Character and directions of social work in psychiatry

In the beginning of XX century social workers have started to train in sphere of public health services. In post-war years medical institutions of the countries of the West made active employment of experts in the field of social work - first more deeply and more full to understand economic, spiritual go moral problems of the patients, and, second, to resolve these problems with the help of social workers.

The analysis of the foreign literature shows the important role of experts of social work in interaction with people with the limited opportunities, i.e. people, physically or mentally defective. Now the special role of experts is marked in the field of social work in system of services of the psychiatric help. In much the advanced countries (the USA, Sweden, the Great Britain) more than thirds of heads of the centers of mental health have higher education in the field of social work.

In this sphere the basic kind of activity - preventive maintenance of mental diseases which has three levels.

1) Whenever possible exception or decrease in risks of mental diseases. In spite of the fact that full unanimity at psychiatrists concerning the reasons of mental diseases till now it is not achieved, social workers are convinced, that many these reasons have social character: poverty, famine, a defective feed. Emotional problems grow out stresses of an economic origin more often, and frequency and a degree of gravity of mental diseases are caused by growth of unemployment. Thus, preventive maintenance of mental illnesses is directly connected to preventive maintenance of social problems.

2) Increase of a degree of resistibility of the person to psychogenic factors. The social worker allocates groups of the raised risk among the population and renders the preventive help to their representatives which means development and realization of the programs assisting to people to realize a degree of risk, to receive the information on the help accessible to them or even to change perception of the mental illness, establishes the reasons of the difficulties which have arisen at them, disputed situations, renders assistance.

It is extremely important to help the person before symptoms of disease become too obvious.

3) Participation in the course of treatment, rehabilitation of mentally unhealthy people with the purpose to help the client socially to function and be useful to and a society.

In the majority of the foreign centers of mental health of the advanced countries social workers are participants of the "command" uniting doctors - psychiatrists, psychologists and other professionals. All members of such "command" are professionals in the area, however only the social worker is capable to find necessary social resources to support the patient or to return it{him} by a usual life. Efficiency of actions of the social worker depends on his knowledge in the field of psychiatry (knowledge of terminology, pharmacology of psychotropic means), knowledge of the legislation on protection of mental health, influence of an environment on mental health, his skills to work in a command.

In the Great Britain the special divisions basing in the work on medical establishments of a psychiatric structure are generated. In psychiatric hospitals psychiatrists estimate a condition of patients and define methods of treatment. When the way of treatment is specified, carrying out of monitoring of a condition and the forecast of rehabilitation of the patient can be charged to the expert of social work.

The problem of powers of the social worker in sphere of protection of mental health is also very little developed. So, in the Great Britain the social service prosecutes subjects of compulsory hospitalization under social indications.

Social work in psychiatric (psychoneurological) establishment is understood as a complex of the measures directed on increase of social competence mentally of patients, formation at them the responsibility for the social behaviour, and also social protection, support of these patients and other aspects of their social rehabilitation.

Let's stop more in detail on activity of the expert of social work. In the first conversation with the patient the expert fills in a questionnaire for an estimation of social functioning and makes the diagram of quality of a life of the patient. Further there is a teamwork of the psychotherapist, the psychologist and the expert to social work by adequate techniques for the given patient within the framework of group work. Occupations (session) can 2 times a week are carried out, their duration makes 1,5 hours. Each patient passes about 10 sessions. The part of patients continues to visit occupations is out-patient also the expert of social work conducts with them occupations as clubs of dialogue, library therapy, therapies by creative self-expression, dancing and impellent therapy. Social workers in parallel conduct work with family and the nearest environment with the purpose of expansion of a circle of dialogue, improvement of attitudes with relatives who mark, that the appeared interests at patients do by their more patient, stress-steady and less disputed. Experts of social work can take part in creation of communities of relatives of patients which on a basis itself and mutual aid improve quality of a life mentally patients.

It is necessary to note, that social work is directed, first of all, on a social level of functioning of patients, and also partly and on an interpersonal level (interaction in family, on work, etc.), being crossed in this area with psychotherapeutic intervention. However, as against psychotherapy which subject of activity is experience, at realization of social work by a subject of activity event is. Social work is directed not on comprehension by the patient of the feelings, not on deployment of experiences, and for concrete ways of interaction with associates. The expert who is carrying out social work, at its carrying out remains at a level of event, a situation, social - behavioural training.

At realization of social work some directions of activity are allocated.

The first direction is a work with the concrete patient psychiatric (psychoneurological) establishments, with its concrete problems and complexities of social functioning.

The second direction is a work with the groups of patients having similar problems: the lonely patients sick, having communicative complexities, patients with the low income, patients with a deep level of mental infringements, initial conditions, invalids, etc.

The third direction is work in community: among patients of a hospital, substationary, hostels for persons with the mental frustration, lost social communications, etc.

And, at last, one more direction of activity is interaction with the state, public and private organizations, including, rendering the social help, mass media and the population with the purpose of formation of the adequate attitude to mental illness and mentally the patient.