5.5 CEUs in your hand! Permit Non-Profit U.S. Boston, PAID Postag No. MA 58183 Social Work Org. e CE Institute FOCUS continuing education courses Earn CEUs On Your Own Time, From Earn Wherever 5.5 CEUs You Are Inside! Inside: 1.5 CEUs! 1.5 CEUs! 1.5 CEU! 1 CEU! The System is Down: Disability Social Work: This is Your Brain Understanding and Creating More Connecting Critical on Food: How Food Acknowledging Accessible Services Cultural Competence, Impacts Mood and History as we Support for Diverse Families Intersectionality, Mental Health People in their and Anti-oppressive Vaccine Choices Practice Karen Zilberstein, LICSW Lisa Johnson, PhD, MSW, Uma Naidoo, MD Lamont D. Simmons, EdD, Rose Singh, MSW, and MSW and Elspeth Slayter, Elspeth Slayter, PhD, MSW PhD, MSW P. 2 P. 9 P. 17 P. 23 Upcoming Virtual Continuing Education Offerings: The Intersections of Historical Mass Annual Trauma, Racial Terrrorism, and School Social Work Conference African American Mental Health Earn 2 CEUs! Earn 5.5 CEUs! SAVE THE DATE: September 15, 2021 SAVE THE DATE: October 8, 2021 Virtual Virtual with Joy DeGruy, PhD, MSW, author of “Post Traumatic Keynote: Antiracist Practice Principles for School Social Workers Slave Syndrome: America’s Legacy of Enduring Injury Kathy Lopes, LICSW, Director of Diversity, Equity, and and Healing” Inclusion, Newton Public Schools Details and registration coming soon: naswma.org Details and registration coming soon: naswma.org 2 2021 Social Work CE Institute – FOCUS Continuing Education Courses YOU ARE HOLDING 1.5 CEUs IN YOUR HAND! How it works: Read this CE program, complete the Post-Test and Evaluation, and mail to the Chapter office with your check. Score 80% or better and NASW will mail you a certificate for your CEUs. It is that easy! The System is Down: Creating More Accessible Services for Diverse Families Karen Zilberstein, LICSW additional funding to grant them. On the one hand, the Learning Objectives Fragmented and Underfunded Systems system allows states to try and meet local needs. On the other, no incentives exist to meet those needs, making At the completion of this program, participants should service quality and availability vary widely from be able to: American families struggle with a variety of needs that propel them to enlist different types of services. One in state to state or even between counties. Other sources of revenue, such as reimbursements from insurance 1. Describe the obstacles families face in obtaining six American children live in poverty, out of which 73 companies, also influence the availability of services. care. percent are children of color (Children’s Defense Fund, 2020). One in six American youth are diagnosed with Starting in 1975, a series of laws mandating educational 2. Identify ways social workers and a developmental disability, and one in five will suffer equality for children with disabilities were passed, but psychotherapists can ease burdens on families. a debilitating mental disorder at some point (Boyle et sufficient resources were also not allocated to funding al., 2011; Merikangas et al., 2010). Approximately 70 3. Consider what structural reforms are needed to them. In 2016, grants appropriated by Congress covered percent of American adults have experienced a traumatic alleviate current problems. less than 10 percent of what states spend on specialized event and just under 20 percent develop posttraumatic education (Chingos, 2017). The remaining monies stress disorder (Kessler et al., 1995). Thirty-eight come from a combination of state and local taxes. As a percent of Americans identify as racial minorities, About the Author consequence, considerable disparities in education also many of whom suffer negative health effects from exist within and across cities and states, with wealthier experiencing racism (Comas-Diaz, 2016). Dislocation, Karen Zilberstein, LICSW, school districts generating more financing and resources substance abuse, violent communities, incarceration, as is a psychotherapist and to meet students’ needs than poorer ones. Clinical Director of the well as many other hardships also impact families, with Northampton, Massachusetts many suffering multiple adversities. When children and The end result of limited and decentralized funding is an chapter of A Home Within. families have numerous needs, their situations become uneven, disorganized, and inadequate system for serving A former Adjunct Professor more complex and service delivery trickier. Despite a children with mental health problems and disabilities. for 12 years at Smith College high need for services, many families find it difficult Demand for services far outstrip supply (Anderson et School for Social Work, she to access the supports and services that would benefit al., 2017; Marshall et al., 2017). Schools and mental has published numerous them. health agencies often struggle to fully meet the needs of journal articles on various the clientele they serve. As one director of an outpatient Underlying the difficulties with service access and aspects of psychotherapy mental health agency explains, delivery lie a variety