Martin Webber's blog

If this week has taught me anything, it’s that I’m not cut out to be a diarist. It’s a real struggle to come up with something original to say each day without it becoming too dull. Anyway, here goes for the final time this week…

This morning started with social work in the news. A new Chief Social Worker (for children and families) was announced and Frontline was announced again. Twitter sparked into life with social workers (in my twitter feed at least) spitting blood with fury.

The Frontline proposals have divided the profession, including social work academics. Against the tide of discontent, Donald Forrester’s thoughtful blog makes the case for change. I found myself agreeing with many of the points he makes.

The proposed method of practice learning in Frontline involves intense weekly conversations about practice, often involving taped sessions. This is the method of advanced practice learning we used on the post-qualifying advanced award I led at the Institute of Psychiatry, King’s College London. Experienced practitioners attended weekly case consultation groups with tape recordings of their practice which were analysed by an experienced psychotherapist and discussed by the group. Students found this an intense, but transformative experience.

Our experience has been that this method is an excellent bridge between the academy and social work practice. It challenges practitioners to consider theory and research to support the interventions they are using. I am certain that if it is properly resourced it provides a good model of practice education for experienced practitioners, though I am less certain how it will work on a qualifying programme. Our students needed considerable resilience to withstand our intense focus on their practice and I’m not sure a 5-week summer school will provide that. But I’m happy to be proven wrong.

I am also concerned about the resource implications of the Frontline model and how sustainable it will be if rolled out wider. For example, where are the experienced clinical supervisors going to come from? Social workers at the BASW conference yesterday bemoaned the lack of supervision they received. When they did receive supervision it was focused on targets and processes rather than permitting them to reflect on their practice. A new cadre of supervisors may need to be trained, but by whom? My post-qualifying course which trained people to provide this form of supervision was closed down as soon as I handed my notice in last year as it was less profitable than other courses ran by my former department.

I’m not convinced that 5 weeks training is sufficient to gain the knowledge required to safely practice as a social worker. The proposed curriculum appears very narrow in focus and I’m concerned that graduates may struggle with complex cases where the intervention techniques they are trained in don’t work. I know it’s not a very good comparison, but graduates I have taught on Increasing Access to Psychological Therapies courses have the same menu of intervention options for a range of different case scenarios. They have a limited ability to think laterally or creatively in situations of complexity. I am a little worried that Frontline graduates, who are taking responsibility for challenging child protection cases within 12 months of starting their training, may similarly struggle.

My scepticism is not based around concerns that resources may move away from universities to practice based learning in the future if the model is proven to be effective in protecting children and improving social work practice. I fully support evidence-based interventions and I welcome evaluations of social work education (though I wonder what the control group will be and if the graduates will be randomised to Frontline or a normal Masters programme in social work). But I am concerned about the narrow focus on children’s social work and the likely squeeze on mental health and other areas of a traditional social work curriculum. All social workers need to know something about working with people with mental health problems and understanding their needs. Many of the parents Frontline graduates will work with will have mental health or personality problems. Ignorance about this may lead to defensive or insensitive practice.

I am not frightened of change, nor am I pretending that all is well with social work education. But there is an on-going reform process and I can see no reason why this method could not be piloted as part of a wider reform process. It is being imposed from outside the profession, creating suspicion and hostility. It is focused on only one practice domain – child protection – leading to fears about diminishing status or importance of other areas of social work practice.

The attention it attracts through government backing and the media circus which follows it, distracts focus away from what is not permitting practitioners to practice effectively: the conditions in which local authority social workers are working. Caseloads have grown exponentially since the Baby Peter case. One practitioner I spoke to yesterday had 90 (yes, nine-zero) cases. How can that be allowed? Local authorities are having to save £millions because of the austerity measures and Directors of Social Services are happy to commission less effective services if they save them money (I was in a meeting with them last week when this was openly discussed). If social workers had reasonable case loads, proper clinical supervision, supportive managers who were not driven by targets imposed from above, and the support to develop their practice, it is likely that their practice will improve. It is disingenuous to suggest that poor qualifying programmes are solely responsible for bad practice.

