Is Social Work's Door Open to People Recovering from Psychiatric Disabilities?

********** Social workers are the major providers of mental health services in the United States, yet the profession has been reluctant to include recovering consumers in its ranks. This article contrasts social work's historic focus on the deficits believed to be inherent in colleagues' history of psychiatric disorder with an empowerment perspective. The article describes perceived risks and benefits to clients when the social worker has a history of a psychiatric disorder. It reviews recovering consumers' successful roles as paraprofessionals in mental health services delivery as a demonstration of the strengths consumers bring to the mental health field. Finally, it identifies barriers to social work employment faced by the social worker who has a history of a psychiatric disability. Key words: empowerment; NASW Code of Ethics; psychiatric disability; social work profession Social workers have expanded their role in the field of mental health and now are the major providers of mental health services in the United States (Substance Abuse and Mental Health Services Administration [SAMHSA], 1999; Vourlekis, Edinburg, & Knee, 1998). Yet social work's historic inclusion of underserved client groups into the profession is not evident in mental health. For people with a history of a psychiatric disorder, barriers to professional social work employment are still apparent within the profession regardless of the individual's current functioning. In the social work literature, social workers and social work students with psychiatric disabilities are discussed infrequently, and then only from the perspective of their potential impairment (Mowbray, 1999; Reamer, 1992). Will the social worker with a psychiatric disability be able to withstand the stress of social work employment? Will the social worker's personal issues--those related to the psychiatric disability--interfere with his or her p rofessional abilities? These concerns are well-grounded in the profession's core value of client protection and professional practice standards that focus on boundaries between clients and practitioners. Emerging practice models that incorporate an empowerment perspective provide an alternate framework consistent with social work's history of inclusion of people from ethnic minority groups and people representative of the profession's clientele. The profession is challenged to maintain its core value of client protection while publicly opening its doors to people recovering from psychiatric disabilities with a strong commitment to and aptitude for the profession. Those who question the inclusion of people recovering from psychiatric disabilities believe psychiatric symptoms, no matter how well managed, will interfere with the provision of social work services. In this view, services may be of lower quality, and clients may potentially be harmed. These advocates also express concern for the well-being of the social worker recovering from a psychiatric disorder, who may be harmed because of the added stress of social work employment, coupled with the pressure of working with clients whose stories are similar to the social worker's own struggles. Psychiatric symptoms may worsen. Boundary issues, in which the practitioner overidentifies with the client, may arise and cloud the worker's judgment. Conversely, those who advocate for professional inclusion of people recovering from psychiatric disorders identify benefits that outweigh potential risks. In this view, clients will be helped because the social worker has an intimate understanding of the life experiences of the client. This view acknowledges that perceived similarities between the client and the social worker can facilitate the development of a productive relationship. The social worker who is recovering from a psychiatric disorder also can serve as a role model for the client. This view promotes social justice because judgment about the suitability of an individual for social work practice is based on the individual's current functioning rather than diagnosis. …