SWR 432
Shabab Ahmad
Assistant Professor
Central University of H.P
Social Work in Mental Hospital Setting
• Mental Hospital
• Mental Health Institution
• Psychiatric Nursing Home
• C.G.C
• Psychiatric Clinic
Role and Function
• Aim as to reform the patient to community
• Better adjustment ( Socio-Psycho) of Pt.
• Making detailed history of Pt.
• Total Responsibility of psychological Rx
• Using Psychotherapies, Counseling Techniques, and conducting
Case work etc.
Four Fold Operation:
Within the Patient
Within the Family
With the Prospective Employer
With community People
Role of PSW
CLINICAL: NON-CLINICAL :
Promotion of MH
Intake Awareness Camp
Reception- Accepting Conducting Workshop
Diagnosis Making Case Record
Treatment Case Identification
Pre- convalescent Providing referral Services
Pre-Parol Services Providing Recreational
Follow- Up : after care Therapies
Program Administration
Counselling – Adm & Disch Training for Health
Volunteer
Values : PSW
Worth & dignity of the Individual
Respect for the Pt.
Acceptance
Non-Judgemental Attitude
Value for Individual’s capacity for change
Value related to client self determination
Social justice & social change
Equal opportunities
Non Discrimination
Psychiatric Social Work
Model & Approaches
• Psycho-Social Model • Functional Model
• Problem Solving Model
• Behavior Modification
Model
• Family Therapeutic Model
• Task Centered Model
• Crisis Intervention Model
• System Model
Unit -1 Topic 3
History of Psychiatric & Medical Social Work
Development in USA: M&PSW
Phase -1: Including the time of 1st World war
1920: Dr. William Healy established the Child Guidance Clinic (CGC) for the
Juvenile delinquents in USA.
Psychiatric Social
Work
In Correctional
In Health Institution In Industrial Setting
Setting
PSW in School Setting: In school setting the PSW acts as a
Consultant, Counsellor, and as a PSW. He share his / her
knowledge with pupils, teachers, parents and with other
supportive body & discipline.
PSW provide the link b/w the school and social agencies and act as a
broker for the services provided for pupils and their families &
communities.
PSW: Involvement Public
Management
Parents
PSW
Teachers
Students
As a PSW within in a School setting is in direct contact
with students as well as Teacher and administration
team. PSW deal with the problem of child. He provide
the counselling, therapies psychiatric treatment, clinical
test etc. for resolving the child in school setting.
Here are different illness occur in child
1. MR 7. Absenteeism
2. Conduct disorder 8. Poor Performance
3. Tic Disorder 9. School Phobia
4. Speech
5. Habit Dis
6. Pervasive Development Dis
Psychiatric SW: in Health Institution
Psychiatric Hospital, Nursing home, Psychological clinic, health ward,
general Hospital.
Role:
History Taking
Interview taking
Counselling
Referral
Record Making Case Work
Restoration
Clinical Role
Non Clinical Role
PSW in Correctional Institutional Setting:
PSW play a very imp role in correctional institutional. In CI
SW/ PSW/ MSW provide the redirection & re-education to
child, Juvenile or to person who have committed the crime,
or involve in anti social behavior.
CI are – reformatory School, Special School, Probation Home,
Observation Home, Remand Home, Bal Sudhar Grah, etc.
Role:
Helping to enhance the capacity & Motivation
Allowing them for Ventilation of feeling freely
Giving the information
Help the offenders in decision making
Assisting modification of the environment
Organize development programme : Personality, Psycho-Social.
Providing Vocational Training
Rehabilitation
Role of SW/MSW/PSW: in Industrial Setting :
In industries , factories or in any business establishment, where
many worker / employees works, and they sometime suffer with
Job stress, work interest, conflict in job situation, in-adjustment
within organization and psychological problem among employees
which deal by professionals SW/MSW/PSW.
They deal with common Employee’s Problem:
Stress, Over work load, Absenteeism , Emotional Problem, Family
Problem, Accidents, Health Hazards, Improper Communication
etc.
SW can do- Case Work , Group Work, Research Work, Administrative
Work in Organisation.
Thank You
Unit -1, Topic – 1
Mental Health
&
Normal & Abnormal Behaviour
Normal
&
Abnormal
Normal Behaviour
Concept of Normal:
Medical Model
Statistical Model
Utopian Model
Subjective Model
Social Model
Process Model
Continuum Model
• Medical Model: Normal personality or health behaviour is
conceptualized as absence of psychiatric diseases or
psychopathology.
• Statistical Model: Statistical normal personality or MH fall with in
two standard deviation of normal distribution curve.
• Utopian Model: In mental health the focus in defining normality
is on “ optimal functioning”
• Subjective Model: In this normality is viewed as an absence of
diseases or disability or help –seeking behaviour.
