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Anti-Oppressive Social Work Practice in Mental Health

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by Anish Alex MSW, RSW

Current mental health approach in Canada is a shift from the traditional mental health services to a community based Psychiatric rehabilitation (Steele, et al., 2007). The guiding philosophies of community mental health rehabilitation are empowerment, competence and recovery. This approach is a combination of ecological and progressive system models. There are various theoretical perspectives in the social work practice in a community mental health rehabilitation setting such as developmental theories, personality theories and practice theories. Generally practice theories are predominantly used such as psychodynamic theories, cognitive-behavioural theories, humanistic theories, and postmodern theories.A conversion of conceptualized anti-oppressive perspective into real life and values of practices required a connection between theory and practice in the area of community mental health. Even though postmodern theories are being used; the overriding perspective in the ground of mental health is a bio-psycho-social model (Diaz-Granados et al., 2010).

Oppression Can Only Survive Through SilenceAs an anti-oppressive social work practitioner, I have to define my theoretical understanding about the fundamentals of anti-oppressive practice like egalitarianism and social justice. The principles for specific practice behaviour and relationships that minimize power imbalances and promote equity and empowerment would help me to practice an anti-oppressive social work among mental health consumers (Larson, 2008). As Larson (2008) explains, during the psychiatric intervention, workers need to develop a service plan component which includes treatment plan, vocational service, peer support and life skill training in full participation with the service user.  Jennifer Martin (2003, as cited in Larson, 2008) suggests that anti-oppressive practice stands for social justice and criticizes the current social relations which are promoting social injustice especially in social work practice. Anti-oppressive practice basically addresses power imbalance and promotes change in the power relationship. This practice includes a self reflection, understanding of the oppressor and oppressed and critical evaluation of entire intervention process in terms of nature of relationships between worker and client (Larson, 2008). It also include a set of behaviours’ and /or skills of the practitioner in harmony with specific clientele circumstances.

A clear and conscious consideration of my social location will perhaps helps me to avoid the reproduction of ‘power over’ relationship with my clients; it also reinstate the connectedness with the client problem. Critical self reflection includes a critique on our own assumptions, values and believes (Hickson, 2011).  As Fook & Askeland (2006) explained critical self reflection is the manifestation of critical theories and it is the reflection through the lens of critical thinking (as cited in Hickson, 2011). I believe that critical self reflection is an approach to personal as well as professional practice to integrate or reintegrate and make sense of own believes and assumptions. I learned that progressive practice on the ground of critical and postmodern theories are possible in various social work fields including mental health, in spite of the dominance of medical model. Social work profession with its theory, practice and research and with a holistic approach needs to develop a primary alternative to mainstream mental health approaches (Morley, 2003).

A study conducted by Arboleda-Flórez & Stuart (2012) found that stigmatization degrades the value of people with mental illness. A social and professional support system need to be created to support mental health consumers and provide proper services. Anti-stigma approach needs to be practiced in all levels of mental health services. Social workers can be a strong partner in the initiative of anti-stigma practice and do advocacy for equitable treatment for service users from the mental health service system as well as from the society. Moreover social worker should be aware about own behaviour that could reproduce stigmatization (Steele, Dewa, & Lee, 2007).  Educate general public about the myth and misconception about mental illness; also resist and protest the negative representations. I think anti-stigma initiatives will not only help the service users but also increase the credibility of social work profession (Arboleda-Flórez, & Stuart, 2012).

I found that mental health field in Canada have some dominant construction of social work practice and limited space for progressive thoughts. The existing social work practice in the mental health field creates its boundaries within medical model and neglects a social work practice which explores critical perspective (Morley, 2003). Critical social work helps people to understand the dominant ideology discourse and relocate subjectively in to that discourse. It will empower people to reconstruct their socially constructed identity and engage in social change process. However, this process will possibly enable people to challenge the existing dominant ideologies and deconstruct the social status quo order.

As a social worker, I think it is my responsibility to assist my clients to deconstruct the dominant discourses which are maintaining social orders and power relations. From a critical point of view, I understand the need for raising consciousness about structurally oppressive factors which are influencing the use of mainstream mental health services through my social work interventions with service users and communities.

