REVIEWER: HS 2 Community-based care in corrections is designed to
take individuals from prisons and local jails and place
NEW SETTINGS FOR HUMAN SERVICE DELIVERY
them in the community within supervised, planned
One way to describe the broadening scope of human programs. These programs link educational services,
services today is to think about where services are counseling, substance abuse treatment, and
delivered. In many instances, services continue to be employment assistance. In these programs, much of the
delivered in agencies or institutional settings; but with a responsibility falls to the client to take the initiative in
growing emphasis on making services accessible and using available services
comprehensive, service delivery in nontraditional
School-based services or full-service schools are
settings has increased. Rural services, industrial and
popular terms that describe the creation of an array of
military settings, and schools are highlighted in this
integrated support services in schools where children,
section
youth, and families need to be successful
INSTITUTIONAL AND COMMUNITY-BASED SERVICES
Dryfoos and Barkin (2006) suggest that the integration
There has been a change in philosophy regarding the of educational, health, and social welfare services may
delivery of services in institutional settings and in the provide support for vulnerable children growing up
community. The difference in settings is an obvious today.
factor. Earlier institutions were located in remote places
HUMAN SERVICES IN RURAL AREAS
because pastoral settings were believed to be peaceful
and calming. These settings may also have been chosen Interest in providing services in rural areas is increasing.
because members of society did not like to be reminded Two factors account for this interest. First, historically
of the existence of people with mental illness. those living in rural areas, which are losing population,
Correctional facilities have been built in rural areas have been disadvantaged, experiencing a steady erosion
because the criminal population is considered in their quality of life. They are more likely to be elderly,
dangerous to others. Again, people did not like to be be members of disadvantaged minorities, lack the kinds
reminded of this population. Now, however, in mental of opportunities available to metropolitan counterparts,
health, the trend continues toward downsizing and need the help of human service agencies and
institutions and increasing the number of community- professionals.
based services
Small towns and rural areas are attracting those who
Community-based mental health has changed the see advantages in living where there are lower crime
nature of service delivery. The focus of treatment has rates, opportunities for professional advancement, and
become health and wellness instead of illness. The larger labor pools with lower wage expectations. Thus,
process involves other social institutions such as an increasing number of people who are not
schools, recreation facilities, and religious organizations. disadvantaged live in rural areas; indeed, they may have
In addition, the psychological and medical treatment significant wealth. They include property owners,
received by clients has been adapted for community- professionals, and business people. Those who are living
based care. Much human service work is in case in rural poverty and those who are not disadvantaged
management: The human service worker acts as may experience similar problems, such as mental illness,
planner, consultant, and liaison between the mental family conflicts, and physical limitations, that require
health agency, the client, and the other supportive the help of social service agencies and helping
institutions. Human service professionals also provide professionals.
help for the families of people with mental illness
A second reason for the interest in human services in
Youth in Need is a St. Louis area multiservice agency rural areas is the difficulties or barriers in providing
that reaches homeless and runaway youth on the accessible and adequate services. Recruiting and
streets. retaining trained health care and helping professionals,
the large geographic distances between HUMAN
One of the founders of YIN, Reverend Earl Worley
SERVICES TODAY 63 clients and providers, the cost of
services, the maintenance of confidentiality, the
isolation, and the coordination of care are all A priority of the administration of George W. Bush is the
problematic in rural areas. Another significant barrier is New Freedom Initiative that has asits purpose the
the community stigma attached to having problems and elimination of the barriers that prevent people with
receiving services. This negative perception may disabilities from participating fully in community life.
prevent individuals and families from getting the initiative provides a comprehensive, government-wide
professional help they need. In some cases, individuals Meeting basic human needs in the military is different
seek informal help from the extended family, the from accomplishing the same in a civilian setting, partly
church, and social clubs, particularly when formal because of the atmosphere of discipline and
support systems are lacking. commitment to the organization. In 1881, the American
Red Cross began providing social services to the military
HUMAN SERVICES IN INDUSTRY AND THE MILITARY
out of a concern for the health and welfare of the men
Traditionally, human services has been associated with and women in uniform. A medical orientation
people in financial need, particularly those who are characterized military social service until 1976, when
unemployed or who are labeled as poor. Today’s the Service to Armed Forces (SAF) was developed to
employers recognize that workers who are physically help the military better serve the families of military
and psychologically well are more productive personnel. Field offices were established in military
employees. Industry has learned to identify signals that hospitals and military installations to assist
indicate when an employee needs assistance: tardiness, communication between service personnel and families.
absenteeism, ineffective job performance, and inability
In January 1999, the Navy also announced a new
to cooperate or communicate with others
program, LIFElines, that links personnel and families by
The Federal Comprehensive Alcohol Abuse and Alcohol e-mail. This program was part of a $3.4 million Quality
Prevention, Treatment and Rehabilitation Act (the of Life program that promotes a national model leading
Hughes Act) was passed in 1970 and created the the way in human resources support services.
