History of Social Work Research in Mental Health
Social work’s interface with mental health promotion and the treatment of mental illness dates to the earliest roots of our profession. From the asylum to the development of community based services, social workers counseled clients and supported families, undertook efforts to prevent mental illness and alleviate its consequences, developed programs, and advocated for public policy and funding to assure that mental illness is treated in parity with physical illness.
Working with other professions involved in this arena, social workers have been involved in the emergence of theories of etiology and interventions, which have been tried, modified, and refined through practice, and through research on that practice. Social workers have traditionally maintained a bio-psychosocial focus — that is, concern for the interaction of the individual and the social environment.
While many social workers provide services in private practice settings, the majority of services are offered in community-based agencies, both public and private, and in hospitals and prisons. Social workers are the largest provider of mental health services, providing more services than all other mental health care providers combined.
In 1988, Lewis L. Judd, MD, then director of the National Institute of Mental Health, appointed a Task Force on Social Work Research, comprised of leaders in the profession, to examine the current status of research and research training throughout the profession of social work. The Report of this Task Force, Building Social Work Knowledge for Effective Services and Policies: A Plan for Research Development, provides not only an assessment of research status at the time, but also recommendations for building research capacity within the profession.
The report noted, “There is a crisis in the current development of research resources in social work. The contributions of practice-relevant research to the knowledge base of social work practice lag far behind the dynamic growth of the profession and professional education” (p. viii), and “there is too little published research that deals with critical professional practice issues” (p, ix). Building Social Work Knowledge for Effective Services and Policies: A Plan for Research Development was grounded in numerous studies and surveys, noted in Appendix B. The report was seminal in the development of IASWR to be the profession’s jointly supported organization; IASWR ‘s mission is framed by the report.
In the ensuing decade NIMH funded seven mental health research centers in schools of social work, with the goal of increasing research and training social work researchers; the Institute also funded a range of technical support efforts. All of this resulted in a significant increase in the number of NIMH-funded social work researchers, expanding social work’s contribution to mental health research.
Moving Forward : A National Focus on Social Work Research
To highlight this expanded contribution, in June 2002, the National Institute of Mental Health convened a workgroup of researchers to present findings from current social work research in mental health and to discuss future research directions consistent with NIMH research priorities. Moving Forward: Building on Social Work Contributions to Mental Health Research gathered presenters through a competitive, peer-reviewed process which resulted in a wide-range of research perspectives and design. The meeting was organized around:
Improving Care for the Most Needy
- Health Disparities
- Psychiatric Disorders among Women on Welfare
- Mental Disorders in Childhood
- Services for persons with Severe Mental Illness
- Depression in Non-Specialty Sectors of Care
- Motherhood and Mental Illness
- Service Needs of Delinquent Adolescents
The meeting included social work mental health researchers, NIMH staff, NIH staff interested in social work research contributions, and representatives of key social work organizations (NASW, IASWR , SSWR, CSWE). Denise Juliano-Bult, MSW, chief, Systems Research Branch, Division of Services and Intervention Research at NIMH and convener of the meeting, summarized the conclusions and recommendations as follows:
- Intervention Development – Current research should move toward development of model interventions as well as addressing the organizational and structural barriers to their implementation.
- Systems Coordination – Better communication and coordination of services is needed between mental health systems and various other non-specialty service systems such as child welfare, adult and juvenile justice, foster care, substance abuse, public assistance, Indian health, homelessness, aging, and veterans services.
- Engagement of Clients – Development of effective outreach and transitions services to individuals and families are essential, given the challenges of working with those who are severely ill, resistant to or suspicious of treatment, multi-system users, and persons with special sociocultural or gender concerns.
- Measurement Issues – New approaches to research design and measurement are needed to address target populations involved in multiple service systems, to address the client-clinician dynamic (what occurs in the treatment process), and to address practice setting variation.
- Professional Collaboration – Social Worker researchers and clinicians should partner more effectively with researchers from other disciplines in order to advance knowledge on community mental health.
To read abstracts of the Moving Forward presentations and to see references related to their published research, click here. It should be noted that while these abstracts are representative of the range of social work research inquiry and theory testing, they are but a small measure of the inquiry and theory testing in mental health oriented research conducted by social workers.
For more information, refer to NASW journals, available online at www.naswpressonline.org
- National Institute of Mental Health. (1991). Building Social Work Knowledge for Effective Services and Policies . Washington , DC : Author.