The Resilience Hub approach for addressing mental health of health and social care workers during the COVID-19 pandemic: a mixed-methods evaluation.

Background: Resilience Hubs provide mental health screening, facilitation of access and direct provision of psychosocial support for health and social care keyworkers in England affected by the coronavirus disease 2019 pandemic. Aim: To explore implementation of the Hubs, including characteristics of staff using the services, support accessed, costing data and a range of stakeholder perspectives on the barriers and enablers to Hub use and implementation of staff well-being support within the context of the pandemic. Design: Mixed-methods evaluation. Setting: Four Resilience Hubs. Methods: Findings were integrated via mixed-method case studies, including: analyses of Hub mental health screening (N = 1973); follow-up questionnaire data (N = 299) on service use and health status of Hub clients; economic information provided by the Hubs; 63 interviews with Hub staff, wider stakeholders, Hub clients and keyworkers who did not use the Hubs. Results: Findings were consistent across Hubs and workstreams. Most Hub clients were NHS staff. Under-represented groups included men, keyworkers from minority ethnic communities, care homes and emergency services staff. Clients reported comorbid mental health needs across multiple domains (anxiety; depression; post-traumatic stress; alcohol use; functioning). Their health status was lower than population norms and relevant pre-pandemic data. Several factors predicted higher needs, but having pre-pandemic emotional well-being concerns was one of the most robust predictors of higher need. Sixty per cent of participants who completed follow-up questionnaires reported receiving mental health support since Hub screening, most of which was directly or indirectly due to Hub support. High levels of satisfaction were reported. As in many services, staffing was the central component of Hub cost. Hubs were predominantly staffed by senior clinicians; this staffing model was consistent with the generally severe difficulties experienced by clients and the need for systemic/team-based working. Costs associated with health and social care use for Hub clients were low, which may be due to barriers to accessing support in general. Enablers to accessing Hubs included: a clear understanding of the Hubs, how to self-refer, and managerial support. Barriers included confusion between Hubs and other support; unhelpful beliefs about job roles, unsupportive managers, negative workplace cultures and difficulties caused by systemic issues. Some keyworkers highlighted a perceived need for further diversity and cultural competency training to improve reach to under-represented communities. Other barriers for these groups included prior negative experiences of services, structural inequalities and stigma. Some wider stakeholders had concerns around growing waiting times for Hub-provided therapy, and insufficient data on Hub usage and outcomes. Feedback was otherwise very positive. Limitations: Main limitations included lack of comparative and pre-pandemic/baseline data, small numbers from under-represented groups limiting fine-grained analysis, and participant self-selection. Conclusions: Findings highlighted the value of the Hub model of outreach, screening, support navigation and provision of direct support during the coronavirus disease 2019 pandemic, and as a potential model to respond to future crises. The research provided recommendations to improve Hub promotion, equality/diversity/inclusion access issues, management of specialist resources and collection of relevant data on Hub outcomes and activities. Broader recommendations for the primary prevention of mental health difficulties across the health and care system are made, as individual support offers should be an adjunct to, not a replacement for, resolutions to systemic challenges. Research recommendations are made to conduct more robust evaluations of the clinical and cost-effectiveness of the Hubs, using larger data sets and comparative data. Study registration: This study is registered as researchregistry6303. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132269) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 29. See the NIHR Funding and Awards website for further award information.

Many health and social care staff struggled with mental health difficulties during the coronavirus disease 2019 pandemic. The study evaluated new National Health Service services ('Resilience Hubs') that were set up to help these keyworkers. We worked with four Hubs to: (1) look at who accessed the Hubs and what difficulties they had; (2) ask Hub 'clients' which support they used, and how helpful they found the Hubs; (3) look at what resources are needed to run the Hubs, to understand their 'value for money'; (4) interview people who worked with or used the Hubs (e.g. Hub staff, Hub clients, but also keyworkers who did not use the Hubs) to have their feedback. We used this information to make recommendations for the Hubs and the organisations that work with them. We found that Hub clients were mainly National Health Service staff. Many had several mental health difficulties, including anxiety, depression and post-traumatic stress disorder. Few men, staff from minority ethnic communities, care home workers and emergency service staff used the Hubs. People were generally happy with the support they had from the Hubs; clients who completed a follow-up questionnaire rated the helpfulness of support provided by Hubs as 92 out of 100 on average. Staffing was the main cost, as Hubs were mainly staffed by experienced clinicians. Things that made it easier for people to use the Hubs were clear understandings of Hub support and how to access it, and the support of their managers/employers. Some keyworkers from minority ethnic communities wanted greater diversity in the Hub teams. Some had concerns around waiting times and about not knowing enough about how well these services worked. Feedback was otherwise very positive. Our recommendations included how to: better promote the Hubs; improve inclusion of and support for individuals from minority groups; get better data on how well and for whom they work; and for employers to pay more attention to the mental health and well-being of keyworkers beyond the coronavirus disease 2019 pandemic.

