Special Project

The Find Hope Facebook Page

 

 

Introduction

My internships was at the Volunteer Behavioral Crisis walk in center in Chattanooga, TN were I conducted mental health assessments, determined level of care, made referrals for treatment and conducted follow up calls. The Crisis center was built to ensure individuals received treatment for their mental health needs. Most of the clients served are uninsured or on Medicaid. Throughout my internship at the Crisis walk in center in Chattanooga, I was surprised to learn that the majority of clients that I spoke with, did not know how to find resources and did not fully understand why or how therapy is effective. Looking back on my own personal experience with therapy, I wish I knew then what I have learned in my courses and review of research. This knowledge would empower me to know how to guide my own treatment and allow for self-determination. I decided to launch a Facebook page that provides easy access to useful information pertaining to mental health. Facebook is a great way to spread the word and information can be easily shared and accessed. The information is out there but you have to search for each thing. I wanted to create a page where you can find it all in one spot and not have to go hunting for each thing. It includes information on hotlines such as 988 which is the mental health emergency line. It also offers information about 211, an information line where callers can have access to free and confidential assistance for finding resources. Information about mental health grant funding is provided such as the government grant called Behavioral health safety net. Information is included on how to contact legislators for change and a sample letter is included. Research pertinent to mental health issues are highlighted on the page as well. Whenever I provided education to clients about research, they were always interested and grateful. I realized that many people do not understand research the way it is written and appreciate it being put into simple terms. Clients love being empowered with reliable knowledge. Some of the topics highlighted on the page are different local agencies and the services they offer as well as spreading awareness about the role law enforcement plays in Crisis situations. This page will continue to grow and many things will be shared and highlighted in the future. I plan to educate people about the different aspects of treatment and how that works. There are many misconceptions about how therapy works and I aim to clear those up. This will reduce the likelihood of people discontinuing treatment due to being disappointed in how it progresses. I hope to also bring awareness to gaps in care and encourage people to write to legislators about those and other problems that stand in the way of people getting treatment. Stigma is still a huge hinderance in mental health care. I intend to provide education and awareness that will reduce stigma.

What social issue has been addressed and why?

The social issue being addressed by this page is a lack of knowledge of resources and gaps in care. The area social work I will be working with is mental health. I will be working with the adult population who suffer from mental health issues. Micro theories that inform this work are social learning theory, systems theory, psychosocial development theory, Maslow’s hierarchy of needs, self-determination, person centered, person-in -environment and strengths perspective. Bandura’s social learning theory suggests behavior is learned by observing others and modeling their behavior. Systems theory focuses on the understanding the relationships between different parts of society and how they impact individual behavior. Erikson’s psychosocial development theory suggests that your identity develops through specific stages throughout one’s lifetime. Macro theories that inform this work are conflict theory, social exchange theory functionalism, symbolic interactionism and systems theory. Conflict theory and interactionism focus on individuals behavior and social interactions. Functionalism focuses on the functions of different components in society and how they work together to achieve stability. The information found on the Find Hope Facebook page will not only guide them to resources such as where to go for help, but educate them on the services available and how those work. This page serves as a one stop shop for all things mental health where they can find the information they need. I started this page while interning at the Crisis walk in center in Chattanooga. I spoke with countless clients that voiced frustration in that they did not know where to find help or information. I saw a profound need for knowledge and information to be shared and what a better place to do it than social media where information can be shared to thousands in a matter of seconds. I also came across gaps in care where clients could not get the treatment they needed due to a lack of resources or other agencies not valuing individuals with mental health issues.

What interventions have been designed?

In creating this Facebook page, it is my mission to reach as many individuals as possible within the community. I hope that his will inspire other communities to do the same. Furthermore, it is my priority to empower individuals with the knowledge of how to contact their legislators for change and be informed on research. Evidence-based treatments are the most effective interventions used in mental health treatment are are the recommended first line of defense against mental health disorders such as depression and anxiety (Singla, 2021). Common interventions for mental health include therapy, medication management and case management. Evidence -based practices for these interventions include cognitive behavioral therapy, strengths perspective, mindfulness based therapy, dialectical behavioral therapy and LOGO therapy. In working at the Crisis center, many clients I spoke with had no knowledge of what evidence-based practices meant. I also observed that clients tend to rely on the expertise and guidance of the professionals. Their lack of knowledge left them powerless in directing their own treatment. In my experience, not all mental health professionals are competent or ethical. By empowering individuals with this knowledge, they will be able to determine if their treatment is going in the right direction. Research has shown that individuals are more likely to seek treatment when they are informed about their diagnosis and treatment Lien, 2023). This page will also aid in combatting stigma which is associated with being reluctant to seek treatment (Babij, 2023). 

