ABSTRACT
Most hospitals in Nigeria lack to look the patient with multifaceted perspective. Social worker provides services to meet the needs of individuals, communities and society. Therefore, the main objective of this research was to assess and explore the Importance of social workers in the Yaba Mental Health Hospital (YABALEFT). Qualitative research approach particularly a case study research design was used. A total of 355 participants were selected from office of which five social workers and ten from the staff members by using purposive sampling. In-depth interview with the social workers and other informants and observation were used to collect data for the study. The data were analyzed by triangulation technique, to create a meaning from qualitatively generated data.
The findings of the study shows that, the social workers of the hospital worked at varied level in line with the standards stated on the NASW Standards for Social Work Practice in Health Care setting (2014). Concerning their main importance of social worker in the center, the social worker provided both stated in their job description and outside their job description. However, the study identified that there is a limitation on the presence of an organized and scientifically based job description. According to one of the major findings of this particular study, social workers in the mental health hospital faced various challenges. Most of the challenges were related to the lack of awareness about social workers importance, office problem and lack of office facilities. Moreover, the social workers use different mechanisms to overcome those challenges such creating awareness and develop rapport with the staff. The implication of the research aim at the implication of applying the main standards of social work practices in the health care settings in the hospitals throughout the country effectively and consistently. The study recommends that the rehab center should give attention for the staff of social workers and their activities.
CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Mental ill-health refers to mental health problems, symptoms and disorders including mental health strain and symptoms related permanent and temporary stress. Mental health is crucial to the overall all well beings of individuals and societies. Relative poverty, low education and inequality in the country associated with an increased risk of mental health problems. Mental, neurological and substance use disorders are also linked with many mental disorders related problems (WHO, 2004).
According to WHO, mental and neurological disorders account for 13% of the total Disability Adjusted Life Years (DALYs) lost due to all diseases and injuries in the world. By the year 2020 neuropsychiatric conditions will account for 15% of disability worldwide, with unipolar depression alone accounting for 5.7% of DALYs. Thus, there is a need for prevention and promotion of mental health at the level of policy, legislation and resources allocation. Over half centuries World Health Organization (WHO, 2004) defines Health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” Besides, Mental health defined as „a state of well-being in which the individual understands his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community (WHO, 2004,p.79).
The social work profession promotes social change, problem solving in human relationships and the empowerments and liberation of people to enhance wellbeing utilizing theories of human behavior and social systems, social work intervene at the points where people interact with their environment principles of human rights and justice are fundamental to social work (IFSW ,2001). This skilled activity shows how social work skills and interventions can be used in practice to enhance our effectiveness and helps bring about positive outcomes from human being (IFSW, 2001).
Mental health is the capacity of the individual, the group and the environment to interact with one another in ways that promote subjective well-being, the optimal development and use of mental abilities (cognitive, affective and relational), the achievement of individual and collective goals consistent with justice and the attainment and preservation of conditions of fundamental equality (IFSW 2001). Moreover, Mental Health consists of the following themes which includes psychological and social harmony and integration; quality of life and general well-being; selfactualization and growth; effective personal adaptation; and the mutual influences of the individual, the group and the environment (WHO, 2003). Mental illness is one of the most disturbing illnesses that anyone could get in their lifetime. Collective health condition does not solely rely on one‟s physical, emotional, and spiritual health but also on their mental health. A mental disorder or mental illness is a change in an individual‟s way of thinking and feeling that impedes their ability to perform their daily activities, cognitive, emotions or behavior (IFSW, 2001).
The importance of social work are consistent with the goals of the professions of social work and include helping patients problem solve and cope with life stressors; linking individuals with resources, services, and opportunities; promoting effective and humane service systems; and developing and improving social policy (Gambrills,1999, p.27).
One of the key importance that social workers serve in an inpatient rehabilitation setting is as a patient advocate. The importance of helping the patient understand and adjust to hospital procedures, understand medical plans, and assisting the patient‟s family with financial planning is crucial.
The social worker‟s role as an advocate also includes maintaining open lines of communication between the patient, family, and other members of the health care team. He or she also will learn each family‟s dynamics while understanding its strengths – and encouraging the use of these strengths (IFSW 2001). In addition to advocacy work, social workers also help people solve problems in their daily lives. They may assist those who are adopting a child, fighting an illness, or facing an addiction. They help protect abused or neglected children, deal with behavioral problems in schools, and help hospice patients adjust (Mphelane, 2006;)
The development of mental health services and service provision centers goes in opposite to developed counties for developing countries. Nigeria is also the multicultural state with the large number of population in Africa, but it has very small numbers of social workers, in hospitals and hospitals, social workers help patients to become familiar with the hospital environment, cope with the challenges they face, and facilitate the whole treatment process and contribute to their well-being. This shows that the care social workers and the hospital institution provides to patients is multifaceted (Hiwot, 2014).
