Supports and Gatekeeping: Experiences of Schools of Social Work with Students with Mental Health Conditions

Background and Purpose:

Some social work educators advocate for people with mental health conditions to become social workers because they may possess knowledge and insights that equip them to help others achieve recovery goals. Educators also are tasked with gatekeeping, ensuring that future clients receive optimal services.

Minimal research exists about how schools handle these dual responsibilities. A 2007 study found that students with mental health conditions (SMHCs) experienced problems in the classroom and field, the majority of schools offered accommodations, and gatekeeping was a concern to some participants. Recent studies indicate that some instructors support SMHCs while others hold negative attitudes toward them, but research is needed about institutional-level approaches related to SMHCs. This study helps fill this gap by asking Deans/Directors (Directors), MSW Coordinators (MSWCs), and BSW Coordinators (BSWCs) about their programs’ (1) experiences with SMHCs and (2) existing and needed resources related to SMHCs.

Methods:

Quantitative and qualitative data were collected via an online survey of Directors, MSWCs, and BSWCs identified from a list of CSWE-accredited programs. The survey asked about: whether student disclosures effected admissions decisions, problems SMHCs have experienced, whether SMHCs had been terminated and had graduated, available and desired resources related to SMHCs, and descriptive information about participants and their schools.

Approximately 22% of those contacted via email participated (N=188), including 48 (25.5%) Directors, 49 (26.1%) MSWCs, and 91 (48.4%) BSWCs. The majority were White (70.2%), female (71.3%), from public institutions (56.9%), and had been in their administrative positions at least 3 years (66%).

Data analysis for this exploratory study included univariate descriptive and bivariate chi-square analyses of quantitative data and inductive content analysis of qualitative data.

Results:

Most participants (64%) said SMHCs had disclosed mental health conditions during admissions and most were admitted without conditions. A large majority (87%) described problems experienced by SMHCs, including excessive class absences (50%) and needing intensive efforts from field staff (40%). Qualitative data indicated boundary issues, inappropriate behaviors in class and field, and a reliance on personal experience over professional knowledge were key challenges. 

About half (55%) indicated a student had been terminated due to mental health issues, an outcome reported more often by BSWCs than MSWCs (χ²=10.975, df=4, p=.027). Most (87.8%) said SMHCs have graduated, though some needed additional emotional support (59%), on-campus (47%) or off-campus (43%) counseling, and other resources to succeed. Over 80% rated on-campus counseling, legal advice about schools’ responsibilities and students’ rights, disability resource centers, and accommodations as desired resources. Qualitative analysis revealed concerns that policies focusing on SMHCs might be discriminatory.

Few statistically significant differences emerged by participants’ positions, whether institutions offered BSW, MSW, or combined programs, or other variables.

Conclusions and Implications:

Major findings include that certain supports may improve the likelihood of success for SMHCs and that few significant differences emerged across program characteristics. Implications include that regardless of program characteristics, administrators need information about programs’ legal responsibilities, students’ rights, and accommodations. Finally, clarity is needed within social work education regarding the dual responsibilities of supporting students and gatekeeping.