Mental Health Directors Survey Results In August 2014 a survey of Mental Health Directors and Administrators was conducted to explore interest in and opinions about participating in the development of an online or hybrid MSW Program and to gather input regarding possible models and features of such a program. Surveys were constructed around specific content areas including MSW positions, employment and promotion capacity, field placements, supervisory availability, promotion of an online/hybrid program, and potential barriers or benefits. Surveys were disseminated via the Central Region Mental Health Directors Partnership Group to agency directors and administrators. The surveys were conducted online. Results are presented below. Sample: A total of 51 surveys were completed. Of the 51 individuals responding, 45 (88.2%) were administrators at a social service agency or facility. Of these, 30 (58.8%) were from a private or non profit agency or organization and 16 (31.4%) were from public mental health. MSW Positions: Administrators were asked a series of questions about whether they knew of individuals in their agencies and/or communities who they believed would be interested in applying to an online/hybrid MSW Program, whether they had job positions in their agencies for MSWs, and whether they would be interested in offering support to their employees trying to gain an MSW degree. Approximately half of the respondents indicated they knew of individuals who would be interested in applying to an online/hybrid MSW program, in both their agencies (52.9%, n=27) and their communities (45.1%, n=23). Questions were included to estimate the number of interested individuals. Responses varied widely, with a range of 0 25 for agency employees and 0 6000 for community members, limiting further analysis regarding these questions. The vast majority (82.4%, n=42) of survey respondents indicated that they did have MSW level job positions in their agencies. Estimates of the number of job positions ranged from 0 500. In addition, 70.6% (n=36) indicated they would be interested in offering support to employees trying to gain an MSW degree. Employment and Promotion Capacity: Directors and administrators were asked a series of questions about employment and promotion capacity in their agencies. Two thirds of respondents (68.6%, n=35) indicated there were advantages (promotion, salary, etc.) in their agencies for staff to obtain an MSW degree and over three quarters (78.4%, n=40) indicated they would support employee promotion to positions commensurate with their highest degree. Participants were asked if they would be willing to provide staff with flex or release time to participate in an MSW Program during normal work hours. Participants were divided, with 45.1% (n=23) saying they would, 17.6% (n=9) saying they would not, and 31.4% (n=16) saying they were not sure. Several participants provided comments which indicated that this was not a common practice or that it had not been done in the past, but that it might be possible. Two thirds of participants (66.7%, n=34) were sure, however, about offering in agency learning experiences, with several stating they were 1
open to varied internship arrangements such as out of class assignments or internships in separate parts of the agency. Field Placements: Participants were asked to estimate the availability of field placement (internship) sites for MSW students in their agencies and communities using categories of 0, 1 5, 6 10, and over 10. Two thirds of respondents (64.7%, n=33) indicated there were 1 5 possible field placements in their agencies. Respondents were less sure about their communities, and the most common answer about the number of field placements in their communities was that they did not know (45.1%, n=23). Another 15.7% (n=8) indicated there were 1 5 field placements in their communities and 27.6% (n=15) indicated there were over 10. Respondents also estimated the number of agencies in their communities providing behavioral health services. Nearly half, (47.1%, n=24) indicated there were over 10, one quarter (25.9%, n=11) indicated there were 1 5, and 15.7% (n=8) did not know. As the survey was intended to gather input and opinions about 2 separate models of field practicum, participants were asked specifically about whether they would be willing to discuss or consider summer block internship placements of full time for 3 months and whether they would be willing to discuss or consider cooperative placements with other community agencies outside of their organizations (i.e. job swap; employee off site location, etc.). Results were mixed, with a considerable number of respondents not sure about these placement alternatives. The number and percent of respondents answering in each answer category (Yes, No, Not Sure) is presented in Table 1. Table 1: Placement Consideration Yes No Not Sure Are you willing to discuss/consider: n % n % n % Block summer placements. 22 43.1 10 19.6 12 23.5 Cooperative placements with other community agencies. 22 43.1 2 3.9 22 43.1 In addition to being asked whether they would discuss/consider block placements or cooperative placements, participants were invited to provide comments about each of these areas. Most respondents did not include open ended comments, but those who did provided both things to consider and areas of concern. In the area of Block Placements, concerns were primarily related to the length of time cases remain open in mental health and to the cost of releasing an employee from a work assignment for 3 months. In the area of Cooperative Community Placements comments indicated interest in this as a possibility. All narrative comments are provided unedited in Table 2. 2
