Mental Health Social Work: Field Overview and Current Challenges

The promulgation of 'good' mental health continues to be one of the recognised fields of operation of social work practice designed to assist people, families and groups within communities who deal with mental health issues (Alston et al., 2018).

This sector comprises of a range of services offered which include evaluation and differentiation, psychotherapy and treatment, emergency treatment and supervision among others (Brennan et al., 2020). These workers train in various settings like hospitals, community health, schools, private practices, correctional facilities and non-governmental organizations. Their practice model is therefore cross-cutting and founded on systems thinking, recognizing the psychological, social, and biological context of the clients they attend. 

These social assistants’ roles and responsibilities are numerous and are crucial to the wellbeing of society. They provide direct client services and are involved in policy advocacy, law making, and creating awareness (Walton et al., 2021).

One of the main focuses of their work is about helping the clients become stronger, and recover their self-advocacy. Their work is very important in the society today due to rising incidences of mental health disorders. The World Health Organisation (2022) reports that 280 million individuals undergo depression worldwide. This implies that there is a high demand for skilled human resource capable of delivering efficient mental health solutions and efficient care models that would suit various needs of individuals and communities.

However, these social workers face numerous challenges and conflicts, as well. For instance, the problem of access to mental health services remains pertinent, till date. For a large proportion of the population, there are barriers to care, including costs, no insurance, and geographic inaccessibility to care for low-income and rural populations (Merchant et al., 2022).

The WHO also acknowledges that the global community has a massive problem with mental health, as over 75 percent of those who need help do not receive adequate services. For example, only 70% of people with psychosis in developed countries take medication while, in developing countries, only 12% do the same (Brauer et al., 2021). Depression remains a major global health concern and despite the availability of standard mental health services in developed countries, less than a third of people diagnosed with depression seek professional help (Brauer et al., 2021).

The access concerns are compounded by workforce shortages. There is a critical shortage of mental health workers including social workers all over the world to address the increasing need for services. According to the WHO (2022) and various national studies, the mental health workforce is not only scarce but also geographically unevenly-distributed (Walton et al., 2021; Brennan et al., 2020). This results in high caseloads and higher turnover rates among existing professionals, especially in rural and under-resourced areas where the shortage of mental health personnel hampers the availability of services. 

Stigma and discrimination remain as the major challenges to mental health services across the globe. People with mental health disorders often experience discrimination and human rights abuses in society and in healthcare services (Thornicroft et al., 2022). Such stigma makes many of them avoid seeking help and thus worsening their conditions. Education and advocacy to eliminate the stigma associated with mental disorders are important, but changing the perception of the population is a lengthy process. According to the WHO, there is a need to change the way people think about and respond to mental health and its determinants, as well as enhance mental health care. 

Another significant issue is the coordination of mental health care with other health and social care services. Mental health treatment may sometimes consist of a multi-dimensional treatment plan to target different aspects of the functioning of the patient (Dalgleish et al., 2020). However, there are numerous organisational challenges and limited inter-sectorial collaboration that may hamper the process of care integration. On this front, WHO’s mental health action plan 2013-2020 advocates for the improvement of community mental health and its integration with primary care for accessible and cost-effective mental health care. 

Another major challenge is the issue of how to obtain enough funding and policies to support the development of the industry. The reality is that many countries experience the lack of funding and do not have mental health policies at all. It is also difficult to ensure that money is being spent wisely and that there are policies that can be implemented to ensure effective and efficient mental health services (Knapp & Wong, 2020). Policy barriers and organizational structures can limit the ability of social workers to deliver optimal patient care. The WHO has recommended that governments should allocate more resources to mental health and put in place policies that will improve services.

The COVID-19 pandemic has brought to the forefront and aggravated existing issues in the mental health domain. It has caused an increase in the prevalence of mental health disorders as a result of factors such as quarantine, job loss, and concerns about one’s health (WHO, 2022). In response, many countries increased their telehealth services, which have been crucial during the lockdown and restrictive measures in providing mental health care. However, the transition to telehealth has not been without its drawbacks, some of which include the ability to ensure that clients and providers are well equipped with the right technology and knowledge on how to practice telehealth effectively. 

Mental health at work is another area where both challenges and opportunities are considerable. Conditions such as long working hours, low decision latitude, job insecurity, and discrimination are detrimental to mental health (Lecours et al., 2022).

