Medical social work is a sub-discipline of social work that addresses social components of medicine. [1] Medical social workers typically work in a hospital, outpatient clinic, community health agency, skilled nursing facility, long-term care facility or hospice. They work with patients and their families in need of psychosocial help. Medical social workers assess the psychosocial functioning of patients and families and intervene as necessary. The role of a medical social worker is to "restore balance in an individual’s personal, family and social life, in order to help that person maintain or recover his/her health and strengthen his/her ability to adapt and reintegrate into society." [2] Interventions may include connecting patients and families to necessary resources and support in the community such as preventive care; providing psychotherapy, supportive counseling, or grief counseling; or helping a patient to expand and strengthen their network of social supports. [3] In short, a medical social worker provides services in three domains: intake and psychosocial assessment, case management and supportive therapy, and discharge planning and ongoing care that extends after hospitalization. They are also involved in patient and staff education, as well as with policy research for health programs. [4] Professionals in this field typically work with other disciplines such as medicine, nursing, physical, occupational, speech, and recreational therapy.
The history of medical social work is intertwined with the history of social medicine. Dr. Richard Cabot, a physician associated with one of the earliest medical social work departments, noted that the active efforts to combat preventable diseases emerged through the actions of social workers. These actions included initiatives like the Anti-Tuberculosis Crusade, the Clean Milk Crusade, the Pure Food Law, the Playground Association, and the School of Hygiene. [5]
Medical social workers in Britain and Ireland were originally known as hospital almoners or "lady almoners" until the profession was officially renamed medical social work in the 1960s. [6] In 1895, Mary Stewart became the first lady almoner in Britain with her appointment to the Royal Free Hospital in London for a three-month trial period. [7] Some sources credit Anne Cummins as the "mother of almoners" as she had the ability and the funding to first establish a comprehensive social work service at St Thomas's Hospital in London in 1909. [8] Lady almoners determined the patient's ability to contribute towards their own medical care at charity hospitals. This approach was also followed by Australia during its vassal period with Great Britain. They adopted an approach similar to strength-based case management, and formal education for almoners was introduced in Australia in the early 1920s to carry out the required tasks. [9]
In 1922, the Institute of Hospital Almoners in Britain was formed. A group focusing on the application of psychology to the treatment of mental illness separated from it and established the Association of Psychiatric Social Workers, largely due to the mental health courses provided by the London School of Economics in 1929. In 1964, two separate professional bodies of Hospital Almoners, one an institute and the other an association, merged to become the Institute of Medical Social Workers. [10] These professional groups later merged with the British Association of Social Workers, which was formed in 1970. In Britain, medical social workers were transferred from the National Health Service (NHS) into local authority Social Services Departments in 1974 and generally became known as hospital social workers.
Medical social work was started in 1921 by Ida Pruitt in Beijing. In-service training was given to social workers for carrying out casework, adoption services and recuperation services. [11]
Dr. Clifford Manshardt an American missionary in 1936 started formal training in social work in India through Dorabji Tata Graduate School of Social Work. [11] The first medical social worker was appointed in 1946 in J.J. Hospital, Bombay. In 1960s scope of medical social workers increased in India. [12]
In Ireland, the origins of medical social work go back to paediatrician Ella Webb, the first physician in Ireland to appoint almoners to work in her dispensary for sick children that she established in the Adelaide Hospital in Dublin, and to Winifred Alcock, the first almoner appointed by Webb in 1918. [13]
Almoners from St Thomas’ Hospital, London, who arrived in Singapore in 1948 and 1949 are recognized as the forerunners of hospital social worker's in Singapore. Medical Social Worker is a Singapore Ministry of Health recognized profession for psychosocial care and a required professional by bylaw in every clinical specialty department. [14] [15] [16]
The Massachusetts General Hospital was the first American hospital to have professional social workers on site, in the early 1900s. Garnet I. Pelton, Ida Maud Cannon and Dr. Richard Clarke Cabot were the central figures of the hospital social work. [17] Clarke credited his approach as similar to that of Anne Cummins in London. [18] The establishment of medical social work services in the United States is attributed to the inspirational and insightful efforts of the Society for the Aftercare of the Insane in England, the reorganization of Lady Almoners' work by C.S. Loch and Colonel Montefiore, the visiting nurses who conducted the final medical tasks of the hospitals, and the social service training Dr. Charles P. Emerson provided to medical students at Johns Hopkins University. [19] Cannon started specific training for medical social workers in 1912. The major duties carried out by medical social workers were case management, data collection, follow ups, care coordination, health education, financial assessment and discounting patient medical fees. [17] However, historically, social workers began engaging independently in the healthcare field much earlier. In 1893, Jane Addams established a medical dispensary at Chicago's Hull House. In 1912, social worker Anne Moore conducted a study on possible dispensary abuse in New York County. This was during a time when the prevailing belief about poverty was that it was an outcome of consequentialism. Moore found that 90% of the patients were deserving of free treatment. A survey conducted in 1976 revealed that half of the directors in federally mandated health planning bodies were social workers, and more than 17,000 social workers provided their services at varying levels in Medicare participating hospitals. [20]
Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social work practice draws from liberal arts and STEM areas such as psychology, sociology, health, political science, community development, law, and economics to engage with systems and policies, conduct assessments, develop interventions, and enhance social functioning and responsibility. The ultimate goals of social work include the improvement of people's lives, alleviation of biopsychosocial concerns, empowerment of individuals and communities, and the achievement of social justice.