Conclusion

 An equitable distribution of the mental health service sector requires more targeted inclusionary strategies and beneficial approaches. We must strengthen the link between need of assistance and use of mental health services. In addition, it is important to develop a comprehensive policy to promote the use mental health services among those who are marginalized and in need of assistance. The influencing factors for mental health service use and determinants are varied in various studies; the common themes are stigmatization, lack of role in the treatment process, power imbalance, culture and lack of knowledge about the system. An approach with an anti-oppressive perspective can make changes in mental health service sector. A critical approach in mental health field is inevitable to make the field more accessible to general public. I think multiple approaches can bring mental health as a priority area in social policy discourse. According to Larson (2008) anti-oppressive social work practice in mental health field faces numerous challenges. An alternative thought from the existing dominant “marginalized and pathologies” (p.44) model can make significant changes in service user’s life. Above all, though this framework is truly motivating the social work professionals especially those who are just out from the universities, the existing dominant system in the mental health field is not supportive (Larson, 2008) thus it is important to fill the gap between theory and practice.

References

Arboleda-Flórez, J., & Stuart, H. (2012). From Sin to Science: Fighting the Stigmatization of Mental Illnesses. Canadian Journal Of Psychiatry57(8), 457-463.

Diaz-Granados, N., Georgiades, K., & Boyle, M. H. (2010). Regional and Individual Influences on Use of Mental Health Services in Canada. Canadian Journal Of Psychiatry55(1), 9-20.

Hickson, H. (2011), Critical reflection: reflecting on learning to be reflective, Reflective Practice: International and Multidisciplinary Perspectives12(6), 829-839.

Khandelwal, S. K., Jhingan, H. P., Ramesh, S. S., Gupta, R. K., & Srivastava, V. K. (2004). India mental health country profile. International Review Of Psychiatry16(1/2), 126-141. doi:10.1080/09540260310001635177

Larson, G. (2008). Anti-oppressive Practice in Mental Health. Journal Of Progressive Human Services19(1), 39-54. doi:10.1080/10428230802070223

Morley, C. (2003). Towards critical social work practice in mental health. Journal of Progressive Human Services, 14(1), 61–84.

Anish Alex MSW, RSW is a Canadian Social Worker who currently attends Ryerson University. You can visit his blog at http://anishalex.blogspot.ca/.

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Ending Gender-Based Violence in Conflict

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On this International Women’s Day, let’s applaud the advances made in the fight against gender-based violence this year, but also look to the work that still needs to be done.

The #metoo movement saw powerful men held accountable for a range of predatory behavior against women and girls. US states have been finally addressing the issue of child marriage. The Women’s March saw people from around the world gathering once again to advocate for women’s issues. Survivors of Female Genital Mutilation (FGM) also spoke out and said #metoo.

There is no denying the strides that have been made.

Yet, the Council on Foreign Relations estimates that 35% of women will face physical abuse during their lifetime. Furthermore, gender-based violence continues to be a common tool used to terrorize populations during conflict.

A poignant example of this is of the pervasive use of gender-based violence against the Rohingya women fleeing Burma. Rape has been used systematically by the Burmese military against these women, including children and older women. In addition to facing this violence, these women lack basic post-rape medical care after arriving in camps in Bangladesh.

Another recent example of gender-based violence in conflict is that of the Yazidi women who were kidnapped, raped and sold into sexual slavery by ISIS. One brave survivor, Nadia Murad, has spoken throughout the world to raise awareness of the genocide committed against the Yazidi people and to ask for justice.

Even in refugee camps, where women flee to in search of safety, there is exploitation of women. Syrian women have reportedly been forced to trade sex for food aid. The problem has gotten so bad that the women will no longer go to get food. Sadly, sexual exploitation of refugees in conflict zones by aid officials has happened in other crises as well including a vast human trafficking network during the conflict in Bosnia.

Perpetrators of gender-based violence during wartime are not only those in power but often include civilians, as has been documented in the Democratic Republic of Congo—pointing to the pervasiveness of the problem.

With the call for accountability for crimes against women, let this be the “Time’s Up” on gender-based violence committed during war. Ms. Murad and her lawyer Amal Clooney are advocating for evidence to be collected and brought to the International Criminal Court in the case against ISIS–one step toward holding perpetrators accountable.

Murad states, “I want to be the last girl in the world with a story like mine”. Let us channel the fire that brought about these movements to fight back against exploitation of women, especially the women facing the unimaginable difficulties of war.

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Turnkey: A Co-Housing Experience in an Italian Public Service for Addiction

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Turnkey is a term used in the economic field, but it also fits well in a social rehab project. The idea comes from the need to give some answers to the problem of those patients that experienced a long term therapy in an addiction rehab center for 3 or 4 years.

In the Italian welfare system, the outpatient service team -work (doctor, psychologist, educator, nurse and social worker), operating in the addiction recovery can schedule long term treatment in the residential rehab centers. In some cases, this long time permanence is something obliged, because of the serious addiction and also for the lack of different life perspectives after the recovery.

