The history of school social workers and their role in supporting students with mental health in schools

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School social work is a specialized area of practice within the broad field of the social work profession. Starting from the early twentieth century, school social workers bring unique knowledge and skills to the school system and the student services team.

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JOURNAL OF SCIENCE OF HNUE DOI: 10.18173/2354-1067.2016-0118 Social Sci., 2016, Vol. 61, No. 12, pp. 168-176 This paper is available online at http://stdb.hnue.edu.vn THE HISTORY OF SCHOOL SOCIAL WORKERS AND THEIR ROLE IN SUPPORTING STUDENTS WITH MENTAL HEALTH IN SCHOOLS Nguyen Thu Ha Faculty of Social Work, Hanoi National University of Education Abstract. School social work is a specialized area of practice within the broad field of the social work profession. Starting from the early twentieth century, school social workers bring unique knowledge and skills to the school system and the student services team. School social workers are instrumental in furthering the purpose of the schools: to provide a setting for teaching, learning, and for the attainment of competence and confidence. Students’ unmet mental health needs can be a significant barrier to student academic and personal-social development and even compromise school safety. School social workers are prepared to recognize and respond to student mental health crises and needs. School social workers address these barriers to student success by offering education, prevention, and crisis intervention. Keywords: Social work, social workers, school social work, school social workers, history, mental health, schools. 1. Introduction School social workers have long been concerned about children who are not able to use what education has to offer. Schools and families are environments where children should develop, discover their own dignity and worth, and come to realize their potential. Social work has much to contribute to schools. While teachers develop the potential of learners through transmitting knowledge, skills and values, social workers can provide support for learners’ well-being so they are ready to learn. Social work provides special attention to those who are marginalized by problems such as poverty, oppression or disability, mobilizing the strengths of family, school and community to overcome obstacles to educational success. Using ecological systems theory to evaluate and solve problems, social work is well suited to supporting schools by helping learners benefit from education. Received date: 21/5/2016, Published date:29/10/2016 Contact: Nguyen Thu Ha, e-mail: thuha.sw.hnue@gmail.com 168
The history of school social workers and their role in supporting students with mental health... Vietnam has changed rapidly over the past two decades; economic development and an open door policy of economic liberalization have stimulated both economic growth and social change [4]. A side effect of these changes is a transition in disease patterns. For large segments of the population, the main diseases are no longer the diseases of poverty, but increasingly diseases that are seen in wealthier societies [5-9]. However, the health problems related to a more prosperous lifestyle are not equally distributed across the country; there are increasing gaps between rich and poor, and between urban and rural areas [7,10]. There has been a rapidly growing public awareness of mental health problems, such as stress, anxiety, depression and suicide among adolescents [9,10]. Together with Decision No. 32/2010/QD-TTg of the Prime Minister about development for social work profession, school social work has also been building. Mental health is also a problem in school which social worker have to address. The basic questions are: Who are school social worker? What should the role of the school social worker be in a particular school community? and What should they do to support students with mental health in school? Therfore, in this study we are trying to explain the history of school social worker in the world especially the United States in which have had big steps in school social work development and explain the role of school social worker in supporting students with mental health in school. 2. Content 2.1. Brief history of school social work School social work began from 1871 in England and then during the school year 1906–1907 it simultaneously was gradually built in New York, Boston, Hartford [1] and Chicago [8] in United States. These very first workers were not hired by the school system but worked in the school under the sponsorship of other agencies and civic groups. In New York, it was a settlement house that sponsored the workers. Their purpose was to work in various projects between the school and communities of new immigrants, promoting understanding and communication [6]. In Boston, the Women’s Education Association sponsored “visiting teachers” who would work between the home and the school. In Hartford, Connecticut, a psychology clinic developed a program of visiting teachers to assist the psychologist in securing social histories of children and implementing the clinic’s treatment plans and recommendations [6]. In Chicago, Louise Montgomery developed a social settlement type of program at the Hamline School that offered a wide range of services to the Stockyards District community [8]. This unheralded experiment anticipated the much later development of school-based services for the entire community. In many ways these diverse early programs contained in rough and in seminal form all the elements of later school social work practice. Then in 1913 in Rochester, New York, the Board of Education hired visiting teachers for the first time. Only three years later in 1916 at the National Conference of Charities and Corrections, a definition of school social work emerged in the presentation of Jane Culbert. The definition would focus on the environment of the child and the school, rather than on the individual child. The school social worker’s role was 169