I welcome the desire to attract people into the profession who could potentially enhance it in some way. That is to be welcomed. But why create a completely separate entry route? There are already postgraduate programmes who only take graduates with a minimum 2:1 degree. There are already work-based routes into social work.  At risk of repeating myself, why couldn’t this initiative be considered within the existing package of reforms?

As I have banged on about for many years – though mostly before I started blogging, unfortunately – investment needs to be made in enhancing post-qualifying education. Yes, qualifying education should be robust and equip students for practice on their graduation. But post-qualifying education – in the first year of practice and beyond – needs to be properly resourced and supported by employers. The Frontline method of practice education could be used as an intensive on-the-job post-qualifying training in different specialisms for newly qualified social workers (who have received a robust generic qualifying education). Many Approved Mental Health Professionals have rated their specialist post-qualifying training very highly and are respected for their expertise. If a similar model of high-quality practice education were rolled out across the profession, we could similarly enhance the status of social work across the board.

This had started out as a diary entry but I haven’t actually said anything about my day and the work I did. It wasn’t terribly interesting, to be honest, and involved mainly catching up on a backlog of emails, half-finished reports and some marking. As I said, I don’t think I’ll take up writing a diary.

Competition time

There were three entrants to my competition – two on my blog and one on twitter.

The three most viewed posts on my blog to date are:

End of social work at the Institute of Psychiatry

Good practice in personalised care in mental health services

Social workers and self-disclosure

Unfortunately no-one guessed them correctly, but I have used my random number generator to pick a winner from the three entrants.

And the winner is … {Drum roll} … Ermintrude.

Many congratulations. Your prize will be in the post c/o The Magic Roundabout!

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This article first appeared on 16th May 2013 on The Conversation

The conviction of seven men for rape, child prostitution and trafficking in Oxford on Tuesday brings to an end another horrific case of child sexual exploitation.

Social services were again in the firing line for failing to protect the girls and Joanna Simons, the Chief Executive of Oxfordshire County Council, was quick to issue an apology on behalf of the local authority. But social workers alone are not to blame.

The ethnicity and culture of the perpetrators has come under scrutiny, as in similar cases in Derby and Rochdale. The disproportionate number of Asian men in sex-grooming gangs was widely reported. While existing data on perpetrators is patchy and unclear, there does appear to be an over-representation. However, it’s also clear that perpetrators of child sexual exploitation come from all ethnic groups in the UK and not all victims are white British girls.

Stereotyping perpetrators and victims does not help to protect young people. But, without abandoning core professional values, social workers need to be confident about identifying and tackling grooming behaviour without issues of culture or ethnicity obfuscating the risk to the children involved.

Child abuse is a social problem

Child abuse is a significant social problem. Data collected for the NSPCC in 2009 found that about a quarter of young people in the UK reported experiencing abuse or neglect as children.

Since the Baby Peter case in 2007, child protection social work team caseloads have increased exponentially. Cafcass, the organisation that represents children in care cases, witnessed a 62% increase in the number of local authority care applications from 2007-8 to 2011-12.

Children in local authority care also have poorer educational outcomes and a greater prevalence of offending and substance misuse behaviour than the general population. This is likely to be because of vulnerabilities that are already there, but risks from being in the care system can’t be overlooked. It isn’t surprising that the prevalence of emotional distress and mental health problems among looked after children is also high.

Childhood trauma isn’t always resolved just because you grow up. It can contribute to the onset of severe mental health problems for many people. Child physical, sexual and emotional abuse increases the risk for all mental health problems, in particular post-traumatic stress disorder. Long-term separation from a parent before the age of 16 has also been identified as one risk factor for psychosis. The connections between problems in childhood and mental health problems in adulthood are well established.

Parental mental health problems are also a significant risk factor for the neglect and maltreatment of children, but mental health services don’t always consider the needs of children. Similarly, child protection social workers are there to act solely for the child.

Integrated working in mental health is at risk

The government wants more integration between health and social care by 2018.

Bridging the gaps between children’s social care services, provided by local councils, and adult mental health services, provided by the NHS, could help to protect children and meet the mental health needs of their parents.