These kinds of patients need more therapeutic help in order to return to civil society in order to find  meaningful social membership. Usually, these clients have no meaningful familiar connections, no job, and no significant friendship.

In the last years, our social services system has become more careful about the use of public money. They noticed social workers more equipped to provide therapeutic interventions using a holistic approach in order to spare economic resources. Social workers are more capable to assist patients in reaching a better life condition by using their abilities toward social integration.

The Project

Five years ago, the program’s director asked for the professional team to think about a solution for the rehabilitation of the” long term patients”.

I started wondering about the meaning of poverty which is not only economics but it also the satisfaction of primary needs. It’s the lack of healthy relational bonds which weakness a lot the patients coming out of the drug addiction recovery programs.

I also noticed that this relational deficiency is a modern human condition; in the weakest social situations the loneliness is something that “destroys the mind “.

So I got an idea: I proposed to my director to start thinking about a possible apartment for a temporary co-housing for at least two patients.

He liked the project and submitted the plan to the municipalities which have the competence in the social side of rehabilitation. The municipalities agreed to the project and financed it.

For the patients in long term recovery, the rent was paid through the financing with the municipalities (an average of 6.000 Euro a year for 4 years, renewable), whereas the utilities and the others cost of the house has been in charge to the occupants.

The management of activities like the admission of the patients, the guaranteed respect of the therapeutic contract, the check of daily life and the help in the money administration, are some of my specific competences as a social worker.

In my job role, I had a significant part into find fitting persons for the project who were able to live together. I also contributed to choosing the people eligible to live in that specific therapeutic situation.

I helped the patients to organize their new life and to establish minimum rules of mutual life in the apartment. The project is strictly tied to the learning of the skills required to come back to live a regular life.

For example:

– living together is an opportunity for the patients to learn mutual respect

-cleaning the home and paying the utilities is a way to come back to daily responsibility and autonomy.

– having a good neighborhood relationship is a way to learn again to have good relationships without drug addiction to interfered an apartment, next to the main social and sanitary services of the town.

The results

Since 2011, we housed 11 clients in the apartment with an average of one year placement. We should consider that one year in a residential rehab center cost 30.000 euro each person.

Eight of them returned was able to manage a regular social life, their addiction, a job, maintain social relationships which helped them to achieve a dignified lifestyle.

Two persons are still in the co-housing situation, one of them has a regular job, and he is searching for an own house. Only one person abandoned the treatment.

This intervention is a daily challenge for our team; it gave us good results in the recovery outcomes like independence, citizenship, struggle against the stigma and improvement of personal resources.

We also have spared a significant amount of public money while offering to our clients a higher quality of life.

The creativity and the professional skills mixed together with the help of other colleagues in the multidisciplinary teamwork made this project an effective strategy to help patients overcome their circumstances.

So, I can call myself a responsible social worker, because I help to improve the personal resources in my client’s life. I was mostly inspired from the basic professional principle “start from where the client is”.

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Child Welfare

Getting Care Right for All Children – Free Online Course

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Join over 5,000 learners from across 172 countries who now understand just how important the UN Guidelines for the Alternative Care of Children are when caring and protecting vulnerable children.

Now is your chance to register to be part of this FREE global online course. Starting on 19 February, it is open to everyone who is interested in or responsible for children’s care and protection.

It only takes a maximum of 4 hours a week to take part in this six-week truly interactive course. Allowing you to learn wherever and whenever it suits you.

By the end of it, you’ll better understand the key principals, pillars and implications of the UN Guidelines. You’ll also connect and learn from people throughout the world.

What to expect?

During this course, you’ll have access to a mixture of learning materials including:

  • A film following a family moving through the care system.
  • Filmed lectures, articles and reports from world leading experts.
  • Online discussions to debate, ask questions and share opinions.
  • Quizzes.

Commissioned by leading international agencies, the course is run by CELCIS and delivered through FutureLearn, the digital education platform.

Course materials delivered in English, with some course materials available in French and Spanish. Don’t miss your chance to take part!

This course is designed for practitioners and policymakers from both state and non-state bodies (such as NGOs, CBOs and private service providers) and anyone working in providing services around children’s care.

This might include social workers, para-social workers, community support workers, lawyers, psychologists, child protection professionals, teachers, medical workers and care workers, including those in family-based and residential settings.

The course will also be accessible for people not working directly in this field and others with an interest or responsibility in the field of child protection and child care.