Delineation of core roles of oncology social workers in inpatient settings: a secondary data analysis.

There is limited literature on the roles and tasks conducted by oncology social workers (OSW) who work with cancer patients in inpatient units. The purpose of this study was to delineate the roles reported to be significant to practice among OSWs who practice in inpatient settings and to identify the domains into which these roles fall. The data used in this secondary data analysis were collected in a large national study of OSWs to delineate the roles and tasks across all cancer settings. The sample extracted for this study were 240 OSWs who endorsed providing direct care to cancer patients in inpatient settings. Exploratory factor analysis revealed eight factors made up of 34 tasks. The roles were aligned with three of the four service areas in the Association of Oncology Social Scope of Practice and seven of the nine competencies set forth by the Council of Social Work Education. The findings can be used to enhance communications about the roles of inpatient OSWs across OSW constituencies, increase awareness of the role supervision and consultation to ensure equitable and just practice, enhance social work coursework to prepare students to work in healthcare inpatient settings, and in future research.

Assessing stigma: Health and social worker regard towards working with people using illicit drugs in Athens, Greece.

BACKGROUND: After the 2008 Global Financial Crisis and resulting economic austerity, the rise in illicit drug use engendered an increased need for people who use drugs (PWUD) to access medical care, compounded by the COVID-19 pandemic. Research shows that perceptions of medical staff towards PWUD facilitate or act as a barrier to accessing health care. This study provides a better understanding of health and social work professionals' perceptions by assessing stigma levels towards PWUD in Athens, Greece. METHODS: This is a mixed-method study. It calculates the stigma score for professionals (n = 60) and the stigma score associated with specific drugs based on the Medical Condition Regard Scale through a quantitative analysis of responses to a semi-structured online survey about attitudes of health and social work professionals towards PWUD. It draws on the qualitative analysis of 12 semi-structured interviews with 16 service managers, providers, and health services advocates working in the charity sector to determine whether perceptions of PWUD affect writing and implementing policy and protocols for services. RESULTS: Stigma towards PWUD exists amongst health and social work professionals in Athens. Professionals who have worked with PWUD for longer periods of time, professionals who have had specific training on working with PWUD, and professionals who feel that they have the necessary training to work with PWUD all demonstrated a higher stigma score than those reporting the opposite. Cannabis and opioids were associated with lower stigma scores while shisha had the highest level of stigma associated with it. Finally, professional environments are not conducive to alleviating stigma as the lack of training specific to stigma, the lack of professional supervision, and worker burn-out are key barriers faced by professionals in their everyday practice. CONCLUSIONS: Reducing and eliminating stigma towards PWUD among health and social workers requires immediate action. Measures to be taken include: introducing training programs focused on stigma towards PWUD to healthcare providers, social workers, lawyers, police, the media; increasing professional supervision on field work for health and social workers; introducing low barrier health care and specialist units. Peers and field-focused organisations should meaningfully participate in drug and alcohol policymaking, program development, and implementation.

Enhanced train-the-trainer program for registered nurses and social workers to apply the founding principles of primary care in their practice: a pre-post study.