 

Babij, A. D., Earl, S., Becker, W., Hoyt, C. L., Burnette, J. L., Marston, A., & Crispin, K. (2023). Mindsets of mental illness: What are the implications for stigma? Stigma and Health. https://doi.org/10.1037/sah0000482

Lien, Y. -J., Chen, L., Cai, J., Wang, Y. -H., & Liu, Y. -Y. (2023). The power of knowledge: How mental health literacy can overcome barriers to seeking help. American Journal of Orthopsychiatry. Advance online publication.

https://doi.org/10.1037/ort0000708

Liegeois, A. (2005). Ethical dilemmas in community mental health care. Journal of Medical Ethics, 31(8), 452–456. https://doi.org/10.1136/jme.2003.006999

Mcleod, S. (2023, June 14). Psychodynamic approach in psychology. Simply Psychology. https://www.simplypsychology.org/psychodynamic.html

Singla, D. R. (2021). Scaling up psychological treatments: Lessons learned from Global Mental Health. American Psychologist, 76(9), 1457–1467. https://doi.org/10.1037/amp0000944

Theoretical Perspectives

  • Micro theories that inform this work are social learning theory, systems theory, psychosocial development theory, Maslow’s hierarchy of needs, self-determination, person centered, person-in -environment and strengths perspective. Bandura’s social learning theory suggests behavior is learned by observing others and modeling their behavior. Systems theory focuses on the understanding the relationships between different parts of society and how they impact individual behavior. Eriksons’ psychosocial development theory suggests that your identity develops through specific stages throughout one’s lifetime.
  • Macro theories that inform this work are conflict theory, social exchange theory functionalism, symbolic interactionism and systems theory. Conflict theory and interactionism focus on individuals behavior and social interactions. Functionalism focuses on the functions of different components in society and how they work together to achieve stability.

Results

This is an ongoing project that individuals can utilize indefinitely. This page will continue to be of service to individuals in need of resources for mental health. This page will continue to grow and flourish as more information is added to the page. It is my goal that individuals will gain knowledge from this page that will empower them to be in control of the direction of their treatment. 

There is a growing need for reform of the law 33-6-404 Certificate of need for emergency treatment and transportation. I am to continue to advocate for change. In working with Crisis, I observed a lack of enforcement of this law which resulted in clients being neglected and denied care. Many of these individuals are too acute for family to safely transport them. Due to stigma and a lack of compassion or knowledge, law enforcement officers will refuse to transport. I will also continue to advocate for the Behavioral Health Safety Net grant allotted to mental health care by law 71-5-148. This grant has bridged the gap for many uninsured individuals who were unable to seek treatment before this policy was put in place. I will continue to spread awareness for this policy to ensure it continues. 

Policies that address issues for this population are:

  • Behavioral Health Safety Net grant allotted to mental health care by law 71-5-148. 
  •  33-6-404 Certificate of need for emergency treatment and transportation. 
  • SB167/HB100- Guardians and Conservatorships
  • SB574/HB88  – drug and alcohol rehabilitation- requires state agencies to seek funding for the development of a substance use disorder for women with children 
  • SB207/HB215- requires certain practices for drug and alcohol rehabilitation facilities
  • SB1267HB1353-requires certain requirements for inpatient facilities
  • SB145/HB159- Privacy and Confidentiality Act

Conclusion

After completing this project, no significant limitations were found. Facebook pages are free to create. Time spent managing the page can be at my discretion. This will not be a burden to me as it is my passion and honor to help individuals get care. Comments and messaging features have been turned off so that I do not get overwhelmed with engaging in conversations. I will get feedback from colleagues on how to improve the site and will add new things as I discover more needs or resources.

