"Genius Translator" Jin Xiaoyu brushed the screen behind how to do social work services for patients with mental disorders

Recently, the report "Hangzhou Man Calls from the Funeral Home: Can You Write About Our Genius Son" published by Hangzhou Daily. The self-narrator of this article, Kim Joong-yong, tells the story of his son Jin Xiaoyu before and after suffering from manic depression.

Jin Xiaoyu was ill-fated, blind in his left eye in childhood, diagnosed with manic depression in high school, and was also withdrawn from college and dropped out of school, but he has been self-taught English, Japanese, and German. By chance in 2010, he became acquainted with a translator. In ten years, he translated 22 books, covering english, Japanese, German and other Chinese, spanning novels, art and philosophy. Translation became his only weapon in the fight against fate.

Jin Xiaoyu is unfortunate and lucky. Not every person with mental illness can have the aura of "genius". Even if people with mental illness recover, they are often far away from the crowd and are not in people's attention. Most of them suffer from stigma and discrimination in invisible places.

Li Qiaoming, a teacher in the Department of Social Work of South China Normal University who has handled case work related to mental health, said in an article written for the Beijing News Book Review Weekly, "In addition to the translator Of the "Genius Son" Jin Xiaoyu: "Decontamination" for the mentally disabled, that the diagnosis, treatment and rehabilitation of mental illness are unlikely to be solved by the medical system alone without their social attributes. Theoretically, biomedical care plus community rehabilitation is an ideal system of psychiatric rehabilitation support. However, in reality, employment discrimination has created barriers for mentally rehabilitated persons to return to society and achieve "normalization" of life, and residents' stigma and prejudice against mental illness have also brought resistance to the community rehabilitation of mentally rehabilitated people. Therefore, social education on mental illness has a long way to go.

At the same time, the family members of the mentally rehabilitated person are also subjected to multiple psychological, social and economic pressures such as external stigmatization and care for the recovered person. In the more mature community rehabilitation support system, social professionals such as mental rehabilitation doctors, social workers, and nursing staff can provide "respite services" to the home caregivers of the rehabilitated, which can alleviate the pressure of the caregivers to a certain extent, so that they can provide sustainable home care for the mentally rehabilitated people.

Li Qiaoming believes that from the perspective of social work, we can improve the well-being of mentally rehabilitated people from at least four aspects: first, medical social workers can connect with social work service stations, shelter workshops and other organizations to prevent the "vacuum" of social services after the mentally rehabilitated person is discharged from the hospital; second, when the rights and interests of the rehabilitated person are damaged in the process of returning to society, the social worker can cooperate with lawyers and the media to protect the legitimate rights and interests of the rehabilitated person; third, the community social worker can try to contact and communicate with the potential employer of the rehabilitated person. Minimize possible discrimination in employment and, finally, use social advocacy strategies to conduct community education to reduce the stigma of mental illness and promote the government to establish systems conducive to the development of the recovered.

In specific work, how can social workers serve people with mental disorders? Social worker Jun excerpted two articles to share with you.

The full course of the disease facilitates the rehabilitation of people with mental disorders

Xiao Yang was diagnosed with anxiety disorders and voluntarily requested hospitalization. Xiao Yang's anxiety symptoms are obvious, and his mood is low, which is manifested as fidgeting and worrying about bad things. Through a step-by-step approach, the social worker is guided by Xiao Yang's needs, establishes a professional relationship with him, and provides him with various services. In the process of deepening the service, the social worker helped Xiao Yang understand the policy knowledge in the field of mental health, and taught him some relaxation training methods such as music and painting. When Xiao Yang was discharged from the hospital, the social worker communicated with his family and helped his family learn some home rehabilitation methods and skills. After Xiao Yang was discharged from the hospital, when he came to the hospital to dispense medicines, the social worker actively followed up, guided him, understood the dynamics of his home rehabilitation, and helped him contact professional psychological counseling institutions for regular psychological counseling and counseling.

Xiao Yang's case reflects the exploration of "hospital-community" full-course and integrated professional services provided by Shanghai medical social workers for patients. Treatment and rehabilitation are carried out simultaneously, providing a full-course, integrated whole-person service, which is an effective service model that Shanghai medical social workers have continuously explored in the process of serving patients with mental illness in recent years. Under the full-course service model, all aspects of outpatient medical treatment, hospitalization, hospitalization, discharge, and community rehabilitation run through social work services to promote patient recovery and improve the quality of life of patients.