Nguyen Thu Ha “interpreting to the school the child’s out-of-school life; supplementing the teacher’s knowledge of the child . . . so that she may be able to teach the whole child[;] . . . assisting the school to know the life of the neighborhood, in order that it may train the children to the life to which they look forward. Secondly the visiting teacher interprets to parents the demands of the school and explains the particular demands and needs of the child” [3]. In 1920, the National Association of Visiting Teachers was organized and held its first meeting in New York City [8]. This organization, which later became the American Association of Visiting Teachers. By the end of the 1920s, a wide range of fields of practice had organized themselves around the different settings of school, hospital, court, settlement house, child welfare agency, family service agency, and so forth. During the late 1960s and following years there arose a renewed interest in developing theory and practice in areas such as school social work. At this time, school social work was developing its own distinct identity, methodology, theory, and organization. It had large numbers of experienced practitioners, who were encouraged to remain in direct practice by the structure and incentives of the school field as it had developed. With the development of state school social work associations, and then school social work journals, the search for some balance between what was common to all fields and what was specific to school social work began again. During the final three decades of the twentieth century, the inclusive and individualizing missions of the schools were expanded in response to the recognition of the right of children with disabilities to a free appropriate public education; the school reform movement; and recent concerns around violence, sexual harassment, and bullying in schools. There is a public policy emphasis on high professional qualifications that is meshing with movements toward specialization in school social work. In accordance with national legislation, states are setting standards for “highly qualified” school social workers and introducing post-masters mentorships for more permanent certification for highly qualified school professionals [2]. An now school social work is well established in many countries, and is being introduced in others to help schools handle barriers to education such as disabilities, physical and mental health problems, drug use, adolescent pregnancy, and learning problems; family problems including domestic violence, divorce, child abuse, homelessness, and family illnesses; and problems within the school system such as discrimination, bullying, and inappropriate discipline by staff. 2.2. Occurrence of school mental health problems in Vietnam Mental health disorders are among the most important public health issues globally. Estimates of the global burden of disease place mental illness in the top three conditions in terms of years lost due to disability. The mental health of adolescents and young people is a crucial issue because of the general burden of mental illness and because it has the potential to affect their adult lives, and the lives of the next generation. The problems that adolescents and young people encounter interfere with the way they think, feel, and act. Such problems cause distress and limit their academic achievements and 170
The history of school social workers and their role in supporting students with mental health... ability to be economically productive. They can also lead to family conflicts, substance abuse, violence, eating disorders and sometimes suicide. Mental health problems are also expensive for families, communities, and healthcare and social systems. Going to school especially secondary school can be a stressful period for adolescents, having to cope with many life changes. Psychopathology and life stress may play major roles in suicidal behaviours, especially among rural adolescents. There is a rapidly growing public awareness of mental health problems such as stress, anxiety, depression and suicide among Vietnamese students. Very little research has been conducted on the mental health status of school students in South East Asian countries, such as Vietnam. In the Bulletin of the World Health Organization 2006, Harpham and Tran reported that a fifth of young Vietnamese people experience mental health problems [12]. A cross-sectional study of 972 secondary school students, 13 to 16 years old, in the north of Vietnam showed that a high proportion had poor mental health, with 17.6% having felt sad and hopeless every day for two weeks during the past 12 months [13]. In addition, the number of students that had considered suicide was high, with 6.6% of students having seriously considered suicide during the past 12 months, 1.2% having made a suicide plan, and 0.4% having attempted suicide [14]. The studies of urban youth - 2591 adolescents in Hanoi (2006) [15], approximately 1000 adolescents in Hanoi (2007), [18], and 410 university students in Ho Chi Minh