Abstract: The paper is focused on the preparation of university students for work with people with mental disorders. The aim of the research was to determine on what to focus in the forming of university social work students for work with people with mental disorders. We have conducted the research in the qualitative methodology. The research set consisted of 18 Slovak and Czech organizations or services, which are primarily focused on work with clients with mental disorders. The results describe the necessary professional and personality prerequisites, as well as the need for practice.
Key words: Mental disorders. Professional prerequisites. Personality prerequisites. Forming of students. Social work.
Introduction
Social work, as a helping profession, plays a key role in the support of individuals with mental disorders, their families and the broader community. The increasing occurrence of mental disorders, change of societal perception of mental health and the need for multi-disciplinary cooperation increase the demands for professional preparation of future social workers. Therefore, forming of social work students must be a systematic process, which includes not only theoretical knowledge, but also the development personal competences, soft skills and the ability to reflect on own attitudes towards mentally ill clients.
Work with people suffering from mental disorders represents a specific area of social work, which requires sensitive balancing of professional principles and a human approach. Students, who are preparing for this profession, face the challenge to understand the complexity of mental disorders - their biomedical, psychological and social dimension.
1. People with Mental Disorders as Clients of Social Work
According to the WHO, health is the state of complete physical, mental and social wellbeing, not only the absence of a disease. This definition does not follow the exclusively objective health indicators; it also relies on the subjective perception of health by the individual. The disadvantage is the indication of an ideal state, rather than an exact and formal definition of the term (Hegyi et al., 2011). Health is the result of relationships between the human organism and the determinants of health (Behunová, Rabenseiferová, Šuvada, 2021). It is the result of the relationships between the human organism and social-economic, physical, chemical and biologic factors of the life environment, work environment and way of life (Act 596/2002). Health represents a set of skills of the person to handle the demands of the internal and the external environment (Bočáková et al., 2021).
Mental health can be understood as the absence of mental disorders, which is the narrowest understanding and corresponds to the possibilities of psychiatry and primary prevention. Mental health can be understood as the ability to overcome even excessive stimuli of the internal and the external environment and respond to the adequately. This understanding exceeds the possibilities of psychiatry, because the care belongs not only to medicine, but also to other humanitarian sciences. Mental health can also be defined as the state of balance between the individual and the surrounding world. Health and illness are only a part of his existence. Care for health belongs to the health care services only secondarily, because primarily, it belongs to the whole society and each individual individually (Kafka et al, 1998).
The International Classification of Diseases classifies Mental disorders and behavioral disorders into the following groups: F00-F09 Organic mental disorders, including symptomatic (dementia in Alzheimer’s disease, dementia in Parkinson’s disease, delirium caused by alcohol or other psychoactive substances,..), F10-F19 Mental and behavioral disorders caused by the use of psychoactive substances (mental and behavioral disorders caused by the use of alcohol, opiates, cannabinoids, sedatives or hypnotics, cocaine, hallucinogens, volatile solvents,..), F20-F29 Schizophrenias, schizotypal disorders and delusional disorders (schizophrenia, schizotypal disorders, delusional disorders, schizoaffective disorders,..), F30-F39 Emotional disorders [affective disorders] (mania, bipolar affective disorder, depressions,..), F40-F48 Neurotic disorders, stress-related disorders and somatoform disorders (phobic anxiety disorder, anxiety disorder, obsessive-compulsive disorder, acute stress reaction, post-traumatic stress disorder, dissociative disorders, somatoform disorders,...), F50-F59 Behavioral disorders with bodily disorders and factors (eating disorder, non-organic sleeping disorder,..), F60-F69 Disorders of adult personality and behavior (paranoid personality disorder, dissocial personality disorder, emotionally unstable personality disorder, borderline personality disorder, histrionic personality disorder, habits and impulse disorder,..), F70-F79 Mental retardation (mild, moderate, severe and profound mental retardation), F80-F89 Mental development disorders (autism, Asperger’s syndrome,..), F90-F98 Behavioral and emotional disorders with onset usually occurring in childhood and adolescence (hyperkinetic disorder, behavioral disorder, childhood attachment disorder,..), F99-F99 Unspecified mental disorders (include unspecified mental illness) (National Center for Health Information, 2024).
