Psychiatric Diagnosis and Social Work Practice: The Linkage
Ikwen Stephen Agba
Federal Neuro-Psychiatric Hospital, Calabar
Psychiatry is a specialized branch of Medicine that is concern with the Diagnosis and treatment of mental, behavioral and Psychological disorders.
Psychiatric Diagnosis are referred to as types or classification of mental disorders and this involves the act of identifying the type of mental illness and presenting symptoms experienced by the sick individual/patients. These disorders are characterised by a dysfunction or disturbances in ones thinking, mood, and/or behavior and seriously increases your risk of disability, pain, death, or loss of freedom.
Classifications of Mental Disorders
Interestingly, there are two widely established systems for classifying mental disorders namely:
- Chapter V of the International Classification of Diseases (ICD-10) Produced by World Health Organization, WHO.
- The Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) Produced by the American Psychiatric Association, APA. (British Journal of Psychiatry, 2015).
It may interest you to know that the management and treatment of mental illness in hospital settings involves a multidisciplinary approach,
(Biopsychosocial Approach) with the Psychiatrist taking the lead, Psychiatric Nurses, Psychiatric Social Workers, Clinical Psychologist amongst other members of the Medical team. The five major Psychiatric Diagnosis/Mental illness includes the following but not limited to : Autism, Attention Deficit-Hyperactivity Disorder, Bipolar Disoder, Major Depressive Disorder, Schizophrenia etc. Other types of mental and behavioral disorders include : Sleep Disorder, Eating Disorder, Borderline Personality Disorder, Phobias, Substance Abuse Disorder etc (Atunka, 2004).
In Mental Health Practice, all members of the Medical team play various significant roles in other to bring about the wellness, stability and recovery of the mentally ill patient. The role of the Medical and Psychiatric Social Worker in the management and care of mentally challenged persons is enormous and cannot be overemphasize, but basically involves the application of Social Work Skills, Social Work Techniques and Practice models in addressing the social and emotional components of the illness and providing individualized care, Group therapy, Social Work Counselling, Social Diagnoses and Problem Solving Approach, Casework Management, Crisis Intervention, Resocialization, Reconscientization and Re-integration, Discharge Care Planning, Psychoeducation etc. (Agba, 2008).
The Link between Psychiatric Diagnoses and Social Work Intervention
Most classification of mental disorders is majorly flawed because it is extremely difficult for most systems to capture the complexity of human life. The classification of mental disorder are mainly based on medical model of making diagnosis while social work profession is characterized by the consideration of systems and the reciprocal impact of persons and their environments on human behavior. That is, for social workers the quality of a person’s social functioning should be assessed with regard to the interplay of biological, psycho-logical, and social factors in his or her life. Three types of person-in-environment situations likely to produce problems in social functioning include life transitions, relationship difficulties, and environmental unresponsiveness (Carter & McGoldrick, 2005). Social work interventions, therefore, may focus on the person; the environment; or, more commonly, both.
Psychiatric Social Workers are indispensable members of the mental health team. They play significant roles in the treatment process, with focus in addressing the social determinants of clients illness condition and enhancing the Social functioning and reintegration of the patient/client. As part of the team, it is Sacrosanct for the Social Worker to be knowledgeable in the various types of mental illness and the early signs and symptoms of the illness as they appear in the behaviour of the sick individual. This will be useful to him/her in planning appropriate Social Work Interventions especially during the Casework and Early Psychosocial Assessment.
For example, a Psychiatric patient diagnosed of a Bipolar disorder in a manic episode will differ in presentation or presenting complains from a patient diagnosed of Schizophrenia or Major depression.
Both patients in most cases will present with different symptoms and this will be manifested in their behaviour or judgement due to poor mental state/Lack of insight. After a thorough Psychosocial Assessment the Social Worker will be able to understand the nature of the mental illness and it will guide him/her in planning appropriate Social Work interventions based on the Medical and Social Issues diagnosed. As a matter of fact, with a good grab and understanding of the various mental illnesses, the Social Worker would be able to differentiate one from the other, manage follow up Psychiatric cases and refer cases for early diagnoses and treatment to doctors or other members of the medical team.
A good knowledge of the Medical and Psychiatric history of the patient will enable the Social Worker to have a clearer picture of the patients past or present State of Health so as to be able to design or formulate different care plan for both acute cases and chronic cases.
It is believed that some physical illnesses have their root causes from emotional problems, this is known as “Psychosomatic disorders”, e.g Asthma, Migrain, Peptic Ulcer etc.
In this case after observing the symptoms as they appear in the client, the Social Worker will immediately refer such a sick individual to the Physician for treatment.
The linkage here is that you can’t be an effective Medical or Psychiatric Social Worker if you don’t have a good knowledge of what your patient is being treated for. And as a matter of fact, the Social Worker is closer to the patient and his relation than the other members of the medical team, so therefore a well informed and knowledgeable Social Worker will be able to effectively communicate and Psycho-educate the patient and his/her relatives on the nature of the illness identified, the prognosis, expected roles and possibly ways of preventing relapse.
About the Author
Ikwen Stephen Agba is a Medical Social Worker Practicing in the Federal Neuro-Psychiatric Hospital, Calabar. Holds a Bachelor’s of Science Degree in Social Work (BSW) from the University of Calabar, Cross River State and a Masters of Science Degree (M.Sc) in Social Work, Department of Sociology and Anthropology, University of Benin, Benin, Edo State. His areas of interest include: Social Work Research, Mental Health, Casework Management and Community Relations. He is the author of Medical Social Work Practice: An introductory Analysis.