Social Work and Mental Health 1

Running Head: SOCIAL WORK AND MENTAL HEALTH

Social Work and Mental Health

Landa Michelle Jacobs

The University of North Carolina at Pembroke

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Social Work and Mental Health

Mental Health refers to our cognitive, and/or emotional well being - it is all about how we

think, feel and behave. Mental health, if somebody has it, can also mean an absence of a

mental disorder. Approximately 25% of people in the UK have a mental health problem

during their lives. The USA is said to have the highest incidence of people diagnosed

with mental health problems in the developed world. Your mental health can affect your

daily life, relationships and even your physical health. Mental health also includes a

person's ability to enjoy life - to attain a balance between life activities and efforts to

achieve psychological resilience (Christian Nordqvist). Co-occurring substance use

disorders (SUD) and mental health disorders (MHD) are prevalent in the United States,

affecting between 7 and 10 million adults (Reedy & Kobayashi, 2012). In this literature

review, I will discuss social work as it relates to the mental health field and touch on a

common mental health disorder known as Post Traumatic Stress Disorder (PTSD). I will

also discuss three social work values that relate to social work in the mental health field.

The purpose of the social work profession is to promote human and community well-

being. Guided by a person and environment construct, a global perspective, respect for

human diversity, and knowledge based on scientific inquiry, social work’s purpose is

actualized through the quest for social and economic justice, the prevention of conditions

that limit human rights, the elimination of poverty, and the enhancement of the quality of

life for all persons (Tosone, 2016). According to the DSM-5 (2013), a mental disorder is

defined as “a clinically significant disturbance in an individual’s cognition, emotional

regulation, or behavior that reflects a dysfunction in the psychological, biological, or

developmental processes underlying mental functioning. Mental disorders are usually

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associated with significant distress or disability in social, occupational, or other important

activities” (Tosone, 2016).

One mental disorder is known as Post Traumatic Stress Disorder (PTSD) and is very

common among our soldiers. The symptoms of post-traumatic stress include: negative

alterations in cognition and mood; alterations in arousal and re-activity;

intrusive/disturbing memories and attempts to avoid them; significant distress or

functional impairment; emotional numbing and withdrawal from others; and heightened

irritability (Canfield, 2014). Most commonly among those who have deployed overseas

and served our country. PTSD is a daily struggle. Those who suffer from PTSD find

themselves struggling with relationships, their jobs, their mental state (a lot of times lead

to suicide) and their physical state (Canfield, 2014).

Since PTSD is found among our soldiers, a study found that females have been the

fastest growing population of the military to date. As of 2009, females make up

approximately 14% of the Active Duty force and 17.6% in the Reserve and Guard force

combined (Department of Defense, 2009). In 2009, 1.8 million female veterans consisted

of the total population of veterans (Department of Veterans Affairs, 2009, 2010) During

this review of females with PTSD, two trauma experiences were found in female

veterans, sexual trauma and combat exposure. Combat exposure can include experiencing

enemy fire, ambush, the need to use fire power to eliminate personal threats in combat

situations, as well as, witnessing death and destruction to not only members of their unit

but civilians in the war zones (Middleton & Craig, 2012).

Finally, three of the social work values practiced would be importance of human

relationships, service and competence. As a social worker, the client and social worker
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relationship is important in order to produce change. Clients have to feel that they can

trust the social worker and building a rapport would be the first step in therapy. There

may even be times when a social worker has to do pro Bono services for a client that

doesn't have insurance. Social workers first have to realize that they can’t always provide

the services needed. In these cases, they must refer a client to become more competent

(Elizabeth Hunt MSW, LCSW, Personal communication, March 13, 2016).

Mental Health disorders affect a lot of Americans. People who face this are typically

stereotyped as being crazy. Mental health clients sometimes experience bias in the work

setting and community. They don't want others to know that they seek help in fear of

being judged. They don't want to be looked down on. Some will even prolong their seek

for help because they went all their lives trying to hide it from their families. Mental

health clients need to build a sense of self-awareness and become emotionally

independent. Without treatment, crisis may/will occur. All mental health disorders can

negatively affect ones mental state in life as well as other factors including ones well

being, relationships and even their jobs.