Table 2: Participants Comments Regarding Block Placements and Cooperative Community Placements Considerations: Concerns: Block Placements Not sure if our county HR would allow this, but we would work with a program, yes. It is possible. We currently work with CSU, Fresno with placements for CWS. County BHS is a great opportunity for internships providing a wide variety of observation and participation in multiple areas from children to adult services, field work, case management, recovery services, etc. County BHS also provides excellent clinical supervision and direct supervision. Before an internship can begin, the County requires an MOU which is a lengthy process with the placing agency prior to the internship. Also, the County also requires a background check which we pay for and volunteer orientation. I like the summer block option, as we currently lose our interns in the summer. It would depend on what kind of internship that was being offered. If we have a project that needs completing I would consider that. The amount of training involved means they would probably need to plan on continuing their training. Emphasis would be limited by placement length, thus crisis, case management (FSP) support and community development, groups, plan development. Need more involvement from the students over time. 3 months isn't long enough particularly with acclimating the student to both the agency and the county process. Three months is too short. If they are to see clients, their placement would likely be over before they were finished with client. As we work from a mental health perspective it would be difficulty to have someone come in and just work for a few months and then leave. Our families are usually with us longer than 3 months. Changing service providers can be disruptive to treatment. Our placement works better for a longer period due to continuity of care with our clients. It would be hard to start therapy for clients and then have to terminate services in just 3 months. In a large mental health system ( and for any clinically meaningful placement) 3 months is barely long enough to get comfortable in the work setting, start to develop professional relationships and is too short to learn beginning, middle and end phase therapy skills. I supervise a school based program and summer is usually the slowest time of the year. Not sure I would have enough work for a full time student. A three month internship does not seem to be in the best interest of the student, client, or agency. That's a really short placement. Longer is better. If full time, it may be difficult to keep existing staff on paid status on a summer 3
block internship placement. This is too costly. Either we have to pay for a temp worker to fill or other staff have to pick up the slack. It would be more difficult to manage if this is for an employee. Considerations: Concerns/Questions: Cooperative Community Placements We only have one community agency that might be able to accommodate this. In the past, County BHS provided the clinical supervision for students at related organizations, but it is rare and needs to be approved by administration. When that can be done, it allows the community placements that would otherwise not be available since a licensed clinician can provide supervision. Cooperative placements are more difficult to arrange due to the county limitations. Yes especially if working in the area of integrated health care at a clinic site. I think this option would be a better learning experience. Unsure of what this would look like This might be interesting but I would need more information. Would need more information I'm just not sure how a student had learn the skills needed for social work in an online environment. This really concerns me. Supervision Availability: Respondents were asked about the capacity to provide supervision to field internship students. Most respondents felt that they could provide supervision within their agencies, with 66.7% (n=34) indicating they had 1 5 MSWs available to provide supervision and 10.3% (n=4) had over 10. Nearly 10% (9.8%, n=5) indicated they had no MSW supervisors available in their agencies. In addition, 23.5% (n=12) of respondents indicated there were over 10 MSW supervisors available in their communities, and another 5.9% (n=3) indicated there were 1 5. Half of respondents (54.9%, n=28) indicated they did not know if there were MSW supervisors in the community. Respondents were also asked if they would be open to discussing flexible supervision options in order for staff to participate in and online/hybrid MSW Program. Nearly two thirds (62.7%, n=32) indicated that they would, 3.9% (n=2) that they wound not, and 23.5% (n=12) indicated they did not know. Promotion of Program: Directors and administrators were asked a series of questions related to promotion of an online/hybrid MSW program. They were asked if they would support employees enrollment in such a program, Central Region financial assistance, or the program, itself. They were also asked to identify the types of support they envisioned providing. In the area of providing support for employees to participate in an online/hybrid MSW Program, 41.2% ( n=21) indicated they would provide supports, 9.8% (n=5) that they would not, and 39.2% (n=20) that 4