BACKGROUND: A train-the-trainer approach can effectively support the integration of new practice standards for health and social services professionals. This study describes the effects of an enhanced train-the-trainer program to support registered nurses and social workers working in primary care clinics in their understanding of the fundamental principles of primary care. METHODS: We implemented an enhanced train-the-trainer program for registered nurses and social workers in six primary care clinics. We conducted a pre-post study using quantitative and qualitative data to assess trainers' and trainees' intention, commitment, and confidence in applying acquired knowledge. RESULTS: We trained 11 trainers and 33 trainees. All the trainers and trainees were satisfied with the program. Trainers were less confident in their abilities as trainers following the training, especially regarding tailored coaching (p = 0.03). Trainees' commitment to becoming familiar with the functioning of their clinic (p = 0.05) and becoming part of the team increased significantly (p = 0.01); however, their intention to use their knowledge decreased (p = 0.02). Trainers and trainees identified organizational and professional barriers that may explain the observed decrease. CONCLUSION: An enhanced train-the-trainer program positively impacted registered nurses' and social workers' assimilation of the fundamental principles of primary care. Further research is needed to understand the long-term effects of train-the-trainer programs on primary care trainees and how these effects translate into patient care.

Which diagnoses and arguments regarding severe mental disorder do forensic psychiatric experts in Sweden consider in different cases? A qualitative vignette study.

The decision-making process of experts in forensic psychiatric investigations (FPI) is complex and reasoning regarding psychiatric diagnosis and severe mental disorder (SMD, the judicial concept central to legal exemption in Swedish law) has severe ramifications. Nevertheless, the qualitative aspects of FPI experts' decision-making process have seldom been studied systematically. METHOD: The participants (N = 41) were FPI experts: forensic psychiatrists (n = 15), forensic psychologists (n = 15) and forensic social workers (n = 11). Using three case vignettes and qualitative content analysis, it was explored how case-specific characteristics could affect which hypotheses FPI experts generated regarding a) psychiatric diagnosis and b) severe mental disorder and c) which information sources they required. Each case vignette described a diagnostically ambiguous case but indicated emphasis on: psychotic symptoms (case 1); personality disorder symptoms (case 2) and neurodevelopmental disorder symptoms (case 3). RESULTS: Experts reasoned in a similar manner regarding generating hypotheses and required information, but also in a case-adapted manner. Experts considered various diagnostic alternatives, and some (e.g. psychosis) were mentioned for all three cases. Other diagnoses were only suggested as hypotheses in certain cases (e.g. case 3: intellectual disability). DISCUSSION: In Sweden, a core basis for SMD is psychotic-like functioning, and psychosis was suggested as a hypothesis for all three cases. Experts reasoned in similar ways regarding SMD in all cases, considering various perspectives for and against SMD. Some case-specific arguments for and against SMD adapted to the psychopathological circumstances were found. These could be related to aspects of the SMD concept that become important to ascertain when the type of psychopathology indicated in the case vignette was present; for example, ascertaining reality monitoring for a person with potential delusions of being followed by a criminal gang requires investigation of criminal history and related conflicts. Taken together, FPI-experts considered a broad range of psychiatric diagnoses in various cases. Their reasoning regarding SMD was both based on general and case-specific (or psychopathology-specific) factors.

"Working within broken systems": Social workers bridge the fractures of U.S. healthcare: A qualitative inquiry on moral injury.

Healthcare social workers (HSWs) in the United States are integral to interdisciplinary teams and health services. HSWs have a unique role in healthcare, as they care for their patients' psychosocial needs, through case management and clinical services. There is a gap in understanding how HSWs are impacted by their healthcare work. This study aims to understand the experience of moral injury, a marker of well-being, amongst HSWs in one state in the United States. Moral injury is the moral transgression (or boundary breaking) by oneself or someone in a position of power in high stakes situations and the negative outcomes of those experiences. Using a qualitative approach, semi-structured interviews were conducted with 24 HSWs in August of 2022. Thematic analysis was used to understand the lived experience of moral injury for HSWs. Three themes emerged: 1) HSWs' definition and examples of moral injury; 2) HSWs situated in the "in-between" of policy and practice; and 3) upholding social work values within the medical model. These findings impact healthcare practice and policy, in delineating what falls within the bounds of social work, changing the workflow of health services, and creating further opportunities for interdisciplinary training, well-being initiatives, and systems-level changes. The findings from this work highlight the importance of understanding the moral impact of healthcare work on social workers, which should be further examined in depth not only amongst HSWs but also across the healthcare workforce.

Crossroads of Care: A Black Social Worker's Insights into the Lives of Black Men from Adolescence to Adulthood.