Integrated services for inpatients

Through case counseling and group intervention, social workers make full use of peer support and volunteer resources to provide integrated services for inpatients at all levels, from psychological counseling to social support.

First, assist with hospitalization. For inpatients, social workers assist patients and their families in the admission procedures, help patients understand ward rules and regulations, daily routines and inpatient treatment activities, and build a ward support system through patient associations to eliminate patients' nervousness.

Second, case counseling and group support. By providing case counseling, social workers help patients eliminate negative emotions, overcome fear of illness, and build good will to recover. At the same time, through the organization of group activities, to help patients adapt to the hospitalization environment, improve the quality of hospitalization, so that patients in the group to support each other and have inspiration and understanding.

Again, peer support and volunteer escort. Social workers invite people with mental disabilities who are better in the community to share their rehabilitation experience with inpatients in a peer-supporting capacity to help inpatients build confidence in recovery. At the same time, social workers organize and train university student volunteers and social volunteers to serve hospitalized patients, so that patients can fully feel the care of society and reduce self-discrimination.

Finally, discharge assistance. Social workers assisting patients to discharge is not simply to help patients with discharge procedures, but also to pay more attention to the needs of patients after discharge, reducing their worries. Social workers make a systematic pre-hospital assessment for patients, and consult, formulate and implement plans with patients to help patients successfully discharge from the hospital, enter the community and go to the society.

Full course service for community patients

More than 90% of people with mental disorders in Shanghai receive rehabilitation in the community. "De-institutionalization" is an important goal of mental health services, and providing full-course services for people with mental illness in the community is also the main goal of medical social work services.

First, outpatient care. Social workers provide medical guidance services in outpatient clinics, for first-time patients, social workers through disease knowledge explanation and successful case display, alleviate their medical tension, improve their cognition of mental illness; for patients with follow-up consultation and regular dispensing, social workers conduct a comprehensive assessment by understanding patients with large fluctuations in their condition and difficulties, and negotiate with patients and their families to promote their disease recovery and quality of life.

Second, assist in entering the park. "Garden" or "Sunshine Heart Garden" is an institution in Shanghai that specializes in providing day care, psychological counseling, recreational rehabilitation, and social adaptability training for patients with chronic mental illness who are stable. In order to allow patients to recover as soon as possible, social workers assist patients with mental disorders who meet the conditions for admission to the kindergarten.

Again, home recovery. Most people with mental illness have significant social withdrawal. In order to improve the social skills of patients, social workers go into the community, carry out targeted group services, link resources, and create a good social environment. At the same time, social workers conduct needs assessments for community rehabilitation patients, formulate vocational rehabilitation plans for different places, and work with patients to improve their vocational skills.

Finally, community advocacy to eliminate discrimination. The community is the first stop for the return of people recovering from mental illness. In order to create a good community rehabilitation environment for people with mental disorders in the community, on days such as "World Health Day" and "World Mental Health Day" every year, social workers popularize the knowledge of mental illness to residents through community work methods, reduce discrimination against mental illness, and promote people to treat community rehabilitation patients with mental disorders and their families in a more inclusive manner.

Social workers assist people with disabilities in achieving employment

What hinders the employment of people with disabilities

What hinders the employment of people with disabilities? Employers believe that most people with physical and mental disabilities are difficult to communicate, and in addition to physical dysfunction, there are different risks, such as what to do if a person with a mental disorder becomes ill, and what to do if an accident occurs during the work of the person with intellectual disability. There is also the idea that intellectually disabled people and a small number of other people with physical and mental disabilities go to work to play, and they can't do anything, and even some want to come and go, some often lose their temper and can't communicate... Although these thoughts and feelings of the employer are somewhat exaggerated, they do tell what they have in mind.

In the communication with people with disabilities and their families, social workers use the "Occupational Adaptability Assessment Form" to assess people with disabilities and find that although their physical condition and work skills are relatively good and they are fully suitable for employment, most of them lack working personality, such as beginning and end, work speed, work quality, compliance with workplace regulations, relationships with colleagues, and relationships between superiors and subordinates. Just think: a person who wants to come and go when he wants, which employer is willing to use it?

In view of the employment situation of the above-mentioned persons with physical and mental disabilities, social workers explore the use of the "compensation training model" to meet the needs of people with disabilities for employment and work personality, solve the problem of employers' fear of danger with the "supportive employment" model, and establish a support system for people with physical and mental disabilities, forming a "1+1" intervention model for employment services with physical and mental disabilities to meet their employment needs.