The course will be conducted in English with some course materials (including text and videos) also accessible in Spanish and French, reflecting the truly global nature of this issue.

What previous participants said:

‘I really enjoyed this course and gained a lot from what has been shared in articles, videos and other learners’ posts. This has already impacted my work.’ – Participant from Togo

‘I have learned so much about what happens in other countries around the world. I will continue to reflect on my current practice.’ – Participant from Swaziland

To get access to this free resources, sign up here.

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Employment

Networking – The Best Way to Keep Learning on the Job

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Like most comms professionals, I have a curiosity about learning. Be it about the latest craze on social media, or the newest news platform that I could try and get my organisation into.

I have been fairly diligent about keeping my skills set up-to-date. Regularly attending industry training courses, as well as embarking on a post-grad a few years back while juggling the demands of a busy role.

What’s struck me, however, is that the most profound learning comes from something far less slick than formal qualifications and training sessions, and that’s networking with our peers.

I’ve been fortunate enough to have worked across a number of sectors having moved from the arts, to education, to health, back to education, and then back to health – you get the theme – and now into the children’s sector now into the children’s sector where I work as Communications Manager at CELCIS (the Centre for Excellence for Looked After Children in Scotland).

With each move, I’ve managed to make connections with my counterparts at other organisations. By regularly keeping in touch with them, occasionally meeting up for a coffee, you can gain so much knowledge from each other by comparing notes, woes, and inspirations all in a oner. It really is cathartic. I would urge anyone to get to know their equivalent elsewhere, you never know when you might need them.

In the earlier stages of my career, I established a useful working relationship with a colleague at another institution. Given the supposed ‘rivalry’ between the institutions we worked for (I’m not naming names!) we had to use judgment and discretion when it came to information sharing. There was a real value to us being able to use each other as a sounding board for managing difficult media requests. On one funny occasion, we both spoke to each other mobile to mobile from our respective toilets!

Peer-to-peer learning comes in many forms and guises. An occasional and irregular meeting to talk shop, can lead to bigger plans for shared learning.

From Networking to Communities of Practice

I moved into a job promoting a brand new museum and gallery in central London some years back. Having attended a meeting on Southbank of arts PRs, I was vocal about the need to develop something a little more formal for us to keep abreast of what was happening in our tiny sector of comms professionals. What emerged from this was a working group of budding volunteers, and the establishment of a national conference where like-minded colleagues from throughout the country got together to learn from each other, and hear insights from those at the top of our industry.

What we didn’t realise at the time of its formation was that we really were a Community of Practice in the making (NB ‘Community of Practice’ is the slightly more academic/formal term for networking with peers.

New Year’s Resolution

One of my new year’s resolutions for 2018 is to help keep a network of comms professionals going in the children’s sector in Scotland. We are a varied bunch – from third sector organisations and campaign groups, to academic centres, NGOs and colleagues working in government – but we have much in common: our values as organisations; keeping our comms relevant to our intended audiences; and the need to embrace new and emerging technology.

Anyone wanting to know more, do be in touch.

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Disability

Scottish Journal For Residential Care: Final Call for Views and Experiences of Disability

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The Scottish Journal of Residential Child Care (SJRCC) is inviting submissions for a special themed issue on disability to be published in December 2018.

We are seeking ideas for papers now on any aspect of disability and residential child care – or indeed any aspect of care, or leaving care. We’d like to hear from academics, from people involved in caregiving, and from young people reflecting on their own experience of care and disability.

Although published here in Scotland, the Journal has an international outlook. And this makes sense because concerns about the welfare of children in care is a global one, and international comparison provides us all with an opportunity to develop research, policy, and practice.

We’re always looking for contributors from across the globe to share their wide and varied experience – from practitioners, managers, researchers, and policy folk, to young people with experience of the care system.

Papers from countries other than Scotland are particularly welcome.

Submit now

If you would like to be considered, please email our Guest Editors by Wednesday 31 January: [email protected] You will need to provide:

  • a paragraph with your ideas
  • five keywords
  • your brief biograph (maximum 70 words).

Brief for contributors

We welcome:

  • Academic papers of up to 6000 words in length
  • Practice accounts of up to 2000 words in length
  • Using everyday life activities with individuals with disabilities
  • ‘Breakthrough’ moments when someone showed surprising potential
  • Reflections on situations which helped a fuller understanding of someone’s needs
  • Creating positive environments
  • Changing approaches – working therapeutically.

Open call: submit your ideas and work to the journal

We welcome and publish a real variety of articles and papers on all topics related to residential child care.

