Views of social workers on their role in mental health outpatient and community-based services

Ornellas, Abigail (2014-04)

Thesis (M Social Work)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Mental health is a fundamental aspect of social functioning which affects a significant portion of the population. The movement toward deinstitutionalization became the core focus of mental health policies such as the White Paper (1997) and the Mental Health Care Act (17 of 2002) post-apartheid. However, this process was implemented at a rapid rate, with poor corresponding development of necessary outpatient and community-based facilities and services. Social, cultural, and economic conditions have significant and measurable effects on both individual health status and the delivery of health care. As a result, there is a growing recognition of the need for social work services within the mental health outpatient and community-based care context. Research regarding the role of the social worker within mental health care, particularly within a South African context is poor and therefore a research gap with regard to examining the views of social workers on their role in mental health outpatient and community-based services exists. The overall objective of the study was to, in light of the above, examine the views of social workers on their role in mental health outpatient and community-based care. A combination of both qualitative and quantitative research approaches was employed for the study, with a stronger emphasis on the use of qualitative data. A combination of exploratory and descriptive research designs was utilized as the framework for the implementation of the research approach. This was appropriate for the utilization of both quantitative and qualitative design elements. A purposive sample of twenty social workers was compiled, and data was collected through the means of semi-structured interviews; a pilot study was implemented to test the measurement instrument with two social work participants. Two literature chapters are presented, focusing on the topic of mental health and its related policy, as well as expanding on mental health care and service rendering according to an ecological perspective. These chapters served to achieve established objectives of the study. Chapter four is a presentation of the empirical study. Data which was collected was both relayed and analyzed, in accordance also with the literature study. Data was analyzed, through both quantitative and qualitative analysis and was presented according to identified themes, sub-themes and categories. Relevant tables, figures and participant narratives were used to further substantiate the analysis of data. Chapter five gives an overview of relevant conclusions and recommendations, in terms specifically of the role of the social worker in mental health outpatient and community-based care, in light of the empirical study and data analysis. Five specific roles were identified as being significant for the social worker in mental health care, with regard to their role in therapeutic intervention, working with clients and families in a one-on-one, counseling capacity; supportive services, through linking of clients to necessary resources; advocacy, through fighting for, and protecting the rights of clients and related vulnerable groups within mental health; relational role, recognizing the importance of social and interpersonal aspects on the functioning of mentally ill clients; and finally their role as a holistic worker within a multidisciplinary team, incorporating key aspects of the ecological perspective into assessments and interventions.

AFRIKAANSE OPSOMMING: Geestesgesondheid is ʼn fundamentele aspek van maatskaplikefunksionering wat ʼn beduidende gedeelte van die bevolking affekteer. Die beweging na deïnstitusionalisering het die kern fokus van verwysings na geestesgesondheidsbeleide soos vervat in die Witskrif (1997) en die Wet op Geestesgesondheidsorg (17 van 2002) geword. Hierdie proses is teen ʼn vinnige tempo geïmplementeer, wat die ooreenstemmende ontwikkeling tussen dienste aan buitepasiënte en gemeenskapsgebaseerde fasiliteite en dienste benadeel het. Maatskaplike, kulturele en ekonomiese toestande het ʼn groot en meetbare uitwerking op beide individue se gesondheidstatus en die lewering van gesondheidsorg. As gevolg hiervan, is daar ʼn groeiende erkenning van die behoefte aan maatskaplike dienste in die geestesgesondheidsorg van buitepasiënte en binne ʼn gemeenskapsgebaseerde konteks. Navorsing oor die rol van die maatskaplike werker in die geestesgesondheidsorg, veral binne ʼn Suid-Afrikaanse konteks is onvoldoende. ʼn Gaping bestaan veral in navorsing oormaatskaplike werkers se rol in geestesgesondheidsorg met betrekking tot buitepasiënte en die gemeenskapsgebaseerde dienste. Die oorkoepelende doel van die studie was om, in die lig van die bogenoemde, ondersoek te doen oor die sienings van maatskaplike werkers met betrekking tot hul rol in geestesgesondheidsorg van buitepasiënte en gemeenskapsgebaseerde dienste. ʼn Kombinasie van beide kwalitatiewe en kwantitatiewe navorsingsbenaderings is gebruik vir die studie, met ʼn sterker klem op kwalitatiewe navorsing. ʼn Kombinasie van verkennende en beskrywende navorsingsontwerpe is gebruik as ʼn raamwerk vir die implementering van die navorsing benadering. 'n Doelgerigte steekproef, bestaande uit twintig maatskaplike werkers is saamgestel, en data is ingesamel deur middel van semi-gestruktureerde onderhoude met behulp van ʼn onderhoudskedule. Loodsonderhoude met twee deelnemende maatskaplike werkers is gevoer ten einde die onderhoudskedule te toets. Twee literatuurhoofstukke word aangebied, wat fokus op die onderwerp van geestesgesondheid en verwante beleide, sowel as geestesgesondheidsorg en -dienslewering volgens ʼn ekologiese perspektief. Hierdie hoofstukke dien as fondasie om die doelwitte van die studie te bereik. Hoofstuk vier dien as ʼn verslag oor die empiriese studie. Die data wat ingesamel is, is op grond van die literatuurstudie ontleed. Data is geanaliseer deur middel van beide kwantitatiewe en kwalitatiewe analise en is aangebied volgens geïdentifiseerde temas, sub-temas en kategorieë. Toepaslike tabelle, figure en narratiewe is gebruik om die analisering van data te substansieer. Hoofstuk vyf bied relevante gevolgtrekkings en aanbevelings aan in terme van spesifiek die rol van die maatskaplike werker in geestesgesondheidsorg met betrekking tot buitepasiënte en gemeenskapsgebaseerde dienste. Vyf spesifieke rolle is geïdentifiseer as belangrik vir die maatskaplike werker in geestesgesondheidsorg: maatskaplike werkers se rol in die terapeutiese intervensie met betrekking totberading van individue en gesinne; ʼn ondersteunende rol wat kliënte met die nodige hulpbronne in verbinding bring; ʼn voorspraakrol, deur te beding vir die beskerming van die regte van kliënte en verwante kwesbare groepe in geestesgesondheidsorg; ʼn verhoudingsrol in die erkenning van die belangrikheid van sosiale en interpersoonlike aspekte in die funksionering van geestesgesondheidskliënte; en die rol as ʼn holistiese werker binne ʼn multidissiplinêre span, waarin belangrike aspekte van die ekologiese perspektief in assessering en intervensie geïnkorporeer word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/86468
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