Social Work - Theses

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    Social work in secure forensic mental health inpatient services: towards cultural competence
    Salmon, Catherine Lee ( 2011)
    International migration has moved to the forefront of the global agenda and has become a challenge for governments around the world. According to the Department of Immigration and Citizenship [DIAC] (2007), Australia has become “one of the most culturally diverse societies of the 21st century” with more than six million migrants having arrived since 1945 (p.1). This is despite Australia’s history of racist immigration and indigenous policy, and continued social disadvantage and discrimination experienced by many indigenous and CALD (Culturally & Linguistically Diverse) Australians. Secure forensic mental health inpatient services, like many services, are not meeting the needs of the indigenous and CALD population. This paper will use a critical literature review, from a critical theory and social constructionist perspective, to answer three fundamental questions: What are the problems for indigenous and CALD patients in secure forensic mental health inpatient services? What factors contribute to, and sustain, these problems? What can social workers do about these problems? While cross-cultural forensic mental health research is scarce and often methodologically flawed, key themes emerge. Secure forensic mental health inpatient services are influenced by a complex, socially constructed tangle of institutions, policies and practices. The ‘caring’ mental health system and the ‘custodial’ criminal justice system often have conflicting goals and expectations. Furthermore, public and media perceptions of danger frame the policy context. This leaves patients commonly experiencing discrimination, disempowerment and social exclusion. However, patients from indigenous and CALD populations are further marginalised and have reduced ‘social quality’ (social inclusion, socio-economic security, social cohesion and empowerment) (Huxley & Thornicroft, 2003). The literature attributes this to factors including: discriminatory and reactive government policies, an ethnocentric mental health system that relies on culturally invalid classification systems, and culturally incompetent clinicians and organisations. Social workers have been implicit in these systemic failures through their lack of contribution to the literature and their lack of influence in forensic mental health. This is despite the compatibility of the social work person-in-environment perspective, and its focus on social justice and social quality, with good cross-cultural practice. Frequent references to ‘unexplored’ socio-cultural and environmental factors in the literature, and a mental health policy shift in Victoria towards social inclusion and community development, provide a timely opportunity for social work to assert itself. In this paper, my purpose is to demonstrate how social workers can affect structural change on a professional ecosystem that impedes culturally competent practice. Through this conceptual framework, I have developed Culturally Competent Guidelines for Social Workers in Secure Forensic Mental Health Inpatient Services. These guidelines aim to provide social workers with tools that might empower them to become more culturally competent clinicians, and in the process, enable them to strive for social justice by improving social quality and cultural competence at all levels.