Date of Award
Master of Social Work (MSW)
Research shows that a considerable number of young people in care have mental health diagnoses (Building Bridges, 2008, 9). An article in the Globe in Mail (2007) reported that 47% of youth in care were on psychotropic medication [for mental health, emotional or behaviour issues] (Philp, 2007).
As a worker within the child welfare system, working with crown wards, my own case load reflects these numbers quite accurately. Some of the youth I work with have seen psychiatrists, psychologists or family doctors, and their diagnoses have changed with each assessment -which subsequently affects or changes how the case is managed.
This research sets to show how we arrive at a diagnosis, using institutional ethnography to map the diagnostic process. Using my experience as a children's service worker, I map the types of information gathered and by whom, as they contribute to the diagnosis a child receives.
This study provides a detailed examination of the text-action interplay in the child welfare system, showing the nature and volume of information created by various actors in the system and submitted to the assessing practitioner (i.e. psychologist, psychiatrist). The study also shows how action within the system is often prompted by liability, accountability and worker knowledge.
Recommendations are made to explore our responsibility to youth in care around child welfare documenting practices, emphasizing the importance of youth contributing to the text that defines them within the child welfare world.
Milmine, Sarah, "Youth In Care and Mental Illness: Mapping the Diagnostic Process" (2009). Open Access Dissertations and Theses. Paper 4383.
McMaster University Library