2. Methodology
The aim of the research was to determine on what to focus in the forming of university social work students for work with people with mental disorders.
We have conducted the research in qualitative methodology, where we have used semi-structure interview for data collection, open coding for analysis and the card sorting technique for evaluation.
The main research question was: On what to focus in the forming of university social work students? Subsequently, we have also set specific research questions: What professional prerequisites should social workers have, who work with people with mental disorders? What personal prerequisites should social workers have, who work with people with mental disorders? What would you change about the curriculum?
The research set consisted of workers in social facilities primarily focused on people with mental disorders in Slovakia and the Czech Republic. The research sample consisted of 5 Slovak and 13 Czech organizations or services, so 18 research inquiries total (referred to as P1-P18 in the results).
3. Research Results
We have asked the social workers what they consider to be important in the forming and preparation of students for the occupation of a social worker focused on work with people with mental disorders.
In the area of forming of university social work students, the participants see as important the knowledge of mental diagnoses, offer of adequate subjects, formation of personality traits and effective practice.
Personality Prerequisites
It is important to know mental diagnoses, symptoms of illness and side effect of medications. Know where to find detailed information for illnesses. Know to navigate the facilities and services designed for the mentally ill people. There is also a difference between mentally ill and psychologically ill. Although mental handicaps fall under the F diagnosis, but the work with clients with a mental disorder is different than a psychological one, for example, schizophrenia. The willingness to acquire new information even after graduation is also important i.e. positive attitude to life-long learning. Mastering the methods of working with this target group is considered also important. ”For me, learning about the diseases and handling the client are the most difficult; that you are dancing on thin ice. How to reach him. How to communicate with him. These are skills, which you just have to learn.“ (P6).
Social workers recommend for the social work students to also have psychiatry as a mandatory subject. ”Teach psychiatry at school. They know nothing about psychiatry at some universities. The student comes here and he actually never heard about and no one ever explained anything to him about mental disorders.“ (P2).
Social work students should have an overview of the laws on social services, compensations, employment, etc. To have knowledge on how to arrange a disability pension or compensations. If they know first aid, it is also an advantage; if something acute happens, they know how to properly react and help until the ambulance arrives.
And knowing Word, Excel and the Internet is a given.
Personality Prerequisites
According to the participants, not only knowledge is important, but also personality prerequisites of the students. The basic trait a social worker should have is a positive attitude to work with mentally ill people, as well as to the work of a social worker in general. A social worker should have traits like empathy, communicativeness, client acceptance or decidedness. “It is necessary to have empathy to people in general and especially to the mentally ill people.” (P6). He should also be assertive, so he should also be able to say no - this is within our competences, we can do this and we cannot do that. Or if the client crosses some boundaries, then to be able to tell him yes, this is not right, you crossed a certain line.
Personality traits and skills like being a team player are also considered important: “To have a team spirit, to be able to work with colleagues.“ (P16). Willingness to learn and to engage in lifelong learning through various courses. Empathy should be a given:
It is also necessary to see each client as a unique individual and subsequently also have an individual approach. “You can learn a lot from books, but to me it was very important that each client is unique and not to rely solely on textbooks, but on what he provides and shows me and not to pressure clients to go beyond their skills capacity.“ (P3).
It is important for the students to know themselves well, because they are only a tool, which works. To know about their vulnerabilities and what they are afraid of, because they might encounter it and they might have to solve it. “Social-psychological trainings may be means for forming self-knowledge, where they would complete their therapy and know themselves well.“ (P3). Furthermore, a social worker should master self-reflection to be able to evaluate his work. He should also be self-critical and acknowledge own mistake.
