The paper deals with the community development program to address the mental health issue- anxiety and depression. The chosen community for this purpose is Elizabeth Down in Australia. It is in the City of Playford, in northern suburb of Adelaide, South Australia (Alvaro et al., 2013). The paper highlights the ideas that guide the approach. The selected problem is defined and its impact on the specific group of people is described. The paper highlights the theories that are used to examine the problem and support the social work practice. The essay then describes the way in which the people of this community will be engaged in order to address this problem.
The approach to the community problem is guided by the system theory. A system can be a whole or a component that is composed of subsystems. Considering the elements of the human system, the term mutual causality is appropriate for this case. Human systems are influenced by the environment and in turn influence them. It means that in a given system, several sub components are interrelated. Changes in one sub component will affect other components in the system as well. For instance, an illness of one person in a family may render other members of the family weak. If the illness is prevalent in many members in a community then whole community may become weak. Similar concept is given by the population ecologic theory. According to this theory, a person is connected to others, social institutions, and the physical space that makes up an individual’s environment. As per the theory, trust and relationships in community can make a difference in community interactions (Patton & McMahon, 2014). Using this theory, it is easy for a social worker to develop insight into needs, values, and relationships of the people in Elizabeth Downs. This is the rationale for selecting this social issue from this community. If this problem is untreated, it may create havoc in the whole community leading to increase in mortality. Hence, anxiety and depression from this aspect is a social issue. Throughout the history, the depression has been a social issue and is referred to as “common cold of mental illness” (Walker & Rashid, 2016). The approach to this community development program is also guided by the idea of an “individual good” by improving the social features such as norms, network and trust that will facilitate the people to act together more effectively and pursue the shared objectives. This is in alignment with the theory of social capital, which states that individual good in society may have significant consequences for societal coordination, cooperation and collaboration and eventually good governance (Vogus, 2015). Moreover, the other element of the human system named “Wholeness” emphasise that in order for synergy to occur change is necessary. It emphasise that if one part of the system is changed then it will precipitate in other parts of the system as well (Beckett & Horner, 2015).
Anxiety and depression is highly prevalent in the Adelaide, South Australia. For this essay the main focus will be on the social issue in Elizabeth Downs. In Elizabeth Downs anxiety and depression is mainly prevalent among adolescents and adults. In this community, a high prevalence of depression has been found (Lawrence et al., 2013). People with anxiety experience nervousness, irritability, trouble concentrating, and problem sleeping. In the state of depression, a person may feel sad, hopeless, discouraged, and unmotivated. A depressed individual may experience symptoms similar to anxiety disorder. There are multiple causes of this mental illness in the selected community. It includes increasing incidents of crime such as burning of houses, unidentified people stabbing the local residents and similar other. Increasing rate of unemployment and bullying of college students and adults in colleges, workplaces, cyberspace are other major causes of anxiety and depression among the adolescents and young adults in Elizabeth Downs. All the three causes mentioned above are responsible for insecurity, fear, hopelessness and powerlessness. The cumulative effect of this problem is anxiety and depression (Walker & Rashid, 2016). It has significant impact on the people of Elizabeth Downs.
The physical impact of depression on this people includes effect on the brains, heart and other body parts negatively in long term. In older people, depression and release of inappropriate amount of adrenaline significantly damages the cardiovascular system. The increase of stress on artery and blood vessels increases the risk of blood clot and heart attack. People with anxiety and depression are found to die 25 years sooner than the average person (Corrigan et al., 2014). The social side effect of depression includes change in an individual’s potential to effectively function in world. Depression affects an individual’s relationship with others in the society. Therefore, making the whole community vulnerable to crime and violence. Other social effects of the depression in this community include substance use and abuse, social and family withdrawl, decreased performance at work or school. Adolescents with depression withdraw from studies and some are prone to illicit drug and alcohol abuse (Walker & Rashid, 2016). Different theories will be used to examine the problem and design the intervention.
The theory of vulnerability indicates that the different susceptibility of families, individuals, communities to experience bullying, crime, violence and eventually loss of health from anxiety and depression. Therefore, in this case considering the vulnerability theory an approach to resolve the issue will be used keeping in view the different vulnerabilities within the people (Beckett & Horner, 2015). There are different perspectives of community development. From an individual perspective, the social issue may be due to psychological, individual pathology, biological, or a characteristic defect. The source of blame may include in most cases- “blaming of victim” (Parton, 2013). Interventions may have to be developed considering all the aspects of the individual that is causing the problem.
According to Lee & Hudson (2017) Empowerment theory helps, people gain control over their own lives. People in depressed state in most cases are due to feeling of helplessness. Therefore, these people in community can be empowered to overcome anxiety and depression. This theory is used in social practice to foster power in people that they can use in their own lives, and in community. This theory helps people to act on the issues of highest priority as defined by this people. Thus, it is also referred as multi-dimensional social practice where empowerment includes identification of the power blocks and develops strategy to reduce direct or indirect power blocks. Empowerment is effective in reducing people’s vulnerability and enhancing people’s well being.
