S.W. 698 Social Work Practice in Mental Health		Prof. T. Powell;
Winter, 1999		3796 Social Work Bldg., 1080 S. Univ.
Office Hours: Mondays and Tuesdays 4-6 p.m., and by appointment		Ann Arbor, MI 48109-1106
tpowell@umich.edu		734 763-5930
	http://www-personal.umich.edu/~tpowell/

Course Description

This course teaches practice models and methods of intervention for effective social work practice in mental health care, including the promotion of mental health, the prevention of mental illnesses, and the delivery of psychosocial treatment and rehabilitation services. A major focus is on enabling individuals with mental health problems to increase their functioning and maximize their success and satisfaction. This course has a specific emphasis on services to individuals who suffer from severe and persistent mental illness, substance abuse, and/or who are recovering from the effects of severe traumatic events. Interventions relevant to these conditions help individuals develop/restore their skills and empower them to modify their environments so as to improve their interactions with their environments. Culturally competent and gender-specific interventions are a major emphasis of the course, as are special mental health issues for groups who have been subject to oppression.

Course Content

The course will discuss methods of carrying out functional assessments, resource assessments, establishment of client preferences, development of plans to meet service needs, services to enhance client skill development, and the development and modification of relevant community and agency environments. The emphasis of the course is on approaches that enhance problem-solving and coping strategies and are empowering and supportive to consumers, both individually and in groups and families.

This course will discuss models and methods for the promotion of mental health, the prevention of mental illness, the provision of effective treatment of psychiatric disabilities, with an emphasis on promotion of optimal adaptation when psychiatric disabilities are long lasting. Assessment and intervention strategies will be included for use at the individual, family, group, organizational, community, and societal levels. The course, therefore, will emphasize the integration of micro and macro methods in order to make social, behavioral, environmental, organizational, administrative, and policy assessments, with an emphasis on risks/strengths assessment and capacity-building.

The importance of empirically-based interventions based on sound assessments and service plans will be stressed. A major focus of this course will be gender specific and culturally competent interventions with and for groups who have been subject to oppression, such as people of color, women, lesbian/gay/bi/transgendered people, the aged, and people with disabilities.

Course Objectives

Students who complete this course should be able to:

1. Conduct risks/strengths and psychosocial assessments of individuals, families, groups, organizations and/or communities for the purposes of promoting mental health, early intervention, treatment, and continuing service, with an emphasis on problems faced by people who suffer from severe and persistent mental illness, substance abuse, and/or who are recovering from the effects of severe traumatic events.

2. Plan and/or demonstrate culturally competent, individual, family, group, organizational, and/or community-based capacity building and preventive interventions.

3. Identify and demonstrate understanding of the many components of the mental health system as team member, advocate, broker, community organizer, and program planner in order to interact productively with the many components of the mental health system.

4. Build partnerships with key social networks and self-help organizations and institutions for the purpose of mental health promotion and disease prevention.

5. Understand and appropriately apply values and ethical standards in professional social work practice in mental health.

Course Design:

The course structure, topics and assignments are tentative. To a certain extent we are all teachers; hence your suggestions are not only welcome, but needed. Although we will have a mid-term evaluation of our activities, I hope to hear from you informally about how things are going before then.

Course Assignments:

Please come to class having done the readings and prepared to discuss the topics on the course schedule. Regular attendance is expected. (Please e-mail me if you anticipate an unavoidable absence. Note, however, explanations are unnecessary and not expected. After you have discussed a missed session with members of your group I can meet with you to discuss "makeup" content. I am sorry I will not be able to loan you personal copies of videos shown in class.)

Required: Spaniol, L., Gagne, C., & Koehler, M. (1997). Psychological and Social Aspects of Psychiatric Disability. Boston: Boston University, Center for Psychiatric Rehabilitation. Book is available from Ulrich’s Bookstore, Michigan Union, and Michigan Book and Supply

Coursepack: $44.01 Dollar Bill's 611 Church St. 665-9200

1) Discuss article in Spaniol, Gagne and Koehler (1997). Choose one of the articles on the schedule by January 19 so that we can make adjustments as necessary and identify responsible persons. By the date scheduled prepare a critique of the article that includes: a) the key points, b) a critique and c) an application or example of one of the key points. The critique should be about 300 words and not more than one sheet (preferably 1 page using a small font or, if necessary, two pages on one sheet). Distribute copies to class one week in advance (early volunteers may distribute day of class). Please understand, however, that the discussions may not be held on the scheduled date in order to accommodate guest speakers and other course content. Your understanding will be appreciated. (If an absence is unavoidable, arrange to have someone pick up the handouts, or second best, contact the person who did the critique. The instructor will not have extra copies)

Ask someone to be your timer so that your discussion does not exceed 10 minutes (less is OK). Lead a class discussion encouraging critique, elaboration and examples of the points made in the reading. Evaluation: ü or ü +

Please see me to discuss your interests (note office hours above). In particular, I would like to discuss your interest in various topics, particularly those you are considering for the second and third assignment. This can be an informal meeting before or after class, or at another time convenient for you. It may be helpful to confer with me more than once, first early in the term, and then again when you are further into the project. If the conference is sufficiently early in the term, it may be useful in sharpening the focus and developing a bibliographic search strategy.

