EFFECTIVENESS OF THE ROLE OF MEDICAL AND PSYCHIATRIC SOCIAL WORKERS WORKING IN HEALTH CARE FACILITIES

METHODOLOGY

Field of Study

The researcher focused on social workers who were currently working in hospitals or other health facilities in Vellore district and in various parts of Chennai, who were in practice and has a work experience of minimum 2 – 3 years in hospital or health care facilities. The researcher focused on government and private hospitals in Chennai and Vellore districts. The researcher focused on these two places for data collection as it was feasible based on the count of the health facilities located in Vellore and Chennai.

Research Design

The research design was descriptive design. The descriptive research design was used in order to cover the objectives of the study and get a clear information regarding the medical and psychiatric social worker’s role in health facilities, to know about their role when working in interdisciplinary teams, the challenges they face and how effective is their learnings the researcher interacts with the participants and collects data through questionnaire.

Universe

The universe of the study consisted of medical and psychiatric social workers working in hospitals and health care facilities in Vellore district and Chennai.

Sampling Technique

The sampling technique used by the researcher was exponential non-discriminative snowball sampling and a sample size for the study was 50 medical and psychiatric social workers working in hospitals and health facilities (n=50).

Characteristics of Sampling

• Medical and Psychiatric social workers working in hospitals and health care facilities with a work experience of minimum 2-3 years.
• The participants should have completed their Master’s in social work

Tools of Data Collection

The tool used for the data collection is a self-structured questionnaire prepared for the purpose of effective gathering of information which is framed based on the objectives of the study.