I recently had the opportunity to interview Elizabeth Hunt MSW, LCSW who works

for Positive Progress Services of Pembroke North Carolina. She became employed for

Positive Progress in October 2012 as a receptionist. In May 2013 she became an

Advanced Practitioner (AP). After a year as an AP, she worked her way up to Qualified

Professional (QP) which was in May 2014. In June of 2014, she became a Licensed

Clinical Social Worker Associate (LCSWA) and after passing her test a month ago she is

now a Licensed Clinical Social Worker (LCSW). In order to be hired for her positon she

had to have a masters degree and licensure. I learned that after you obtain your masters
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degree, you will send off an application to be approved and then you are licensed, under

supervision. You will be under supervision of another social worker who has their masters

and is an LCSW. During the supervision you must work 3,000 hours to be fully licensed

and pass a state test. You can test every 90 days within 2 years of your masters degree and

the cost is $300.00 per test (Elizabeth Hunt MSW LCSW, Personal communication,

March 13, 2016).

At Positive Progress, she has many different job responsibilities including outpatient

therapy, clinical assessments, treatment plans and is responsible for writing out 140

outpatient clients. The comprehensive clinical assessment is 15 pages and gathers family

history, legal history, educational history, medical/suicidal/homicidal ideations, support,

basic needs, clinical summary of things that contribute to symptoms etc. She also attends

multidisciplinary meetings with the medical director, PA, and office staff. She must

monitor clients’ medications and staffs needs with provider (Personal communication,

March 13, 2016).

She often plays various roles such as an enabler when she helps clients learn how to

cope with situations and environmental stressors. Mrs. Hunt is also an advocate when she

attends court cases and a mediator when she assists clients in resolving conflicts in

community and home environment. As she talks about the mental health field and the

population she serves, she explains that a lot of her clients suffer from environmental

stressors, traumatic events, stressful situations and family conflicts that may contribute to

the specific mental health symptoms that they experience. These symptoms make up their

assessed diagnosis. For example: depression, bipolar, PTSD. Through person-centered

interventions, the mental health population learns to cope effectively with their symptoms
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and daily life. On a daily basis, she uses different skills to work with her clients such as

motivational interviewing, engaging and communication with diverse populations and

providing services to support change in the individual and also in their environment

(Personal communication, March 13, 2016).

At Positive Progress, she works at micro, macro and mezzo levels. She works at a

micro level when she does individual therapy. She may work at a macro level when she

has to collaborate with DSS, foster care agencies and primary care physicians to assist in

clients’ needs. Rarely does she work at a mezzo level but when she does it’s through

group therapy sessions at psychosocial rehabilitation center in Red Springs. A problem

she faces when she works with the mental health population is she feels as if she works

harder than her clients and as a social worker, you aren’t suppose to do that. Your client

has to want to change. You cannot do it for them. It makes it all worth the while when she

has success in a client and can actually see the change (Personal Communication, March

13, 2016).

I asked her, “Does work life affect daily life?” Her response was simple: “I have a

hard time taking my cape off at 5:00” (Personal communication, March 13, 2016). She

tells me that the worst part about her job would be documentation. Its time consuming yet

extremely important and a lot of writing to do. If it isn’t documented, it didn’t happen

(Personal communication, March 13, 2016).

Mrs. Hunt really enjoys what she does. I could tell by the way she spoke about some

of her clients and how she seems to relate to each and every one of them. The main thing

I feel like she focuses on with her clients is establishing rapport. Trust is a very big deal,

especially in the mental health field. Mental health seems to be a very interesting field to
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work in and it seems like there is never a dull day. I had a great experience interviewing

her and in that small amount of time I learned a lot. You must never judge someone

because you do not know their story. Everyone is fighting their own demons. We all cope

in different ways and deal with situations very differently. Social Workers truly change

lives and make a difference in clients lives by advocating for their needs.
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References

Amanda R. Reedy PhD MSW & Rie Kobayashi PhD LMSW (2012) Substance Use and

Mental Health Disorders: Why Do Some People Suffer From Both?, Social Work in

Mental Health, 10:6, 496-517, DOI: 10.1080/15332985.2012.709480

Carol Tosone PhD (2016) Clinical social work education, mental health, and the DSM-5,

Social Work in Mental Health, 14:2, 103-111, DOI:10.1080/15332985.2015.1083513

Julie Canfield PhD MSW (2014) Traumatic Stress and Affect Management in Military

Families, Social Work in Mental Health, 12:5-6, 544-559,

DOI:10.1080/15332985.2014.899296

Katherine Middleton MSW & Carlton David Craig PhD (2012) A Systematic Literature

Review of PTSD Among Female Veterans From 1990 to 2010, Social Work in

Mental Health, 10:3, 233-252, DOI: 10.1080/15332985.2011.639929

National Association of Social Workers, (2008). Code of Ethics of the National

Association of Social Workers. Washington, DC: NASW