Health care, or healthcare, is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions all constitute health care. The term includes work done in providing primary care, secondary care, tertiary care, and public health.
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.
A children's hospital(CH) is a hospital that offers its services exclusively to infants, children, adolescents, and young adults from birth up to until age 18, and through age 21 and older in the United States. In certain special cases, they may also treat adults. The number of children's hospitals proliferated in the 20th century, as pediatric medical and surgical specialties separated from internal medicine and adult surgical specialties.
Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. The discipline is concerned with understanding how psychological, behavioral, and cultural factors contribute to physical health and illness. Psychological factors can affect health directly. For example, chronically occurring environmental stressors affecting the hypothalamic–pituitary–adrenal axis, cumulatively, can harm health. Behavioral factors can also affect a person's health. For example, certain behaviors can, over time, harm or enhance health. Health psychologists take a biopsychosocial approach. In other words, health psychologists understand health to be the product not only of biological processes but also of psychological, behavioral, and social processes.
The Institute of Mental Health (IMH), formerly known as Woodbridge Hospital, is a psychiatric hospital in Hougang, Singapore.
Home health is a nursing specialty in which nurses provide multidimensional home care to patients of all ages. Home health care is a cost efficient way to deliver quality care in the convenience of the client's home. Home health nurses create care plans to achieve goals based on the client's diagnosis. These plans can include preventive, therapeutic, and rehabilitative actions. Home health nurses also supervise certified nursing assistants. The professional nursing organization for home health nurses is the Home Healthcare Nurses Association (HHNA). Home health care is intended for clients that are well enough to be discharged home, but still require skilled nursing personnel to assess, initiate and oversee nursing interventions.
Health and Social Care is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.
Case management is a managed care technique within the health care coverage system of the United States. It involves an integrated system that manages the delivery of comprehensive healthcare services for enrolled patients. Case managers are employed in almost every aspect of health care and these employ different approaches in the control of clinical actions.
Health advocacy or health activism encompasses direct service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. Advocates support and promote the rights of the patient in the health care arena, help build capacity to improve community health and enhance health policy initiatives focused on available, safe and quality care. Health advocates are best suited to address the challenge of patient-centered care in our complex healthcare system. The Institute of Medicine (IOM) defines patient-centered care as: Health care that establishes a partnership among practitioners, patients, and their families to ensure that decisions respect patients' wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care. Patient-centered care is also one of the overreaching goals of health advocacy, in addition to safer medical systems, and greater patient involvement in healthcare delivery and design.
Patient advocacy is a process in health care concerned with advocacy for patients, survivors, and caregivers. The patient advocate may be an individual or an organization, concerned with healthcare standards or with one specific group of disorders. The terms patient advocate and patient advocacy can refer both to individual advocates providing services that organizations also provide, and to organizations whose functions extend to individual patients. Some patient advocates are independent and some work for the organizations that are directly responsible for the patient's care.
Psychiatric rehabilitation, also known as psychosocial rehabilitation, and sometimes simplified to psych rehab by providers, is the process of restoration of community functioning and well-being of an individual diagnosed in mental health or emotional disorder and who may be considered to have a psychiatric disability.
Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. Shortages of qualified nurses are found in many countries.
A hospital is a healthcare institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency department to treat urgent health problems ranging from fire and accident victims to a sudden illness. A district hospital typically is the major health care facility in its region, with many beds for intensive care and additional beds for patients who need long-term care.
Richard Clarke Cabot was an American physician who advanced clinical hematology, was an innovator in teaching methods, and was a pioneer in social work.
Compared with other neighbouring countries, Guyana ranks poorly in regard to basic health indicators. Basic health services in the interior are primitive to non-existent, and some procedures are not available at all. Although Guyana's health profile falls short in comparison with many of its Caribbean neighbours, there has been remarkable progress since 1988, and the Ministry of Health is working to upgrade conditions, procedures, and facilities. Many Guyanese seek medical care in the United States, Trinidad and Tobago or Cuba.
Anne Emily Cummins was an early British medical social worker who was later called the "mother of almoners".
Grace Mary Parbery was an Australian social worker who mainly operated in New South Wales.
Mental health in Singapore comprises the mental healthcare systems in Singapore and the mental health of people staying in Singapore. Singapore opened its first psychiatric hospital, the Institute of Mental Health, in 1928, and all general hospitals currently have psychiatry departments. Major depressive disorder is the most common mental illness in Singapore, with about six percent of the population suffering from it. Alcohol abuse and obsessive–compulsive disorder are the second and third most prevalent mental illnesses, with incidences of 4.2% and 3.6% respectively. 13.9% of the population in Singapore has experienced either a mood, anxiety, or alcohol abuse disorder in their lifetimes, with more than 75% never seeking professional help. Rates of mental illness have been increasing since 2010, and a large treatment gap exists for mentally ill populations.
Marjorie Steel aka "Edith" Steel OBE was a British almoner or medical social worker. She was General Secretary of what is now called the Institute of Medical Social Workers from 1946 to 1964.