  • Peer-reviewed academic papers
  • Short reflections or commentaries on research, policy or practice
  • Methodological papers from doctoral studies
  • Accounts of relevant conferences
  • Book reviews
  • Obituaries

For more details, download our submission pack.

The Scottish Journal of Residential Child Care is a peer-reviewed, open access e-journal which aims to provide a rich forum for debate and dissemination about the topical issues in residential child care research, policy and practice.

The topics covered are wide-ranging and relate to all aspects of residential childcare, including the interface between residential care and other contexts, such as health, education and other care settings, as well as topics relating to children’s wellbeing in public care.

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Global

The Call of the Rohingyas: A 21st Century Holocaust

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Photo: AFP

The brutal killings of Rohingyas have been confirmed by the international diaspora as being – The Worlds most persecuted minority”. Rohingya progeny is found in Myanmar with the consistent brutal violence and forced fleeing which has become their daily existence.

A very minute spec of Humanity (The Rohingya`s) in the 21st century is in crisis and a strength of belonging to one`s land is transformed into a reality of statelessness. It’s a well directed ethnic cleansing, the level of hatred was and continues to such an extreme that Rohingyas hurriedly left their lands using the quickest available means of transport, mostly using water transportation, out of the fear of being persecuted in hopes of seeking shelter on whichever shore they reach. Despite being denied entry in many countries, they continue to float, as though living dead bodies would have done.

The very act of stamping down masses or crushing them is not limited to ethnic cleansing only, it`s a negative transformation injecting a lifelong fear, or memories of fear, hatred, and rejection from other nations, a destruction including emotional, physical and sociological. It`s a small term to call the Rohingya`s ethnic cleansing as genocide, it`s beyond the wordy jargons, something which humanity is witnessing in the 21st century – The Holocaust! The Renaissance of Killings!

“A Tale to be talked out or a Tale to be dusted in the coming years.”

The world needs to ponder, what are the paths that lead to the extremity of injected ethnic cleansing which violates almost all laws of human rights whether national or international, do question the level of insecurity any minority or small groups of tribes/masses undergo? What is the credibility that these lives will survive with dignity? The damage is done, though hope has not to be lost, human values are slowly dying a natural death, wonder the uncaptured inhuman phases the Rohingya`s are forced to live with?

There are innumerable talks on United Nations protocol, Laws which are ratified and not by Nations who want to help but find reasons to rejection or acceptance of its non-ratifications, security threats yes or no, but there is no one talking about, where do these group of neglected people go?  Who will repatriate them while guaranteeing security and safety and thereby normalising towards rehabilitation?

What does it mean to be a Rohingya?

Just one day to be a Rohingya can cost you to stand just nowhere, belonging to no one, with nothing at all to exist except a body which is better living then dead if escapes to any other land or for that matter even surviving for days in the sea ….and curse oneself to be born, living in highly impoverished conditions with  no health care access, and a life of  full of crippled mobility.

The case of Rohingyas is being dealt in a manner where a strategic displacement in shifting the identity from National identity to individual minority group with a stateless status, and it is this very depreciating transformation has been played well enough to plan a systematic exodus of the ethnic group and flush them out of the Nation just as the slag of any process.

“ Myanmar is going through self inflictment, injuring its own people, it is not that easy, it kills the reputation of a Nation globally, affects its economic growth and this ethnic cleansing has witnessed a history, a history which is not supposed to be repeated but to be repealed!!”

What can or can`t the Nations do, is not the struggling or comparative question, the responsibility is more on how can this mass exodus of Rohingyas be addressed by the neighbouring Nations and not stopped.  The reason of not stopping this exodus is clearly understood, since the history of Rohingya cleansing in Myanmar, dates back in 1970s, which is a proof of foment, displaying ethnic rifts and polarisation by using genocide as a tool to clean the cultural and religious species of Rohingyas.

 “  Is Myanmar carrying  a Heritage of Horror for its next generation”

They are subjected to a systematic marginalisation and wherever they have migrated, they are living in sheer abysmal conditions after escaping the fear of persecution. Not that migration has given them any promising hopes for rehabilitation but the least it could benefit them is saving life and continuing the survival struggle. An exhumation of the Rohingya history will bring out how this ethnic group has been time and again subjected to violence, hatred, rejection, forced labour, imposed a legal stateless status, restricted freedom of movement and to be précises a 21st century Holocaust!

 “Is it a fight of religion or a fight to displace people who are of no good (as considered by their own nation), for the Nations economy and residing at that terrain which is explorable for tapping rich natural resources?”

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