• Social Model: A normal is expected to behavior a socially
permission behaviour.
• Process Model: It view normality as a dynamics & changing
process, rather than static as a concept.
• Continuum Model: It describe normal & abnormal disorder as
falling at the two ends of a continuum rather than being
disparate entities.
Abnormal Behavior:
Biological Model
Psycho-Social Model
Socio-Cultural Model
Diathesis -Stress Model
Criteria used to define Normality & Abnormality
Descriptive Criteria: D.C is integrated the type of
behaviour considered normal & Abnormal
Explanatory Criteria: It explain why particular
behaviour is normal and it is concern with as an
assumption process.
Methods
The 6th revision of the International Cl. of disease, injuries & causes of
death (1948) included psychiatric disorders for the first time.
ICD 8 (1972) glossary
ICD 9 (1978) glossary
ICD 10 (1992) International Statistical classification of diseases & related
health problems
Dissatisfied with ICD 6.
The American Psychiatric Association published the DSM Diagnostic and
Statistical Manual Disorder-IV.
Evolution of DSM: DSM 1: 1952
DSM II: 1968
DSM III: (1980); DSM IIIR 1987
DSM IV: (1994); DSM IVTR 2000
ICD 10 : Composition Of Chapters
Chapter number an designation Range of codes
I Certain infectious and parasitic diseases A00-B99
II Neoplasms C00-D48
III Disease of the blood and blood forming organs
and certain disorders involving the immune D50-D89
mechanism
IV Endocrine, nutritional and metabolic diseases E00-E90
V Mental and behavioural disorders F00-F99
VI Diseases of the nervous system G00-G99
VII Diseases of the eye and adnexa H00-H59
VIII Diseases of the ear and mastoid process H60-H95
IX Diseases of the circulatory system I00-I99
X Diseases of the respiratory system J00-J99
ICD 10 : Composition Of Chapters
Psychiatric Interview
Psychiatric Interview:
Principles:
1. Sense of Reassurance
2. Sense of Acceptance
3. Confidentiality
4. Sense of Relief
5. Rapport Building
6. Case Record
Objective of Psychiatric Interview:
To describe the patient condition, family development and
emotional factors affecting his behaviour .
To find out the pre –disposing factors
Making diagnosis
To identify the psychological emergencies
To prepare plan for Treatment and interventions.
D. Thought Disturbance:
-Stream of Thought: Flight/ slow/ circum-stantiality /
blocking
- Possession of Thought: OCD/ against desire
- Content of Thought: Delusion, Phobic,
- From of Thought: Derailment/ Omission/ fusion/
Delusion:
Delusion of Control- some one is controlling the thoughts
Thought Insertion- some body inserting the Thoughts
Thought Broadcasting- Telecasting of Thoughts
Thought Withdrawal- Elimination of Thoughts
E: Hallucination :
Auditory: [ elementary, 1st person, 3nd person H]
Visual,
Gastetory:
Tactile: Tactile or insect are moving in body, or on body.
Pseudo Hallucination:
Extracompine H: a hallucination which is outside the
limits of the sensory field
Reflex H: a stimulus in one sensory field produces a
hallucination in another.
Functional H: a stimulus causes the hallucination, but it is
experienced as well as the hallucination.
Hypnogogic H: when the subject is falling asleep, during
drowsiness
Hypnopompic H: when the subject is waking up
F.: Sensorium:
Alertness: yes /No
Orientation: Intact or Not Intact
Memory: Recent, Remote, Recent Past
Fund of Knowledge: any information
Abstract Thinking: similarities / difference
Judgment : Personal/ social/ test
Insight: Present / Absent
1. Complete denial of illness
2. Slight awareness of being sick and need help,
but dyeing at same time
3. Awareness of being sick, due to something
unknown reasons
4. Intellectual Insight: fail to resolve the problem
5. True Emotional Insight
Emphasis on:
- Alleviating Client distress
- Decrease the malfunctioning
- Enhance the client satisfaction
- Person in the situation
Use:
Intra-inter personal conflict
Dealing the faulty Attitude perception
Dealing with faulty communication
2. Function Approach: Jessie Thaft & Robinson in
1930
3. Problem Solving Approach: by Perlman in 1957
4. Task Centered Approach: (Rapid Action): by
Laura & William J. Raid in 1950, at Chicago
University.
