What Influences Social Workers’ Attitudes toward Working with Clients with Severe Mental Illness?

Abstract

A national random survey of 2000 NASW members in post-master's practice in mental health was conducted to investigate their experiences with and attitudes about working with individuals with severe and persistent mental illness (SPMI). Through a series of structural equation models, we examined the influence of different frustrations reported by the respondents on their attitudes toward working with individuals with SPMI. Results suggest that social workers' attitudes toward working with individuals with SPMI are primarily influenced by their frustrations related to client behaviors and treatment issues, rather than frustrations with system related issues. Implications for social work practice and directions for future research are discussed. (105 words) Keywords severe mental illness; attitudes; frustrations; burnout; schizophrenia; direct practice Social workers provide the majority of direct mental health services in the United States for individuals with severe and persistent mental illness (Newhill & Korr, 2004; Substance Abuse and Mental Health Services Administration, 2001). As such, social workers represent a primary and important treatment provider for this population. However, research has confirmed what many social work practitioners have long known: working with individuals with severe and persistent mental illness (SPMI) is challenging (Acker, 1999; Mason, Almos-Gallo, Bacon, McQuilken, Henley, & Fisher, 2004;Reid, Johnson, Morant, et al., 1999;Wykes, Stevens, & Everitt, 1997). There are also indications that social workers and other mental health professionals may hold less than positive attitudes toward this population, and that these attitudes have an important impact on outcomes for individuals with SPMI (Barrowclough et al., 2001;Heresco-Levy, Ermilov, Giltsinsky, Lichtenstein, & Blander, 1999;Newhill & Korr, 2004). However, to date, this research has yet to elucidate the factors that contribute to social workers' attitudes toward individuals with SPMI. Given that working with this population is challenging, it is reasonable to hypothesize that the frustrations experienced in clinical work with individuals with SPMI may be related to the development of negative attitudes. If true, this has implications for strategies that might help foster more positive attitudes and improve the retention of staff in community clinics that serve these clients.Over the past four decades, a body of research has evolved pointing to the importance of the attitudes of those caring for individuals with SPMI. The majority of this research has * Correspondence concerning this article should be addressed to Shaun M. Eack, School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, Pittsburgh, PA 15260. Phone: (412) 596-7657. sme12@pitt.edu. focused on family caregivers who, as a consequence of deinstitutionalization and the curtailment of institutional mental health care, often assume significant responsibility for family members with SPMI (Cuijpers & Stam, 2000). This research has been rema...

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