City (2009) [16], revealed ranges of suicide ideation from 9.2-10.6%. Another study of 1226 secondary school students conducted in Ho Chi Minh City indicated that the percentages of students who had seriously considered suicide, planned to commit suicide or actually attempted suicide during the past 12 months was 6.3%, 4.6% and 5.8% respectively [17]. In addition, the prevalence of depression, anxiety and psychological distress was 26.3%, 16.2% and 36%, respectively. Some 17.6% of secondary school pupils in a study in the north and 34.0% of first year university students in another study in Cantho City in the south reported feelings of sadness and hopelessness every day for two weeks in the past 12 months [11]. Four studies reported a high rate (10%) of students who had considered attempting suicide in the past 12 months [12-15]. Prevalence rates of suicidal behaviour increased significantly with age, and female adolescents were more likely to report suicidal feelings than males. Other studies reported an association between smoking/substance abuse and emotional/behavioural problems among adolescents [16]. Those involved in physical fights and/or attacks had higher levels of alcohol problems and poor mental health [17]. These studies demonstrate the high prevalence of depression, anxiety and educational stress among adolescents, as well as the strong association between educational stress and poor mental health. However, risk factors for depression and anxiety, and students’ perspectives on how to reduce depression or anxiety, have not yet been investigated. According to many students in schools, mental health was a large problem among them. They felt very stressed, anxious, and often worried. Many students remembered other pupils with symptoms of depression. They are often quite silent and seldom speak to anyone. They did not want to do anything in class even when they were asked to do something, and they did not care if they had good or bad results. Poor mental health 171
Nguyen Thu Ha may lead to poor somatic health. There have been several suicide attempts in recent years. Suicide is a sensitive topic for both family and school, but the number of reported suicides among pupils has apparently increased. There are many factors contributing to poor mental health such as: Academic pressure: The pupils consider academic pressure to be a huge problem. They pointed to an overloaded academic curriculum and to pressure from teachers, parents, peers, and themselves to do well. In Vietnam, parents are also very focused on their children’s success and future career. Pupils also experience pressure from their peers, as competition is fierce. Problems associated with pleasure seeking: Although entertainment is part of normal life, most of the pupils thought that too much pleasure seeking could have a negative impact on students’ study and health [19]. Pleasure seeking behaviour that they thought could lead to problems included following media personalities, friendship, gaming, internet, and cigarette smoking. They also thought that these problems mostly occurred among pupils from rich families because they could use money for pleasure instead of needing it all for their study. According to the respondents, pupils who indulge in pleasures also often break school rules and show resistance to school regulations. Although smoking and substance abuse are prohibited in schools, some boys smoke. They usually smoke tobacco in the coffee shops close to schools and in the toilets. The students said that those who smoke tend to break school rules often and show resistance toward school and teachers. Love and sex: Some parents do not allow their children to be involved in relationships before finishing secondary school, especially girls, since they are afraid that their children will not focus on their studies. Pupils considered that homosexual relations are appearing more frequently among young people, linked to greater personal freedom and a modern life style, far from the concepts of the feudal society of the past. Homosexuality was linked by pupils to early sexual intercourse, lost concentration on studies, and even suicide attempts. Seeking advice or help outside the family is also necessary because pupils cannot easily share their feelings with their parents. Schools do have Secretary Boards, Youth Unions and Parents’ Associations, and some schools have medical professionals that can be consulted, but these institutions do not yet function well. One reason is that pupils have little knowledge and skills on mental health and psychology. In addition, pupils with mental health problems may not recognize their own problems and may not seek help. 2.3. The role of school social worker in in supporting children with mental health in secondary school School Social Workers are trained mental health professionals with a degree in social work who provide services related to a person’s social, emotional and life adjustment to school and/or society. School social workers provide mental health services in schools and have specialized training to meet students’ social-emotional needs. Schools often are one of the first places where mental health issues are recognized and addressed. 172
