1. QUALITATIVE ANALYSIS OF THE NEED FOR SOCIAL WORKERS IN THE MEDICAL INSTITUIONS OF NIS Prof. dr Natalija Jovanović

2. Two focus groups Medical managers and social workers By interviewing three managers and six social laid off, and the person who engaged in the business of social work in health care institutions

3. QUALITATIVE ANALYSIS specimen: a social workers and directors of medical institutions of Clinical Center of Nis: Department of Mental Health and Special Hospital psychiatric illness "Gornja Toponica"

4. The main research question for managers is: The study was to determine the level of development of social work in health care institutions, where there is a need for the work of this profile with users of health services

5. Research goals: determine what significance that is, the management of health facilities, work social worker determine the terms of reference in which social workers working in health care facilities determine what knowledge and skills of social workers in health care institutions, recognized for quality work

6. Specific research objectives: A deeper understanding of the need for social work with specific patients: chronic, mental health, juvenile, the disabled and others. Introducing the manner and scope of work of social workers in the health sector. Collecting information on whether there are prescribed standards in the work of social workers in health care specific groups of patients. Determining the real needs for social work in specific areas of health care, in order to better protect the health of patients and in the best interests of patients.

7. social work  Social work is a scientific discipline that studies human behavior and interpersonal relationships to their improvement, promotion of social change, problem solving in interpersonal communication and empowerment of individuals and groups  IASSW (International Association of Schools of Social Work) and IFSW (International Federation of Social Workers) define social work as a profession that promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being.

8. In-depth interview was conducted in the period April 2014. Clinical Center Nis. The Special Hospital "Gornja Toponica"

9. Clinical Center Nis These tasks are performed by social workers who are employed at the Department of Mental Health and Psychiatry developmental period. These social workers provide services in the field of social work all clinics, while at the same time, they are not organized in a special service, nor a chief from among their ranks. They work in teams, namely in the Team section of addictions, Tim day hospital, the Team for adolescents and children's department. In Clinical Center Nis there is no common social work services.

10. The Special Hospital "Gornja Toponica" The hospital specializes in working with chronic mental patients who have complex problems in social functioning and involvement in the community Capacity Hospital provides care for approximately 800 patients, with 523 employees. Hospital meets the health needs of a very large area, with over 6 million people from Belgrade to the border with the Republic of Macedonia

11. The Special Hospital "Gornja Toponica" Members of the Special Psychiatric Hospital: mental illness, drug addicts psycho-active substances and the elderly psychiatric patients. Their number is growing as a result of post- traumatic condition in which there is our society, political and economic crises that have caused numerous social problems: unemployment, job loss, poverty, disease, chronic illness, disability, substance abuse, mental illness, violence, aging population, social exclusion

12. findings to occur and new types of psychiatric diseases and disorders, and problems caused by the specifics of the environment and everyday life: these are patients who have a distorted sense of perceiving reality and accept that they are sick and they need help. Working with such users of medical services, it is not enough only to the level of medicine, there is a need to recognize the great work of social workers to provide support to individuals and families for social inclusion

13. Social workers stand out the need to monitor patients who have completed the Hospital sled lack of social approach to a large percentage of the returnees in sickness and in even greater health, psychiatric and social problems but Psychiatric patients are particularly vulnerable, because they are usually unable to work, rejected by their families and relatives, are materially destitute, and if absent, and social work with such patients, the overall problems are rapidly becoming more complex

14. The work of social workers Has not standardized There is no rulebook social workers in health care institution, nor is there a written protocol There is a job description for the work of social workers in the departments, there are the services provided by the Republic Health Insurance Fund, which provides for the operation of social workers In job description is provided: Working with individual and family Collaboration with the Center for Social Work, Social Protection Fund, the Health Care Fund of pension and disability insurance, nursing homes, social care institutions

15. Clinical Center Nis the republican institution founded in 1990. In size, the other institutions in Serbia and provides services to patients south and southeast Serbia, with about three million population The institution is a teaching base of the Faculty of Medicine in Nis, with about 240 professors and associates. Clinical Center consist of the 24 clinics, centers and institutes service. Hospital capacities are approximately for a 1,500 people, with 3,000 employees (2,251 medical and 769 non-medical staff), and 5 social workers.

16. Social workers CC Nis Most social workers work at the Clinic for mental health and neuropsychiatric developmental age, which is part of the Clinical Center Nis Clinic for Mental Health and Neuropsychiatry developmental age is a highly specialized health institution that deals with the protection and promotion of mental health of the population, especially adolescents; observes acute and chronic psychiatric diseases and disorders

17. Social workers CC Nis perform services of clinical care, clinic patients and patients who are unable to asylum needs, providing shelters, pointing to temporary housing or accommodation on the basis of expert opinions and arranging access to services (from infants to the elderly patients). At this clinic employs four associates who work on social work

18. Social workers CC Nis not organized as a service, but are part of volumes: Tim Day Hospital, Tim for adolescents and children's ward and Tim department for addiction. They provide services to all departments in the Clinical Center Nis, in particular: the Department of Mental Health and Neuropsychiatry developmental age, the Clinic for Children's Internal Diseases, Department of Neurology, Department of Nephrology, Department of Orthopedics and Rheumatology, Department of Oncology, Department of Obstetrics and obstetrics, and all other clinics when the need arises

19. Social workers CC Nis Social workers were removed from the work of doctors, working in teams provide advisory services to doctors for patient care, in the application of socio- therapeutic measures, to assess the patient and the like.