RESULTS

1. Socio – Demographic profile of the respondents – The data shows that more than one third of the respondents were of the age between 31 – 40 years and one third of them were between 20 – 30 years of age. The average pay scale of the respondents was between 21,000 and 30,000, 80% of the respondents’ specialization were in medical and psychiatric social work, 10% were specialized in Community Development, 8% were specialized in Human Resource Management and 2% were specialized in Family and Child welfare. 28% of the respondents’ current work place was in a government health facility and 72% of the respondents were currently working in private health facility. Half of the respondents’ job title in their current work place were medical social workers, 22% of the respondents were referred as psychiatric social workers and 28% of the respondents were referred as social worker who are assigned to do many other works along with their major role.
2. b. Role of the Medical and Psychiatric Social Workers – One third of the respondents’ major role is Counselling in the health facility that is 32%, Teaching and Training is the second major role found among the respondents with 10% followed by Public Relations Services and Rehabilitation is 10% respectively, 8% of the respondents major role was giving therapy (cognitive behavior therapy, group therapy, family therapy and psychotherapy), facilitator, case assessment respectively. 2% of the respondents involved in care giving and case managing. According to “Cannon (2010) hospital social worker’s role includes the direct treatment of the patient’s social and psychological problems which were among the causes or effects of their health problems or which acted as barriers to cooperation with the medical treatment plan”. Social workers specialized in medical and psychiatry were also assigned to perform service counselling (22%), following – up with the inmates (13%), 8% of the respondents were also assigned to perform socio – economic assessment of the patients, perform psycho-social-vocational rehabilitation, and perform liaising, 7% of the respondents were functioning as mediator, advisor and involved in group teaching regarding family planning. 21%. 14% of the respondents involved in the assessment of patients. According to “ (Morrow, 2014) Medical Social Workers are most often referred as social workers, and sporadically may have other titles, such as case/care manager”. About 86% of the respondents involved in referring patients to other services, 32% of the respondents rarely involved in admitting patients and 28% of the respondents sometimes involved in the process, 36% rarely involved in discharging the patients and 24% of the respondents sometimes involved in the discharging process. Medical and Psychiatric social workers also involved in teaching and training process, 46% of the respondents involved in teaching the social work interns, 24% of the respondents involved in teaching the nursing students and 20% of the respondents involved in teaching medical students. According to Herbert H. Stroup it is one of the functions of the medical social workers to educate nursing and medical students about the social aspects of illness and medical care (Stroup, 1948).
3. c. Working with interdisciplinary teams – Vast majority of the respondents (80%) had job contact with doctors, more than two third of the respondents (70%) had job contact with therapists and 68% of the respondents had job contact with psychologists and administrators. A high majority of the respondents (86%) maintained records when working in interdisciplinary teams. More than two third (68%) of the respondents involved in planning budgets in the organization. Records maintained when working in interdisciplinary teams included records of their job or their current role in the health facility, records of other professionals and general records. Three fourth of the respondents maintained the records that reflected their current role in the health facility. When it comes to organizing activities more than two third of the respondents (72%) involved in organizing interdisciplinary meetings, 48% involved in organizing case conferences. 98% of the respondents maintained records that reflected the patients’ data, 86% of the respondents maintained records that holds the details of the collaboration with other health professionals. A vast majority of the respondents involved in maintaining the follow – up records.
4. d. Social work methods and approaches used in the work place – Three fourth (74%) of the respondents reported that they felt field work is adequate, 88% of the respondents reported that they always used case work, 46% occasionally used group work, 54% occasionally used community organization, 42% never involved in social work research and 46% of the respondents occasionally involved in social welfare administration. A high majority of the respondents (86%) used the knowledge of community organization and more than two third (72%) of the respondents worked with community for community organization. A high majority of the respondents (84%) educated the community on health related issues and (82%) of the respondents motivated the community for health and hygiene. The approaching methods used by the respondents involved – through phone call that is 33% of the respondents approach their clients through phone calls for follow-up treatments and 26% of the respondents involved in home visits.
5. e. Challenges faced by social workers – The research showed that 60% of the respondents sometimes faced physiological difficulties such as clients coming in with hearing and vision impairment where transfer of information is difficult, 42% of the respondents sometimes faced psychological difficulties of clients. 34% of the respondents never faced any environmental difficulty in the work place such as noise or congestion and 40% of the respondents reported that they often face cultural obstacles in the treatment process such as customs, religion and attitude of the clients towards the treatment process. The respondents specialized in Medical and Psychiatry reported that 55% of them felt that the workload is somewhat heavy and 25% felt it to be very heavy. 40% of the respondents specialized in community development felt that the workload is very heavy and somewhat heavy respectively. The respondent specialized in family and child welfare felt that their workload is very heavy. Half of the respondents specialized in human resource management felt that their workload is very heavy and somewhat heavy respectively. The majority of the respondents that is 78% reported that along with counselling as their major work they are also assigned to do other works which leads to heavy workload – 64% working with individuals, 60% dealing multiple clients, liaising and engaged in public relations work, 50% involved in administrative work and 46% involved in working with the communities. The satisfaction rate of the respondents working in government and private health facility based on the relationship with health centre staff showed that 7% of the respondents working in government felt unsatisfied whereas 11% of the respondents working in private health facility felt unsatisfied with their work. The research showed that the unsatisfaction rate was based on the decisions made by the team leader was high among the respondents working in private which was 14% whereas in the government health facility it was 7%. Based on the opportunities provided to upgrade skills and knowledge 11% of the respondents working in private health facility reported that they are unsatisfied whereas the rate is lesser among people working in government which was 7%, 14% working in government health facility reported that they are unsatisfied with their supervisor’s recognition of the respondents work whereas in private the percentage was only 11%.

