Background
Social workers in social services departments frequently encounter mental health issues as one of the most central, complex, and challenging aspects of their work. The Ministry of Welfare and Social Affairs (hereinafter: the Ministry of Welfare) has increasingly recognized the significance of mental health in the Ministry’s work and the necessity for inter-ministerial interfaces, which involve structured collaborations with other ministries, to effectively address mental health concerns. This recognition is manifested in the pilot model for inter-ministerial coordination and cooperation in the field of mental health of children and youth that was developed in the Haifa and the North District of the Ministry of Welfare in 2019. This project aims to foster collaboration between the Ministry of Welfare and the Ministry of Health, with the goal of providing a more coordinated and effective response for children and youth who require psychiatric hospitalization and out-of-home care after their release. The Supervision Service of the Ministry of Welfare’s Haifa and the North District is responsible for developing and implementing this model. The pilot model includes a joint district forum that brings together professionals from the Ministries of Welfare and Health, along with other relevant stakeholders; mental health contact persons in the social services departments; guidelines for providing a coordinated response in the field of mental health that were disseminated to the social services departments and the three hospitals in the district; seminars, training sessions, information and awareness raising initiatives; and negotiation and mediation between social services departments and hospital staff.
The Ministry of Welfare has expressed interest in adopting this pilot model as official ministry policy and in implementing it in other districts as well. Therefore, it is crucial to understand and conceptualize the model, as well as to assess its practical implementation. In light of the above, the Supervision Service of the Haifa and the North District asked the Myers-JDC-Brookdale Institute to evaluate the implementation of the pilot model and provide assistance in its refinement and further development, if deemed necessary.
Research Goals
- To review the need for the pilot model among professionals and parents of children and youth who have undergone psychiatric hospitalization
- To review the implementation of the pilot model, including:
- The operation of the inter-ministerial district forum
- The role of the mental health contact person in the social services departments
- The role of social services department district managers and district supervisors
- The implementation of the guidelines: factors that promote the adoption of the model and implementation of the guidelines, and obstacles encountered in this process
- The effectiveness of the model, the level of satisfaction with it, the extent to which the teams involved comprehend the model, and its impact on collaboration between the involved parties
- To refine the model for cooperation and the provision of coordinated care
- To review the factors that facilitate the implementation of the model, as well as the barriers and challenges encountered in adopting it as ministry policy and implementing it effectively.
Methodology
The research methodology employed several data collection techniques.
- 41 semi-structured interviews were conducted with professionals from various fields at the Ministry of Welfare’s national headquarters and the Haifa and the North District, and with professionals from the Ministry of Health’s Haifa and the North District
- Three online surveys were administered to professionals: (a) among mental health contact persons in the departments of social services; (b) among managers in departments of social services in the Haifa and the North District (c) among supervisors in the Haifa and the North district
- An online survey among parents – An online open-ended questionnaire which was distributed to participants who were part of a national online group of parents with children and youth who have either recently experienced psychiatric hospitalization or are currently hospitalized
- A review of relevant “gray literature” such as guideline documents and summaries of seminars
Findings
The study findings indicate that mental health issues occupy social workers at the social services departments in their day-to-day work, presenting complex professional challenges within the departments of social services. However, social workers in the departments of social services feel that they lack adequate tools and knowledge to effectively address mental health issues in their work. Additionally, they face constraints in terms of budgetary resources and time allocated for this purpose. Furthermore, the absence of post-hospitalization treatment and rehabilitation facilities in the community exacerbates the difficulties and challenges that the departments of social services face in this field. These challenges are compounded by the heavy workload that social workers in the departments of social services must contend with daily.
The research findings underscore the imperative of implementing the pilot program for inter-ministerial cooperation and coordination in the field of mental health for children and youth, which was developed in the Haifa and the North District. This model has demonstrated its significance, efficacy, and substantial contribution to facilitating a coordinated response between the services of the Ministry of Welfare and the Ministry of Health. However, the process of assimilating and implementing this model has encountered various obstacles that necessitate careful consideration and resolution. Addressing these barriers is crucial to enable the adoption of the model as Ministry of Welfare policy and to ensure its successful implementation.
Summary
The research findings show that the pilot model offers several distinct advantages. One of these advantages is the enhancement of mutual understanding regarding different work processes and the varying pace of work in each ministry. This mutual understanding serves as the foundation for collaborations and efforts to adapt the work processes and pace. Consequently, guidelines and regulations were established as part of the model, facilitating a more organized work procedure in the departments of social services and a clearer delineation of responsibilities for each partner involved. Additionally, this has streamlined the work process and optimized resource utilization.
Recommendations
In order to sustain the model, it is crucial for the Ministry of Welfare and Social Affairs to adopt it as an official policy. This can be done, for instance, through the integration of the model within the existing regulations for social work. Adequate resources should be allocated to support the adoption of the model, including the provision of a dedicated position for a mental health contact person within the social services departments, similar to other specialist positions in the departments. In addition, a mental health specialist supervisor should be appointed at the ministry’s headquarters. The supervisor’s role will include raising awareness on the subject of mental health at headquarters and in the districts.