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Article

Deinstitutionalization in Macro Practice  

Steven P. Segal

The deinstitutionalization policy sought to replace institutional care for populations in need of care and control with prosocial community-based alternatives. U.S. institutional populations, however, have increased since the policy’s inception by 205%. As implemented, with the assistance of advocacy and cost-cutting factions, it has succeeded only in enabling the divestiture of state responsibility for target groups. It sought to prevent unnecessary admission and retention in institutions. As implemented, deinstitutionalization initiated a process that involved a societal shift in the type of institutions and institutional alternatives used to house its target groups, often referred to as trans-institutionalization. For many in need of institutional placements, it has succeeded in preventing all admissions, expanding admissions for others. In seeking to develop community alternatives for housing, treating, and habilitating or rehabilitating its target groups, it has succeeded in establishing a variety of alternative living arrangements and showcase and model programs illustrating what can be done; yet, it has failed to deliver on investments in such programs to serve the majority of its target groups. It has resulted in the abandonment of substantial numbers to homelessness. It has been documented, from political, economic, legal, and social perspectives, how this policy has affected the care and control of populations such as older adults, children, people with mental illness or developmental disabilities, people under correctional-system supervision, and, more recently, individuals without a home. Suggestions for a truer implementation of deinstitutionalization’s initial aspirations are available.

Article

Public Health Social Work  

Sarah Gehlert, Julie A. Cederbaum, and Betty J. Ruth

Public health social work is a substantive area within the discipline of social work that applies social work and public health theories, frameworks, research, and collaborative practices to address contemporary health issues through a transdisciplinary lens. It is epidemiologically informed and characterized by prevention, health promotion, and other integrative practices. With its strong focus on health impact and population health, public health social work is central to the profession’s viability and success for tackling pervasive 21st-century challenges, such as health inequity, behavioral health integration, chronic disease, health reform implementation, and global health.

Article

Suicide and Public Policy  

Janelle Stanley and Sarah Strole

The historical context of suicidal behavior and public policies addressing suicide arose simultaneously within the United States, and both reflect a culture of discrimination and economic disenfranchisement. Systems of oppression including anti-Black racism, restrictive immigration policy, displacement of American Indigenous communities, religious moralism, and the capitalist economic structure perpetuate high-risk categories of suicidality. Suicidal behavior, protective factors, and risk factors, including firearms, are examined in the context of twentieth and early twenty first century public policy. Recommendations for public policy will be discussed with consideration for policies that impact communities disproportionately and social work ethics, such as right to die laws and inconsistent standards of care.

Article

Women: Overview  

Ruth A. Brandwein

This overview article introduces the topic of women, beginning with general demographic information. The section on poverty and inequality, which follows, describes the gender differences and delineates some reasons why women are poor and unequal. Issues of child care, welfare, and education are explored. Interpersonal violence and sexual trafficking are discussed, followed by a discussion of health and mental health issues affecting women, including access to health care. The role of women as well as women social workers in politics is briefly explored. Throughout, attention is paid to intersectionality. The article concludes with a discussion of current trends and challenges, with a brief examination of changes in policies affecting women from the Obama presidency to the end of the Trump administration in 2020, including implications for social justice, as well as implications for social work.