This chapter focuses on the clinical treatment of four impaired grandfamilies in rural areas. The approach and experience are similar to grandfamilies in urban areas, especially inner cities, but their social/economic situation may be more desperate and culturally enhanced, and with few resources. The first case study involves the treatment of a child from a toddler through his adolescent years the lens is on resilience. The second one looks at grandfamilies from a family systems approach. The third explores the impact of early trauma and transgenerational influences on the adult children and grandchildren. The fourth case study examines the role of the judicial system and the need for clinicians to advocate in the courts on behalf of grandfamilies. In all four of the cases, the chapter implements a holistic, but personalized, approach to mitigate the negative impact of substance- and alcohol-use disorders, family abuse, transgenerational effects, and cultural influences.

This chapter discusses major empirical data and studies on the prevalence of sexual assault and treatment for sex offenders and includes a discussion about issues associated with special sex offender populations. The Bureau of Justice Statistics (BJS) suggests that sexual assault includes a wide range of victimizations, separate from rape, or attempted rape. The feminist movements of the 1970s gave public voice to issues of adult sexual and domestic violence. The victim-offender relationship has been shown to be a key factor for violence, apart from depressive symptomatology and other pervasive mental health disorders, such as posttraumatic stress disorder (PTSD), substance abuse, fearfulness, and other somatic complaints. Sexual assault victimization has numerous costs and consequences for the victim, the offender, their families, and society at large. Criminal justice costs of sexual violence include those incurred for law enforcement, court proceedings, personnel, public education, and incarceration of convicted offenders.

Perhaps the most crucial and significant question rehabilitation researchers have sought to answer over the past several decades is: How is it that some persons with disabilities appear to excel and succeed in life beyond all expectations, whereas others seemingly succumb or yield to the limits imposed by their disabilities and society? This chapter explores the multiple factors that contribute to this dichotomy. It focuses on disability from a salutogenic orientation (focusing on the traits of healthy and successful persons) as opposed to the traditional pathological approach (focusing on the reasons and treatment of those beleaguered with ongoing mental and physical health problems) (Antonovsky, 1987). The chapter briefly explores several of the more common disabling conditions in the United States, specifically substance use disorder (SUD), depression, anxiety, and suicide. It also explores the literature behind positive psychology and also the environmental and social barriers that obstruct wellness.

Substance use disorders (SUDs) are complex health conditions, which are frequently remitting and relapsing disorders. They can impact many domains of life and require comprehensive knowledge in order to assess in a meaningful way. This chapter conceptualizes people living with SUDs from a holistic, ecological, and trauma-informed perspective and discusses the diagnostic criteria for SUD, including assessment for severity of disorder. It first outlines ways to broadly assess clients at risk for SUD or currently struggling with SUD using an ecological model. Because SUDs are complex and impact many life domains, the chapter includes discussion of health and disability, risk factors, protective factors, and assessments for commonly co-occurring life features, such as trauma, as part of comprehensive SUD assessment practice. This approach aligns with the International Classification of Health, Disability and Functioning model of inclusion of personal and environmental factors known to impact functioning, health, and rehabilitation and recovery efforts.

Mental illness can be both a cause and a consequence of homelessness. People with mental health problems are more likely to become homeless than those without mental disorders. The mentally ill who are most at risk of homelessness have serious mental illnesses such as schizophrenia and bipolar disorder. This chapter examines the relationship between homelessness and mental illness and substance abuse. It examines the risk factors for homelessness as well as special groups such as homeless families, women and children, and veterans. It also examines the recent rise of homelessness and related societal responses. The chapter discusses the role of homeless courts and the shelter system. Responses to homelessness include Housing First and Treatment First model approaches. The National Alliance on Mental Illness policy recommendations are discussed, as are the recommendations of the National Alliance to End Homelessness. Finally, the chapter addresses the role of social workers in reducing homelessness.

Mental health issues and services have been relegated to the periphery of healthcare and have not received the clinical and research attention they deserve. This chapter addresses the fragmentation of the mental health system and examines barriers to psychiatric hospital innovations and service integration. It offers recommendations that may streamline and improve the system. The integration of mental health and substance abuse screening, assessment, and treatment into primary care physician offices is showing positive outcomes. The chapter provides a sample description of collaborative care components, a model that has shown effectiveness in treating anxiety and depression. To be effective, treatment for mental health problems must coexist within a healthy lifestyle. Much recent attention has been given to the role of technology in improving the delivery of mental health services. The chapter examines organizational changes that can support service innovations and includes suggestions for promoting social workers as important innovators in mental healthcare.

This chapter reviews global ideas about mental health and addresses the stigma associated with mental illness that is often exacerbated by the media. It provides an overview of mental illness in the United States today. The chapter also begins authors’ examination of the role of mental health social workers in providing services and developing policy. This is to apply the core competencies of social work to mental health as determined by the Council on Social Work Education, the accrediting body of social work undergraduate and graduate programs. The chapter provides the nine core competencies of social work that address the policy, research, and treatment needs of those with mental illness, suggestions for how social workers can help to reduce the stigma of mental illness, for substance abuse and mental health services administration, and for the principles that guide the provision of mental health services by social workers.

This chapter examines what mental health is and ideas about why African Americans manifest lower rates of mental health problems than expected. It explores theories of African American mental health proposed by Wilcox, Ramseur, and Edwards. The chapter explains thriving and examines factors that impact mental health for African Americans including socioeconomic status, discrimination, and mistrust. It discusses John Henryism and the Strong Black Woman ideology as they relate to mental health for African Americans. The chapter also discusses mental health stigma along with how it relates to mental health treatment and perceptions of self. It examines the strengths that African Americans manifest, which can improve mental health. The chapter also discusses specific mental health issues in the African American community including factors such as depression, substance use, and psychotherapy. Finally, it explores the issues concerning the future of mental health among African Americans such as increasing the number of African American mental health professionals.

This chapter covers the developmental stage of adolescence and a relatively recently conceptualized development stage of emerging adulthood, comprising a total of 12 years of life. It discusses topics such as crime and violence against individuals with disabilities, substance abuse among IWDs, the “thrills and chills” personality, and traumatic onset disabilities. While experiencing biological changes and gaining more individuation, adolescents and emerging adults begin vocational exploration, decide upon higher education, and initiate romantic, sexual relationships. For both adolescents with and without disabilities, body image and physical attractiveness become very important. Traumatic onset disabilities are more common during the adolescent years, and, in particular, spinal cord injuries, traumatic brain injuries, and alcohol and substance abuse are typically acquired in adolescence.