The overall number of social workers in the United States is projected to increase gradually over the next decade. In contrast, the percentage of social workers employed through health facilities is projected to experience a more dramatic increase of 19.5 percent between 2008 and 2018. To date, no research has been conducted to examine reasons for this increase.
Researchers have hypothesized four possible reasons for the increase in interest in health-related social work:
- The past personal experiences of those who pursue health-related social work
- The increase in the population of older adults in the US
- The relatively greater job and financial security found in health-related social work
- A general interest in health care reform
In a recent issue of the journal Health & Social Work, Keyon R. Mitchell, MSW, and Dawn Marie Joosten, LCSW, PhD, published their findings in a study of University of California MSW students who had chosen a concentration in health. This study aimed to identify determinants of health concentration selection among the MSW students. Since 2007, the number of students that select the health concentration has experienced exponential growth, from 21 students in 2006 to 110 in 2012.
The objective of this study was to identify determinants of concentration selection among MSW students at the USC School of Social Work. The USC School of Work curriculum offers a variety of concentrations including health, mental health, families and children, work and life, and community organizing planning and administration. In recent years, the number of students selecting the health concentration increased dramatically. This study used mixed methods to identify determinants of concentration selection.
Using questionnaires, Mitchell and Joosten were able to determine that for these students, the most important factors for choosing a concentration in health-related social work were job and financial security, and secondarily from personal experience. Health care reform was much more rarely an important factor in the students’ choice.
Because of the significant increase in social workers entering health settings, their research suggested that it is important for academic institutions to provide curriculums to students to develop the necessary skills to become effective practitioners in health settings. Following the completion of their study, faculty in the health concentration made curriculum modifications to the health policy course. The curriculum now ensures that student competencies reflected policy relevant to direct practice in health settings through a myriad of federal-, state-, and county-level policies. The curriculum emphasizes health care access, disparities, quality and safety, preventive care, mental health, ethics, professional standards, social service programs and eligibility criteria, safety net services, and health care reform. It also provides education on home and community-based services for lesbian, gay, bisexual, transgender, questioning; minority; female; child; older adult; homeless; and veteran populations. The modified curriculum reinforces NASW’s Code of Ethics, with its emphasis on training health social work students to serve individuals and families from various backgrounds. Effective social work practice in health settings requires social workers to engage in practice informed by theory, evidence, and policy.
As Mitchell and Joosten point out:
[S]ocial workers as case advocates can work in health care settings to address and advocate for policy changes at organizational, community, and legislative levels when they observe any of the following seven warning signs that health care consumers face when working with their patients: (1) inability to finance medical care, (2) poor-quality medical care, (3) ethical rights that are violated, (4) medical care that lacks cultural competence, (5) lack of access to preventive care, (6) untreated mental health needs, and (7) lack of linkage to home and community-based services by health care providers. With the projected increase in the labor market for social workers in health care settings, social workers will continue to be key members of multidisciplinary teams in health care settings. With specialized training as case advocates, policy advocates, and clinicians, MSW social workers trained through health concentration programs and health courses will play an important role as health care reform continues its implementation. Social workers will be key advocates involved in reducing health disparities. They will improve access to preventive care, health insurance, social programs, and home and community-based programs. Social workers will ensure that patients’ ethical rights are not violated, and they will strive to enhance the quality of life and well-being of their patients.