Massachusetts Groups Issue Principles Addressing Racism

The Massachusetts Medical Society (MMS), the statewide professional association of physicians and medical students with more than 25,000 members, and the Massachusetts Department of Public Health (DPH) have teamed with the deans from the state’s four medical schools—Boston University School of Medicine, Harvard Medical School, Tufts University School of Medicine, and the University of Massachusetts Medical School—to address racism in academic medicine and in health care organizations.

Buoyed by a shared goal of eliminating racism in medicine, the organizations worked to form a set of principles that will guide deliberate actions that will create an antiracist, diverse, inclusive, and equitable medical culture.

“In order to break down the structures of structural racism, we must learn, we must teach, we must lead. I am so proud of the Massachusetts health care community for coming together in this time of crisis,” says David A. Rosman, MD, immediate past president of MMS.

The principles include acknowledge and learn, lead and commit, disrupt and transform, and cultivate.

“This landmark statement recognizes that we must address structural racism to be able to combat health inequities,” says Monica Bharel, MD, MPH, former Massachusetts public health commissioner, who left the DPH on June 18. “With this set of principles, we are committing to create and sustain a culture across medicine in Massachusetts that is equitable as we seek to dismantle racism in all of its forms, starting with our medical students’ education for years to come.”

Last year, the MMS declared that racism is a public health crisis and constructed an organizational antiracism action plan in which the MMS committed to promoting equity and racial justice, supporting physicians who have been marginalized, and prioritizing antiracism in its strategic plan.

“It is mission critical for the Medical Society, the DPH, and our state’s medical schools to lead in supporting the next generation of physicians and their patients,” says MMS President Carole Allen, MD, MBA, FAAP. “This document outlines important steps to address systemic racism as it manifests in health care. The Massachusetts Medical Society is committed to health care as a basic human right; racism in all its forms interferes with that right and leads to unacceptable and disproportionately poorer outcomes and premature death for members of the Black and Brown communities.”

— Source: Massachusetts Medical Society

FSU Research Study Addresses Effects of Client Violence on Child Protection Workers

Florida State University (FSU) College of Social Work researchers have found a link between work-related violence and poor health outcomes for child protection workers.

The new study, published online by the Journal of the Society for Social Work and Research, focused on the events that occur after a child protection worker has experienced violence perpetrated by a client. Researchers found that workers who were not adequately supported by employers after such an event experienced high levels of psychological distress.

“We know that child welfare workers experience client-perpetrated events,” says Melissa Radey, PhD, MA, MSSW, a professor at the College of Social Work. “The study provided us an opportunity to examine the context of these events—when and how these violent events unfold and the consequences of such violence.”

Radey, along with Lisa Magruder, PhD, MSW, program director of science and research at the Florida Institute for Child Welfare, and FSU Professor of Social Work Dina Wilke, PhD, MSW, examined worker perceptions of an event, not solely the type of violent event. These perceptions contributed to workers’ reactions and the consequences of the incidents.

Rather than emphasizing the prevalence of violence experienced by child welfare workers, the study increases understanding into how workers experience violence and workplace responsiveness to these incidents.

Researchers conducted 34 in-depth qualitative, telephone interviews with child protection workers throughout Florida hired in 2015 to 2016. All workers had experienced some form of physical or nonphysical client-perpetrated violence since being on the job. Their perceived levels of spontaneity, personal attack, and workplace responsiveness shaped their psychological consequences from the violence.

“The framework suggests that a violent incident and the way workers perceive them then influences worker health outcomes,” Magruder says.

Workers who experienced spontaneous violence and felt attacked because of their role as a worker, such as in the case of a child removal, experienced few consequences if they received adequate agency support. Alternatively, workers who experienced calculated violence and felt personally attacked, as in the case of receiving threats to themselves or their family members, experienced high levels of psychological distress, including increased fear, stress, insomnia, and burnout, particularly when they felt agencies dismissed their fears.

The study suggests the important role that child welfare agencies can play in defining, preventing, and addressing violence through supervisor and frontline worker training protocols. Validating child welfare workers’ perceptions of violent incidents and supporting them can improve worker safety and well-being.

About one-half of participating child welfare workers in the study perceived their agencies as responsive. Those workers who perceived their agencies as responsive experienced fewer negative health consequences.