they did not know. For those who indicated they would provide support, the most common type was flex time (45.1%, n=23) followed by unpaid time off (31.4%, n=16), local financial incentives (25.5%, n=13), and paid time off (15.7%, n=8). Additionally 17.6% (n=9) indicated they would provide an other type of support, and identified modified work schedules, paid placement, use of vacation time, educational leave, tuition reimbursement, and paying for supervision as types of support they would provide. When asked if they would support the Central Region Partnership group providing financial incentives to students in an online/hybrid MSW program, 58.8% (n=30) of respondents indicated they would, 13.7% (n=7) that they would not, and 17.6% (n=9) that were unsure. Of those who indicated they would support this, 60.8% (N=31) would support offering stipends to students, 58.8% (n=30) would support loan assumptions, 54.9% (n=28) would support scholarships, and 5.9% (n=3) would support other mechanisms such as paid internships. In addition one person indicated that he or she believed there should be additional financial incentives for any person with lived experience who is pursuing a higher degree. All participants were asked about their own interest in supporting an online/hybrid MSW Program by participating in the development or operations of such a program. One third of respondents (35.3%, n=18) indicated they would be interested in this, 21.6% (n=11) indicated they would not, and 29.3% (n=15) were not sure. For those who were interested in participating in planning and advising activities with the MSW Program, over a third were interested in promoting the program in their agencies (39.2 n=20%), joining an advisory group for the curriculum (37.3%, n=19), or joining an advisory group for student admissions (33.3%, n=17). Another 21.6% (n=11) would be interested in hosting a recruitment meeting. Barriers and Benefits: Finally, directors and administrators were asked a series of open ended questions about potential barriers and potential benefits of developing an online/hybrid MSW Program and about other issues that should be addressed or that they would like to know about. Extensive comments, which will be very useful to ongoing program development around a potential online/hybrid MSW program, were provided. All narrative comments (unedited) to each of these questions have been compiled, and are included in this report as Appendix A. 5
Appendix A: MH Directors/Administrators Narrative Comments by Question What are the Potential Barriers? Finding qualified supervisors who programs will allow (if they are not MSW's). For Frontier counties, the distance for travel can be a barrier; especially if the student needs to pay for their own lodging and gas. If students are requiring more supervision than their agency can provide. The complicated boundary of being a student and an employee at an agency. Coordination with CSU System. County MOU and administrative requirements. Rural counties don't always have home access to internet, important that assignments and access be flexible. Interactive limitations of a "virtual" campus for developing networking and relationships with classmates and instructors. Accreditation issues. Would the MSW program be accredited so as to allow its graduates to take the LCSW exam? Starting an online curriculum is significant work, let alone finding professionals willing to teach. One of my experiences with professionals who have on line degrees in the mental health field is the lack of time in the field placement often only a couple of months. When I received by MSW years ago I had two significant placements for extended periods. In all my years I have yet to meet a graduate from an online mental health program that outshines one who went to a school based one. Practicum sites. For our agency, it would be inability to redirect staff requirements due to funders expectations (grant requirements) and too short of internship; this would not be beneficial to clients or the student. Evaluating the extent of learning achieved by each student through online education; lack of classroom structure and shared learning with other cohorts in the program. Limit the time away from office, (in house placement). I'm concerned about the integrity of graduate social work education when it's done online. Supervision from a LCSW. Lack of LCSWs available within our own organization for supervision Learning in this field takes place through processing and interacting with others to hear of their experiences. The importance of diversity education in the classroom. I foresee difficulty in comparing on online/hybrid program to a 16 week classroom curriculum. Financial usually. I think it has been frustrating for individuals who are already working in the field to have to do internships and I think that there should be a way to use your existing position to fulfill the internship requirements. Experience is very important and the MSW requirements don't seem to value work or lived experience as a part of the educational process. The major barrier would be cost for the potential student for the program and the potential loss of income if a full time employee. 6
Lack of supervision. Very concerned that there would be limited classroom time and limited internship time. This is a social profession, with specific values. Social work is not a trade where simple skills can be learned and then applied. The possible types of interaction with clients are endless and exposure to the instructors, to the other experiences that the other students are having, and clinical supervision are essential to the "art" aspect of therapy and social work. In my experience about 50 percent of the students graduating from MFT programs such as University of Phoenix and National are of the clinical quality I expect. As an LCSW I worry that my profession could be "watered down" by programs offering to provide content for the sake of graduating students with very little emersion into the learning and high educational expectations. If your students are on a clinical track, being supervised by a licensed MFT should be an option. Only emphasized if on the clinical track though, this for us makes it difficult to bring on MSW students from some schools. Without the class room environment you are unable to see the true person/student. As a result people whom may not be eligible in a traditional format for social work will now get accepted based on the base writing presentation. Kind of like