The history of school social workers and their role in supporting students with mental health... School social workers serve as the primary mental health providers for students and may be the only counseling professionals available to students and their families to initially identify and provide interventions for those issues. And school mental health settings usually include services in three broad levels of health care application: prevention, treatment and rehabilitation. Prevention: aims to reduce the incidence of disease or dysfunction in school and family through modifying stressful environments and strengthening the ability of the student to cope. Prevention involves the promotion and maintenance of good health through education, attention to adequate standards for basic needs and specific protection against known risks. In school mental health settings, preventive activities include students, families and teachers education regarding emotional self-care and healthy relationships, building community knowledge and skills (community development), social action, and advocacy for social justice. Treatment: aims to reduce the prevalence (number of existing cases) of a disorder or dysfunction and includes early diagnosis, intervention and treatment. In school mental health settings, treatment activities are focused on students experiencing acute psychiatric symptoms, emotional trauma, relationship problems, stress, distress or crisis and include assessment, risk management, individual, couple, family and group counselling, intervention or therapy and advocacy. Rehabilitation: aims at reducing the after effects of disorder or dysfunction, and involves the provision of services for re-training and rehabilitation to ensure maximum use of remaining capacities by the individual. In school mental health settings, rehabilitation activities focus on students who are disabled by mental illness and may include individual, couple, family, and group interventions to build knowledge and skills, provision of specialized residential, vocational and leisure resources, and advocacy to ensure the development of needed services and to change community attitudes. School social workers have special expertise in understanding family and community systems and linking students and their families with community services essential to promote student success. School social workers’ training includes specialized preparation in cultural diversity, systems theory, social justice, risk assessment and intervention, consultation and collaboration, and clinical intervention strategies to address the mental health needs of students. They work to remedy barriers to learning created as a result of poverty, inadequate health care, and neighborhood violence. School social workers often focus on providing supports to vulnerable populations of students at high risk for truancy and dropping out of school, such as homeless, foster, and migrant children, students transitioning between school and treatment programs or the juvenile justice system, or students experiencing domestic violence. They work with teachers, administrators, parents, and other educators to provide coordinated interventions and consultation designed to keep students in school and help families access the supports needed to promote student success. School social workers design and implement school-based programs to promote a positive school climate among all students. They work with the entire student body 173
Nguyen Thu Ha to identify students in need of more intensive interventions and connect these students to additional services in the community where needed. School social workers serve as a resource to the principal and other educators, providing consultation and training on identifying students with mental health needs and a referral process when services are sought. Working more closely with individual students and their families, school social workers also create a bridge between the school and the community when linking such services. This coordination is critical in a successful school and community partnership to maximize limited resources, facilitate better service delivery, and maintain communication between partners. The role of the school social worker in school mental health including: • Provision of evidence-based education, behavior, and mental health services. • Promotion of a school climate and culture conducive to student learning and teaching excellence. • Maximization of access to school-based and community-based resources. The most effective way to implement integrated services that support school safety and student learning is through a school-wide multi-tiered system of supports (MTSS). In a growing number of schools across the country, response to intervention (RTI) and positive behavior interventions and supports (PBIS) constitute the primary methods for implementing an MTSS framework. Effective MTSS requires: • Adequate access to school-employed specialized instructional support personnel (e.g., school social workers, school counselors, school psychologists, and school nurses) and community-based services; • Integration of services, including mental health, behavioral, and academic supports and school-based and community services; • Adequate staff time for planning and problem solving; • Effective collection, evaluation, interpretation, and use of data; and, • Patience, commitment, and strong leadership. Many professionals within a school help to support students’ positive mental health. These include school social workers, school counselors, school psychologists, school nurses, and other specialized instructional support personnel (SISP). School-employed mental health professionals serve in critical leadership roles related to school safety, positive school climate, and providing school-based mental health services. School social workers offer their unique training and expertise to link mental health, behavior, environmental factors (e.g., family, classroom, school, and community), instruction, and learning. Safe and successful learning environments are fostered through collaboration among school staff and community-based service providers while also integrating existing initiatives in the school. Rather than viewing safe schools as a targeted outcome for a separate program or plan developed by the school building principal alone, an effective model seeks to integrate all services for students and families by framing the necessary behavioral, mental health, and social services within the context of school culture 174