But competing priorities in the NHS and local authorities are pulling them apart. For example, local authorities are concerned that the social care needs of vulnerable adults are not given enough importance in mental health services.

And in the NHS the introduction of so-called diagnostic-led care clusters, which require mental health workers to assign people to different categories such as “problems associated with hallucinations and delusions”, takes an increasingly medical approach that doesn’t value social issues.

A recent evaluation by the Social Care Institute for Excellence highlighted the barriers and opportunities for agencies to work together. A study I published last month in Child and Family Social Work found that those working in NHS mental health services and children’s social care services thought having joint agreements improved how they worked together.

But as the evidence stacks up that integrated community mental health teams are probably the most effective way to engage and treat people with mental health problems in the community, the pressure to cut the budgets of local authorities is leading some to actually pull out their mental health social workers. This is going in the opposite direction to the idea of integrating health and social care.

It’s against this backdrop of disintegrating community mental health services – though Minister for Care and Support Norman Lamb has not appeared to refer to it – that the government wants greater integration of health and social care. It’s potentially good news for many people with both health and social care needs, but cuts to budgets mean some local authority directors of adult social care services may need some convincing about pooling their cash.

To improve services to meet the needs of both children and adults, we can’t ignore the problems that are already there between those already trying to do this – and with less money.

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Today has been a really satisfying day. I’ve been able to connect with people I’ve worked with in the past and those I look forward to working with in the future.

It involved an early start to get the train to London. Leaving the house at 6am is so much easier when the sun is already high in the sky than in mid-winter when it still feels like the middle of the night. It’s one of the great things about living in North Yorkshire – you get to see the sky!

On the train I had a very fortuitous meeting with the administrator of a charitable trust I have been planning to submit a research grant application to. I had met him before in my previous job but I wasn’t entirely sure it was him as it was a few years ago and was only a brief meeting. Being a little shy I waited for him to make the first move and got on with marking my dissertations. But he knew who I was and introduced himself, so the awkwardness soon dissipated.

It was good to catch up with him and to break the silence of the early morning sleepy carriage. Making contact with him helped me to think about how I might pitch the bid. Of course, just because I know him won’t guarantee the proposal will be funded. It just doesn’t work like that. But it helps to have a bit of insight into what they may be looking for in a bid.

I think this is a good example of how social capital – the resources we have within our social networks – can help us. Advice, hints, tips and understanding the way in which research funders think helps to maximise success. It doesn’t guarantee it but as the advertising slogan goes, ‘every little helps’. It is the subtle ways in which contacts provide snippets of information which help us to move forward. It’s a message that recurred throughout the day.

I went to London to speak at the BASW England conference, which had the theme of ‘Giving mental health prominence in social work’. The paper I gave focused on unlocking the therapeutic potential of mental health social workers, particularly in their latent ability to deliver and lead on social interventions. I presented some of the Connecting People study to illustrate that it is possible to articulate complex social interventions and develop an evidence base for them which can help to make the argument for their application in routine practice.

Some nodding heads indicated agreement. Well, at least no-one nodded off. If you want to get a flavour of what I said, the prezi I used can be found here.

I was followed by three eloquent speakers who provided diverse perspectives on the conference theme. Mary O’Reilly spoke from her personal experience of using mental health services about being in touch with our own mental health. Faye Wilson spoke about some work BASW has conducted on the mental health of the social work workforce. Finally, Lisa Cherry talked about her personal experiences of being in the care system and how we need to do more to care for the mental health of looked after children.

The following panel discussion was lively. It was clearly a theme the 150 or so practitioners there felt passionate about. However, a sense of powerlessness permeated the discussion. One person spoke powerfully of how she was in the process of being made redundant because she blew the whistle on bad practice. Practitioners are scared to challenge oppressive and bullying managers for fear of losing their jobs and not being able to find another one as vacancies dry up across the sector. This simply isn’t good enough and something needs to be done about it.

Subsequent workshops focused more on solutions and came up with some strategies including:

• working with colleagues to inform local councillors about the issues facing social work, as their decisions can affect local authority social work via Directors and Assistant Directors of Adults or Children’s Services;
• focusing on practitioners’ well-being by being more proactive in looking after ourselves;
• advocating for better supervision or providing peer mentoring;
• campaigning to highlight the impact of the public sector and welfare cuts on poor and vulnerable people across the country; and
• keeping the challenge against inequality alive.