“It is important to note that agency responsiveness is also subjective,” Radey says. “Workers desire various levels of agency involvement. Agencies should consider these preferences when providing the optimal environment for workers.”

The study emphasized that future research is needed on the role of child service worker identities in instigating and handling violence to gain insights into how to minimize and prepare for client violence.

“We need to better understand child welfare workers’ experiences with violence in order to develop policy and practice to best meet their needs,” Radey says. “Through meeting worker needs, we can improve worker well-being, worker retention, and ultimately, client outcomes.”

The researchers suggest that future work can build on the current study’s findings by investigating other stakeholder perceptions, such as client, supervisor, and leadership perceptions. By considering multiple perspectives, multilevel responses to address client violence can reflect the reality of the agency environment to best protect workers.

— Source: Florida State University

Adelphi Awarded Grant to Train Social Workers, Nurses in Integrated Behavioral Health Care

The Health Resources and Services Administration recently awarded Adelphi University's School of Social Work and College of Nursing and Public Health a grant to train 120 graduate students in behavioral health care.

The four-year grant of $480,000 per year will focus on training and placing students in organizations that serve children and adolescents in underresourced communities.

The program, Interdisciplinary Education and Training Experience (IDEATE) Fellowship—Integrated Behavioral Healthcare for Children, Adolescents, and Transitional Youth in New York, is in partnership with Concert Health, America’s leading behavioral health medical group, and Northwell Health, New York’s largest health care provider. Concert and Northwell will host most of the students during their clinical rotations.

“Nursing practitioner and graduate social work students will be jointly placed in clinical rotations in behavioral health care sites, where they will receive coordinated training with actual clients and supervised by trained nursing/social work supervisors,” says Manoj Pardasani, PhD, dean of the Adelphi School of Social Work. “We’re very grateful for the support of both Concert Health and Northwell and of course for the grant itself. It will allow us to better serve our students, help develop a critical workforce for the future and, by extension, serve communities who really need these services.”

Pardasani notes that the pairing of nurse practitioner and social work students fosters an important interdisciplinary approach to providing health services—and the geographic diversity is enhanced by the social work students who have been studying at Adelphi’s Garden City campus, along with centers in Manhattan, Poughkeepsie, and Hauppauge.

The project will begin this fall with 30 master’s degree students from nursing and social work, with a total of 120 students completing the training over the four years. Each cohort will participate in the program throughout one academic year.

“Well-trained behavioral health practitioners are integral to meeting the demand for mental health services, especially in underserved areas,” says Marissa Abram, PhD, an assistant professor in the College of Nursing and Public Health and associate project director for IDEATE. “The collaborative-care model provides a mechanism for holistic care where the patient can have their medical, mental health, and substance abuse conditions managed together. This is important as medical and mental health are intertwined and both are vital to a person’s overall well-being. Psychiatric nurse practitioners provide a variety of services that include treatments such as medication management and psychotherapy.”

Abram notes that she and project director Chrisann Newransky, PhD, an assistant professor of social work at Adelphi, are excited about the interprofessional training the students will receive. The nurse practitioner and social work students will receive training that is cutting edge and reflective of the real world. “Students will interact and collaborate with each other in both didactic and clinical learning experiences,” she says. “Training will be focused on best practice and include contemporary topics like caring for diverse populations and telehealth care.”

In addition to supporting students in their professional development and postgraduate placement, the program also identifies needs at health care organizations and facilities in underserved and low-income areas and brings students and training to those communities.

“The key to increasing access to behavioral health services is to expand behavioral health treatment in integrated settings,” says Virna Little, LCSW, PsyD, cofounder and chief operating officer of Concert Health. “Training nurse practitioners and social workers to practice in integrated settings and to use evidence-based treatments like Collaborative Care will dramatically increase available behavioral health services for safety-net populations. We’re excited to be working with Adelphi to build the nation’s premier training program for the next generation of clinicians.”

Concert Health will be providing placements for students of both disciplines in underserved communities. The students will receive hands-on training from faculty with expertise in working in integrated settings, weekly specialized didactic seminars, and specialized online learning modules.

The grant funder, the Health Resources and Services Administration, is an agency of the U.S. Department of Health and Human Services located in North Bethesda, Maryland. It is the primary federal agency for improving access to health care services for people who are uninsured, isolated, or medically vulnerable.

— Source: Adelphi University