Compensatory training

Compensation training is to assess the occupational adaptability of employment cases, identify their deficiencies, and carry out individualized compensation training for these deficiencies to meet the requirements of employment.

assess. Mainly the "occupational adaptability" assessment, including work attitudes, work behavior, interpersonal relations, work skills, physical load, traffic capacity and other 6 areas of 49 items, the assessment results into a side chart (curve chart), so that you can see the strengths and weaknesses of the service recipients in the work. This needs to be done with special education professionals as the leader, together with social workers, guardians of service recipients and service recipients.

Develop an ISP plan. Based on the assessment results of "Career Adaptability", the strengths and weaknesses of the service recipients are analyzed, combined with the work that the service recipients need to seek, and personal long-term goals are set for the service recipients. The concept of long-term goal formulation is to develop strengths, fill in weaknesses, drive intermediate items, and then formulate short-term goals from six major areas according to long-term goals, and make suggestions for compensatory training. This needs to be done by special education professionals and social workers and clients.

Make a general map of compensatory training. The short-term goals are merged and classified, different training periods and training activity content are determined, and the general map of training activities is made, that is, a weekly training flow table, which makes people clear at a glance. This session also needs to be done by special education professionals, social workers, service recipients and their guardians and trainers.

Implement compensatory training. Compensation training is carried out according to the general map of compensatory training, which is jointly completed by the trainees and social workers. The trainee can be a training institution for people with disabilities, a guardian of the service recipient, or a professional invited by the guardian. Social workers play a role in understanding progress or linking professionals during this time.

Evaluation of the effectiveness of training and education. The main purpose is to assess whether the service recipient has reached the state of adapting to employment, and this link also needs to be led by special education professionals and completed together with social workers, guardians of service recipients and service recipients.

Supportive employment

"Supportive employment" is a model of employment for people with disabilities, in which employment counsellors provide ongoing training to people with disabilities in competitive workplaces to enhance their work skills, environmental adaptation and interaction with colleagues. When the performance of people with disabilities meets the requirements of the workplace, employment counselors gradually withdraw from the work site and provide services in a tracking manner.

The working methods of social workers are as follows:

Sign a service agreement. This is a service agreement signed by a social worker with the assistance of a social worker, a career counselor, a client and their guardian to clarify responsibilities and obligations for everyone to comply with.

Seek the right job and be familiar with the environment and work procedures. At this stage, social workers and employment counselors should determine the employment direction of the service recipients, seek suitable jobs, negotiate employment matters with the employer, including clarifying the responsibilities of both parties, and must relieve the employer's worries, that is, the things that the employer is afraid of mentioned above. Then, the employment counselor should familiarize the service recipient's future work environment, work content, number of jobs and work quality in advance, and assess the adaptability of the service recipient.

Sign a tripartite cooperative service agreement between the employer, the service target and the counselor. The social worker, employment counselor, service recipient, guardian of the service target and the employer shall sign a tripartite cooperative service agreement between the employer, the service target and the counselor, clarify their respective responsibilities, and prepare for entering employment.

Identify supportive employment programs. Social workers, employment instructors, and service recipients work together to formulate supportive employment service plans, including environmental adaptation, work speed, quality, interpersonal relations and other aspects.

Employment support. Counselors need to carry out supportive employment counseling according to the plan, such as "Employment Counseling Speed Yield Record Form", "Employment Counseling Work Quality Record Form", "Employer Satisfaction Record", "Supportive Employment Support Record", etc., and establish interpersonal networks for them, establish some support systems, so that people with physical and mental disabilities can gradually adapt to the job and position.

Assessment of the employment situation of service recipients. It is mainly to assess the effectiveness of service recipients in supportive employment situations to determine the steps for the gradual withdrawal of employment counselors.

Exit Density Support and instead track service support. When the performance of people with disabilities meets the requirements of the workplace, employment counselors gradually withdraw from the work site and provide services in a tracking manner. The tracking service mainly understands the performance of people with disabilities in their work, understands that the object is the service object, the colleagues and employers of the service object, and when they have difficulties, they need to immediately intervene to support until the dilemma is eliminated.

The "1+1" disability employment case service model is a multi-professional cooperation, multi-resource cooperation of the disability employment case service model, which allows the employer to find solvable problems and places of fear in the face of some unfathomable states of the person with the disability, know who to turn to when necessary, and also clarify their responsibilities and obligations, solve the employer's worries, so that the employer is willing to use the person with the disability.

(The article is selected from "Chinese Social Work", with abridgements)

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Source: Chinese Social Work, please indicate the source and author when reprinting

Editor-in-charge: Wang Hao, Yan Wei