20. Findings based on interviews with directors social workers provide services to other clinics of Clinical Center Nis; that is a lack of professional associates this profile that the increased workload for social work Increase in volume is particularly evident with all young patients and adolescents due to: abuse, neglect of children and adolescents, is increased adolescent disorders, and patients to other clinics

21. Findings based on interviews with social workers status of social workers is bad, because you are not in your home area, do not have a special service, their work is not regulated by a separate ordinance, and earnings were lower compared to colleagues in the medical profession, and the accountability of the large and disproportionate to the professional status (doctors decide on the status of the patients only in consultation with them).

22. Job description social worker in cc investigating, designs, organize, participate in solving social pathology, participate in the development, execution, evaluation of multidisciplinary health programs and performs other duties within its jurisdiction

23. Social work in CC There is no standardized form, Create their own socio-anamnestic data collection sheet on the patient, family, work skills and patient engagement, and on addiction and related problems, motivation for treatment, Plan and recommendations

24. Social work in health institutions Social Work in Health institutions is necessary in order not to relapse, returning to the disease Adequate social support for patients is as important as medical care, because even the best medical care is not given complete results, because there is no psychiatric, but other chronic and serious disease, which can be overcome without the support of family and the community

25. Social work in health institutions Finding interview is that health care institutions most needed Profile: Social worker competencies to ensure availability of services and exercising their right to social protection, assisting and empowering patients to an independent and productive lives, improving family relationships and become a dynamic family, gender and intergenerational solidarity.

26. Findings There is no standardized form of any user operation. The social worker's own initiative created a form for registration of suspected abuse / neglect in the health institutions; Form for submission of information to the Ministry of the Interior in Nis, for reporting suspected child abuse; application form Centre for Social Welfare, child abuse; Socio psychiatric surveys to collect data on patient demographic data, family and psychiatric diseases

27. The qualitative analysis of the social workers, the main work according to experience, themselves create and propose measures to protect the interests of children and other patients; there is no adequate supervision, nor standards and contacts for advancement within the profession The tasks performed by the social worker and the monitoring of these patients from birth, preschools, schools; advisory work with parents, establishing educational models in the family, social and therapeutic club for help and advice to parents; support and self-help adolescents in crisis situations

28. Conclusion Social work in health care institutions in Nis is underdeveloped in institutional and procedural terms. In CC Nis there is a special category of social work services, although there is a great need for this kind of work in the best interest of patients

29. In this medical institution social workers perform tasks: social support, help users of health services to achieve them by estimates that they need, and refer them to appropriate services and facilities, if necessary, help to reach the institutions and services, to individuals and their families in teamwork with physicians of different profiles

30. Social workers in The Special Hospital "Gornja Toponica" Organized in the framework of a special service, just organizationally, but they do not have their own, separate space for work, but in special classes. There is also a great need for the work of social workers, because the number of psychiatric patients significantly increased, and their treatment is not possible without social care

31. Social workers in The medical institutions Not analyzed nor special rulebook social workers in health care institution. There are no standardized forms, designed to work with health patients, there that need social assistance, support and protection measures. Questionnaires create your own social workers, based on their knowledge, experience and specific needs.

32. Required knowledge in the area Psychology and psychiatry: Personality Psychology, Developmental Psychology, Psychology of adolescence, family psychology, Psychology of Mental Health, Psychiatry, neurosis, psychosis, Psychopathology Sociology: Sociology of the family, Sociology of Education, Social Pathology, Sociology of Social Exclusion, Sociology socially risky behavior, Sociology protection of children from violence etc.

33. Necessary knowledge Knowledge in the area of law: Family Law, Labor Law, the State Administration, Law on Pension and Health Insurance Knowledge in the area of social work: Social work with individuals, social work with groups, Dimensions of Social Welfare, Social work with psychiatric patients

34. Conclusion The analysis showed that there is a general consensus, participants from both focus groups, to improve the practice of social work in health care. Quality care for medical patients must follow the social work. Therefore, the main conclusion is that the need for a much larger number of qualified social workers in health care institutions. The current number of social workers did not meet the needs of 10%

35. Conclusion Social work is a necessary to quality care in the health service users, in the best interests of individuals and their families. need to create a Master's program of social work in health care institutions or the inclusion of items that would provide the necessary knowledge and skills of future social workers.

36. Prof. dr Natalija Jovanović