The history of school social workers and their role in supporting students with mental health... and learning. Integrated services lead to more sustainable and comprehensive school improvement, reduce duplicative efforts and redundancy, and require leadership by the principal and a commitment from the entire staff. 3. Conclusion Schools everywhere must include all children, whatever the challenges presented by children with different abilities, diverse backgrounds and wide-ranging problems especially mental health problems. These challenges increasingly require a team approach with support personnel bringing various expertize into schools so they can reach expanding educational goals. Students with untreated mental health issues may develop more significant problems which can greatly impact their educational experience and result in poor educational outcomes and possibly dropping out of school. Social workers have a key role as partners with schools in guiding children and youth to their reach their potential intellectually, emotionally and socially. School social workers work with young people and their school and family environments, assisting them to accomplish tasks associated with their learning, growth, and development, and thus to come to a fuller realization of their intrinsic dignity, capability, and potential. The social worker must be able to relate to and work with all aspects of the child’s situation, but the basic skill underlying all of this is assessment, a systematic way of understanding and communicating what is happening and what is possible. Building on assessment, the social worker develops a plan to assist the total constellation - teacher and students in the classroom, parents, and others - to work together to support the child in successfully completing the developmental steps that lie ahead. REFERENCES [1] Costin, L., 1969a. A historical review of school social work. Social Casework, 50, 439–453. [2] Constable, R., & Alvarez, M., 2006. Moving into specialization in school social work. School Social Work Journal, 30(3), 116–131. [3] Culbert, J., 1916. Visiting teachers and their activities. In Proceedings of the National Conference on Charities and Corrections (p. 595). Chicago: Heldman Printing. [4] Silva MJD, McKenzie K, Harpham T, Huttly SRA, 2005. Social capital and mental illness: a systematic review. J Epidemiol Community Health. 59: 619-627. [5] Ford T, Goodman R, Meltzer H 2003,. The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psych. 42 (10): 1203-1211. [6] Lide, P., 1959. A study of the historical influences of major importance in determining the present function of the school social worker. In G. Lee (Ed.), 175
Nguyen Thu Ha Helping the troubled school child: Selected readings in school social work. New York: National Association of Social Workers. [7] Mental Health Europe, 2001. Mental health promotion of adolescents and young people: Directory of projects in Europe. Mental Health Europe. [8] McCullagh, J., 2000. School social work in Chicago: An unrecognized pioneer program. School Social Work Journal, 25(1),1–14. [9] World Bank, SIDA, AUS AID, the Royal Netherlands Embassy in cooperation with the Ministry of Health, 2001. Vietnam growing healthy: a review of Vietnam’s health sector. Hanoi, Vietnam. [10] Giang TL, Duong KH, 2007. Social issues under economic transformation and intergration in Vietnam, vol. 1. Vietnam Development [11] Nguyen TD, Dedding C, Pham TT, Bunders J, 2013. Perspectives of pupils, parents, and teachers on mental health problems among Vietnamese secondary school pupils. BMC Public Health (submitted). [12] Harpham T, Tran T, 2006. From ressearch evidence to policy: mental health care in Vietnam. Bull World Health Organ. 84 (8): 664-668. [13] Tran BP, 2007. Improving Knowledge of factors that influence the mental health of school children in Vietnam. Thesis for Master of Public Health. Brisbane: Queensland University of Technology [14] Nguyen TD, 2009. Child Maltreatment and mental health among first year students in Cantho University of Medicine and Pharmacy, Vietnam. Thesis for Master of Public Health. Brisbane: Queensland University of Technology. [15] Nguyen TH, 2006. Child maltreatment in Vietnam: Prevalence and associated mental and physical health problems. Thesis for the Doctor Degree of Philosophy. Brisbane: Queensland University of Technology [16] Huynh HNQ, 2009. Exloring the mental health of public health and nursing students in Ho Chi Minh City, Vietnam. Thesis for Master Degree of Public Health. Brisbane: Queensland University of Technology [17] Thai TT, 2010. Educational stress and mental health among secondary and high school students in Ho Chi Minh City, Vietnam. Thesis for Master of Public Health. Brisbane: Queensland University of Technology [18] Radloff LS.The CES-D Scale: a self-report depression scale for research in the general. [19] Nguyen TH, Le VA, Dunne M, 2007. Validity and reliability of depression and anxiety scales using in community-based adolescent research. Viet J Public Health. 7 (7): 25-31. 176