This autoethnographic study, "Crossroads of Care: A Black Social Worker's Insights into the Lives of Black Men from Adolescence to Adulthood," explores the intersections of race, education, and mental health throughout the life course of Black men. Drawing on varied professional and personal experiences - from providing telehealth services for college students to being a resource within a predominantly Black high school - the research illuminates systemic barriers and profound effects of marginalization and isolation. Emphasizing evidence-based social work interventions and culturally relevant care, the study underscores the importance of narrative therapy and self-disclosure in addressing Black men's multifaceted needs. The findings contribute to discussions on racial equity in mental health and education, offering actionable recommendations for practitioners, policymakers, and educators to strengthen support systems. Advocating for a comprehensive care model, this research endeavors to empower Black men across various life milestones, enhancing well-being by addressing the complexities of race, education, and mental health.

The extent of implementation and perceptions of maternity and social care professionals about two interprofessional programs for care for pregnant women: a mixed methods study.

BACKGROUND: In 2018, the Dutch government initiated the Solid Start program to provide each child with the best start in life. Key program elements are a biopsychosocial perspective on pregnancy and children's development and stimulating local collaborations between social and health domains, with a specific focus on (future) families in vulnerable situations. Two programs for interprofessional collaboration between maternity and social care professionals to optimize care for pregnant women in vulnerable situations were developed and implemented, in Groningen in 2017 and in South Limburg in 2021. This paper describes the extent of implementation of these programs and the perceptions of involved professionals about determinants that influence program implementation. METHODS: We conducted a mixed-methods study in 2021 and 2022 in two Dutch regions, Groningen and South Limburg. Questionnaires were sent to primary care midwives, hospital-based midwives, obstetricians (i.e. maternity care professionals), (coordinating) youth health care nurses and social workers (i.e. social care professionals), involved in the execution of the programs. Semi-structured interviews were held with involved professionals to enrich the quantitative data. Quantitative and qualitative data were collected and analyzed using Fleuren's implementation model. RESULTS: The findings of the questionnaire (n = 60) and interviews (n = 28) indicate that professionals in both regions are generally positive about the implemented programs. However, there was limited knowledge and use of the program in Groningen. Promoting factors for implementation were mentioned on the determinants for the innovation and the user. Maternity care professionals prefer a general, conversational way to identify vulnerabilities that connects to midwives' daily practice. Low-threshold, personal contact with clear agreements for referral and consultation between professionals contributes to implementation. Professionals agree that properly identifying vulnerabilities and referring women to appropriate care is an important task and contributes to better care. On the determinants of the organization, professionals indicate some preconditions for successful implementation, such as clearly described roles and responsibilities, interprofessional training, time and financial resources. CONCLUSIONS: Areas for improvement for the implementation of interprofessional collaboration between maternity care and social care focus mainly on determinants of the organization, which should be addressed both regionally and nationally. In addition, sustainable implementation requires continuous awareness of influencing factors and a process of evaluation, adaptation and support of the target group.

How Attitudes Toward Evidence-Based Practice Impacts Burnout: A Sequential Mediation Model.

PURPOSE: With the rapid development of China's social work sector, the increasing job pressures, and risks of professional burnout among social workers have become more prevalent. This study examined the relationship between Chinese social workers' attitudes toward evidence-based practice (EBP) and burnout, exploring the mediating mechanisms of evidence-based knowledge (EBK) and service quality perception (SQP). MATERIALS AND METHODS: We applied PROCESS 4.2 macro in SPSS to analyze the data from 5,931 social workers, testing the sequential mediation effects of EBK and SQP between their attitudes toward EBP and burnout. RESULTS: The findings revealed: (1) Attitudes toward EBP had significant indirect positive effects on burnout; (2) EBK partially mediated the relationship between EBP attitude and burnout; (3) SQP partially mediated the relationship between attitudes toward EBP and burnout; (4) Attitudes toward EBP had a sequential mediated effect on burnout through EBK and SQP. DISCUSSION: The findings emphasize the need to implement targeted interventions and training programs to foster positive attitudes toward EBP, promote continuous professional development, and provide access to EBP resources. Moreover, nurturing EBK and SQP could help alleviate burnout by improving social workers' ability to address client issues and enhance their sense of confidence and accomplishment. CONCLUSION: This study fills a research gap by providing empirical evidence on the negative correlation between Chinese social workers' attitudes toward EBP and burnout, while demonstrating the mediating roles of EBK and SQP.