of difficulties that vary with the and mental health care. Her types of policies and funding that govern the various We have data about the ages, socioeconomics, and narrative nonfiction book, programs. Some systems are disorganized because diagnoses of our clients, and we look at it to help Parents Under Pressure: they grew in a haphazard way (e.g., the mental health determine what services to provide. But it is hard to Struggling to Raise Children in an Unequal America, system), others have been purposefully structured start up new programs or treatments. A lot is guided was released in 2019 and won two 2019 Next in complex ways to keep rolls small (for instance, by reimbursement. If the insurance companies won’t Generation Indie Book Awards. The book examines Medicaid and welfare benefits), and still others have pay it, we can’t afford to do it. We eat some costs how well America’s systems of care supports families simply never been allocated sufficient funding to fulfill and do things, anyway. But all our outpatient clinics and what reforms are needed. their mandates (school districts). Across the service lose money. There is very little other funding besides Email: [email protected] sector, limited funding for programs, siloed agencies, insurance. Insurance drives policy and services. and strict requirements for gaining services has led (Zilberstein, 2019, p. 35) Website: https://karenzilberstein.info/ to a lack of integration and accessibility. Looking at examples from the mental health system, Medicaid, When programs must rely upon rigid and inadequate welfare, and schools demonstrates the difficulties streams of funding, it limits how many families can involved. be helped, and in what ways. In order to stay within Introduction budget, programs or states must cut services, install From its inception, the mental health system has never stricter eligibility restrictions, or keep waiting lists Note: The material in this course was first developed been well organized, creating difficulties that have (Center on Budget and Policy Priorities, undated). As a by the author in her book, Parents Under Pressure: yet to be remedied. In previous centuries, individuals service coordinator for DDS notes, Struggling to Raise Children in an Unequal America with psychiatric difficulties or disabilities were either (Zilberstein, 2019), and draws frequently on examples All these resources are limited. Just think about cared for by family members or placed in schools and from that work. numbers. There is only so much availability. So, institutions that were of poor quality and sometimes often, we rely on families reaching out to us. Social work aims to enhance the lives of the most downright abusive. Residents experienced sexual abuse, Families are not always offered services because vulnerable, but how well does the profession achieve unsanitary conditions, and were made to work without we can’t fund everyone and everything. Sometimes its goals? Despite the many services and benefits pay. In the 1970s, a series of lawsuits by parents and we don’t share information, if we feel that the family provided to individuals, families, and communities, the advocates against those schools and facilities, as well as won’t qualify for, or be prioritized for, that service. service sector remains difficult for many consumers to the arrival of new drugs that could control psychiatric That’s hard for us, as professionals. The answer is access. It consists of what Blum (2015) terms “dense symptoms, forced the dismantling of the offending more funding across the human services systems. bureaucracies,” fragmented and underfunded systems institutions. The resulting deinstutionalization helped There’s just not enough. (Zilberstein, 2019, p. 34) that cannot meet current needs. Biases and barriers are fuel new service systems that aimed to provide care in particularly stark in poor communities of color, boxing homes, schools, and the community. Another consequence is that many types of services them out of needed benefits. In order to improve the that families might need cannot be delivered. As the While the new arrangement created a range of delivery of services, the field must make a coordinated outpatient director notes, effort to recognize obstacles and initiate reforms. specialized school and community services that greatly benefit families, community care organizations We see families with intensive needs. They need a lot This course provides an overview of some of the never received enough funding or attention to fully more support. In-home therapy is great, and I value difficulties inherent in the current service system meet needs. In 1963, President Kennedy signed the what they do, but families sometimes need basic and what can be done to address them. Areas to be Community Mental Health Act to finance community- things. Like they could use someone in there who considered include the structure of services, the biases based treatment facilities, but adequate resources were could be a parent advocate, or a nurse, or a PCA, and hurdles they present, the impact on families, never allocated.