Disability And Sexuality And Social Work Practice Social Work Essay

Disability And Sexuality And Social Work Practice Social Work Essay There is a growing recognition of the need to provide sex education to people with learning disabilities, as well as their right to achieve such education. Despite a desire to help with this, social workers and other health professionals can lack the confidence and tools to deliver sex education to this population. In an effort to accumulate evidence of best practice thus far, a narrative review of the literature will be conducted to answer the following question: What interventions are available within social work practice for the delivery of sexuality education to people with learning disabilities? By identifying the key consistencies and inconsistencies across effective interventions, feasible interventions can be established and further research identify. Background and Rationale In the past, people with learning disabilities were excluded from sexual education or help with issues around their sexuality. Fortunately, in modern day society this exclusion is beginning to change, which is in part due to a shift from institutionalised care to supported living. This has resulted in an increase in independent living as well as a greater acknowledgement of the needs of people with learning disabilities. Furthermore, the myth that people with learning disabilities are eternal children (McCarthy, 1999) no longer holds sway and it is acknowledged that people with learning disabilities are not asexual; they have the same needs as people without a learning disability, including needs regarding sexuality. The Sex and Relationships research project, set up in 2007, was particularly influential in challenging the previously faulty beliefs and myths that maintained the exclusion of people with learning disabilities. This was a 3-year research programme conducted by CHANGE (2009), a national organisation that fights for the rights of people with learning disabilities. As part of this project it was found that people with learning disabilities, aged 16-25 years old, shared that they were not told about sex and relationships when they were younger. Furthermore, they also said that if they had been given better sex education, they might have made different choices as adults. This highlights a clear unmet need experienced by people with learning disabilities, as well as indicates that these unmet needs discriminate individuals via reduced choice in adulthood. Professionals working within the field of learning disabilities, including social workers, remain reluctant to become involved in sexuality education due to lack of confidence and lack of availability of educational materials designed for this population (Howard-Barr et al., 2005). They want to support people with learning disabilities, but do not have the information or skills to do so (Garbutt, 2008). Thus, there is a need to establish effective interventions designed to equip social workers and other healthcare professionals with the personal and professional tools necessary to deliver sex education to people with learning disabilities. This provides the rationale for a narrative review of the literature. Research Question The research question posed from the background literature is: What interventions are available within social work practice for the delivery of sexuality education to people with learning disabilities? More specifically: What effective interventions are already available? What are the key concepts and theories relevant to effective interventions? How has efficacy of interventions been assessed? What are the key consistencies and inconsistencies across studies? What answers remain? Research Design and Methods A narrative review of the literature will be conducted in order to identify interventions available within social work practice for the delivery of sexuality education to people with learning disabilities. A narrative review has been selected due to its recommended use with comprehensive topics (Collins and Fauser, 2005), and the benefits that derive from being able to include subjective interpretations based on personal experience of social work practice. Social work is a person-centred and holistic discipline that warrants this phenomenological approach. Furthermore, a narrative review can be used to synthesise evidence from both quantitative and qualitative studies, thus benefiting from the strengths of both approaches, the former of which offers scientific rigour and the latter of which offers subjectivity and depth. The relevant literature will be synthesised through the use of data extraction forms (appendix 1), the identification of key themes and controversies between studies, and the development of a considered narrative for each key theme. By identifying established knowledge within this area, as well as where gaps in knowledge remain, conclusions will be made on the efficacy of different interventions or techniques that social workers could utilise in the delivery of