I am at the beginning of my PhD journey as I began in April this year.

Transcription

1 Introduction I am at the beginning of my PhD journey as I began in April this year. My topic is Mapping the Experience of Queensland Social Workers Living with a Mental Illness. I d like to share with you how this topic came about. I live with bipolar disorder and on occasions I have shared with social work colleagues that I live with a mental illness. I have been amazed at the number of times that the colleague I was speaking with has looked over their shoulder and whispered back So do I. This led to a keen curiosity about social workers and their mental health and my knocking on Professor Bland s door wanting to study this further. My literature review is at the embryonic stage, but I am yet to find a comprehensive study of this topic. There are some studies on the mental health of social work students but very little on qualified social workers. 1 Consequently, the research problem that underpins my proposed study is the lack of knowledge about how mental illness impacts on the social work profession. Like every other section of society, we know that a proportion of social workers will experience mental illness. What we don t know is how having the illness changes the way they work. The other significant factor in examining the mental health of social workers is work-related stress. Social work is an inherently stressful occupation given large caseloads, limited resources, competing demands, dealing with conflict and dealing with complex situations. Other stressful occupations, such as doctors and lawyers, have had their mental health and its impact on their practice studied comprehensively. 2 So why is there a lack of knowledge about the mental health of social workers? Part of the answer is the stigma associated with mental illness, which makes social workers less likely to openly discuss their mental health problems and to participate in research and discussions about how it impacts on their practice. As Repper and Perkins state, The label of mental illness has been associated with a number of undesirable characteristics such as dangerousness, unpredictability and incompetence. 3 These are the very associations that social work practitioners wish to avoid. In trying to redress this lack of knowledge there are four underlying questions that I want to consider: 1) How do social workers experience mental illness? 2) Is this experience different to other occupational groups? 3) If there is a difference, to what extent is this related to social work training and experience? 4) How has their experience of mental illness changed the way they practice? As the proposed study focuses on subjective experience I plan to use a qualitative methodology, namely semi-structured interviews. Again, because of the focus on lived experience, the recovery model will form part of the theoretical underpinnings of the study. The interviews will largely consist of the participants sharing their story. However, from my personal experience, discussions with colleagues, and early reading, there are some particular factors that, at this stage, I would like to draw out from their lived experience.

2 These factors fall under the headings of: 1) the recovery model 2) the interplay between a social work career and having a mental illness 3) workforce participation and career progression 4) the role of line management and supervision Recovery Model The recovery model enters the analysis in this thesis at two levels. First, as the model that largely motivates the research questions being pursued and second, participants will be asked about their understanding of the model and the extent to which it has informed their understanding of and approach to dealing with their mental health. As the recovery model is forming part of the theoretical framework of the study and is a major paradigm in the current understanding of mental health it is important to know to what extent the participants are familiar with the model and what is their understanding of the model. The theoretical literature reveals a large range of variations in the model. The most common aspects of the personal recovery journey seem to be redefining a sense of self, renewing hope, making sense of the experience of mental illness, having meaning in life including purpose and goals and resuming control and responsibility over one s life. 4 With regard to redefining a sense of self I would like to investigate how having a mental illness has changed the participant as a person e.g. Priorities Values Self image Social roles Life purpose and goals In regard to making sense of their experience I would like to ask How has their experience changed the way they perceive mental illness? Language used to describe it Theoretical view e.g. physical illness, spiritual or cultural phenomenon, existential crisis What meaning or understanding have they attributed to their mental health event? When considering resuming control and responsibility I would like to discuss 1) To what extent would they say they are in control of their treatment and recovery journey? What factors have influenced this state? 2) What experiences were helpful/unhelpful in their journey and why?

3 3) Did they have professional help on their journey? Were the professionals aware of the recovery model/did they use it? To what effect? What other techniques did they recommend/use and to what effect? 4) Did they access support through mutual self help or peer support from others with a lived experience of mental health problems? To what effect? Hope is a vital element of recovery and I would like to include discussion about the participant s dreams, goals and aspirations for the future. Another important element of recovery is not just recovery from the illness but recovery from the consequences of mental illness. 5 These include stigma, social isolation, difficulties with finances and housing and relationship problems. It would be important to know to what extent participants experienced these consequences and what strategies they used in dealing with them. Participants would be familiar with such issues from their own practice and it would be important to consider how they felt about experiencing such issues in their own lives. Which leads to The interplay between being a social worker and having a mental illness This relates to the question of whether social workers experience mental illness differently to other groups and /or professions. Does being a social worker affect the way an individual experiences mental illness? Eg with regard to mental health is being a social worker a protective factor, an unhelpful factor or neither? Does their social work training and experience influence the strategies and services they use to deal with mental illness? Do the skills learnt in social work act as a buffer against mental illness or is the experience of illness so disabling that they are unable to access those skills? I would also like to discuss the experience of moving from being a service provider to a service user or vice versa. If the mental health condition developed after they become a social worker, I would like to discuss how the experience has changed their practice. If their mental health condition occurred before they became a social worker, I would like to discuss to what extent it influenced their decision to become a social worker, what were they hoping to achieve by becoming a social worker and to what extent have they achieved this? Has their social work training and experience changed the way they approach having a mental illness? Part of the literature review will be looking at studies of other professions and mental illness which I hope to compare with the findings of this study.