2) Program Review. Visit, on two or more occasions, a self-help or advocacy group or a program such as an ACT, clubhouse, chemical dependency service, prevention program, rehabilitation program, supported housing, minority oriented service, shelter or community meal service. Or choose an agency program. Discuss relevant issues such as conceptual underpinnings, skill requirements, employment gateways and provider and organizational networks, relevant social work curriculum and problems to be solved (organizational and individual client).

Client Service Plan Review. Discuss the details of a client service plan including engagement, assessment, intervention, support, rehabilitation and evaluation. Include DSM-IV and P.I.E. codes. Other assignment options are possible, indeed you are encouraged to go beyond those identified. Multicultural and chemical dependency, supportive services and rehabilitation topics are especially welcome since they are underrepresented in the text.

Prepare a 15 minute class presentation to the class (select a timer as above). Consider using powerpoint but, in any event, provide handouts. Include in the handout at least two key references and one key web site. Construct an evaluation form that will elicit quality feedback from class members. Group projects are encouraged. (Evaluation: Needs more work; Good; Exceptional;

3) Term Paper. Write a paper on some element of the first Course Objective above. Essentially, it should be a detailed report of your work with an individual, family, group, organization and/or community. Also discuss how the paper addresses one of the other course objectives. Due April 6. Grade equals 33% of the course grade

Another option is to write about the policy and practice implications of a first person (memoir) or narrative account of mental illness or substance abuse. Include at least four key references and two web sites in your paper. Some examples are:

Backlar, P. (1994). The Family Face of Schizophrenia. New York: Putnam. Baldwin, J. (1970). Another country. New York: Dell. Berryman, J. (1973). Recovery: A novel. New York: Farrar, Straus & Giroux. Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and the collison of two cultures. New York: Farrar, Straus and Giroux. Feinberg, L. (1993). Stone Butch Blues. Ithaca: Firebrand Books. Fitzgerald, F. S. The Crack-Up. Grant, S. The Passion of Alice. Hayden, T. One Child. Hurston, Z. N. (1937-1990). Their eyes were watching God. New York: Harper & Row. Jamison, K. R. An Unquiet Mind. Kaysen, S. (1993). Girl, Interrupted. New York: Vintage Books. Kramer, L. The Destiny of Me. Kushner, T. Angels in America. Lamb, W. (1998). I know this much is true. New York: Regan Books, Imprint of Harper Collins. Lyden, J. (1997?). Daughter of the Queen of Sheba. Boston: Houghton Mifflin. McCourt, F. (1996). Angela's Ashes. New York: Scribner. Morrison, T. (1977). The song of Solomon. New York: New American Library. Munro, A. Open Secrets. O'Faolain, N. (1997?). ARE YOU SOMEBODY: The Accidental Memoir of a Dublin Woman. New York: Henry Holt & Co. Schiller, L. Quiet Room. Sheed, W. (1995). In Love With Daylight: A Memoir of Recovery. New York: Simon & Schuster. Sheehan, S. (1995). The last days of Sylvia Frumkin. New Yorker, 200-212. Simon, C. The Mad House. Solomon, A. (1998). Anatomy of melancholy (Personal History). New Yorker, LXXIII(42), 46-61. Styron, W. Darkness Visible. Trevor, W. (1997). The Mourning: Why are the Irish so predictably unwelcome in London? The New Yorker, 70-80. Walker, A. The color purple. White, E. A Boy's Own Story. Wyden, P. (1998). Conquering Schizophrenia: A Father, His Son, and A Medical Breakthrough. New York: Knopf.

4) Final exam: Includes short-answer essay questions on class lectures and discussions, readings, handouts, and earlier assignments. The exam will be available April 20. The exam will be graded according to your knowledge of the concepts considered in class and your ability to integrate and discuss their relevance to practice situations. Due April 27. Grade equals 33% of the course grade.

Assignment Notes: Grades for the first and second assignments and class participation 33% of the course grade and will be recorded as marginal, credit, or credit plus. A grade on either end, a marginal or credit plus grade, could change the overall course grade which will be the average of the term paper and exam grades. Participation refers to the quality and range of discussion, not the amount.

With the exception of the final exam, assignments can be modified to suit your interests. Remember, however, it’s important to talk early.