sexuality education to people with learning disabilities. Inclusion and Exclusion Criteria Inclusion in this review will be confined to primary research meeting the following additional inclusion criteria: Randomised control trials (RCTs); control trials; prospective pre- and post-test cohort studies; qualitative studies. The study needs to be testing or exploring an intervention for the delivery of sexuality education to people with learning disabilities. Population: social workers or other healthcare professionals working with people who have learning disabilities. Studies conducted over the last 5 years (2006-2011). In addition, the following exclusion criteria apply: Studies conducted before 2006. Non-English studies. Studies that do not meet the pre-defined inclusion criteria. Search Strategy A search of the literature will be undertaken using Boolean logic, which will allow for a more sensitive search of the title and abstracts of the following databases: the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Embase, PsychINFO and The Cochrane Library of clinical trials. Keywords to be searched include learning disabilities OR learning dis*AND sex* AND educ* OR train* OR interv* OR intervention studies. The truncation symbol (*) will be applied to search for words that might have various endings (e.g. sex* will find sex, sexuality, sexual). The reference list of all articles that are obtained in full will also be hand-searched for relevant studies. In addition, two key social work journals will be hand-searched from 2010 to 2011 to identify the most up to date research in this area: British Journal of Social Work and Journal of Social Work. The title and abstracts of all literature identified by the search strategy will be scanned for relevance, with irrelevant or duplicate articles being excluded. All records meeting the pre-defined inclusion criteria will be obtained in full for data extraction. A data extraction form recommended by the National Institute of Clinical Excellence (NICE, 2010) will be used to elicit key details from each of the studies obtained (appendix 1), including: study design; intervention; and, main findings. Synthesis of Findings Thematic content analysis will be used to identify key themes across studies, followed by the identification of convergent and divergent findings within these key themes (Aveyard, 2010). Narratives will be created for the most prominent themes. A critical analysis of how social work practice could be informed, developed and improved with respect to the evidence obtained from this review will be included, with a specific emphasis on the importance of evidence-based practice. Study Resources, Risks and Timetable Internet databases that provide access to academic peer reviewed journals will be the primary source utilised for searching the literature. The university library will also be a valuable resource for locating learning disability and social work journals that can be hand-searched, as well as providing access to a librarian who can be asked for advice on suitable web-based subject gateways. In addition, the reference lists of reviewed articles are a source of access to further relevant research. Ethical approval will not be required for this review. A timetable for completing this review is presented in Table 1, with the deadline for submitting the reviewing being February 2012. Table 1: Timetable for Review Action Dates 1. Choose research question based on scoping of the literature and consideration of relevant policy. Beginning of March 2011 2. Conduct a preliminary literature search to gather information on the background and rationale for review. Mid-March 2011 3. Develop a review proposal and timetable, including search strategy and inclusion criteria, etc. End of March 2011 4. Conduct first search of the literature, utilising selected web-based databases, excluding irrelevant or duplicate records and obtaining the full text of remaining records. Complete data extraction forms for each study. April and May 2011 4. Hand-search selected journals, obtaining the full text of relevant records and completing data extraction forms for each study. June 2011 5. Hand-search the reference lists of all articles included from the database and journal searches, obtaining the abstract of potential articles of relevance. Exclude those that become irrelevant on closer inspection and obtain the full text of remaining references. Complete data extraction forms for each study. July 2011 6. Identify the key themes and controversies between studies. Write a narrative for each key theme, including objective discussion of studies and subjective interpretations in relation to experience, knowledge, and social work policy. August and September 2011 7. First draft of introduction and rationale chapter. October 2011 8. First draft of methods and results. November 2011 9. First draft of discussion chapter. December 2011 10. First full draft of review make necessary adjustments and finalise. January 2011 11. Submit final review. February 2012