 

Competencies

Competency 1: Demonstrate Ethical and Professional Behavior

    • Volunteer Behavioral values treating all clients with dignity and respect. VBH places a strong value on privacy and confidentiality. 
    • VBH had weekly professional development activities during supervision to ensure competency.
    • Professional behavior is utilized in all communication on the landing page.
    • Technology is used effectively and appropriately.
    • I maintain self-care by limiting time dedicated to this landing page. I maintain professional boundaries while navigating this social media landing page.
    • I exhibit commitment to professional growth by staying informed on social issues and staying informed on new and upcoming research. I share only what is evidence based.

Competency 2: Engage Diversity and Difference in Practice

    • VBH values the human rights of all individuals and values the dignity and worth of each person. We combat systemic racism by ensuring that all individuals get equal treatment and quality care. 
    • VBH collaborates with law enforcement, medical hospitals, primary care doctors, probation officers, homeless shelters, alcohol/drug treatment facilities, jails, group homes, transportation agencies and many more agencies throughout the community to provide total care. 
    • VBH requires monthly Relias trainings for all employees on a variety of topics. 
    • This landing page advances human rights and social justice by empowering individuals with knowledge to be informed on how to advocate for change and take the lead in guiding their treatment. Social media is accessible to most of the world and is therefore very diverse. On this landing page, I was able to work with individuals from all cultures, ethnicities, religious beliefs and socioeconomic backgrounds while pursuing cultural competency, showing respect and valuing the dignity and worth of each and every person. I will pursue cultural competence with all individuals and issues that are addressed on my landing page.

Competency 3: Advance Human Rights and Social, Economic, and Environmental Justice

    • VBH creates an environment where employees take care to ensure individuals differences are celebrated and not discriminated against. In the mental health assessments, we ask a series of questions that gives us the clients full story from their childhood history to future hopes. Hearing the pain that individuals have suffered has allowed me to see the humanity in each and every person. Witnessing the suffering of others has peeled away at matters such as differences. The pain and suffering that individuals incur throughout their lifetime make things like biases seem so trivial. I no longer see people in terms of their race. I only see their potential to live their best life and overcome their pain. Knowing the suffering that individuals endure has blessed me with the ability to focus on their humanity and healing instead of differences.
    • I was able to demonstrate leadership as this landing page gives me a platform for advocating for human rights and social justice. I aspire to empower individuals with the knowledge on how to facilitate change by contacting legislators. I posted resources for how to write to Legislators and where to find them. I will be inclusive by posting information relevant to all diverse populations and the social issues those groups experience.

Competency 4: Engage in Practice-Informed Research and Research-informed Practice

    • VBH utilized research-informed practice in their assessments and evaluations. Employees have to take monthly Relias trainings that must be renewed every year. Through the experiences gained as a Crisis clinician, employees gain expertise through observations by direct contact with clients during assessments. 
    • VBH collects and analyzed data from chart audits to ensure quality processes in company practices. This allows us to effectively analyze the impact and effectiveness of our interventions on the individuals and the community.
    • I was able to demonstrate that I stay informed in current research on practice, policy and programs and share these findings on my landing page. I reviewed research on the impact of gaining knowledge and combatting stigma in regards to seeking mental health treatment. I will empower individuals with knowledge about research and how to find and explore evidence based research. I will use this landing page to conduct empirical research to evaluate need for reform to advance the purposes of social work.

Competency 5. Engage in Policy Practice

    • VBH promotes policy practice by providing training and resources for its employees such as Relias training and Crisis Intervention training class. VBH regularly writes to legislators to advocate for better care and more funding. Transportation and bed availability is a huge obstacle in clients receiving care. Mental health stigma is the largest barrier. There is a lack of compassion and understanding for individuals with mental illness. I observed this to be a barrier to clients receive quality care and getting treatment at all. ER’s would rescind CON’S due to limited space. Individuals that were suicidal or psychotic were discharged as medical emergencies were seen as more eminent danger. These individuals were at a high risk of likelihood of harm coming to them due to their acuity. I also experienced many law enforcement agencies refusing to transport clients to ER’s on CON’s despite the law stating that law enforcement is legally responsible for individuals on a Certificate of Need. VBH serves several surrounding counties. Each county had different policies and procedures which made it difficult to get clients the care they need. VBH is continuously writing to legislators to make these barriers known and ask for policy change. The hope it to have a nationwide policy for transportation and care of individuals on CON’S. I will use my landing page to advocate for this.
    • On my landing page, I shared information about state funding for mental health care grants to spread awareness of resources available to individuals seeking treatment. I will use this landing page to advocate with and inform stakeholders to impact policy change. I shared a post about the co-responder program that Volunteer Behavioral Health has collaborated with law enforcement with. This program ensures individuals get the mental health treatment they need.

Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities.

    • VBH operates as a client-centered approach that recognized each individuals unique needs, strengths and experiences using strengths perspective, person-in-environment, active listening, empathy and cultural competence.
    • VBH strives to help clients overcome their barriers and improve their quality of life and well-being. We collaborate with friends, families and other agencies to identify barriers and address their goals.
    • I examined evidenced based practices to prepare for professional engagement across systems and engage with systems utilizing evidence-based strategies. On my landing page, I shared information about evidence based practices, what that means and why it is important. I shared about various therapy modalities and their effectiveness in treating certain symptoms. This will empower people with the knowledge and understanding about their treatment.

Competency 7: Assess with Individuals, Families, Groups, Organizations, and Communities.

    • VBH strives to consider multiple aspect of an individuals life such as physical, emotional, financial and environmental factors. This allows us to get the full picture of the clients needs in order to provide the best recommendations for treatment. 
    • On my landing page, I shared information on diagnosis, criteria, symptoms and assessments to empower individuals with knowledge on their diagnosis. I shared information about medications and expected outcomes from them.

Competency 8: Intervene with Individuals, Families, Groups, Organizations, and Communities.

    • VBH implements interventions tailored to each individuals needs and goals while valuing autonomy. We build upon clients strength and community resources and recognize the importance of clients being active participants in their care. 
    • I implemented clinical evidence-based interventions. I integrated macro level evidence-based strategies with organizations/communities. I identify gaps in care and share information that might fill those gaps. I encourage individuals to contact legislators to advocate for bridging those gaps. I shared information about tools used such as various assessments.

Competency 9: Evaluate with Individuals, Families, Groups, Organizations, and Communities.

  • VBH places a strong emphasis on client centered care in assessments, evaluations and treatment. We respect clients autonomy and encourage their engagement and self-determination by empowering them with knowledge. We encourage clients to share feedback and to share their ideas on how they would like their treatment to go. During assessments, clients share their lived experiences to inform evaluation findings. We collaborate with families and community stakeholders to ensure their voices are heard and their wishes are considered. 
  • VBH adheres to the National Social Workers Code of Ethics and adheres to those ethical guidelines. During weekly supervision, ethical dilemmas are discussed and best course of action is determined as a group effort. 
  • I  selected evidence-based evaluation strategies according to their efficacy with specific client systems. I suggested and implemented necessary services based on gaps in care identified while working in the Crisis center. Through my observations and review of comments/feedback, I will continue to evaluate the impact this has on individuals.

Ethical Decision Making Model

Clarify the issue

  • Identify the problem
  • Analyze biases
  • Identify stakeholders
  • Consider relationships   

 

 List relevant MSW values and standards of practice

  • Determine what ethical guidelines and standards of practice apply NASW Code of Ethics
  • List all relevant values and practice guidelines

Determine the nature of the dimensions of the dilemma

  • Apply ethical lens
  • Critically analyze all aspects

Critical thinking

  • Review ethical questions

Risks and benefits

  • Consider all options
  • Risks and consequences
  • Hierarchy of ethical principles and risk management

Identify the solution

  • Make a choice and justify it

Determine an action plan

  • Develop an action plan: 
  • Consult with colleagues/supervisor
  • Identify social justice issues (advocacy)

 Implement Plan

  • Implement chosen strategy utilizing evidence-based practice.

Evaluate/reflect

  • Evaluation-assess effectiveness and efficiency
  • Identify additional problems or need for more action
  • Final outcome/consequences

 

Liegeois, A. (2005). Ethical dilemmas in community mental health care. Journal of Medical Ethics, 31(8), 452–456. https://doi.org/10.1136/jme.2003.006999