Incidence, trends and factors associated with psychological injury among health and social care workers in New South Wales, Australia: a retrospective cohort study of workers' compensation claims.

OBJECTIVES: To describe and compare the incidence and trends of workers' compensation (WC) claims for psychological injury: (1) between health and social care (HSC) industry and other industries; (2) among specific occupations in the HSC industry; and (3) to determine if psychological injury claim rates differ by age and gender in the HSC industry and among specific occupations. METHODS: A retrospective cohort study was conducted using data from the New South Wales WC system. Workers with accepted psychological injury claims between July 2012 and June 2021 were included. Negative binomial regression models were employed to estimate incidence rate ratios and 95% CIs. RESULTS: The HSC industry had a higher incidence (2.4 per 1000 workers) than all other industries combined (1.1 per 1000 workers). In the HSC industry, the incidence increased from 1.8 in 2013-2015 to 3.4 in 2019-2021. Ambulance officers had the highest incidence (24.9 per 1000 workers) and the highest growth rate. Nurses and midwives, and aged and disability care workers also had fast-growing incidence over the 9 years. Risk of psychological injury claims was highest among female workers and older adults. CONCLUSIONS: The increasing incidence and trend of psychological injury claims among HSC workers in New South Wales signify a growing public health issue. Greater efforts are needed to prevent work-related psychological injury in the HSC industry and support affected workers. The different patterns of psychological injury claims across occupations suggest that interventions should be tailored to each occupational group.

Exploring the Experiences of Community-Dwelling Older Adults on Using Wearable Monitoring Devices With Regular Support From Community Health Workers, Nurses, and Social Workers: Qualitative Descriptive Study.

BACKGROUND: The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices. OBJECTIVE: This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device. METHODS: We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data. RESULTS: A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses. CONCLUSIONS: Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.

Research-related knowledge, understanding and practice in public mental health: the voices of social workers and occupational therapists.

INTRODUCTION: Previous studies have explored facilitators and barriers to research conducted by allied health professionals in general medical settings. Since the mental health system is acknowledged to be significantly under-funded and more poorly functioning than general medical services, it is unclear whether the published facilitators and barriers also apply to mental health settings. This study sought to explore the research-related knowledge, understanding and practices of allied mental health clinicians based in a large public mental health service. METHODS: A mixed methods study recruited 59 occupational therapists and social workers working in a dedicated metropolitan public mental health service in Melbourne, Australia. Quantitative survey results are reported elsewhere. Semi-structured interviews were conducted with 16 survey responder volunteers. Thematic analysis was conducted on the qualitative survey and interview data. RESULTS: Four main themes were identified: research must connect with clinical practice; fragments of knowledge; research in practice; and research is not part of my professional identity. The third theme, research in practice, comprised four subthemes: no time for research in clinical roles, missing communication, lack of ownership, and what I need to do research. CONCLUSIONS: This study found that research and research-related activities were not considered part of the mental health social workers and occupational therapists' professional identities. Dealing with this issue may be instrumental to the realization of these clinicians' professional peak-body associations' code of practice and to government mandated practice standards. We provided several strategies to encourage both clinicians and services to view research-related activities as an everyday part of clinical roles. This is especially important if we think of allied health evidence-based practice requiring a reasonable level of research-related skills and/or competencies to appraise, practice, evaluate and adapt their evidence-based practice.

Examining associations between child welfare workforce well-being and utilization of casework skills with children and families.

