RESUMO
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Summary Social Work is defined as a profession which takes care within the social environment, of the individual who simultaneously experiences diverse problems and deficiencies that affect and alter his personal, group and his community's development. Therefore, the social worker is a trained professional who takes care and looks for solutions to specific problems of individuals in accordance to specific and viable goals. This way we can say that the goal of Social Work is the well-being of human beings and, of course, this includes the promotion of mental health as a means to achieve it. This paper contains a review of the research carried out by social workers on mental health in Mexico during the period from 1970 to 2000. The sources of information for this analysis include the following documents: Revista Salud Mental, published by the Instituto Nacional de Psiquiatría: Ramón de la Fuente, Revista de Trabajo Social published by the Escuela Nacional de Trabajo Social at the Universidad Nacional Autónoma de México (UNAM), Revista de Trabajo Social produced by the Asociación de Trabajadores Sociales Mexicanos A.C.; and other publications issued by Centro de Integración Juvenil (CIJ) and Hospital Fray Bernardino Alvarez (HFBA). The papers were selected on the basis of what is defined as social research, in other words, a process designed to obtain knowledge of a social phenomenon through the application of a theoretical body to an object of knowledge by means of a series of procedures comprising a method. All the papers were authored or co-authored by a social worker and published between 1970 and 2000. They were related to the psychosocial sphere or mental health issues and included field research, and were produced and published in Mexico. Social work became a profession in Mexico in the 1930s, and in the 1940s, psychiatric social work emerged as a specialization of Medical Social Work and research began to be mentioned as part of the methodology of this discipline. Psychiatric social work has been influenced by the Hegemonic Medical Model (HMM), characterized by a biological approach, in which disease receives more attention than health or the prevention of illness, and there is a division between practice and research. Although there have been advances in this respect, social work should be included within the sphere of mental health since this is a more integral concept. Mental health may be defined as the capacity of the individual, group, and environment to interact with each another in a way that will produce subjective well-being, optimal development, and the use of mental capacities to achieve individual and collective goals in order to promote social welfare and improve the quality of life. Objective To describe the characteristics of the research conducted in Mexico by social workers in the mental health sphere. Material and method A descriptive study of social work in the sphere of mental health from 1970 to 2000 based on an analysis of the characteristics of the publications produced during this period, to determine the authors' thematic areas, type of research and academic back-ground. Results The main findings of the 37 papers analyzed were as follows: one article is published per year, with variations in the different decades, two were published from 1970 to 1980, seventeen appeared from 1981 to 1990 while a total of 18 were published from 1991 to 2000. Most part of the research (62%) was carried out in the Federal District and in a number of states such as Mexico, Nuevo León, Tamaulipas, Oaxaca and Jalisco. Most of the papers were published in the Revista de la Escuela Nacional de Trabajo Social (33%). The larger part of the articles, (57%), refer to various issues linked to drug addiction and alcoholism and to a lesser extent to youngsters (18%) who are not involved in drug consumption, children (8%), family violence (6%), poverty, women, training, and the number of patients that drop out of mental health, each of which accounts for 2.8%. The research covered, 23 cases of which 63% were descriptive, 18% exploratory, 16% correlative and 3% explanatory. The theoretical frameworks were drawn partly from medical sciences and mainly from the social sciences such as sociology, and included health-sickness, migration, marginalization, poverty, family, socialization, group theory, social classes, and social welfare. Among the anthropological issues included were culture and indigenism, gender theory, while legal issues included human rights, anti-social behavior, crime and criminology. Medical issues comprised epidemiology, health, prevention, treatment, addiction and alcoholism, while social psychology topics included identity, mental health and youth gangs. The most commonly utilized techniques were various types of interviews and participant and non-participant observation, while the most widely used instrument was the questionnaire. In 75% of the research, the first authors were women while 25% had professions other than social work. A total of 49% of the authors and co-authors had graduate studies including specializations, master's degrees and to a lesser extent, doctoral degrees. Various studies on drug addiction report that addicts come from marginal neighborhoods, with a low level of educational achievement, with under-employed households heads, although some of the studies carried out on populations living in poverty reported that the inhabitants did not have any addictions. What differentiates the two groups, i.e. consumers and non-consumers of drugs and alcohol are specific characteristics. Familial characteristics included addictive models, family disintegration, inappropriate communication, inability to demonstrate affection and emotion, present-absent father, desertion by father, orphanhood, absence of parents due to work, conflictive relationship with parents, family violence and unclear limits. Social characteristics included poverty, unemployment, migration, marginalization, expectations of a magical cure, drug consumption starting at an early age, stigma as a means of preserving identity through acceptance by a group or gang, group's permissiveness towards consumption and dropping out of school. Higher indexes of socio-economic marginalization due to unemployment and under-employment, early deprivation and conflictive family dynamics appear to be linked to the presence of addictions. The consumption of inhalants is also associated with the most under-privileged groups. Violence is associated with migration, prior experience of mistreatment in childhood, abandonment, pover ty, low educational achievement and alcoholism. Studies show that after women who have been battered by their husbands make a formal complaint to the police, their husbands become less aggressive. Another important finding is the fact that most addicts drop out of treatment programs during the early stages of the latter, with 40% dropping out during the diagnostic stage and 60% before ten treatment sessions. This suggests that brief interventions should be designed to deal with drug addicts and alcoholics. The fact that patients drop out treatment programs offered by mental health services is due to personal reasons rather than to the quality of the care provided by a particular institution. Preventive programs and programs offering individual, family and group orientation should be provided, while research should be undertaken to gauge the effectiveness of the intervention and to incorporate the results of the latter into treatment programs to improve the population's mental health. In addition to dealing with drug addiction and alcoholism, programs should be designed to cope with other mental health issues such as depression, anxiety, schizophrenia and old age.