According to the WHO (2022), across the world, approximately 12 billion working days are lost yearly due to depression and anxiety and these losses amount to about a trillion US dollars. To ensure mental health at the workplace, there is a need to enhance organisational interventions, addressing psychosocial risks, and offer mental health services at the workplace.

This entails ensuring that organizations are aware of policies and practices that are conducive to promoting mental health and providing help and education to employers and employees. 

Overcoming such challenges call for multi-sectoral and multi-stakeholder approach that comprises of advocacy, education, policy reforms and international cooperation. Through all of these integrated efforts, the field might be able to overcome the obstacles and provide the clients with the best possible assistance and care.

Identifying and Addressing Gaps in Mental Health Service Delivery

A challenge that seems to persist and affect the delivery of mental health services in the contemporary society is the issue of long waiting list for mental health services. It has emerged due to the growing need for mental health services, scarcity of personnel, and the slow-paced infrastructure (Lattie et al., 2022). These slackening is not good since it aggravates the already existing conditions, and harms patients in need by thereby worsening their symptoms.

Another factor that exacerbates the issue of long waiting lists is the scarcity of human capital in the workforce (Chenoweth & McAuliffe, 2021). The demand for mental health professionals such as social workers, psychologists, and psychiatrists has increased significantly, and there is a severe shortage of such professionals in the world.

The mental health workforce is not only scarce but also geographically and functionally imbalanced, which results in an overloaded number of patients and high levels of burnout among employees. This shortage is most acutely felt in rural and other underserved regions, where the general lack of mental health workers greatly reduces the availability of care.

For instance, in the United States, over 50% of the counties do not have a single practicing psychiatrist; rural areas have one-third the number of psychiatrists and one-half the number of psychologists of urban areas (Mongelli et al., 2020). 

There are also systematic factors that contribute to the problem of delayed access to mental health services. Most mental health services employ conventional service delivery systems that are not capable of addressing the current influx of patients (Merchant et al., 2022).

These models have long referral chains, have ineffective triage, and do not include technology, which results in longer time to provide care. A study by Thornicroft et al. (2022) highlighted that there are several best practices available, but the traditional model of service delivery does not integrate these well, thus contributing to waitlists. 

Telehealth services have been recommended as one of the most promising approaches in addressing this issue. It has been used in the reduction of the waiting time and the enhancement of the accessibility to mental health (Molfenter et al., 2021). Due to the social distancing measures that were adopted as a result of COVID-19, there was a rise in the utilization of telehealth services (Molfenter et al., 2021). It involves the use of video and audio calls, texting, and other forms of telecommunication to provide mental health services. This model has been proved to be useful in ensuring that the patient who is unable to access the clinic or the hospital due to distance or disability is not left out.

Telehealth reduces the need for infrastructure which may pose constraints in the usual service delivery models (Sizer et al., 2022). It also enables providers to attend to a number of patients within a shorter time that could have been spent consulting with the patient.

Moreover, it has the capacity of enhancing integration between mental and primary care to enhance the care delivery process and make it more coordinated for patients (Molfenter et al., 2021). 

Nonetheless, telehealth has its own disadvantages that I will also discuss below. One of the main concerns is technology adoption, particularly referencing patients who cannot afford it or live in low-income or rural areas where they might have limited or no internet connection (McBain et al., 2023).

Additionally, telehealth may not be suitable for all types of therapy, particularly those that require direct engagement among individual therapy participants. Therefore, it is clear that telehealth is a valuable resource but it should be complemented with other innovations and systematic changes.

In order to improve telehealth and to address the problem of wait times in mental health care delivery, several other approaches have been suggested. For example, the use of walk-in models means that patients can attend and be treated without a prior appointment which eliminates long waiting times (Galle, 2021). Moreover, Triage mechanisms can assist in sorting patients according to the severity of their conditions so that those who are most critically ill get the attention that they require (Sizer et al., 2022). Integrated care teams, which consist of medical social workers, psychologists, and primary care physicians, can provide a holistic and coordinated approach to management and treatment. 

Furthermore, there is a need to invest more in mental health services. National and regional authorities and policy makers should ensure that there are adequate resources to increase the mental health workforce, infrastructure, and new models of service delivery (Chenoweth & McAuliffe, 2021). For instance, the British Medical Association has made realistic and tangible targets for increasing the number of mental health workers, shielding funding from inflation, and enhancing funding on primary care and mental health research (Adams et al., 2021). 

