Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.
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Adult Protective Services
Patricia Brownell and Joanne Marlatt Otto
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Bioethics
Larry W. Foster
Bioethics and biomedical ethics are defined. Common bioethical concepts, exemplary moral values, fundamental ethical principles, general ethical theories, and approaches to moral reasoning are reviewed. The scope of topics and issues, the nature of practice situations in bioethics, and social work roles on organizational bodies that monitor and respond to bioethical issues are summarized, as are trends in bioethics. Practice contexts, from beginning to end of life, are highlighted with biopsychosocial facts, ethical questions and issues, and implications for social work—a profession uniquely positioned in giving bioethics a social context.
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Digital Technology
Gina Griffin
As technological advances continue to develop, delivering macro human service through social work innovations becomes a new priority for the discipline. Digital technologies offer potential applications using tablets, smartphones, cloud computing, artificial intelligence, and wearable technology to enable whole new possibilities for human services. As a result, policymakers and community organizers alike can access the existing information much faster, and potentially connect with hard-to-reach communities to make meaningful decisions. Incorporating the latest digital trends from business and industry settings to macro social work practice are highlighted. By utilizing digital technology, human service organizations can become more proactive and citizen-centered, potentially transforming personal and economic capacity.
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Drug Policy Reform
Sheila P. Vakharia
Social workers are uniquely qualified to be effective drug policy advocates for effective and equitable policies through their commitment to advancing social welfare and promoting social justice. The prohibitionist antidrug policies that began at the turn of the 20th century have been a key driver for the criminalization of millions of Americans over time, a disproportionate number of whom have been people of color. The period beginning with President Richard Nixon’s “War on Drugs,” in addition to contributing to inequality and marginalization, has exacerbated a number of public health and safety harms, suggesting that past policy approaches have not met their intended aims. The North American opioid overdose crisis in the early 21st century is presented as an illustrative case study because its persistence and mounting death toll exemplify the challenges with the current model of drug prohibition. Areas for macro social work interventions include legislative advocacy through lobbying, provision of expert testimony in legislative hearings, engagement in reform through litigation, involvement in social action, and performing policy analysis and research.
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Homelessness and Macro Interventions
Eva M. Moya, Amy Joyce-Ponder, Jacquelin I. Cordero, Silvia M. Chávez-Baray, and Margie Rodriguez LeSage
The emergence of social work and macro practice is often associated with the eradication of poverty and prevention of homelessness through the efforts of 19th century settlement houses. Structural violence and social determinants of homelessness are often grounded in unequal social, political, and economic conditions. Health and mental health were affected by the lack of stable housing, causing and increasing the complexity of health and human service needs and services. Furthermore, due to inequities, some populations are inadvertently more likely to face chronic homelessness, which can be mitigated through the role community-engagement and macro practice interventions.
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Institutional Racism and Effects on Health and Well-Being
Valire Carr Copeland, Betty Braxter, and Sandra Wexler
Racial inequality negatively influences the lives of people of color in the United States. Although race refers to differential concentrations of specific genes, the impacts are confined to physical characteristics such as skin color, hair type, and eye color. Rather than designating meaningful biological categories, race is a social construct. Yet, where there are inevitable intersections with institutional structures and interpersonal health relationships, race and racism produce inequities.
Racism occurs within and permeates the overarching political, social, cultural, and economic systems of American society. It can take several forms: structural, institutional, interpersonal, and internalized. Institutional racism in the healthcare system yields adverse effects on the physical and mental health and well-being of racialized individuals and communities. These inequities are well documented.
Recommendations are offered for creating a fairer and more just healthcare system in America. Equality and equity in the country’s healthcare system will be achieved only if racism is challenged in all its forms.
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Managed Care
Vikki L. Vandiver
Since the mid-1980s, managed care has been one approach used to address the economic crisis in the American health-care system. This entry overviews managed care from the perspective of policy, procedure, practice, and system. Specifically, emphasis is given to understanding the emergence and history of managed care, multiple definitions, how it works, and examples of managed care plans, key legislation, existing research, its future, and implications for social-work practitioners.
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Medicaid and Medicare
Victoria M. Rizzo, Sojeong Lee, and Rebekah Kukowski
In 1965, Titles XVIII and XIX of the Social Security Act were passed, creating Medicare and Medicaid and laying the foundation for U.S. healthcare policy. Originally, Medicare was created to meet the specific medical needs of adults aged 65 and older. In 2022, individuals with end-stage renal disease, amyotrophic lateral sclerosis (ALS), and other disabilities may also receive Medicare, regardless of age. Medicaid was established to provide a basic level of medical care to specific categories of people who are poor, including pregnant women, children, and the aged. As of 2010 as part of the Affordable Care Act (ACA), states are provided with the opportunity to expand Medicaid to close the coverage gap for public health insurance. This entry provides explanations of Medicaid and Medicare and associated social healthcare programs in the United States. An overview of significant programming developments and trends, future directions, challenges, and controversies as of 2021 are also provided.