Social workers are also essential members of interdisciplinary hospital teams. Working in concert with doctors, nurses, and allied health professionals, social workers sensitize other health care providers to the social and emotional aspects of a patient‟s illness (Alemayehu N. 2009 p.23). The importance of social workers in hospitals are broad ones. However, Mental illnesses have given little attention among the scholars and the working centers. Hospital social workers use case management skills to help patients and their families address and resolve the social, financial and psychological problems related to their health condition (Yitbark, 2012).
It is the social worker‟s responsibility to reserve their profession and undeniable contribution in hospitals and health care settings. Since social workers make a great effort for the wellfunctioning of the society, it is very essential for the society to understand their importance especially in the health care setting (Judd and Sheffield, 2010).
To the best of my knowledge, there have been very few studies conducted on the areas of Mental health disorder in Nigeria. This research tried to assess and explore the Importance of social workers in the hospitals. My interest emanated from my field work practice for the courses of practicum I and II in this hospitals. Moreover, my field work practice in the hospital for the course practicum motivated to work on this area; and the researcher observed the challenges that social workers face in the hospitals.
1.2 Statement of the problem
Social worker activities occur in many settings. In order to provide effective services, Health social workers need to be aware of these factors that working at different setting. Therefore, Social workers who operate in variety of environment assume various importance to do in the design, delivery and evaluation of care (Browne, 2012). According to the guide of social worker‟s professional to practice in hospitals (NASW,1999), there are a numbers of factors that affect the role of social workers played in hospital setting. Some of these factors were including factors related to the organization and operation of the hospital system and the way in which work is organized within a hospital. In addition, the importance of working in an interdisciplinary context was also stated clearly in the guide of social worker (NASW, 1999). However, the importance of social workers in mental health care have got little attention. Burtland tried to explain (2001), regarding to mental health policy more than 40% of the countries have no mental health program. According to WHO (2001), it is only after the development of publication of world development report, disability adjusted life year for estimating the global burden of disease and other emerging scientific investigations, the burden of mental disorder come in to great public agenda. Thus, currently the effect on mental disorder on various economic and social aspects are becoming highly the research area (WHO, 2001).
In Nigeria, there were very limited research papers on the area of mental health problems. The work of Ababi(2008) was focused on the economic problems of schizophrenia and bipolar disorders in the rural Nigeria. As to him the total direct cost of Nigeria because of schizophrenia and bipolar disorder is approximately from $687, 390.69 to $3.23 million and from $39.1million to 113million respectively. Thus, the research found that the challenges of mental illness on care givers as multifaceted problem to the society.
According to Rahel (2014), she conducted qualitative research with a purpose of identifying the practices of health professionals in medical social work at Menelik II Hospital. She found that health professionals have poor understanding of the medical social work practice within the health facilities and no involvements of social work practices with in their day to day activities. In her study, she indicated that there should be a medical social work interventions and establishment of the department of social work in the health care institutions (Rahel, 2014).
However, she didn‟t see the importance of social worker and their interventions in the area of mental health rehabilitation. Thus, this research tried to see the gap that is not addressed in her paper and the real practices of social workers in mental health settings.
In the similar ways, Hiwot (2012) tried to explore the role and challenges of social work in selected hospitals in of Addis Ababa. The research finding showed that social workers played a role of facilitating the services for the poor individuals. She tried to identify whether the direct patient care importance and indirect patient care importance were practiced or not. According to her, both patient care importance performed by social workers fulfilled the criteria‟s of the services, but her research is totally missed the major importance of the social workers in health care setting. Even though, it was a good start to see the actual and expected importance of social workers in hospitals, there is a gap in assessing the major Importance in the case of mental health hospitals.
Yitbarek (2015) tried to explore the challenges of Yaba mental health hospital as the only hospital next to Amanuel Mental Specialized Hospital (AMSH). He identified various challenges of the rehabilitation services in the center; however he didn‟t explain the works of social workers in the hospital. Thus, this research paper interested to explore the Importance of social workers in this hospital. According to Alemayehu G. (2005) who conducted research at institutional level on assessment of the prevalence, determinants and effects of mental disorder among Haromaya University students which provided a great role in the field of study of mental health. The finding of this research shows that the prevalence of mental illness among the university students is 19.3%. The study implies the cooperative work of health social workers with the community. From the findings the Importance of social workers didn‟t get attention.
In 2014, a position paper was prepared by the Australian Association for Social Workers Queensland Branch (AASW) with a purpose of developing a position statement in relation to social work‟s distinctive contribution to the contemporary health care system. The goals of this position paper are to identify the key and unique value that contemporary social work practice contributes to achieving effectiveness and efficiency in improving health outcomes for patients accessing health services; and to demonstrate the contribution that social work makes to providing patient-centered models of care (AASW,2014). This study also tried to give a brief insight into the main importance of social workers in mental health rehab center of Yaba and explore their contribution to the improvement of mental health outcomes.
Therefore, this planned study is designed to fill the gap of understanding and to clear the confusion on the importance of social worker in Yaba mental health rehab center and to produce the first systematic evidence on the Importance of social workers.
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