DISCUSSION

1. Socio – Demographic profile of the respondents – the socio demographic profile of the respondents showed that the respondent’s average age ranged from 20 to 40 and majority of them were specialized in medical and psychiatric social work. This finding showed that social workers irrespective of their specialization were also employed in the health care setting, social workers specialized in community development, human resource management and family and child welfare were also seen working in psychiatric and medical wards performing the functions of a medical social worker. This also lead to the findings that the designation or the work title of social workers varied from medical social worker, psychiatric social worker and social worker assigned to perform other duties such as maintaining records, admission and discharge process and facilitating.
2. Role of the Medical and Psychiatric Social Workers – From the responses given by the respondents the study showed majority of the medical and psychiatric social workers role was counselling, public relations services and rehabilitation, teaching and training of students in medical field. Respondents specialized in Community Development were also assigned to mediate, perform psycho-social-vocational rehabilitation and conduct service counselling. Very few of the respondents were involved in the admitting and discharging process.
3. Working with interdisciplinary teams – social workers when working in interdisciplinary teams get to work with other health care professionals such as doctors, therapists, psychologists and administrators. When working in teams their job or role was to maintain records of their jobs, records of other professionals and general records, patient records and details of collaborative events with other health professionals and the reports of follow-ups. They also involved in organizing meeting and case conferences.
4. Social work methods and approaches used in the work place – Discussion– from the study it shows that majority of the respondents considered and used case work on a regular basis in their work place. Community organization and social work research were only used occasionally. The respondents felt that knowledge in community organization is important when working with communities and while implement any health plans. The respondents of the study used phone calls and home visits as methods to approach patients.
5. Challenges faced by social workers – The respondents of the study stated that they faced physiological difficulties because transfer of information to the patients was difficult, they also faced cultural barriers when patients with strong belief in custom, religion and practices were against the effective treatment process. The research showed that 26% of the respondents working in government health facility and all the respondents working in private health facility were satisfied with their current job, since the job is creative, gratifying and management seem to be supportive, whereas only 2% of the respondents working in government health facility reported that they were not satisfied with their job since its of low status, no upward mobility, wage increase is not related to their performances and unhealthy practices in the work place. Majority of the medical and psychiatric social workers felt that their workload was very heavy irrespective of their specialization as they were assigned to perform other jobs along with their current role. From the study, it shows that respondents working in private health facility were unsatisfied. The reasons were the decisions made by the team leader affected their performance, and not much opportunity was provided to upgrade their skills, however respondents in government health sector stated that often their work goes unrecognized by their supervisors. working in both the settings, it makes the students more knowledgeable in applying their ideas and thoughts in community as well as in hospitals or any other health facilities.
   The importance of case work, group work and community organization should be made known to the students and the knowledge to apply them is important irrespective of their specialization (Medical and Psychiatry, Community Development, Family and Child welfare and Human Resource Management).

    

   Implication: Knowledge of medical and health should be developed among social workers of any specialization as it plays a major role in community where the basic medical facilities is not available.

6. Workplace – The role of social workers is mistreated in most of the work places and they are assigned with many other duties irrelevant to their profession and job. This is one of the main causes that social workers have heavy workload and causing increased burnout rates. Their role should be recognized not only by the government but also by their work place.The workplace should provide proper training facilities and legal guidance from the government to the social workers working in the health facility. Meetings in the health setting should involve social workers and meetings should be organized for social workers related to health and medicine provided by the work place.

    

   Implication: This study provides that the role of social work is very important and its necessary to have social workers in every department in the health facility, and every hospital or health facility should have a department of social work.

7. Social Workers – Social workers should attain practical knowledge regarding their current field of work, social workers in health facilities need continuous and regular update in developing knowledge regarding their field.Their role in multidisciplinary team should be recognized and should be able to implement it in a manner where they are able to apply the theoretical knowledge of policies and schemes available for people with various health issues.

    

   Implication: Social work helps in developing skills and knowledge regarding various health schemes and policies that other professionals in health facilities lack, in such situations social workers are approached.

CONCLUSION

The role of social workers play a major role in almost every field and it is important that their role is recognized, often the need for social workers help is unrecognized and are provided with jobs that are totally irrelevant to their role and profession. This is due to the lack of identity that social work is a profession in India. Social work profession should be licensed and should be labelled a profession and mot a charity work or social service which is often misinterpreted by the society. The government should take initiatives to remove the stigma among people and make it a profession where many can gain out of the profession and can also serve those who need help the most.