It is important to be able to set a balance between emotions and brain: “Even sick clients have to follow rules. In society, everyone must follow some rules. They client will quickly get used to not having to do anything and that he has everything for free, or that the worker will do it for him. If I’m a victim and someone keeps affirming it, then this is not help. Give support and what the client does with it in order to move on. Emotions and rationality - balanced scales!!! The most difficult thing is to acknowledge that I’m responsible for this and not the environment or bad past experience, for example from family. The client is responsible for his life.“ (P7).
The forming of students’ attitudes to people with mental disorders is also important. “For it to be presented that it is an area, which requires companionship and social interaction and that those people are not different from us, that they only need more support and that they should not be afraid to work with these clients.“ (P5).
Humility is also a good personality prerequisite: „To have humility – to the world and to the people; it is good if the worker has it.“ (P6).
Practice
Compulsory practice is part of the social worker university studies. However, we have encountered negative feedback from the participants for these practices in their facilities. The social workers complained about non-systemic solution of practice on part of the school’s leadership, absence of connecting theory to practice in the curriculum and about insufficient preparation of the students for practice on part of the teacher responsible for practice.
”The preparation of all university institutions for field work is absolutely insufficient. Actually, they are creating laboratory conditions at schools in regards to the fields of psychology, social work and everything related to the disabled person. They are not preparing the student at all to meet reality, they only teach and train them for different subjects, which are completely useless, if they are not linked to actual practice. This is wasted energy and finances. We only receive people for practice, who arranged for this at their own initiative, because the school follows the path of least resistance, where someone knows someone, who works at a non-profit, so they would have it the closest. There is no connection, neither contractual, nor financial. It is expected that facilities, like ours, completely free of charge, without anything, when any student comes, they will attend to him immediately they immediately provide pedagogical leadership without any legal connection. Of course, we do this. It did not happen to us that we would refuse someone. This state is unsustainable, illegal and it has no anchoring in the system. These are non-systemic steps, which have to be changed somehow. Some universities, it’s something horrible, unbelievable. Time and again we write it in the student’s evaluation. No one acknowledges it. The schools believe the facility is prepared in a way, where it does nothing, it just waits until someone comes and then integrate him for practice. Actually, this is a disruption of the organization’s operations, because in a facility like ours, the clients have to get used to the new person, the social worker has to familiarize him with schedule, etc.“ (P2).
”I would recommend something general in the 1st year and more practice in the 2nd and not much in offices, but go in the field and have the ability to see clients and work with them.“ (P1). ”Ideally, it would be internship at psychiatry.“ (P3).
”Sometimes, they come here as part of their practice. But it would be good if they would be guided by the school to prepare activities and to communicate with the client during these activities. So they would practice in school how to conduct the conversation, because they often have this funny attitude that look, we just glued postcards or cut them, but the client might feel better talking during the activity, that this doesn’t have to be a guided conversation with papers, so that the humanity wouldn’t get lost.“ (P5).
The participant see as very important practice in different facilities focused on people with mental disorders and the incorporation of more practical subjects in the curriculum.
4. Conclusion
In the field of forming university social work students, the participants see as important the knowledge of mental diagnoses, disease symptoms and especially mastering the methods of working with this target group. Practice in different facilities focused on people with mental disorders and the incorporation of more practical subjects in the curriculum is considered very important. However, personality traits and skills like teamwork, willingness to learn and to engage in lifelong education through different courses are also considered important. Empathy should be a given. It is also important to establish a balance between emotions and the brain. And humility is also a good personality prerequisite.
Social workers are those, who are often contacted by people with a mental disorders as first, yet there are relatively few studies devoted to the practical preparation future social workers undergo, if this preparation exists and if it is sufficient. The need to connect social workers working with clients with mental disorders with good preparation for this occupation is the basic prerequisite for the social workers to be able to effectively and meaningfully devote themselves to serving this group of clients (Triplett, 2017).
Author: PhDr. Michaela Šuľová, PhD.
Catholic University in Ruzomberok, Faculty of Theology, Department of Social Sciences
ORCID 0000-0002-6289-6936
References
Act No. 596/2002 Coll. the Human Health Protection Act
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