I feel that we need to speak with one voice about injustice and the pressing issues people who need social work services are facing every day. I am disappointed that the College of Social Work and BASW could not sort out their differences and have now gone their separate ways.

But there is hope. Individuals within both organisations share the same values and are committed to speaking up for the profession and the people we work with. I was really pleased to meet with Ruth Allen, Chair of the Mental Health Faculty in the College of Social Work and Faye Wilson, Chair of the BASW Mental Health Reference Group after the conference to discuss a shared approach going forward. There was absolute agreement and commitment to speak with one voice on issues facing mental health social workers. With the imminent disintegration of mental health services, this is needed now more than ever before.

Prior to this meeting I had time to fit in a bit of filming with Shula Ramon. Shula, based at University of Hertfordshire, is involved in a number of really interesting projects including developing a European e-learning Masters programme on social inclusion and recovery. She interviewed me on film about social capital and mental health, and the Connecting People study. Extracts from the interview will be used as film clips on the e-learning programme which will provide education and training in social approaches in mental health services.

Throughout the day I’ve been able to catch up with old students, former colleagues and social work-friendly journalist Andy McNicoll. (See yesterday’s post about his recent Radio 4 interview about psychiatric bed shortages). I was also introduced to several new people who I hope to connect with again in the future.

I went home with the feeling that together we are stronger. I know it’s a terrible cliché, but there is something powerful about collective efficacy in challenging the dominant institutions which oppress. It’s important to hold onto a little optimism that things may get better, but we have to work together to bring about that change.

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I’ve been working at home today because I had a placement visit which was closer to my home than the university.

Cutting out the commute gives me an extra two hours for work and family. Although I often help out with the school run, it gives me the opportunity to get my head down and make an early start at the computer.

Some people can only concentrate first thing in the morning, whilst others find their best time is late at night. I have found that I don’t tend to have a better time of day for working. For me it’s much more about focusing on the task in hand and the time of day fortunately doesn’t seem to affect me. Deadlines are important, though. Either self or externally imposed, they help to get the job done.

I’m very fortunate to have a quiet space at home to work in. Our home has a spare room – which I rather grandly call my study – where I can lock myself away and concentrate. Prior to moving last year I worked at home in a garden shed. Well, it was a converted summer house but the huge variations in temperature (freezing in the winter snow and boiling in the summer sun), and the various spiders and slugs which found their way in, made it feel close to nature. On a cold and wet day like today I’m pleased to be working indoors!

The focus of my work today was finishing the draft of the paper I’ve been working on for the past few days. Its focus on the potential disconnect between the academy in which social work is researched, theorised and taught, and the agency in which social work is practiced, is timely. The Frontline proposals to fast-track bright graduates into social work via a summer school and work placements, have largely bypassed social work academics. The government-backed plans have been based on a similar scheme for teachers but have been developed with no reference to the current extensive reforms of social work education. We argue in our paper that practice-based research provides an opportunity to integrate the academy and the agency to meet the needs of both.

En route to the placement review I caught Andy McNichol, a Community Care journalist, being interviewed on Radio 4′s All in the Mind. Andy was talking about psychiatric bed pressures which are meaning that people detained under the Mental Health Act are increasingly being placed out of their local area. The lack of available beds is a significant stressor for Approved Mental Health Professionals and contributes to the high levels of stress and burnout we have found. People with mental health problems continue to be treated as second class citizens, far from the ‘parity of esteem’ which government ministers wish to see in the treatment of mental and physical health problems in the NHS.

The placement review itself went really well. The student is engaging with the learning opportunities available on the placement and there are clear signs of progress since it started. Although it is down to the support and supervision provided on the placement, it is great to see a student thriving in a practice setting and making sense of the university learning in this context.

We had an interesting discussion about the issues facing people in rural North Yorkshire, perceived to be a prosperous area of the country. You don’t need to scratch far beneath the surface to find the social problems here which social workers across the country are very familiar with – poverty, mental distress, poor housing and debt, to name but a few – and the stigma attached to them.

