Training Social Work Students in Integrated Health Care: A Strategy to Reduce Chronic Disparities

Background & Purpose: The COVID 19 pandemic has highlighted existing health disparities in the U.S., with black and brown Americans dying at higher rates than white Americans. There are many reasons for chronic health disparities: under-insurance, lack of access to regular health providers, lack of effective mental health screening, neighborhood safety, and access to healthy food and transportation, among other factors. One strategy to improve disparities for marginalized communities is integrated care. This model of care integrates medical and behavioral health providers in order to better identify behavioral health and social care needs, reduce stigma, and increase access to care. Social workers play important roles in integrated care settings, including: advocacy around racism and discrimination, assessing for and education on social determinants of health, clinical interventions for mental health and substance use disorders, and care coordination for social care needs. Therefore, universities have begun novel training programs to better prepare social workers to work in these new integrated care settings. Given the importance of training efforts for integrated care readiness, the aim of this study is to better understand the experiences and educational needs of recent MSW trainees.

Methods: We conducted two focus groups of MSW students who had recently completed an MSW fellowship training program in integrated care (N=9). A semi-structured interview guide explored students’ experiences in integrated care internships and classroom experiences. Focus group were transcribed verbatim and content analysis of qualitative data was used to identify themes characterizing the focus group discussions. Each transcript was independently coded by the three members of the researcher team. After initially reading through all transcripts, the researchers met to discuss findings and reconcile differences in coding.

Results: Content analysis of the focus group data resulted in three main themes: Gaps in Knowledge about Integrated Care, Developing Professional Identity on a Team, and Adaptation of Core Social Work Skills. Student feedback aligns with current literature, highlighting variability among placements, need for additional training resources, and value of social workers on interprofessional teams. Unique findings include challenges and rewards of professional identity development on teams and examples of adaptations of traditional social work roles in integrated care.

Conclusions/ Implications: Integrated health care is a model in which social workers have important roles to play in addressing disparities and improving health and behavioral health outcomes of marginalized populations. In order to prepare social workers for these new practice roles, educational programs must develop effective curricula and collaborative community partnerships that span the classroom and field education. The student voices shared in this project provide us with helpful insights to ensure integrated care readiness among MSW students. Information about current gaps in knowledge, community resources (e.g. supervisors) and adaptations of core social work skills can inform social work educational efforts in the future.