BACKGROUND: While child welfare scholarship has paid much attention to workforce well-being such as burnout, secondary traumatic stress (STS), and compassion satisfaction, few studies have investigated how these outcomes influence utilization of casework skills. OBJECTIVES: This study aimed to understand the relationship between child welfare workforce well-being and use of casework skills. Specifically, we examined associations between burnout, STS, and compassion satisfaction and casework skills including parent/youth engagement, safety and risk assessment/case planning, and relative/kin connections. PARTICIPANTS AND SETTING: Participants comprised 786 child welfare direct service workers and supervisors in a Midwestern state. METHOD: Using a repeated cross-sectional design, data were collected via online surveys. Multivariate regression tested relationships between measures of well-being and casework skills. RESULTS: First, higher compassion satisfaction was positively associated (p = 0.000, f2 = 0.14) while higher burnout (p = 0.000, f2 = 0.04) and STS (p = 0.002, f2 = 0.01) were negatively associated with use of engagement skills. Similarly, higher compassion satisfaction was positively associated (p = 0.000, f2 = 0.18) and higher burnout (p = 0.000, f2 = 0.06) and STS (p = 0.001, f2 = 0.02) were negatively associated with use of assessment/case planning skills. Lastly, compassion satisfaction (p = 0.000, f2 = 0.06) was positively associated and burnout was negatively associated (p = 0.000, f2 = 0.02) with relative/kin connections. CONCLUSION: Child welfare workforce well-being may influence use of casework skills. More research is needed to understand how positive workforce well-being impacts service delivery and, ultimately, child and family outcomes.

Enhancing Evidence-Based Practice in Rural Social Work: Applying the Theory of Planned Behavior to Identify Key Determinants.

PURPOSE: This study explores the application and extent of utilization of Evidence-Based Practice (EBP) among rural social workers, identifying key factors such as attitudes, social pressures, and perceived barriers that influence its use. METHODS: Utilizing the Theory of Planned Behavior as a framework, this research involved a comprehensive survey targeting rural social workers. The survey assessed their attitudes toward EBP, the social pressures, and the barriers in implementing EBP. Data from 91 participants were analyzed using multiple regression to determine how these factors impact EBP utilization. RESULTS: The analysis indicated that while attitudes toward EBP did not significantly affect its use, perceived ease of use, social pressures, and practical barriers were significant predictors. Interestingly, the data showed that external factors like organizational support and resource availability played a larger role than personal attitudes in the adoption of EBP. The regression model successfully explained 39% of the variance in EBP usage among rural social workers. DISCUSSION: The findings underscore the importance of external over internal factors in the adoption of EBP within rural settings. The study suggests that improving access to EBP resources and enhancing organizational support could facilitate more effective use of EBP among rural social workers. CONCLUSION: Effective implementation of EBP in rural areas necessitates addressing both perceived and actual barriers. Developing strategies to enhance resource availability and organizational support is recommended to boost EBP adoption, ultimately aiming to improve service outcomes and client well-being.

[Professionals' Perceptions Regarding the Implementation of Guided Self-help in the context of the Programme québécois pour les troubles mentaux]. / Perceptions des professionnels face à l'implantation d'autosoins dirigés dans le cadre du Programme québécois pour les troubles mentaux.

Objective Common mental disorders, such as anxiety and depression, have many individual and societal consequences. Various treatments are available for people with these diagnoses, including medication and cognitive behavioral therapy. When these disorders are mild or moderate, psychotherapy is the recommended first-line treatment, given its greater long-term efficacy than pharmacotherapy. However, this is not what is observed in practice: medication is much more widely used than psychotherapy, the latter's accessibility being greatly reduced by long waiting lists. An alternative to these accessibility difficulties is the stepped-care model, which includes guided self-help. These are low-intensity interventions that enable more people to be treated with fewer resources (e.g., fewer meetings with a professional). The Programme québécois pour les troubles mentaux (PQPTM; Quebec Program for Mental Disorders) is a stepped-care model recently implemented in some settings in Quebec. The aim of this study is to gather the perceptions of social workers (SWs) in a Centre intégré (universitaire) de santé et de services sociaux (CI[U]SSS; Community mental health center) on the implementation of the PQPTM guided self-help. Methods To this end, three focus groups of approximately 1h30 were conducted with 13 SWs. The data were coded and analyzed using a thematic qualitative inductive-deductive approach, based on the Consolidated Framework for Implementing Research (CFIR) and the participants' responses obtained during the focus groups. Results The barriers and facilitators to PQPTM guided self-help implementation identified relate to different CFIR constructs: intervention characteristics (e.g., monitoring, type of self-help), internal implementation parameters (e.g., training, organizational pressures), caregiver characteristics (e.g., experience, appropriation time), user characteristics (e.g., age, personality) and process (e.g., treatment integrity, supervision). The results of this qualitative study show that SWs have varied perceptions and opinions of the PQPTM guided self-help: 64% of the themes discussed were nuanced, while 25% were considered exclusively as barriers and 11% exclusively as facilitators. Conclusion These results shed light on the factors that can contribute to the successful implementation of the PQPTM guided self-help in Quebec, with a view to improving it at the heart of the specific CI(U)SSS of the current study and in other mental health centers in Quebec. Several recommendations are made in this respect: for example, to increase upstream planning for future implementations, to maintain access to training and supervision, and to guarantee the availability and printing of self-help guides.