This evening I have been working on an unplanned piece of writing, but a tight deadline piqued my interest. I was contacted yesterday by a journalist asking me to write for a new website called The Conversation. I checked out the Australian version and found that it published academic analysis and insight into contemporary issues. Its aim is to utilise expert knowledge to understand issues and problems facing the world today. The UK version of the site launches tomorrow.

My scepticism was allayed by a piece on The Media Show on Radio 4 (sorry, I don’t have many diverse cultural influences do I?) on my way home from the placement visit. The launch of The Conversation UK website tomorrow was talked up as a way for academics and researchers to share their research with a mass audience (the Australian site has over 840,000 visitors each month). As I think it’s absolutely crucial for us to communicate our findings more widely, I got tapping on the keyboard.

The piece I was asked to write has gone online as I have been writing this post and will feature on the site when it is launched tomorrow. It explores some of the news items I referred to in yesterday’s post and somehow I have managed to connect together the child exploitation case in Oxford with moves toward greater integration in health and social care. I have peppered it with links to research and various sources of data to support some my cogitations. I’m not sure it works, but the editor seemed happy enough. I’m sure I will get feedback about it one way or another, though.

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Its Sats time at my girls’ school. These tests for 11-year olds will determine which class they will be in at secondary school and provide valuable performance indicators for primary schools (or, in other words, help to place them in league tables).

These tests have been controversial since they’ve been introduced and have not been popular amongst teachers or parents. The new spelling and grammar test is designed to raise literacy standards, but I’m not convinced it’s the right way. I’m certainly in favour of improving standards in education – I’m as frustrated with the poor literacy of some university students as the next person who teaches in higher education. But a regime of testing inhibits creativity and skews students’ learning towards performing in tests. Getting students to read about something which may not appear in an assessment is becoming increasingly difficult as many are just concerned about passing the test.

As the debate about this on the Today programme rumbled on this morning I couldn’t get out of my mind the brilliant animation of Ken Robinson’s RSA talk on changing paradigms in education. He talks about enhancing children’s creativity rather than stifling it through a regime of testing from an early age. I think there are some important lessons for higher education in there somewhere too, but do take a look and let me know what you think.

Today was punctuated by meetings so I knew I was never going to achieve what I had set out to do. I did make some progress on the paper I was working on yesterday, but not as much as I had hoped. It is one of my eternal frustrations – dealing with the ‘here and now’ jobs alongside writing the papers and grants which make the ‘tomorrow’ jobs possible. Both need doing, but a balance needs to be struck somehow.

I chaired the first seminar of the new Centre for Mental Health Social Research (CMHSR) at lunchtime today. Liz McDermott (Lecturer in Social Policy in our department at York) talked about her really interesting study exploring narratives of lesbian, gay and bisexual young people discussing self-harm and suicide in online fora. The seminar explored how her method of analysing the content of discussion fora produced different narratives about self-harm than researcher-led studies.

A podcast of the event will be available soon, but you can get a flavour of her presentation from the tweet stream below. We weren’t terribly successful in engaging people from cyberspace in our discussion, but it is our first seminar and we’re just getting going. You can engage with our events and find out about our developments on Twitter by following @YorkCMHSR or searching for tweets using hashtag #cmhsr. Our next seminar on 12th July will feature Lisa Brophy from University of Melbourne talking about community treatment orders. These seminars are open to all, so please do come along if you can.

Tweets about “#cmhsr”

After the seminar the CMHSR steering group met to discuss how we can promote collaboration amongst Centre members. We are currently undertaking a scoping study to identify the important research questions in the field of mental health social research – please click here to find out more information about this and to suggest your research priorities for us to consider. We are planning to synthesise responses and set up small working groups to develop research proposals in the areas of highest priority. I am really pleased at the interest in CMHSR so far, but it is now time for us to capitalise on this and develop some proposals to get some new studies underway.

I also had a really interesting tutorial with a student this afternoon and spent some time with him discussing social interventions in mental health services. He has been surprised at the low status afforded to them but, instead of being deterred from working in community mental health services, he appeared keen to promote them and challenge the hegemony of psychiatry and psychology. It was so rewarding to see a student not content with the status quo and anxious to get qualified and make a difference.