National Institute on Alcohol Abuse and Alcoholism. The
Operation Iraqi Freedom (OIF), launched in March 2003,
act was significant for the field of human services
reminded us that war can be traumatizing for some
because it established an approach that was different
military personnel and their families. OIF has become
from the treatment for people with mental illness. The
the largest sustained ground operation since Viet Nam.
act required federal agencies to have alcohol abuse and
Soldiers exposed to combat may develop mental
prevention programs available to employees—programs
disorders, such as posttraumatic stress disorder,
now well-known as employee assistance programs
depression, and generalized anxiety. In fact, about one-
(EAPs). EAP services are offered to employees of most
third of U.S. military personnel who have returned
major corporations. Some address broad needs of
home are receiving mental health services (Gardner,
workers, such as counseling for abuse, personal issues,
2006).
and marital problems; encouraging wellness with diet
counseling, exercise, stress management, and personal The U.S. military has several programs to screen war
awareness education; and developing work-related veterans as they return stateside. One program gives
skills through such programs as employee orientation, veterans a half-day schedule so they can reconnect with
management development, human relations training, their families; the other part of the day is spent with
team building, organizational development, and their soldier buddies. A second program is the Post-
preparation for retirement. Deployment Health Assessment to screen for both
physical and mental health problems.
The scope of human services has once again expanded
beyond the fundamental provision of basic assistance. IMPACT OF TECHNOLOGY
Passage of the Americans with Disabilities Act (ADA) has
Technology continues to change the delivery of human
also had a significant impact on business, industry, and
services. Human service providers are expanding the
other employers. Signed into law by President George
ways that they use technology to help their clients both
H. W. Bush on July 26, 1990, ADA was patterned after
directly and indirectly. Technology is used in the areas
the 1964 Civil Rights Act.
of communication, information management, service
delivery, and professional development. Development Communications also occur through the World Wide
in technology is dynamic, and continued change is the Web using individualized web pages. In this way, many
norm. Administrators of services, direct service individuals and organizations can provide information to
providers, and clients are all ‘‘customers’’ of the those online. The World Wide Web is a powerful
computer systems that continue to emerge and we multicultural tool used to connect people to other
expect growth in the creative use of technology to people.
continue occurring at a rapid pace. The primary goal for
Web logs (blogs) are sites where individuals can post
using technology in the human service delivery system
their diaries, journals, thoughts, and opinions about
is to provide services more effectively and efficiently.
their experiences of or ideas about a particular subject.
For many human service professionals, use of
Numerous blogs focus on human services
technology has already helped them provide better
quality services in a more cost effective manner. As
these technologies become more interwoven in our
lives, they will be used simply because they represent
the standard way of doing business. One pervading
ethical concern about the increased use of technology is
the protection of confidentiality. As paper and face-to-
face communication has shifted to technology-driven
methods, protection of the client and the helping
activitymust continue to be ensured.
COMMUNICATION
Computer technologies and the advances in satellite
communications support the ways many interactions
occur in human service settings.
E-mail continues to be one way human service
professionals communicate and share information and
files with colleagues, whether they are in the same
building or across the state, nation, or sometimes,
globe. Human service professionals also use distribution
lists and Listservs to share ideas and concerns regarding
ethics, treatment, managed care, and funding. Instant
Messaging (IM) and SMS (Text Messaging) are two new
ways that individuals are communicating with each
other. IM typically represents communication from
computer-to-computer, while Text Messaging is
typically between cell phones. Both of these methods of
communications allow individuals to communicate
synchronously. The advantage of using IM and Text
Messaging is the ability to send and receive messages
instantaneously.
Another way human service professionals in distant
locations can communicate with each other is by
teleconferencing. Many large organizations find this
technology a cost-effective way to conduct meetings
and to talk with each other about service delivery, new
programming for clients, and ways to learn new
information and skills.
THE INTERNATIONAL DIMENSION Caucasian, Black, Indian, and Asian. Another well-known
individual who has affirmed his mixed ancestry is the
Today, people travel the world in a matter of hours
actor Keanu Reeves, who is Hawaiian, Chinese, and
rather than days or weeks. Advances in communication
Caucasian. The 2000 Census was the first attempt in this
keep us instantly informed about developments
country to identify multiracial individuals.
throughout the world by satellite, e-mail, and faxes. The
information borders, with users in most countries TRENDS IN HUMAN SERVICES
around the globe.
Human services will be different in this century. We
SUMMARY know that change occurs rapidly. In this chapter, you
have read about changes already taking place that
External reviews—evaluation of a request for
impact service delivery today. The utilization of
services prior to service delivery
technology, managed care, and the diverse and
Standards of good practice—specification of
nontraditional settings for helping activities will
outcomes, relationship of outcomes to services,
continue to impact human services, but other trends
and efficient and effective service delivery
will influence what and how services are delivered and
Continuum of care—integrated system of
to whom. It is appropriate that as part of our discussion
settings, services, professionals, and levels of
of human services today, we devote some thought to
care
the future. It will come quickly
CHALLENGES IN INTERNATIONAL HUMAN SERVICES
AGING IN AMERICA
Global population began to increase rapidly in the 20th
Growth and change of the elderly population in America
century, a situation aptly described by the term
rank among the most important demographic
population explosion. This was not a worldwide
developments of the 20th century and will continue
phenomenon but occurred almost entirely in the
their importance in the 21st century. This development
developing countries of Africa, Asia, and Latin America.
has serious implications for the next 50 years. The
The dramatic contrast in growth between the more
population in the United States aged 65 and over is
developed and less developed countries continues to
expected to double in size within the next 25 years. The
increase.
number of those 85 and older is also increasing. The
Another challenge is urbanization, a long-term global Hispanic population of older adults is expected to grow
trend that is most pronounced in poor countries that from 2.2 million in 2004 to over 15 million by 2050.
are least able to cope with its pressures.