4 Workforce Participation and Career Progression This is a topical issue as the House of Representatives Standing Committee on Education and Employment is conducting an inquiry into mental health and workforce participation. It will be interesting to compare their findings regarding the general population with those specific to social work. We know the importance of employment in maintaining the mental health and social wellbeing of the individual and we know of the financial and social benefits to the wider community. Within the recovery model employment is a significant part of regaining purpose, meaningful activity and social roles. It would be important to know what percentage of participants have left the social work profession; to what extent did mental illness cause them to leave the profession and do they see themselves returning to social work in the future? Other questions would include: 1) Have they had to take leave from work due to mental health issues and how supportive has the employer been in regard to this? 2) Have participants had to change the nature of their work due to mental illness? For example, the number of hours worked, type of duties, pay level. How has this impacted on their view of themselves and their future? 3) Do they think their mental health problem has affected their career progression? 4) Social work is an inherently stressful occupation. To what extent have their mental health concerns been caused by work-related stress or exacerbated by work-related stress? 5) Are they a sole practitioner and what impact has this had on their mental health? 6) Do they practise in a rural/remote area? What impact does this have on their mental health and access to mental health services? It can be very difficult to seek assistance as a professional in a small community. 7) Have they experienced any barriers in returning to work? Line management and Supervision It would seem sensible that good line management and supervision would contribute to staff retention in the event of mental illness. If supportive, these relationships could greatly contribute to recovery. Mancini s study found that compassion, self determination and supportive relationships were identified as the most critical components in the recovery process. 6 I would like to investigate this issue and that of disclosure. Has the participant disclosed the illness to their line manager or supervisor? If yes, what was the response? If no, what prevented them from disclosing? Have they disclosed to other colleagues and how was this received?

5 With regard to supervision, the frequency and perceived quality of supervision would be considered. Participants would also be asked how helpful supervision has been in managing work-related stress and maintaining employment. Sourcing Participants Participants must be eligible for membership of the AASW and reside in Queensland. To source participants I plan to send out information through the AASW and other social work networks and then interested people can contact me. If you are aware of any social work networks in Qld I would very much appreciate the contact details. My is kim-marie.mortensen@bigpond.com Ethics With regard to ethics the project will be assessed by the University of Queensland Ethics Committee. The participants will be voluntary and self selected. They will be advised about the issues to be addressed in the study and will need to give informed consent to participate. They can withdraw from the study at any time. Confidentiality All personal information will be confidential and will not be published. Identifying information such as age, gender, location and position title will be reported as groups to maintain anonymity. Data collected will be collapsed into themes not presented as individual case studies. Interviews will be conducted on a one to one basis. Once the interviews have been transcribed they will be sent to the participants for correction and provision of any extra information. Risk to Participants Participants will be advised prior to the interviews that they are likely to take several hours and may raise highly emotive issues. Levels of fatigue and emotional distress will be monitored throughout the interview and participants can pause or withdraw at any point. In my social work career I have worked in crisis situations and mental health. In my private life I act as a mental health mentor. I am experienced at responding to strong emotions on a one to one basis.

6 Summary My plan is to redress the lack of knowledge about the mental health of social workers and its impact on their practice by conducting in-depth interviews with Queensland social workers who, for the purposes of the study, identify as having a mental health problem. 1 Collins S, Mental health difficulties and the support needs of social work students : Dilemmas, tensions and contradictions Social Work Education v25n ; Horton EG, Diaz N, Green D, Ali A Mental health characteristics of social work students: Implications for social work education. Social Work in Mental Health 2009 v79n ; Lemieux CM, Plummer CA, Richardson R, Simon C Mental health, substance use and adaptive coping among social work students in the aftermath of Hurricanes Katrina and Rita Journal of Social Work Education 2010 v46 n ; Collins S, Mental health difficulties and the support needs of social work students : Dilemmas, tensions and contradictions Social Work Education v25n Brain and Mind institute Courting the Blues: attitudes towards depression in Australian law students and legal practitioners University of Sydney 2009; Hickie, I. The mental health of Australian lawyers : A challenge for the law schools and the profession Brain and Mind Institute, The University of Sydney 2008; Riley,J. Mental Health and Employment: Issues for Lawyers University of NSW Law research Paper no ;Mental health and ill health in doctors Department of Health (United Kingdom) February 2008; Caplan, R.P. Stress, anxiety and depression in hospital consultants, general practitioners and senior service managers British Medical Journal 1994 n ; Pilowski,L and O Sullivan,G. Mental Illness in doctors British Medical Journal 1989 v Repper,J and Perkins,R. Social Inclusion and Recovery: A Model for Mental health Practice Bailliere Tindall Edinburgh Davidson L, O Connell M, Tondora J and Lawless L Recovery in Serious mental Illness: A New Wine or Just a New Bottle? Professional Psychology: Research and practice 2005, v36, ; Davidson L Living Outside Mental Illness. Qualitative Studies of Recovery in Schizophrenia New York University Press New York 2003; Deegan P.E Recovery; The Lived Experience of Rehabilitation Psychosocial Rehabilitation Journal 1988 v11 n Anthony W, Cohen M, Farkas M, Gagne C Psychiatric Rehabilitation (2 nd edition) Center for Psychiatric Rehabilitation Trustees of Boston University Boston 2002 p100; Deegan P Recovery as a Journey of the Heart Psychiatric Rehabilitation Journal 1996 v19 n3 p96. 6 Mancini M.A, Hardiman E.R and Lawson H.A. Making Sense of it All: Consumer Providers Theories About Factors facilitating and Impeding Recovery from Psychiatric Disability Psychiatric Rehabilitation Journal 2005 v29n1 p54.