Job Satisfaction Among Direct Care Workers

In an effort to transform the public mental health system, in 1963, President Kennedy proposed the Community Mental Health Act. It was the first among several federal initiatives to create a community mental health care system. Once the act was ratified, there was an intense deterioration in institutionalization, otherwise known as “deinstitutionalization”, and by 1980 there was a 75% declined of the inpatient population at many public psychiatric hospitals. In 2000, there was less than 10% of the public institutionalized just fifty years earlier. In 2009, there was even a more dramatic shift among children and adolescence whereby there was a 98% decline in

During the 1950s, people who had a disability had two options of housing which included living with their families or living in an institution. However, families did not receive much support since most public welfare services were used towards institutional care, such as mental hospitals and orphanages. Throughout the 1960s there were movements to deinstitutionalize, which at that time basically led to smaller institutions. The 1970s allowed for even smaller community-based residential services that were typically designed for not more than 12 people that were similar in terms of age, independence, or ability. Even though different funding was available, many standards were violated in most of the institutions. Throughout the 70s there were movements to close state institutions and provide more community residential services as well as family support. During the 1980s groundwork for families was laid to expand their control of the nature of the support they received and more options were available to help out with living outside an institution. People with developmental disabilities began to gain increased support to having homes of their own during the 1990s and funded had dramatically increased to over $735 for family support programs in 1998. In 2001 the federal government began a new freedom initiative to “remove barriers to community living for people of all ages with disabilities and long-term illness.” In 2011 the decision that the isolation of people with

Many years ago, mental illness was viewed as a demonic possession or a religious punishment. In the 18th century, the attitudes towards mental illness were negative and persistent. This negativity leads to the stigmatization and confinement of those who were mentally ill. The mentally ill were sent to mental hospitals that were unhealthy and dangerous. A push in the mid 1950s for deinstitutionalization began because of activists lobbying for change. Dorothea Dix was one of these activists that helped push for change. The change called for more community oriented care rather than asylum based care. The Community Mental Health Centers Act of 1963 closed state psychiatric hospitals throughout the United States. "Only individuals who posed an imminent danger to themselves or someone else could be committed to state psychiatric hospitals" (A Brief History of Mental Illness and the U.S. Mental Health Care System). Deinstitutionalization meant to improve quality of life and treatment for those who are mentally ill. This would hopefully result in the mentally ill receiving treatment so they could live more independently. The hope was that community mental health programs would provide this treatment but sadly there was not sufficient or ongoing funding to meet the growing demand for these programs. Budgets for mental hospitals were reduced but there was no increase for the community based programs. Many mentally ill individuals have been moved to nursing homes or other residential

Before 1955, the mentally ill took shelter in mental facility institutions. After 1955, the United States’ deinstitutionalized these facilities and made policy changes to the mental illness treatment system. However, those policy changes are flawed. Some say rather than abandoning mentally ill patients and depriving them of shelter, the United States government should change the way the mentally ill are treated in their current living situations. Instead of changing the attitudes of those who provide services to the mentally ill, it would be more beneficial to change the services themselves.

The conditions of psychiatric hospitals were poorly maintained yet again. From the late 1800s until the mid-1900s, the conditions of these institutions were hit or miss. Despite the rising population of those in need of mental health treatment, conditions were deteriorating across the board. This pushed in the deinstitutionalization movement (Nevid, Rathus, & Green, 2014). This was a push to remove patients from state-run hospitals into a more community-based treatment center. In most cases today, there are treatment plans in place depending upon the severity of the disorder an individual may be suffering from. It’s more about treating an individual with any variety of modern techniques or therapies and trying to reintegrate them into society rather than a lifelong stay in an institution. Deinstitutionalization didn’t work the way it was intended. After it was put into place there was a rise in the homeless population and different programs that were supposed to be put into place didn’t live up to

Deinstitutionalization is defined as the movement of severely mentally ill people out of large state institutions. In the 1950s, public hospitals housed well over 500,000 people. The reduction in the number of institutionalized people began in 1956. By 1980, the residential population in mental hospitals dropped by nearly three-quarters, an average of 154,000 individuals. This decrease is due to the process of closing public hospitals and transferring patients to community-based mental health services. Consequently, community services were implemented (Talbott 2004).