HOUSING Living arrangements for those 85 and older
The challenges in international human services continue are determined by several factors: financial assets,
to be great. The plights of refugees and migrants, those ability to care for self, social support, cultural values,
with AIDS, the homeless, drug users, and the displaced access to social services, and types of housing available.
in the aftermath of natural disasters—in addition to the The types of living arrangements vary; four alternatives
problems discussed here—are some of those challenges are presented here (Kinsella & Velkoff, 2001).
Monique Kolubo-Simpson is an American-Liberian who First, many individuals own or rent their own homes,
fled Liberia in 1990 after her life was threatened by and their first choice is to ‘‘age in place.’’ Services such
rebel forces as mobile meal delivery or home health care make this
possible. Often in the United States, older Americans do
INFLUENCES ON THE UNITED STATES not choose the second alternative, living with their
Immigrants to the United States increase our awareness children; they want to remain independent and fear
of those nationalities that have become or are they will be a burden. When parents do live with their
becoming part of our population adult children, as an alternative to independent living,
mutual consent contributes to a successful co-existence.
Another interesting ethnic development is the A third choice, assisted living, is a relatively new choice
recognition of multiracial individuals. TigerWoods, the for those 85 and older. The number of individuals
golf professional, has mixed ancestry that includes choosing this option is increasing, because level of care
can be matched to individual need. Assisted living shared meaning. It may include religious groups (e.g.,
environments offer a combination of personal space Jews), country of origin (e.g., China), or any other facet
and social services to meet the needs of their clients. passed from generation to generation (Brammer, 2004).
These terms are important in the United States where
DEPRESSION Just as important as the living
the ethnic and racial structure is changing. In 1998, non-
arrangements for the aging population are the mental
white groups accounted for 28% of the population. The
health issues that many of them face. One important
2000 census puts the number of non-whites at 30%, and
issue is depression. According to the National Institute
by mid-century, the percentage is expected to be
of Health (2006), over 6.5 million individuals over the
almost 50%. It is both statistics and our ethical
age of 65 experience depression.
standards that require us to learn as much as possible
CONFRONTING DEATH AND DYING Although many about minority worldviews. There will not be enough
members of the aging population do not experience minority helpers for each racial or ethnic group to have
depression, sadness and grief over loss are inevitable. its own
These emotions are natural and predictable reactions to
RELIGION Diversity in the United States also embraces
leaving home, deterioration of health, developing a
religious differences. In fact, the United States has been
disability, and losing independence and the ability to
called the most religiously diverse nation in the world,
care for one’s self. Death of a spouse and the process of
primarily because it is a nation of immigrants. Religious
dying present special challenges. According to Erikson
diversity brings both challenges and opportunities to a
(1963), in the final stage of life—ego integrity versus
community. As a challenge, religious difference is a
despair— one comes to terms with both the meaning of
main factor in social conflict on local, national, and
life and the place of death within the experience of
global levels as shown by the political impact of
living. For most individuals over 65, several issues
religious fundamentalism and ethno-religious groups.
around dying and death, such as care for a loved one,
Some object to the presence of other religious groups in
require social support and social services.
their communities, citing the vandalism and violence
The survivor is likely to experience a wide range of against certain groups, the negative stereotypes,
emotions, such as denial, disbelief, confusion, shock, discrimination, and ignorance
sadness, and despair
Religion is an area of strongly held beliefs and emotions.
AN EMPHASIS ON DIVERSITY Those who see diversity as an opportunity or strength
are also intense about their beliefs. They cite the
Typically, when we think about diversity, it is the ethnic richness of significant religious holidays and
makeup of our country that comes to mind. In fact, observances and the increasing number of ecumenical
earlier in this chapter you read about the changing and interfaith organizations as positive forces in
demographics of both the United States and the world, religious diversity
and how those changes will impact human services. It is
accepted today that as you enter the human service
profession you will encounter clients who are different
from you. You will also be working with other helping
professionals who are different from you.
RACIAL AND ETHNIC DIVERSITY Racial and ethnic
diversity often come to mind first when the word
diversity is mentioned. According to Federal
classifications, African Americans (blacks), American
Indians and Alaska Natives, Asian American and Pacific
Islanders, and white Americans (whites) are races.
Hispanic American (Latino) is an ethnicity and may
apply to a person of any race (Surgeon General’s
Report, n.d.). This example reflects the reference of the
term ethnicity to a common culture, heritage, and
