The "double nightmare" of physical illness in the chronically mentally ill: A qualitative research study of the impact on social work practice.
Item
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Title
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The "double nightmare" of physical illness in the chronically mentally ill: A qualitative research study of the impact on social work practice.
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Identifier
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AAI3047245
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identifier
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3047245
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Creator
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Mervis-Itzkowitz, Phyllis.
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Contributor
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Adviser: Irwin Epstein
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Date
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2002
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Language
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English
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Publisher
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City University of New York.
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Subject
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Social Work | Sociology, Public and Social Welfare | Psychology, Industrial
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Abstract
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This dissertation is a qualitative research study of social workers' experiences in community-based settings where chronically mentally ill clients now have co-occurring physical illnesses and/or are dying. The study focused on the occupational and personal stresses this work has created, and on understanding how these professionals coped and transcended these stressors.;The study was conducted more than two decades after the public welfare policy of deinstitutionalization was at its height. The problem addressed in this study is in part an unplanned outgrowth of that policy. Neither lawmakers or community programs, which have 24 hour responsibility for the care of these individuals, anticipated that a significant proportion of these mentally ill adults, as well as others who were never hospitalized and may have been homeless, would eventually develop physical illnesses associated with aging or HIV and AIDS.;The study found that physical illness represents a serious occupational stress for mental health professionals, many of whom consciously chose to avoid work in medical settings. The participants described feeling personally and professionally vulnerable.;One aspect of the stress identified is consistent with health care literature that discusses the emotional impact of serious physical illnesses on staff in the "secondary practice setting" of the hospital. However, there are additional, intensified stresses for mental health professionals in the primary mental health care setting who have 24 hour responsibility for their clients, have been educated to work with the chronically mentally ill, and have expressed a preference for this practice setting.;The study also found that social workers faced with these stressors demonstrated resilience and resourcefulness and described personal and professional gratifications that offset the personal and professional demands of their work.;The exploratory nature of this study, limited sample, and single study site render these findings tentative. Nonetheless, they suggest a role for social work education and agency administrators in preparing and supporting staff in an environment where physical illness has become a regular aspect of their mentally ill clients' profile. There is also a role for research to examine the place of professional values in buffering worksite stress and in determining how generalizable these findings are.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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D.S.W.