His concern about social interventions is at the heart of the presentations I’m giving to the BASW England conference on Thursday and at Community Care Live next week. I discussed with him a paper published recently by the Journal of the American Geriatrics Society and blogged about by the excellent Mental Elf. (I’ve been petitioning the National Elf Service for the creation of a Social Elf to post about research evidence for social care and social work, and I believe that one may be on the way soon…) Anyway, this study conducted a systematic review and meta analysis of cognitive behavioural therapy (CBT) for depression in older people. It found that CBT was no better than active social support in helping reduce symptoms of depression. Or, in other words, good social interventions which enhance support provided to older people with depression can help as much as CBT. We don’t hear this message very often, but it is an important one which I hope will find its way into clinical guidelines and change practice.

Finally, social work has been in the news again today. Oxfordshire County Council apologised for not adequately protecting girls in a child sexual exploitation ring in Oxford. This difficult case raises issues of race, culture and vulnerability, which social work needs to engage with to prevent more young girls being harmed in this way. However, social work appeared conspicuous by its absence from today’s announcement by health minister Norman Lamb that health and social care will become more joined up by 2018. Few people will dispute that integrated care is a good thing, but this announcement appears to take a rather ahistorical approach. The withdrawal of mental health social workers from integrated community mental health teams appears to have been overlooked, as are the lessons which need to be learnt about how the competing priorities of local authorities and NHS Trusts can pull integrated teams apart. Teams have been integrated in mental health services for many years now – surely this would provide plenty of learning opportunities for how to integrate other aspects of the health and social care systems in England?

Perhaps we should introduce the compulsory testing of our politicians to measure their knowledge before they launch policies which appear more about political games (Labour has been talking about integration for some time now) than enhancing care and support for people who need it most…

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I am frequently asked how I find time to engage with people via social media amidst all the other things I do. With the use of a smartphone, I have simply woven it into the fabric of my daily routine (family permitting, of course!).

It’s in the down-time that I check what’s occurring online and I find it useful to start the day before anyone else wakes up with finding out what people are talking about. So, shortly after my alarm went off at 6.15am this morning I checked my Facebook timeline (saw pictures of a collaborator’s wedding in India) and my Twitter feed (early-riser @Ermintrude2 is excellent at tweeting and debating the social care news first thing in the morning – the following, and the discussion it provoked, is a good example of the invisibility of social care in many Department of Health announcements):

Elderly patients will get personal NHS worker to coordinate health care, pledges Jeremy Hunt independent.co.uk/life-style/hea… via @independent ??

— Ermintrude (@Ermintrude2) May 13, 2013

To get to work I drive from my home in Ripon to York and then park in a village on the edge of the city, get my bike out and cycle the last 6 miles. Well, I do normally, but I’m currently between bikes. My last one has served me for almost 20 years and, several groupsets later, has finally given up the ghost. It has seen me through the winter, but the North Yorkshire snow, grit and muck has now got to it and I’ve had to write it off. Replacing the groupset will cost almost as much as a new bike, so I’ve ordered a new one through the Cycle to Work scheme. I’m hoping the voucher will come this week so I can pick it up and get back to my normal routine.

While I’m waiting for my new bike to be sorted out, I’m driving the full 26 miles to and from the University of York with the Today programme and PM (yes, I’m a bit of a Radio 4 geek) for company. As well as keeping me in touch with what’s going on, there are occasional gems. On the PM programme today, for example, there was a piece on a new play Inside Out of Mind. The play is set on a dementia ward and dramatises real life incidents which were documented in an ethnography. Researchers worked on the ward and noted their observations about its daily life. The PM presenter said that instead of writing it up for a peer-reviewed journal, they went to a playwright to dramatise it. This will certainly ensure it has impact!

In the office I picked up dissertations and end of placement reports for marking. Note to self: must get this done by the end of the week. I also picked up an inspection copy of Daisy Bogg’s new book Evidencing CPD: A Guide to Building your Social Work Portfolio. (Another one for my task list). Daisy is one of the most prolific social work authors I’ve come across. I’m fortunate to be supervising her part-time PhD as I’m hoping that some of her writing speed will rub off on me!