Responding to the needs of survivors of intimate partner violence in Lithuania: perceptions of mental health and social care professionals.

Around eight-out-of-ten survivors of domestic violence in Lithuania are women, and of those, eight-out-of-ten suffer violence specifically from their intimate partners (IPV). Women who experience IPV are at higher risk of having mental health conditions. This study aims to explore the perspectives of mental health and social care professionals regarding the provision of mental health support to IPV survivors in Lithuania. Four focus groups were conducted among 29 service providers from across the country. Audio-recordings were transcribed verbatim and analyzed thematically using MAXQDA software. The five main themes derived from the analysis reveal: 1) low levels of IPV awareness among IPV survivors who seek support with their mental health; 2) a lack of specialized training among professionals as a barrier to effective support; 3) a low prioritization on the national level; 4) little inter-sectoral collaboration which undermines the complexity of needed responses; 5) broader systemic problems. The provision of mental health support to IPV survivors lacks the recognition that IPV is gender-based violence and a major public (mental) health problem. The complexity of needed services is absent. Further research needs to explore the utilization of mental health services by IPV survivors and their perceptions concerning it.

Mothers' choice of health management services for under-five children with common illnesses: evaluating social workers' impact in Nigerian health sector.

INTRODUCTION: Every child deserves the right to life. In Nigeria like other African countries, a high burden of child mortality prevails. Attaining a low-mortality rate of children entails that mothers who are the primary caregivers are in the best position to provide quality healthcare management. METHOD: With the phenomenological approach in qualitative research, the researchers sourced data using Focus Group Discussions (FGDs) and In-Depth Interviews (IDI) from 38 mothers of various categories. The participants were purposively selected from four government and mission health institutions in a semi-urban Nsukka town, Enugu State. Data were analyzed thematically. FINDINGS: Results revealed that mothers utilize health institutions including government, mission, private, pharmacies and patent medicine vendors when seeking healthcare for their children. Their inability to recognize potential life-threatening conditions is the leading factor in increasing child mortality. Findings show that because participants were concerned about financial challenges; they were ready to adopt traditional medicine as an alternative to modern medicine. The study showed evidence of unsafe strategies mothers adopt for the health management of their under-five children with common illnesses. Participants indicated little knowledge of social workers' engagement in health institutions. CONCLUSION: Healthy living is essential in the protection from illnesses. Since under-five children are vulnerable to illnesses, their mothers should provide them with quality healthcare management. The study recommends that social workers' engagement with health providers and users in semi-urban societies could help propagate healthcare awareness and strategies in mothers' choice of health management for under-five children in Nigeria. Overall, adequate health policy consideration should be given to all under-five children in Nigeria.

Professional and Personal Attitudes toward Discussing Sexuality and Degree of Religiosity among Social Workers.

This study investigated the correlations between social workers' levels of religiosity and their professional attitudes toward discussing sexual health. The focus was particularly on the potential mediating role of their attitudes to heteronormative beliefs. A random sample of 150 social workers from Israel (Jewish [63.3 percent], Palestinian-Arab [36 percent], and those who self-identified as "other" [0.7 percent]) completed a self-administered questionnaire. The findings revealed significant correlations among professional attitudes toward discussing sexual health, attitudes toward heteronormativity, and degree of religiosity. Social workers with higher levels of religiosity exhibited higher levels of heteronormative beliefs, which, in turn, influenced their professional attitudes toward discussing sexual health. Furthermore, the findings highlight the importance of challenging heteronormative perspectives for all social welfare service users. Social work must establish culturally sensitive training to challenge the hegemony of heteronormative perspectives while connecting to religious and conservative values and perceptions.