Social workers have long been involved in developing, administering, and providing services for people with psychiatric disabilities. Critics of the system, including social workers and mental health consumer-survivor practitioners, have noted that the medical model has been a driving force in policy and services provision. This model is detrimental to consumers' self-efficacy and sense of hope and conflicts with a number of central social work values. The article argues that the values and beliefs of the consumer-survivor recovery movement are closely aligned with those of the profession, and that the movement offers social workers a more promising perspective from which to practice. The primary concepts and values of the evolving recovery paradigm are delineated, and implications for direct practice, administration, policy making, education, and research are discussed.
Effective case managers in community mental health are successful at forging a working alliance with recipients. This article explores one key aspect of case management practice, serving involuntary clients, specifically those on outpatient commitment orders. In 19 intensive interviews, a subset of a larger study, case managers shared their perceptions of the utility of outpatient commitment with a focus on how such orders impacted the professional relationship. We argue that the use of advance psychiatric directives and shared decision-making processes can reduce the need for coercive practice.
Strengths-based approaches that emphasize culturally competent services and naturally occurring community support may be more appropriate than traditional mental health services for African American adults with psychiatric disabilities. An examination of the literature on service utilization and treatment needs for this population highlights the paucity of empirical studies in these areas, while an exploration of the literature related to psychiatric recovery, a prominent strengths-based framework, reveals insufficient application of the approach to the specific interests of African American service recipients. We suggest that recovery is in fact highly compatible with such culturally relevant approaches as the Afrocentric model, and argue that the
Outpatient commitment laws have been proposed as one way to increase service utilization among adults with psychiatric disabilities. While these laws vary from state to state, they are linked by a common set of assumptions about mental health consumers and services. Due to special circumstances surrounding its passage, New York's Assisted Outpatient Treatment Act (AOT) provides an excellent opportunity to examine these assumptions. It is argued that AOT is founded on the following assumptions: Mental health consumers are by definition not competent to direct their recovery; the decision not to use formal mental health services is a symptom of the disability and evidence of poor insight; the best intervention for psychiatric disability is a primarily medical one; and mental health services are universally and consistently helpful. Based on a critique of these assumptions, the author recommends that future research on this and other outpatient commitment policies focus on the consumer experience. In addition, future policies should be designed around a consideration of mental health consumers as a resilient, rather than vulnerable, population. Social workers are urged to apply these arguments to their practice and advocacy.
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