As a senior and seasoned clinical social worker who has recently moved from working full time at a social service agency, to working part time in private practice, I find myself viewing our State of the Clinical Union with a different kind of objectivity. In hopes that my eye has not become too jaundiced in the full sun of summer, I see before us a mental health system of care that is deeply broken and needs serious fixing. And I believe many of you share this view.

I see the causes of this terrible dilemma as being two-fold. First, our nation is in the midst of a major downturn and economic depression that has us all feeling like we are teetering on the edge of a cliff. State services are being brutally slashed due to lack of funding, and mental health programs are fighting over shrinking state and federal dollars. Many of us have received numerous emails from other organizations, both state and federal, exhorting us to attend rallies and contact our senators and representatives about these funding cuts. Second, and perhaps more subtle, is the cultural shift in our country away from the comprehensive integration of health care, especially in the area of mental health. People in marginal circum-stances were once able to rely on their local mental health unit be it an agency district office, or a mental health center for the Basic Three: Psychotherapy, Medications, and Concrete Services. Remember when it was considered routine to maintain ongoing, consistent communications among all members of a given client’s professional support network? It was also standard practice in many top social service agencies to open a client record as part of a larger family case, or at least to include significant family-focused information in the record, all of which enabled the treatment provider to view the client more easily within a society- and family-based context. Instead, those who work in agencies, as well as those who belong to an insurance provider panel in their private practices, are forced to keep treatment records that relate solely to face time with individual clients, and to provide diagnoses that do not take into account the impact of family and the impact of environment two sacred social work principles. The psycho-social overview of client circumstances which helps us understand health and pathology is truly in danger of being obliterated by the push for cost-efficiency and speedy treatment.

I realize how grim this all sounds, but this is where our Illinois Society for Clinical Social Work comes in. We need each other to stand together as a Social Work Body. Belonging to our Society is a crucial step towards working together as a group to stem this unhealthy tide in mental heath care. We can then join our strength with that of other professional organizations, whether the NASW, the American Association of Psychoanalysis in Clinical Social Work (AAPCSW), or other clinical groups. This is not only for the purpose of getting relevant legislation passed, but also for the purpose of educating insurance companies and grant funders about the damage that can come from 1) a lack of comprehensive care, 2) treatment that does not entail the basic social work principles, and 3) over-focusing on the individual as a rote diagnosis that needs cost-efficient treatment.

Whatever your stance on these issues, your participation in the ISCSW allows us to have a rich and valuable dialogue together about the continuing goals of our Society, and ways to make contributions to society as a whole.

I also want to alert you to two upcoming ISCSW conferences. The first is a seminar on October 9, 2009 on Ethics: Boundaries and Dual Relationships to be presented by Eric Ornstein, L.C.S.W., and Henry W. Kronner, Ph.D. Not only is the topic of great relevance to clinicians, it also provides the three hours of continuing education in ethics we all need to renew our licenses this fall.