Preventing Severe Mental Illness: A Grand Challenge for Social Work

The prevention of schizophrenia and severe mental illness was recently identified as a Grand Challenge for social work by the American Academy of Social Work and Social Welfare, as one component of the Grand Challenge to “Ensure Healthy Development for All Youth.” Unlike the other component of this grand challenge, “Unleashing the Power of Prevention,” which has been the focus of decades of social work research, there has been relatively little involvement of the social work field in psychosis prevention. The unveiling of the Grand Challenges initiative at the 2016 SSWR meeting spurned initial discussion of how this critical area of preventive mental health may benefit from the involvement of social work practitioners, policy makers, and researchers. The aim of this roundtable is to continue that discussion and expand the field of interested and involved social workers.

The potential for prevention of schizophrenia, and other diagnoses that fall under the umbrella term of severe mental illness, has grown considerably over the past decade. Early intervention services have greatly expanded in the United States, now constituting a mandated minimum of 10% of each state’s budget from the Substance Abuse and Mental Health Services Administration. Specialty clinics have developed reliable assessments that can identify a sub-population of help-seeking youth who have an approximately 30% chance of developing schizophrenia within two years of follow-up. Most importantly, interventions ranging from cognitive behavioral therapy to omega-3 fish oil tablets have now been shown to be efficacious in preventing or delaying schizophrenia onset among this high-risk population. This is an opportune time for social work to become fully engaged in this emerging research and clinical area, at the ground level. Potential areas of social work involvement include, for example, the development of tailored psychosocial preventive approaches and the exploration of potential stigma associated with preventive mental health interventions.

Presenters will provide an overview of the current state of research and social work involvement in psychosis prevention. In this context, presenters will provide a conceptual look at universal, selective, and indicated prevention strategies, and will discuss the unique role of social workers in public mental health. In particular, social workers may be in an ideal position to provide the diverse array of supports needed by this population, ranging from clinical services to support with employment, education, and maintaining quality of life. Presenters will consider these issues in the context of clinical and cognitive changes that are experienced by this at-risk population, as well as individual-level treatment strategies such as cognitive remediation, coping and social skills training, and stress management. Presenters will also consider needed research regarding strategies to address the barriers to engagement and ongoing care associated with fear, stigma, socioeconomic and other disparities, and beliefs and misbeliefs about mental illness, recovery, and treatment associated with limited mental health literacy.