Please do not put papers in folders as they are easier to handle without them. Late assignments will be graded down one level (e.g. B+ to B) and will not receive comments except where arrangements have been made in advance.

Preliminary Course Schedule

1/12	What is the nature of the sorrow or heartache experienced by persons with an illness (consumers) and family members? How would you address it? What do you say and not say to someone hearing voices? How can you help someone develop meaning and satisfaction with his or her impairments? Discussion of course design, schedule and assignments AMI of Washtenaw County Mtgs, Information, AMI Office 734-994-6611 Jan 11 Landing the Right Job, 7:30 St Clare’s Episcopal Church/Temple Beth Emeth, 2309 Packard, Ann Arbor,
1/19	Strauss 2-13; Sullivan 14-23 Come prepared to choose the article for which you will be the discussion leader. Indicate three preferences on the separate selection sheet and rank order them. Roles and programs in mental health services Program review options: ACT, case mgmt, clubhouse, self-help, rehab services, emergency services, medication clinics, partial hosp, hosp, supported housing afc, residential, supported education, library programs, meal programs, recreational programs, companionship programs. AMI Public Education Committee (All welcome) Jan 13 7pm NEW Center, 1100 N. Main St, Ann Arbor AMI Board Meeting (All welcome), Jan 20 7pm NEW Center
1/26	Davidson 25-39; Estroff 40-50; Strauss 51-67 Roles in mental health services: case manager, therapist, ACT social worker, meal program specialist, supported housing specialist, supported employment specialist, supported education specialist
2/2	Chapter 2, The Experience of Recovery, pp. 74-133 Discussant A, pp. 74-103; Discussant B, pp. 104-133 February, 8, AMI meeting: Civil Commitment, Guardianship Issues7:30 St Clare’s Episcopal Church/Temple Beth Emeth, 2309 Packard, Ann Arbor,
2/9	Copeland, 228-239; Lefley, 246-253
2/16	Marsh 254-269; Moller 270-279
2/23	Jennifer Schizophrenics Anonymous Spaniol 280-284; Hatfield 285-292
3/2	Spring Break March 8, AMI meeting: 7:30 St Clare’s Episcopal Church/Temple Beth Emeth, 2309 Packard, Ann Arbor Troubled Children - Robert Sain and Debby Snyder
3/9	Minkoff 334-347; Marsh 358-369
3/16	Kurtz 401-410; Segal 430-440
3/23	Borinstein 452-460; Spaniol 477-484
3/30	Lyons 485-496; Finley 497-510
4/6	Harding 511-520; Paulson 552-561 Paper Due April 12, This is What We Think: Making Your Voice Heard - Virginia Koster AMI meeting, 7:30 St Clare’s Episcopal Church/Temple Beth Emeth, 2309 Packard, Ann Arbor
4/13	Mack 562-584
4/20
4/27	Exam due

Relationship to Four Curricular Themes

Social Science and Behavioral Research is presented throughout the course and includes findings from evaluation studies and intervention research in social work, psychiatry, psychology, anthropology, and sociology.

Multiculturalism and Diversity are integrated throughout the course especially in view of the fact that mental health problems are experienced very differently in various cultures, each of which has its own indigenous responses to healing. In addition, the stresses associated with mental health problems and access to appropriate services are differentially affected by gender, poverty. race/ethnicity and sexual orientation. The students must be aware of these issues and helped to develop culturally competent and gender-specific interventions and interventions to overcome oppression and discrimination as barriers to access to and quality of care.

Social Justice Issues have special relevance to the processes of psychosocial rehabilitation. Persons with psychiatric disabilities are often discriminated against with respect to access to education, employment, housing, and financial assistance. Health insurance plans often discriminate against persons with mental as opposed to physical disabilities. Social justice issues are often seen with respect to the processes of commitment, the rights of people in mental institutions, the rights to treatment (such as in the criminal justice system), access to attorneys, and the determination of competence to stand trial or when mental illness is offered as a defense in a criminal proceeding.

Promotion/Prevention/Treatment/Rehabilitation are addressed throughout the course. Mental disabilities often occur or are exacerbated as a result of stressful environmental conditions and the ways of seeking changes in these conditions or preventing them will be stressed.

Relationship of This Course to Social Work Values and Ethics:

Virtually every topic of this course is related to issues of social work values and ethics, and these issues will be dealt with in this course. Examples of these issues are priorities assigned to various services and populations by mental health agencies and the role of social workers in molding these priorities, recognition of the right of self determination of consumers of mental health services, the principle of the utilization of the least restrictive environments for treatment of mental disorders, the values placed on preventive services, an understanding of the responsibility of workers to strive for less stressful environments in relationship to preventing mental problems, the creation of community respect for individuals in the community whose behavior, while lawful, departs from community norms, and promoting community awareness of the "not in my back yard" phenomenon.