation and rehabilitation services that are ideally designed to address the challenges faced by persons with mental illness. In addition, it is argued that emphasis on a recovery model serves as an important framework for developing effective interventions.
Kendra DeLoach McCutcheon
Social workers have a responsibility to challenge discrimination and promote social and economic justice. To fulfill this responsibility, it must be understood how discrimination exists and the detrimental affect it has on the relationship between individuals who are disenfranchised (targeted groups) and individuals who have privilege, resources, and power (advantaged groups) (Hardiman & Jackson, 2007). This entry will present an overview of discrimination, define the various forms of discrimination, present public policy and legislation regarding discrimination, and discuss implications for social workers and the profession.
Development of the brain in the first 3 years of life is genetically programmed but occurs in response to environmental stimuli. The brain is organized “from the bottom up,” that is, from simpler to more complex structures and functions, so the experiences and environment that shape early development have consequences that reach far into the future. This entry describes the ontogeny and processes of fetal and infant brain development, as well as major risks to early brain development (during pregnancy and after birth), with emphasis on the factors seen in social-work practice. Neuroscience research is changing social work practice, and understanding early brain development and the contributors to poor development is critical for social workers in medical, mental health, child welfare, and other practice settings.
Elizabeth C. Pomeroy, Danielle Parrish, Angela M. Nonaka, and Kathleen H. Anderson
This article reviews existing knowledge on the assessment of children with fetal alcohol spectrum disorders (FASD) and available screening, prevention, and intervention services. The wide range of preventable conditions associated with FASD throughout the life cycle is described, along with associated high-risk maternal behaviors. In addition, cultural and social determinants are discussed, in an effort to inform social work practice. The differentiation of FASD and protective factors that have been identified as reducing negative outcomes for children and their families affected by prenatal alcohol exposure are also explained. Finally, multidisciplinary and culturally appropriate prevention services are emphasized as well as early diagnosis and strength-based intervention strategies.
This entry provides an overview of the state of health care in the United States. Service delivery problems such as access and affordability issues are examined, and health care disparities and the populations affected are identified. A discussion of two primary government-sponsored health care programs—Title XVIII (Medicare) and Title XIX (Medicaid), and the Patient Protection and Affordable Health Care Act—are reviewed along with various health care programs and major existing service delivery systems. Ethical conflicts in providing health care, and new directions and challenges are discussed, along with future roles for social workers.
Larry D. Icard, Jacqueline J. Lloyd, and Gisoo Barnes
HIV/AIDS has introduced an array of issues and needs for children, youth, and their families. Family-focused interventions have emerged as a viable strategy for researchers and practitioners seeking effective and appropriate responses for the prevention, treatment, and care of children, youth, and families affected by HIV/AIDS. This discussion provides an overview of the epidemiology of HIV infection among children and youth, and highlights common elements and trends in the development, implementation, and testing of family-focused interventions. The discussion concludes with a commentary on areas for future attention.