An example of a strategic approach towards tackling workforce shortages is the Behavioural Health Workforce Demonstration project in the United States of America (Mongelli et al., 2020). The purpose of this effort is to recruit and retain the mental health and substance abuse treatment workforce in key public safety net settings. In this project, sources of funding for retention bonuses, hazard pay, and overtime are aimed at reduction of turnover and staff burnout among the behavioural health workers.

Another strategy is the increased financing of national loan repayment programs and the granting of more scholarships for those who choose the field of mental health. 

Also, the growth of the number of Certified Community Behavioural Health Clinics (CCBHCs) is the USA is another progressive model in mental health care. They offer a comprehensive package of services within the same roof thereby, increasing the number of individuals they serve and decrease the time people spend, waiting to be attended to. In terms of employment, CCBHCs have established 27 new positions per clinic on average, and the workforce has expanded by 16%, which may demonstrate the potential of new funding and services models (Brooks Holliday et al., 2023). 

It is also pertinent to acknowledge and address the regulatory factors that hamper the delivery of mental health care (Alston et al., 2018). When administrative loads are high, there is less time to spend with clients, which results in fatigue and dissatisfaction with work. Streamlining documentation, promoting EHRs usage, and staffing appropriate support personnel will enable clinicians to invest more time with patients (Merchant et al., 2022). It may also help in reducing the waiting list and improve the overall efficiency of treating mental health related disorders. 
Therefore, further investment and policy support are required to ensure the sustainability and the long-term effectiveness of these strategies in reducing the waiting time and enhancing the accessibility of mental health care for the all individuals in need.

Reflecting on Personal and Cultural Values in Social Work Practice

It has been a profound experience writing this essay on access to mental health services specifically the concern of long waits. This discussion is highly relatable to my situation as a female student from Nigeria where social-economic vices prevail and access to mental health care services is limited. 

Similar to most countries in Africa, the Nigerian population faces constraints in accessing mental health services (Wada et al., 2021). These impediments include lack of sufficient human resource in the sector, lack of funds to support mental health services, and negative attitudes towards people with mental disorders. I have grown up in such an environment, and I have seen people with mental health problems who cannot receive proper treatment. This has helped me develop a strong belief in the need for affordable and equal mental health services and fueled my desire to be a social worker.

Socially, the understanding of mental health in Nigeria is still a taboo and people have many misconceptions about it (Jidong et al., 2021). It is common for people in traditional societies to believe that mental illness is a result of witchcraft, and thus, the affected individuals are discriminated against and neglected. This cultural background has helped me to appreciate the importance of cultural competence when it comes to providing mental health services. Social work practice should embrace cultural beliefs in treatment and fight for the best practices in treatment while avoiding prejudice against traditional practices by African communities. 

In relation to my socio-economic status, as a student who does not have much disposable income, I have gained an understanding of the limitations to accessing mental health care. Economic challenges heavily limit the likelihood of receiving adequate mental health treatment (Brennan et al., 2020). It has aided in giving me a clearer perspective on those, who face similar challenges and strengthened my resolve to advocate for policies that would ensure that mental health services would be accessible to all and not just for those who are privileged enough to afford it. 

During the course of conducting this research and writing the current essay, I have realized the importance of such innovations like telehealth to solve access problems. In a way, telehealth can be seen as an avenue of bringing mental health services to those who have little to no access to it, such as rural residents and low-income people (Molfenter et al., 2021). However, it is dependent on certain conditions such as the use of the internet and other related technologies, which are basic hurdles in Nigeria. These have broadened my perspective on how technological advancements can underpin mental health care delivery, and the need to make these advancements accessible to all. 

Essentially, this paper provided a lens to appreciate the role of system approach and policy in the improvement of mental health services. There is a severe shortage of mental health professionals and this is not an issue that is unique to developed nations, but also developing ones such as Nigeria (Wada et al., 2021). It is important to increase awareness of the necessity for increased funding for mental health workforce development and strategies for attracting and retaining these personnel. The approaches that I have learned emphasize advocacy, education, and policy change as the only way to bring about a change in the mental health care system, which is essential for providing effective mental health assignment help. 

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References

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