I try to keep up with emails on an on-going basis so they don’t stack up. My system is to deal with quick things straight away and put aside those which need a proper response. Then, in down time between other tasks, I come back to them later. However, I’m always trying to deal with a backlog and just don’t have enough ‘down time’ to give to clearing my inbox. I’ve heard that the best way of dealing with it is just to delete them all and if it’s important then someone will get back to you. I’m rather hesitant about doing that as I know I’ll just delete something important and will regret it later.

Anyway, in my first tranche of emails this morning came two rejections. One was for a systematic review paper which received quite different reviews from its four reviewers. They ranged from ‘publish it now, this paper is just perfect’ to ‘I don’t know why this journal is considering this paper for publication’. Unfortunately the editor was more persuaded by the latter argument than the former. The second was an abstract for a paper for a special issue of a journal. Both will be edited and sent elsewhere.

These kind of rejections are completely ‘par for the course’ in an academic’s work. I’ve made several unsuccessful grant applications over the years and papers are quite frequently rejected from the first journal I send them to. I’m still learning not to take it personally, but due to my personality type I view myself as a constant improvement project so I think carefully about how I can improve future submissions to improve my ‘hit rate’.

The substantive piece of work I undertook today was preparation for the presentation I’m giving at the BASW England Conference ‘Giving Mental Health Prominence in Social Work’ on Thursday this week. I’ll write more about it then, including providing a link to the presentation. I’m really looking forward to it as I enjoy discussing my research with practitioners and sharing some of my thinking behind it.

Fortunately, today was a meeting-lite day. Large organisations like universities can suck you in to their overwhelming bureaucracy and you find that you don’t get any work done as you’re always in meetings. I try to keep them to a minimum. On Mondays we have a brief half-hour social work team meeting. Although the first thing we discussed was the length of the meeting (keeping to half an hour is sometimes a struggle!), the agenda covered a range of items including covering colleagues’ work during sickness, whether or not we should apply for the Frontline tender, research ideas and projects to improve the quality of social work education we provide. Decisions were made, actions were noted and the meeting finished on time. Just how I like it!

Amidst sorting out the formatting of the follow-up questionnaire for the Connecting People study, confirming travel and accommodation arrangements for forthcoming conferences and making arrangements for the start of a new co-ordinator for Making Research Count next week, I made a bit more progress with one of the papers I’m working on.

I aim to get pieces of work written up as soon as possible so they remain timely and useful. This is not always achievable, but having tight deadlines helps. A recent call for papers has prompted me to quickly pull together a paper from a symposium I chaired at the European Conference on Social Work Research in March. The paper is exploring one of the themes of this blog – the role of ‘the academy’ in the development of the social work profession. I’m writing this with six collaborators, taking the role of editor. Two contributions are in and I’m in the process of shaping it up so I can show the remaining contributors where their pieces will fit in.

I had hoped to get it drafted today, but that’s another job for finishing off in the morning. I’ll let you know how it goes!

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I set up this blog to help in a small way to bridge the gap between social work academia and practice.

One of its aims has been to discuss ongoing research and to disseminate findings via accessible posts which explore the implications of research for social work practice. There is a growing recognition that we need to communicate research findings more effectively than just publishing them in journals and, since I started blogging in 2011, other academic blogs have come along with a similar purpose. I believe that it is not acceptable to only publish social work research in peer-reviewed journals in formats which are inaccessible to practitioners (if they have access to them at all). To have an impact on practice we need to communicate using different media.

Another aim of this blog is to demystify what a social work academic actually does. There is a perception – unfortunately correct in some cases – that academics are too distant from practice to be able to contribute meaningfully to the profession. However, the perception that we all live in ivory towers is not accurate and does not fully appreciate the role of social work academics in the development of the profession. Therefore, I blog about some aspects of my work to open up discussions about important issues on the practice/academy interface.