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Mental Health Courts
Matthew Epperson, Julian Thompson, and Kelli E. Canada
This article discusses the emergence, structure, and purpose of the mental health court. It details the therapeutic aspects of the mental health court and its function as a specialized-treatment court serving persons with serious mental illnesses in the criminal justice system. Guiding themes, such as the criminalization of mental illness, therapeutic jurisprudence, and drug-treatment courts are described. It also identifies key legislation that contributed to the funding and proliferation of mental health courts. The effectiveness of mental health court, along with current criticisms regarding its impact on participants’ mental health and recidivism outcomes, are also covered. Last, social work values and the various roles of social workers in the mental health court are highlighted to demonstrate the relevance of mental health court to contemporary social work practice and intervention.
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Mental Health Policy Overview
Christine M. Rine
Mental health practice is inextricably linked to how this concept has been understood in a historical context from which policies and systems of care develop. How mental health is perceived has shaped policy, as much as policy has influenced how mental health has been defined and subsequently treated. Early frameworks evolved, furthering the multidisciplinary nature of policies and services highlighting social and environmental contributions. Holistic approaches that appreciate social determinants are a comparatively new way to understand and advance mental health policy that underlies access to insurance, programs, and services based on qualifications and eligibility. A chronological and historical overview highlights interconnectedness and provides context to the development of mental health policies, initiatives, and systems of care. Content specific to roles of the social work profession should be included.
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Military Social Work
Kelli Godfrey and David Albright
Although there are many definitions of military social work, this article primarily focuses on social work by uniformed personnel within the United States military. Social work with military and veteran-connected populations is also done by civilian professionals.
The history of military social work in the United States is rooted in the civilian professional social work community and is a microcosm of that sector. Military social work has a rich history of providing services to military men and women and their families during periods of peace, conflict, and national crises. Military social workers have been involved in humanitarian operations and have participated in multinational peace-keeping operations. Social work in the Army, Navy, and Air Force is tailored to the mission of their particular service. However, joint operations between the services are becoming more frequent. Military social workers adhere to the National Association of Social Workers (NASW) code of ethics while providing service to an institution with its own unique culture, standards, and values. The role of military social workers has expanded since the Global War on Terrorism began, in 2001.
Military social work encompasses a wide variety of skills, performed by social workers who are both civilian and military, ranging from crisis to working with families. Military social work is unique and often faces ethical dilemmas even though military social workers still follow the National Association of Social Workers’ Code of Ethics. The history of military social work dates back to the early 1940s, but has evolved with the needs of military members and their families. The Army, Air Force, and Navy all have social workers, both civilian and those who wear the uniform. Due to the number of veterans and military families living throughout the United States, and seeking care in community settings, recommendations to establish competencies for social workers working with military and veteran-connected populations is underway.
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Posttraumatic Growth
Selena T. Rodgers
Trauma literature has seen a paradigm shift from pathology to embracing positive trajectories. Posttraumatic growth (PTG), defined as a positive psychological change resulting from a struggle with traumatic or life-changing events, may occur in a variety of populations and events. This entry, therefore, aims to increase our understanding of PTG. The entry begins with the conceptualization of PTG, followed by a discussion of protective factor associations, measures, and psychometric priorities. Nuanced attention is given to global translations and cultural aspects. The entry then presents debates about the challenges, controversy, and biases, as well as an overview of the empirical literature. The entry concludes with PTG contributions for social-work practice and pedagogy, together with recommendations for future research.
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Psychosocial Support in Emergency Settings
Maryanne Loughry
The integration of psychosocial support into emergency responses is a recent development. In the 1990s, the need to address the mental health and psychosocial well-being of individuals and communities affected by emergencies became clear following the breakup of the former Yugoslavia (1991–1992) and the Rwandan genocide (1994). Prior to this, mental health in emergencies was primarily addressed in clinical settings. However, the humanitarian field was divided between the medical sector, which asserted that psychiatric clinical intervention was best, and many nonmedical actors, who preferred a person-in-environment approach. The need for consensus resulted in the Inter-Agency Standing Committee (IASC) working group’s establishment of the framework of Mental Health and Psychosocial Support (MHPSS), which combined both approaches. The IASC Guidelines on MHPSS in Emergency Settings, published in 2007, are widely recognized as explaining how best to administer psychosocial support in emergencies. This ended decades of tension between mental health and psychosocial experts in emergency and humanitarian settings.
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Smart Decarceration
Carrie Pettus
After a period of mass incarceration that spanned the 1970s through the 2010s, the United States remains the leading incarcerator in the world. Incarceration rates in the United States outpace those of other countries by several hundred per 100,000. Incarceration rates began to decline slightly in 2009, when there was a loss of fiscal, political, and moral will for mass incarceration policy and practices. First, the onset of smart decarceration approaches, the historical context from which smart decarceration stems, and the societal momentum that led to the conceptualization of smart decarceration are described. Smart decarceration is a lead strategy in social work that has been adopted by the American Academy of Social Work and Social Welfare as one of the 12 Grand Challenges for Social Work for the decade 2015–2025. Finally, an overview of the current status of smart decarceration and details shifts and initiatives to pursue at the intersection of social work and smart decarceration is provided.