Impact of Mental Health Disorders in Childhood and Adolescence

Among the stated objectives of the Healthy People 2010, a national, multi-stakeholder program that aims to improve the over-all health of the American people through health promotion and disease prevention is to expand treatment services for mental health disorders. In particular, the program is aimed at â€Å"increasing the proportion of children with mental health problems who receive treatment† by enhancing the support network of affected children and their families and improving their access to mental health and other social services.The inclusion of mental health disorders as a priority public health issue that needs to be addressed stems from the acknowledgement of the gravity of the social and economic costs of mental health problems to families and communities. More importantly, the inclusion of mental health as a national health priority reflects a significant shift in attitude in public health policy.Indeed, mental health disorders have affected a significant portion of the American population for a long time. Estimates from the United States Department of Health and Human Services reveal that mental health problems affect 20 percent of the population annually. Likewise, the risk of developing mental health disorders cuts across age, ethnicity, gender, education, and socio-economic status, making children almost as vulnerable as older people to mental health problems.It is estimated, for instance, that 20 percent of children and adolescents within the 9 to 17 age group are likely to exhibit symptoms of mental health disturbances such as major depression, schizophrenia, and anxiety disorders; with 5 percent of the cases being severe and debilitating to children’s normal growth and development. (USDHHS (a), 2000)Clearly, the impact of mental health disorders on children and adolescents’ well-being is grave. Children and adolescents with mental, behavioral, and emotional disorders usually perform poorly in school and are more vulnera ble to alcohol and drug addiction. As in adults, mental health disorders also increase the risk of children and adolescents towards violent and aggressive behavior and suicide. In the 1999 alone, the suicide rate among children and adolescents was as high as 2.6 percent. (USDHHS (b), 2000)Unfortunately, mental health disorders have been poorly understood which usually deprives those affected of access to necessary treatment and services. It is worth noting, for instance, that only 27 percent of children and adolescents afflicted with mental health disorders avail of treatments, most of them receiving help mainly from in-school facilities and services. (USDHHS (b), 2000) Prevailing health policies have largely ignored the fact that mental health problems usually begin during childhood and adolescence and may have a lifelong impact on affected children. In the same manner, the public and social costs of mental health disorders have been largely ignored or underrecognized.On the other hand, mental health disorders have been shown to have a tremendous impact on public and private health spending, amounting to $69 Billion in diagnosis and treatment expenses. (USDHHS (b), 2000) Majority of these costs were shouldered by public funds while the remainder were paid for through private spending. The figures could be higher when the indirect costs of mental health illness on productivity, damages to property, criminal justice and litigation, and insurance claims are accounted for.Likewise, mental health disorders also place a tremendous strain on the economic lives of families and communities. A study done by Busch and Barry (2007) aimed at determining the impact of childhood mental disorders on the financial well-being of families with afflicted children reveals that the impaired functioning of children with mental disturbances affects parents’ work productivity and caring for or arranging for the care of the child often leads to lost family income in terms of lo st work hours. (p. 1090) The researchers contend that caring for children with mental health disorders are as costly as caring with children with other chronic illnesses. (p. 1088)Busch and Barry’s study was conducted by analyzing the responses of respondents to the National Survey of Children with Special Health Care Needs (NS-CSHCN) to compare the effects of children’s mental health disorders on the family’s economy to the economic impact on the family of children requiring special health care needs. (p. 1089)To this end, the researchers utilized propensity-score matching and logistic regression in controlling for differences between children with mental health disorders and the general population sample. Results of study supported their contention that caring for children with mental health disorders was a cause of financial burden especially for those who were privately insured. (p. 1089) Results of the study also showed that caring for a child with mental h ealth disorder severely limited the labor-market participation of parents, increased the time they spent caring for or arranging for childcare, and consequently reduced the time parents spent on other activities. (p. 1091)Thus, the authors encourage the implementation of programs and policies aimed at supporting the families of children with mental health disorders to alleviate the adverse economic outcomes brought about by heavy costs incurred from intensive and extensive child care and treatment requirements. (p. 1095) Such programs could include the elimination of mental health restrictions in private insurance policies that prevent or reduce children’s access to mental health services and treatment that increases the risk of prolonged and degenerative disability. Another suggestion made by the authors is extending financial assistance to families caring for children with mental disorders that would help defray some of the costs involved in the medical care of such childre n. (p. 1094)It is clear that the social and economic impact of mental health disorders should be a great concern for the nursing community. Nurses, who are at the frontline of health service delivery, play an important role in health promotion and disease prevention. As a critical health workforce, nurses’ support in the implementation of mental health programs is crucial in meeting health objectives and achieving positive health outcomes. Nurses have the ability to contribute to the promotion of mental health through a renewed focus on patient-centered care that takes into account the holistic dimensions of health and places emphasis on early detection and diagnosis of mental health problems.Nurses are an important part of the support network of families and communities with respect to the provision of information and other forms of resources. Given that mental health disorders are preventable and treatable diseases, the ability of nurses to provide a timely referral for tre atment services and intervention for children and adolescents who exhibit the symptoms of mental, behavioral, and emotional disturbance would be a significant factor in improving the health and lives of children and adolescents. A significant improvement in the detection of mental health disorders, for instance, can be achieved with adequate attention on the part of nurses on the cognitive, emotional, and psychological aspects of their patients.Therefore, the nursing community, as an important part of the health workforce, must be conscious of the prevalence of mental health disorders and be sufficiently informed about their role in the prevention and treatment of these problems. This way, nurses will be able to provide the needed support to reduce the economic and social costs of mental health-related diseases. Nurses will also be fully prepared to meet the exacting challenge of improving the health and quality of life of the individuals they serve.Works Cited:Busch, Susan H. & Col leen L. Barry (2007). Mental health disorders in childhood: Assessing the burden on families. Health Affairs, 26(4): 1088-1095.United States Department of Health and Human Services (a) (2000). Healthy People 2010: Leading Health Indicators. Retrieved 21 April 2008 from the Healthy People 2010 website: https://www.healthypeople.gov/Document/html/uih/uih_bw/uih_4.htm#mentalhealth

Foundations and Limits of Freedom of the Press - 705 Words

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