Importance of the Social Worker

Transcription

1 Importance of the Social Worker An overview Dr. N K Kirimi, Principal specialist: psychiatrist, Kimberly Hospital Complex

2 Prof Charles Perry. Keith Not much to say on this except that social workers are currently the backkbone of the drug treatment system in South Africa. Obviously contributions are being made by other professionals (eg psychologists, GPs, psychiatrists, nurses, etc.) and non-professionals, but the lions share of the work is being done by social workers. I think this is appropropriate, but Health needs to come to the party in terms of detoxification and brief interventions in primary heath care level. There is a need to upskill many social workers and to move towards instituting a further qualification -- Certified Addictions Counsellor like they have in the USA. Anyone can apply for the training/certification, but it is mostly social workers who do so. Social workers will have a key role in seeing that the new national norms & standards for in- and out-patient treatment are adherred to. None of this will be possible is social workers in the private sector are not paid properly. Retention of good staff is essential. WIll see if Nadine and Bronwyn have any further comments. All the best with your meeting with the Portfolio Committee. Thanks for running this by me, Charles

3 Nadine; Dear Keith, I agree with Charles, social workers are at the forefront of AOD treatment in SA at both in/outpatient level, but much more at outpatient level. Inpatient facilities have the benefit of a multi-professional team which is not always the case for outpatients - they tend to have social workers rendering direct services. Social workers are skilled in working from a system's perspective (the individual in his environment) which is suited and needed for outpatient AOD treatment. Having said this, social workers are also ideal for rendering aftercare treatment services and could be used more effectively in this regard. Social workers working for the department of social development, also render services to outlying rural areas where access to treatment is limited and provide a key role of either referring clients for treatment (if they have the financial means) or providing brief interventions to these clients, especially in instances where patients have no income which is often the case. I further agree that social workers trained generically will benefit from a specialist addictions counseling qualification in addition to their degree course. Suitable incentives such as an increased salary and recognition as an addictions treatment specialist can be used as drawing cards. I trust this will help. Kind regards, Nadine Harker Medical Research Council

4 Objectives; Reality in the N. Cape SOUTH AFRICA The interdependance

5 AOD Rx: The social worker.

6 SA UNDER ATTACK: DR LUCAS

7 CASE 1.

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9 M53 ALCOHOLIC F35 IP F33 F30 M23 SUICIDE M21 POLYSUBST ABUSE M18

10 FINDINDS: DEPRESSION C PSYCHOSIS & HIGHLY SUICIDAL POLYSUBSTANCE ABUSE RAPED BY X9 MAN when 16. These man still roam streets of Roodepan HIV infected

11 Rx PLAN: Tranquilisers Psychotherapy Social work up

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13 Capital: Kimberley Languages: 68% Afrikaans, 20.8% Setswana, 2.5% English Population: (2006) Share of SA population: 2.3% Area: square kilometres Share of total SA area: 30.5% Population density: 3 people per square kilometre Gross regional product: R29.7- billion (2003) Share of total SA GDP: 2.4%

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16 Genital HSV

17 Lymphogranuloma venereum

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20 CASE 2.

21 SA DOH Guidelines Medical WHO Stage 4 disease CD4 <200cells/mm 3 Psychosocial Demonstrated reliability x 3 visits No active alcohol / drug abuse No untreated active depression Disclosure Insight Other Able to attend clinic regularly

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24 THE CRISIS

25 Range of Substances of Abuse Alcohol; Intoxication: Dependance Fetal Alcohol Syndrome Dagga;unpublished data 9.2% prevalence of Tardive Dyskinesia(TD) 8pts abusing dagga(62.5%) 25.2% of study pop use dagga

26 Unpublished data. males females totals 102(62%) 61(38%) Dagga use (non TD) 31(21%) 2(1.4%) TD Dagga use alcoh & dagga nicotine 13 8(61.5%) 4(30,7%) 14(93.3%) 2 0

27 THE CRISIS:

28 THE CRISIS:

29 Multidisciplinary Team: TREATMENT. PREVENTATIVE.

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31 The Future: WESTEND KMB. DISTRICT HOSPITALS PHC CLINICS

32 AOD Rx: The social worker.

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