Lonnie R. Snowden
This entry describes the extent of the mental health problem in the United States, trends in treatment rates, and evidence that public recognition of mental illness and related interventions is increasing both in the United States and internationally. Emphasis is given to the structure of the mental health system's major sectors, to the key roles that social workers play, and to the challenges they face, outlined at the conclusion of several sections, in providing effective and quality care against the complex backdrop of this system.
Shaun M. Eack
Mental health research is the study of the causes and correlates of mental health and illness, approaches to improve mental well-being, and the delivery of effective mental health services to those in need. Social workers have been leading researchers in each of these areas of inquiry, and this article provides an overview of the broad field of mental health research, with particular emphasis on the contributions of social work. A biopsychosocial review of research on the correlates of mental health and illness is provided, followed by a synthesis of studies examining pharmacological and psychosocial approaches to improving mental health. Research on mental health services is then presented, with a focus on studies seeking to improve access to quality care and reduce service disparities. Key directions for future mental health research include identifying specific causal predictors of mental illness, improving existing treatments, and disseminating advances to the community.
Laurens G. Van Sluytman
Through the efforts of individuals and groups, America has made significant strides in affording civil rights to a majority of its citizens. It has not, however, eliminated individual, institutional, and structural discrimination, and in fact, some efforts to eliminate inequality for certain members of society have elicited subtly coded forms of discrimination. These subtle forms are referred to as microaggressions. This entry defines microaggressions and explores the existing literature concerning its taxonomy. We discuss the impact of microaggression on individuals and groups (for example, social, cognitive, political, and economic) based on race, and extend this discussion to gender, sexual orientation, class, disability, and religion groups. The article makes use of examples within American history, such as the presidency of Barak Obama, voter ID laws and the Defense of Marriage Act (DOMA). Accumulated recommendations on best practices for countering microaggressions on the micro-, mezzo- and macro- level of social work practice are presented.
Jesse J. Harris, Col. USA Ret. and Kyle L. Pehrson, Col. USA Ret.
The history of military social work in the United States is rooted in the civilian professional social work community and is a microcosm of that sector. Military social work has a rich history of providing services to military men and women and their families during periods of peace, conflict, and national crises. They have been involved in humanitarian operations and have participated in multinational peace-keeping operations. Social work in the Army, Navy, and Air Force is tailored to the mission of their particular service. However, joint operations between the services are becoming more frequent. Military social workers adhere to the NASW code of ethics while providing service to an institution with its own unique culture, standards, and values.
B. Michelle Brazeal and Gordon MacNeil
Obsessive compulsive disorder (OCD) is a debilitating anxiety problem. This article reviews the characteristics, etiology, prevalence, and assessment of OCD and presents information on the efficacy of psychological, pharmacological, and combined treatments for this disorder. Early intervention that includes pharmacological agents (typically SSRIs) as well as behavioral and cognitive-behavioral psychotherapies (particularly exposure and response prevention) is the preferred method of intervening with OCD.
Personalized health care (PHC) is a broad term that describes how we leverage our growing understanding of the human body and developing technology to provide more effective health care. PHC requires that health care providers consider prevention and treatment in the context of available advanced technologies, best practices, and known variables that define us as individuals. These variables or characteristics may run the gamut from genetic, to biologic, to environmental, to even personality, personal values, and choice. By considering how these characteristics interact with specific illnesses and available interventions, outcomes can be improved. The purpose of this article is to: describe PHC’s current conceptualization including relationship with personalized medicine and patient-centered models of care, discuss its development and application by specific stakeholders, and review pertinent economic, legislative, and ethical issues.
Selena T. Rodgers
Trauma literature has seen a paradigm shift from pathology to embracing positive trajectories. Posttraumatic growth (PTG), defined as a positive psychological change resulting from a struggle with traumatic or life-changing events, may occur in a variety of populations and events. This entry, therefore, aims to increase our understanding of PTG. The entry begins with the conceptualization of PTG, followed by a discussion of protective factor associations, measures, and psychometric priorities. Nuanced attention is given to global translations and cultural aspects. The entry then presents debates about the challenges, controversy, and biases, as well as an overview of the empirical literature. The entry concludes with PTG contributions for social-work practice and pedagogy, together with recommendations for future research.
Primary prevention involves coordinated efforts to prevent predictable problems, to protect existing states of health and healthy functioning, and to promote desired goals for individuals and groups, while taking into consideration the physical and sociocultural environments that may encourage or discourage these efforts. This entry discusses the history of this basic approach to professional helping from medical, public-health, and social-science perspectives. It also reviews major theories that guide preventive thinking and action. One section sketches the substantial empirical base for evidence-based practice and how such information can be retrieved. This entry concludes with a review of practice methods for increasing individual strengths and social supports while decreasing individual limitations and social stresses, which together characterize most contemporary preventive services.
Practitioners who were presumed to be competent may develop difficulties that interfere with job performance. Such professionals are considered impaired and may suffer from compassion fatigue, substance abuse, mental disorders, and other forms of distress associated with daily living. Practicing while impaired is unethical and can potentially be harmful to clients. Colleague Assistance Programs from professional associations or diversion systems and legal sanctions imposed by state regulatory boards are forms of intervention strategies that are employed. Self-care strategies and consciousness-raising among professionals are the best forms of prevention.
Zebulon C. Taintor
Psychosocial (or psychiatric) rehabilitation is a mixture of skills and support for persons severely impaired by mental illness. The population in need is vast. Practitioners marshal support at the level needed while helping a person develop skills that will gradually reduce the need for support. Financial support is gained by offsetting treatment and other supports such as institutional care. Social workers are especially well qualified for this work on multidisciplinary treatment teams. Recovery is key to most agency mission statements.