social media a person can present one way on Facebook but is totally different in person. What is the cost of the program? People's first commitment will be their jobs so you will need to offer some flexibility in how people attend courses, etc. Students would need to understand it would still be a rigorous program requiring appropriate attention and study time. All community mental health programs have very demanding billable requirements which make staff time rather restricted and challenging to flex. However, we would be open to ways to overcome this barrier and will be willing to help and support the process and consider part of our mission to grow professionals in the community. Staffing issues. Flexible work schedule, program length, amount of homework and hours. The importance of adequate field placements. What are the Potential Benefits? Developing home grown work force. We are interested in this program in order to continue to develop our young Latino staff so that they can move up the career ladder and provide excellent services from a bi cultural perspective in their native language. More MSW's in the field and in specialties that need them. Collaboration with CSU System. Increased availability of licensed therapists and staff available to county BHS. There has been a shortage of therapists in rural areas. Ability to pursue degree without excessive travel; ability for persons with families to pursue education while still working and being with family. The obvious ease of access, time flexibility and perfect for those students that are selfmotivated and self directed. More professionals in the work force. 7
May be able to offer education to those who are unable to attend a school setting and provides another alternative which may be more helpful for some students' learning style. Potentially increases the interest to pursue MSW career. A widely more distribution of MSW students who would have an opportunity not available to them prior to, locally. More access to graduate education to students otherwise unable to receive it. More qualified social workers would be wonderful, especially in our Foster Care/Adoption program. We are finding it more difficult to find MSW level employees. We have several staff that are trying to determine how to attain an MSW. They are valued staff and we would like to assist in their development. I believe that there are enough MFT programs available to meet the current need in our community. More opportunity for people to obtain the MSW. I think it would be beneficial to have programs for people who need to work to advance their education. I think it may improve the quality of services being provided and increase the pay equity for the mental health system. I think, additionally, it would give people more opportunity for advancement and promotion within the mental health field. I like the idea of providing working professionals the flexibility to complete this degree on line. However, I am glad to hear and think it should be mandatory to have face to face classroom time due to the nature of our profession (being and working with people). The online program would offer potential students an opportunity they might not otherwise have at a regular university. Also, it allows students flexibility with having classes that can work around the demands of their daily lives. There are employees, many with more maturity and commitment, who have clearly thought out their choice to become social workers who because of the phase in life are unable to quit work to attend school in a traditional environment. These staff have experience and commitment and would be excellent practitioners. Flexibility is important and worth looking at but I worry about jumping from full time on campus programs that could be more flexible by offering year round classes or a 4 year or more program that allows people to work...to an online program where you study one or two classes for 8 weeks and meet as a group once per month with only three months for internship. We had year long placements at 10 hours per week the first year and 20 hours per week the second year and that is much different than a three month internship. Offer many an opportunity to work at their pace and to have alternative learning hopefully at a lower cost. People needing to work to support themselves and their families but wanting to further their education and advance their careers. Can be done at night, on your own time. Flexibility and outreach. What are Other issues to address? Bi lingual, Bi cultural outreach and education in Spanish. Opportunities for them to pursue internships and begin collecting hours once they have completed the MSW program. 8
Although I understand you must start with one program such as MSW, why aren't you considering an online/ hybrid LPCC and MFT program also? BHS has more MFT's employed than LCSW's. I would like to see an LPCC and MFT program offered. Supervision requirements and internship requirements. Curriculum, interaction with professors, interaction with peers. Field work placement. The cost of the program. There are other programs but they seem prohibitively expensive in relationship to the pay equity for the field. Definitely develop an internship program as part of the program. Equipment, security, practicum. Quality of instruction and prepping for the real world of working with hurting people every day. What else would you like to know? Can't think of anything at this time. Everything. Has this been thought through? How many students would be in the program, who would teach the classes, what funding sources will be used to support the program? My organization would be interested in participating in an internship program to help students get some experience and hours. Unsure why this would not include MFTs for this possible program or similar program for MFTs. 9