Strength based recovery program will be used in this case. According to Xie (2013) during an emergency and phase of recovery the inherent strength of an individual or communities their assets, and resources should be actively engaged. Anxiety and depression emanates from profound powerlessness. Therefore, interventions will emphasise on empowerment. It will include supporting people to mobilise their capabilities and become self-sufficient. People of Elizabeth Downs will be engaged in activities that will reduce negative valuations and powerlessness due to economic insecurity, crime, and other personal problems. The aim of the practice for this community is to focus on the individual as the unit of analysis.
Prior to delivering the intervention the assessment of the community will be performed to identify the cultural values, beliefs, and traditions of the target populations, and their belief system of giving and taking help. The other purpose of the community assessment is to identify the boundaries within which the interventions on behalf of the target population will occur. With the help of the assessment, it will be easy to find if the service is accessible by the target population and ways they can be achieved (Parker, 2017).
Considering the individual perspective the solution that is most appropriate for Elizabeth Downs: cognitive behavioural intervention or CBT. The rationale for choice of this intervention is plenty of literature evidence on the effectiveness of this form of engagement between social worker and clients in addressing the problem. CBT was found effective in 60 % of the programs initiated by James et al. (2013) to reduce anxiety and depression. Therefore, the plan is to develop culturally adapted CBT training programmes for people in Elizabeth Downs by active participation by social workers.
CBT emphasise on identifying the thoughts and belief system of an individual that is leading to particular emotional and behavioural reaction. For instance, a student may belief that going to college will give people more opportunity to bully him/her. Therefore, social worker trained in CBT will rationalise these thoughts and develop more adaptive belief. This intervention will lead to behavioural activation of a person by his or her active engagement. Using a structured approach, CBT increases the experiences and behaviours that are more rewarding. It helps overcome barriers to engage in new rewarding behaviours and decrease activities that maintain the symptoms (Wells, 2013).
In order to ensure that all the people can access the service CBT will also be made available through the medium of internet. The internet based CBT involves elements such as telephone, video conferencing, and telemedicine. It will be best applicable for engaging college students who are victim of bullying and are mainly tech savvy (Ebert et al., 2015). The other models of CBT which will be used for this specific community includes “Acceptance and Commitment Therapy or ACT”. In ACT people are allowed to verbalise their negative feelings without reacting towards and are counselled not to avoid circumstances that are invoking. The therapeutic effect of ACT is the spiral of positive feelings. Positive feeling will lead to better understanding of truth. The model of ACT facilitates people to accept their behaviour and reactions by learning the techniques to reduce conflicting thoughts. It helps them to be in present, choose a valid direction and take committed action (Bluett et al., 2014).
The other solution included in the community development programme is advocacy. It is vital for social workers as this is the only licensed profession with a mandate to advocate. Advocacy is best to address the issue of bullying. More number of social workers should reach out to people in Elizabeth Downs to teach the art of forgiveness to overcome the experience of bullying. It will increase the self-esteem of the effected people dramatically (Sue et al., 2015).
While implementing the programme the social workers will implement the code of ethics, and demonstrate compassion with curiosity and awareness to address the issues of crime victims. As per the AASW code of ethics, the social work practice during the intervention will ensure respect for human dignity and worth; commitment to social justice and human right; and maintenance of privacy of confidentiality (Bowles et al., 2016). Client centred care and active listening skills will be used to communicate with the victims and build trust. Since, the community involves cultural diversity; social workers will ensure that the diversity of opinion is accepted during engagement, advocacy and intervention.
There are similar issues found in other communities in Adelaide, South Australia. According to Australian Crime Commission (2015) on 9th March 2017 a man has been shot several times after he answered the knock at the front door of his Gilles Plains home in Adelaide’s northeast. The incidents of crime are leaving people insecured about their lives. There is a growing number of cases of anxiety and depression in Adelaide. In the last decade, there is growing number of psychological services and centres for anxiety and depression (Clement et al., 2015). It is recommended to the government to increase cost effective CBT training programs for prospective social workers. There is a need of increasing CBT services in Elizabeth Downs.
In conclusion, social work profession promotes problem solving in human relationships. Social work practice is vital in society for its outstanding role in empowering people and their liberation. Using the theory of social system and empowerment theory CBT and ACT intervention is considered appropriate for addressing anxiety and depression for people of Elizabeth Downs. This intervention was found effective in increasing the self-esteem of people. These interventions interact with people at the point where they interact with their environment. Thus, it is sure to make a positive difference to the community as each individual learns to cater for his needs, increase their capacity and function better, which, are the elements needed to community development.
References
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