Mental health policymakers overlooked the difficulty of finding resources to meet the needs of a marginalized group of people living in scattered sites in the community. Implications of changes in financing will need to be measured and unsuspected responses should be assessed promptly when they occur. A shortage of community resources will eventually mean that it may be necessary to preserve institutional beds primarily until community care is expanded. Structure in an important consumer role in policymaking, monitoring and evaluation has proven to be a valuable source of input in mental health policy advocacy. Particularly in politics who review the demographic pressure on long-term care services establishments. Deinstitutionalization accelerated nationwide due to the federal government in the late 1960s and 1970s. During this time Medicaid and Medicare were created with coverage for a range of services including components of the mental health field. Supplemental Security Income also made an appearance for the mentally ill. (Koyanagi, 2007)

Saratoga County no longer has safe, stigma-free, places for individuals with severe and persistent mental illness (SPMI) to spend their days. SPMI individuals need somewhere to go where they can feel safe and can interaction with others. In the past SPMI Individuals in Saratoga County had the options of attending day treatment, going to a drop-in center called The Social Club, or spending the day being productive in a sheltered workshop environment. Over the past few years all of these options have been removed. First, The Social Club was closed. Next, the day treatment center was changed to a “PROS” model where services are limited, time specific, and the focus is on community integration. Lastly, state and county funding was cut for shelter workshop environments and funneled into work readiness programs focused on integrating SPMI individuals into the community workforce. Integration is a noble aspiration. However, many SPMI individuals do not have the capacity to successfully integrate into community settings. These individuals are better served in situations where their special needs are appreciated and met such as sheltered workshops, drop-in centers and day treatment. Thus, due to the closing or changes in these types of programs, Saratoga County no longer offers safe supportive places for many SPMI Individuals to spend their days.

Deinstitutionalization was made up of three main parts that were intended to help this crisis. 1. The release of the individuals, 2. The diversion from entering into institutions, 3. The development of alternative community services (Lamb & Bachrachm 2001). Successful deinstitutionalization relied upon the planning and actions of all segments of reentry into society. This movement was the prevention/intervention strategy to the constantly reported complaints of institutional abuses of the mentally ill, the cost of state-run facilities, the creation of modern medicines, and the increase in private-run facilities. The strategy was supposed to be better in the long run for everyone and those stricken with a mental illness were supposed to be better off in their communities. Most of the time the communities were too busy to care for their mentally ill in need (Frazer A., 2009). Efforts and commitments needed for successful re-integration into society were scarce so drug/alcohol addicted, mentally ill, and formerly incarcerated would turn to the streets for their needs, ending up in the criminal justice system repeatedly. The lack of intervention strategies for this endless age old problem began to grow larger and plague our correctional

Due to understaffed and underfunded in the psychiatric hospitals, harsh criticism toward the institutionalized care increased. It was also because of changes in the attitudes of staff and abusive practices in the hospital (Leff, 2001, p. 25). The movement of deinstitutionalization reforms from the asylum-based to community-oriented care. Mentally ill people moved from psychiatric institutions to community mental health centers. Even though there were positive reports about the outcome of community-based mental health programs, other reports found opposite. “Many experts hope that by improving community-based programs and expanding inpatient care to fulfill the needs of severely mentally ill patients, the United States will achieve improved treatment outcomes, increased access to mental health care, and better quality of life for the mentally ill” ("Early History," 2000-2013, p. 2).

The purpose of this research was to investigate the cause of the high turnover rates in the direct care field, while addressing strategies to help reduce the high turnover rates. Direct care workers are the primary providers for hands-on health care; direct care workers provide assistance to more than 13 million elderly and disabled individuals though out the United States (Squillace, 2011). They assist with everyday activities such as meal prep, administering medication, bathing, dressing, mobility, in addition to planning daily activities. Direct care professionals play a vital role in the lives of the individuals they assist on a daily basis (Squillace, 2011). They make it possible for these individuals to live meaningful lives

The need for special programs continues to increase yet numerous states have a suspension on building new residential programs. People have reduced attendant care programs that are often vital in providing persons with disabilities essential services for day to day living. Mental health programs have been underfunded leading

The Value Percept Theory argues that job satisfaction depends on whether a job supplies the things an individual value most. Overall satisfactions derive form combined levels of satisfaction from various elements of an individual’s job, whether it’s: pay, promotion, supervision, coworkers, or the work itself. Job satisfaction is based on cognitive and affective components, which is evaluated by what an individual thinks about the job, and how they feel. Cognition evaluation is based on experiences, weighing different aspects of a job; as affect is a reaction of the job, which can fluctuate based on moods and emotions. Level of dissatisfaction is measured by the difference between what one has and what one wants, and the level of importance of that facet to the individual. Statistics have proven, that supplying individuals with what they value, will increase the chance of better performance, which has a high correlation with an individual’s affective commitment with the organization.

This work aims to clarify the extent to which challenge and hindrance stressors affect performance and job satisfaction. I expect to find that Organizational

Job satisfaction is a pleasurable or positive emotional state resulting from the appraisal of one’s job or job experiences. It has been treated both as a general attitude and satisfaction with five specific dimensions of the job: pay, the work itself, promotion opportunities, supervision, and coworkers. Challenging work, valued rewards, opportunities for advancement, competent supervision, and supportive coworkers are dimensions of the job that can lead to satisfaction (Nelson & Quick, 2013, pg.