5. System Approach by L. Von Bertalanffy
Family Assessment Points:
Family Tree
Family Present Condition
Family Occupation
Boundaries and Subsystem
Role Structure and Functioning
Leadership & Decision Making
Communication & Cohesiveness
Adaptive Pattern
Expressed Emotion
Social Support
Family Burden
Thank You
Unit- 4
• Personality Disorder
• Psychoactive Substance use Disorders
• Schizophrenia
• Mood Affective Disorders
• Neurotic Stress Related and Somatoform
Disorders
• Post Traumatic Stress Disorder
Unit-5
• Field of Psychiatry: Child Psychiatry, Geriatric,
Forensic and Community Psychiatry
• Psychological Treatment Methods: Group Therapy,
Family Therapy, Counselling, Behaviour Therapy,
Rehabilitation, Psychotherapy, Cognitive Behavioural
Therapy and Therapeutic Community
• Biological Therapy: Electro - Convulsive Therapy,
Chemotherapy and Psychosurgery
• Transactional Analysis and Existential Approach
• Legal and Ethical Issues in Psychiatry: Indian Lunacy
Act-1912, Mental Health Act-1987 and NDPSA-1985,
PWD Act 1995, RCI Act 1992 and National Trust Act.
Unit-5 Topic
Mode of Treatment:
1. Direct- absence of muscular relaxation and general Anesthesia
2. 2. Modified – presence of Anesthesia
Chemotherapy:
It means Therapy or treatment by drugs or chemical,
which use in the treatment of Psychiatric disorders. It
include the Psychoactive, Psychotropic drugs and
Minerals.
Classification of Psychotropic Drugs:
• Anti Psychotic
• Anti Depressants
• Mood Stabilizing Drugs
• Anti Anxiety
• Anti-Epileptic
• Alocohol and Drugs Dependence
• Miscellaneous Drugs
Characteristics of Chemotherapy:
• In 1987, the Mental Health Act was enacted and became law in
1990, and came into force in all states and Union Territories on
1st April, 1993.
• Mental Health Act have 10 Chapters and 98 Subsections
• CHAPTER I : Definitions ( sec: 1- 4)
• CHAPTER II : Mental Health Authorities (sec: 5- 14)
• CHAPTER IV : Admission and Detention in Psychiatric Hospital & Nursing
home (15-36 total)
Part -1: Admission on Voluntary Basis (sec 15-18)
Part-2: Admission under Special Circumstances (sec 19)
Part -3: Reception Order
Reception order on Application(sec 20-22)
Reception Order on production of mentally ill person before Magistrate
(sec 23-25)
Further provision regarding admission & detention of certain Mentally
ill (sec 26-29)
Miscellaneous provision (sec 30-36)
• CHAPTER V: Inspection, Discharge, Leave of Absence & Removal of
Mentally ill (37-49)
Part 1 : Inspection (visitors, mentally ill & ill prisoners) (sec 37-39)
Part 2 : Discharge (CMO, on application, relatives,) (sec 40-44)
Part 3 : Leave Procedure (45-46)
Part 4 : Removal (sec 47-49)
• CHAPTER VI : Judicial Inquisition about- Management of Property
( sec 50-77)
• CHAPTER VII : Maintenance cost for mentally ill in psychiatric
hospital (sec 78-80)
• CHAPTER VIII : Protection of Human Rights of Mentally ill persons
( sec 81)
• CHAPTER IX: Penalties & Procedure (maintenance of Psy. Hospital
Nursing home, etc) (sec 82-87)
• CHAPTER X : Miscellaneous ( pension, repeal, saving provision of
bonds etc) (sec 88-98)
The Person with Disability Act 1995:
• Full Name : as “The persons with disabilities (equal
opportunities, protection of rights and full participation) Act
1995”.
• Applicable to State Government departments, Boards,
Corporations, Panchayats, other establishments of State
Government and other allied establishments
• The Act was passed with a view to undertake various
measures for the welfare of disabled people, such as
creation of barrier free environments, remove discrimination
in the employment, provision of services for early detection
and rehabilitation of the disabled. The Act also envisages
the establishment of homes for the severely disabled.
• A disabled person is one whose disability has been assessed
at 40% of any disability by the medical authority.
Persons with disability are entitled to exercise their civil,
political, social, economical and cultural rights on an
equal basis with others.
• Disability –” summarizes a great number of different
functional limitations occurring in any populations in
any country of the world. People may be disabled by
physical, intellectual or sensory impairment, medical
conditions or mental illness.
• Such impairment conditions or illness may be
permanent or transitory in nature”.
Statement of objects and reasons- PDA act 1995
• Prevention of Disabilities.
• Protection of rights.
• Provision of medical care.
• Education, training, employment & rehabilitation.
• Create barrier free environment.
• Remove any discrimination.
• Counteract abuse & exploitation.
• Integration of person with disability in to social
mainstream.
Definition:
Impairment: Impairment is any loss or abnormally of
Psychosocially, physiology or anatomically structure or
function.
• Loco-motor disability
• Mental retardation and Mental illness
• Blindness and Low vision
• Hearing Disability
The National Trust Act- 1999
Full Name: The National Trust for Welfare of Persons with autism,
cerebral palsy, mental retardation and multiple disabilities Act,
1999