The paradigm of cultural sensitivity and quality support system for the population implies a client-oriented approach that can account for every socio-cultural aspect of one’s development and perception. Such sensitivity is especially relevant in the context of multicultural and diverse groups, as shame and stigma associated with certain identity characteristics disrupt the quality of social service. According to Kirst-Ashman and Hull, Jr. (2018), “generalist practitioners must learn to approach clients from multicultural groups with a clear understanding of their own view of the world and how it differs from that of others” (p. 474). Thus, taking enough time to recognize the cultural and social norms of interaction and recognizing personal stigma associated with certain groups are critical in providing meaningful support. The present paper aims to conduct a self-evaluation on the matter of the existing stigma and barriers to quality social support on different ecosystem levels and outline the skills and interventions required to facilitate change.
Self-Evaluation
One of the critical aspects of social support is community education, which provides individuals, families, and the community with valuable knowledge about mental health and its implications for people struggling with mental health challenges. As a social support worker, I find psychoeducational groups an efficient way of community outreach and mental health education. Essentially, a psychoeducational group stands for a type of therapy, the aim of which is “to provide the patient and families knowledge about various facets of the illness and its treatment so that they can work together with mental health professionals for a better overall outcome” (Sarkhel et al., 2020, p. 319). However, besides mental health professionals, social workers as well assume irresponsibility for community education.
Over the years of practice, I have recognized the importance of the systems theory in the context of psychoeducational groups. The central idea of systems theory is that “Instead of seeing a client as the object of analysis, workers began to focus on the way in which the client and the client’s important systems were interacting” (Shulman, 2016, p. 11). Thus, the systems that play a significant role in client and community education include micro, mezzo, and macrosystems. According to Kirst-Ashman and Hull, Jr. (2018), micro practice defines the practice directly with individuals, the mezzo practice implies interaction with families and groups, whereas the macro system focuses on the cultural exchange within the community (p. 3). Hence, the process of psychoeducation encompasses social workers’ equal attention to all the systems.
Based on personal experience, none of these systems can exist in isolation. For example, if the community receives quality mental health education, while the issue is not addressed on a personal level, the client will continue to struggle with shame and insecurity. On the contrary, interpersonal communication has little effect when the client is reintegrated into society with minor mental health awareness. According to Rice et al. (2018), “Notably, the stigma process at these various levels are inextricably linked; whereby stigma within social structures at the macro-level shapes group and individual processes at the meso and micro levels, and visa-versa” (p. 11). Hence, it is of paramount importance for social workers to cooperate with clients, clinicians, families, and public institutions in order to bring the maximum benefit of education.
As far as the micro-level is concerned, the emphasis should be placed on the level of social workers’ cultural sensitivity and the professional setting. Thus, social workers need to understand the barriers to a person’s perception of mental health before working with an individual. Despite rising awareness of mental health, the number of people living with mental health issues remains significantly higher than the number of people seeking help (Holder et al., 2018). Such a discrepancy exists due to the increasing role of self-stigma. Researchers define it as a state when “those that suffer from mental illness judge themselves and their mental illness negatively or dismissively because they recognize that the public holds prejudice and will discriminate against them” (Holder et al., 2018, p. 370). Hence, in this scenario, social workers should assure the client that the interaction with a social worker is a safe space that exists with no prejudice against their condition or socio-ethnic background.
The next step, the mezzo level, focuses on communication with the family and the clinical environment. First, families play a critical role in assisting the client in coping with the mental health issue. According to Poon and Kung (2020), “social workers are well equipped to work with both families and their relatives with mental illness given their systems orientation in both theory and practice” (p. 213). Hence, the process of psychoeducation for the families plays an important role in ensuring that the closest ecosystem to the client understands and acknowledges the problem and helps the client love with the condition. On the other hand, the clinical setting presupposes that the intervention environment for the client includes both professional mental health care and social support. Hence, it is necessary for the social worker to engage with a multidisciplinary care team that conducts behavioral health education for the client and dwells on the desired behavioral patterns that would facilitate the therapeutic intervention (De Saxe Zerden et al., 2018). Thus, in the context of a mezzo system, social support mediates the relationship between individual perception of mental health and the support from the closest surroundings.
When it comes to the macro level, the social workers’ primary task is to engage with the community in order to eliminate social stigma related to mental health. According to Holder et al. (2018), “social stigma refers to extreme disapproval of (or discontent with) a person or group on socially characteristic grounds that are perceived, and serve to distinguish them, from other members of a society” (p. 370). The definition implies that social stigma related to mental health leads to implicit and explicit marginalization of people struggling with mental health issues. To eliminate this idea of “othering,” social support needs to develop a framework of psychoeducational interventions through public initiatives and cooperation with clinical and educational facilities. Once more people are aware of the roots of shame and stigma surrounding the notion of mental health, there is a higher chance of eliminating self-stigma on the micro-level and seeking social support. This proves the hypothesis of systems interrelation and the need for a holistic approach to social support services.
Skills Required to Facilitate Change
Based on the data presented above, a social worker is an agent of change whose actions impact the process of stigma elimination. The first fundamental skill required to facilitate change is open-mindedness, as eradicating stigma from one’s consciousness leads to promoting non-biased values. The second mandatory skill is cultural sensitivity, as the interaction with an individual is not about treating everyone equally, it is about making the quality of treatment equal by paying attention to diversity and individual traits. The third skill is active listening because meaningful communication depends on how attentive the social worker is. Self-stigma can be eliminated by making the client feel important and heard. Compassion and empathy are also the pillars of social support because they ensure the connection with the client. Finally, assertiveness plays a significant role in promoting social support and mental health awareness across various social institutions. It can be concluded that social work encompasses various layers of social systems and, thus, remains crucial in promoting emotional well-being in the population.
References
De Saxe Zerden, L., Lombardi, B. M., Fraser, M. W., Jones, A., & Rico, Y. G. (2018). Social work: Integral to interprofessional education and integrated practice. Journal of Interprofessional Education & Practice, 10, 67-75.
Holder, S. M., Peterson, E. R., Stephens, R., & Crandall, L. A. (2019). Stigma in mental health at the macro and micro levels: Implications for mental health consumers and professionals. Community Mental Health Journal, 55(3), 369-374.
Kirst-Ashman, K. K., Hull, Jr., G. H. (2018). Understanding generalist practice (8th ed.). Cengage Learning.
Poon, A. W. C., & Kung, W. W. (2020). An overview of social work approaches in working with families of people with serious mental illness. Mental Health and Social Work, 199-217.
Rice, W. S., Logie, C. H., Napoles, T. M., Walcott, M., Batchelder, A. W., Kempf, M. C., Wingood, G.M., Konkle-Parker, D. J., Turan, B., Wilson, T. E., Johnson, M. O., Weiser, S.D., & Turan, J. M. (2018). Perceptions of intersectional stigma among diverse women living with HIV in the United States. Social Science & Medicine, 208, 9-17.
Sarkhel, S., Singh, O. P., & Arora, M. (2020). Clinical practice guidelines for psychoeducation in psychiatric disorders general principles of psychoeducation. Indian Journal of Psychiatry, 62(2), 319-323.
Shulman, L. (2016). The skills of helping individuals, families, groups, and communities (8th ed.). Cengage Learning.