I don’t think it would be terribly interesting if I were to use this blog as an online diary, providing details of the minutiae of my life. However, this blog lacks a sense of the rhythm of a social work academic’s daily life. Therefore, I am planning to blog each evening this week about the work I do each day to provide an insight into this. I don’t have a typical week, so what may happen this week may not be usual, but it will give an indication as to how my time is spent, what I’m thinking about and what I’m working on. Due to reasons of confidentiality some of the details may be a little hazy, but I hope to convey the important themes of events as they occur.

Diary of a social work academic: Monday

Diary of a social work academic: Tuesday

Diary of a social work academic: Wednesday

Diary of a social work academic: Thursday

Competition time!

If all goes to plan I should blog my 100th post by the end of the week. To celebrate this, let’s have a bit of fun. All you need to do is to guess which are the all-time top three most read posts on this blog. (The list of ‘top posts and pages’ in the right hand column will not help you to answer this question because that only relates to the last 24 hours). You will need to scroll through the archives and guess which three you think have been read the most.

To enter the competition, please post a comment below stating the titles of the top three blogs in their order of popularity. The person who guesses correctly, or is closest to the right answer, will win a signed copy of Reflective Practice in Mental Health. Advanced Psychosocial Practice with Children, Adolescents and Adults. The competition closes at 10pm on Friday 17th May before I make my final post of the week.

Go on, it’s just a bit of fun!

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This post was co-produced with user/survivor researchers Sarah Carr and Tina Coldham

With the advent of co-production, a way of approaching action in social care which accords equal recognition to the assets and expertise of all those involved, are we entering an era of post-participation?

We (Sarah, Tina and Martin) are involved in a research group involving mental health service user and survivor researchers and non-user peers. We are exploring a way to co-produce a research bid which evaluates the effectiveness and cost-effectiveness of personalisation in mental health. Given the nature of the topic it would be almost hypocritical to undertake the task in any other way. Personalisation isn’t about telling people who use mental health services what to do; it’s about all parties working together for mutually agreed outcomes. So, we’re co-producing a bid to fund co-produced research. We’re making good progress, but it isn’t always easy and we have to be reflective about the dynamics of power and influence as we go along.

To some, participation in research means the tokenistic inclusion of a service user (just the one!) on a project advisory group or as the person to whom all things ‘userish’ are delegated, sometimes even the identification of research ‘subjects’. However, service user/survivor researchers can be part of the research team, which can have both its risks and rewards. In most cases non-user academics expect participation on their terms, to support their investigations without involving users in defining the question. In our work, though, we are striving to go beyond this and challenge this understanding of participation.

We are exploring how co-production can work in research from the very start of the process (writing the initial bid) through to co-authoring the final report and disseminating findings. To guide our work we’re using the Purpose, Presence, Process and Impact (PPPI) framework. These guiding principles for participation are being developed by the National Involvement Partnership, a co-ordinator of which is contributing to developing the research bid.

We have created a Lived Experience Advisory Panel (LEAP) of mental health service user and survivor researchers as an integral part of the project team. LEAP members meet separately and together with the full project team. LEAP members are developing proposals for their own work programme, leading on one of the proposed studies within it and co-producing or advising on others.

LEAP members are researchers, trainers and consultants in mental health and social care. Some bring considerable academic, methodological and policy implementation expertise. All have lived experience of mental distress and/or service use. The rationale for their contribution is that they are regarded as peers who are equal but different. It is their diverse perspectives and experiential knowledge that add value and depth to an applied research programme focusing on practice and outcomes. The LEAP co-chairs coordinate activity and support members. One of the members talks with people who are using direct payments and personal budgets in his local area to make sure the questions we are asking are relevant – we describe his task as ‘keeping it real’.

So far the majority of the challenges have been practical ones. Currently, the form to claim payments for this work is not accessible to researchers who do not work in a conventional academic context. Many user researchers work on the margins of universities, often freelance or for community or voluntary organisations, so their profile and CVs look different, making it difficult to complete research grant application forms. Engagement with academic institutions and research funders can be challenging. However, we have spent time discussing how improvements can be made to make processes more accessible and to find ways to allow user/survivor researchers to demonstrate their experience and expertise.

Deriving costs for the time which LEAP members will spend on the proposed research programme has also hit similar difficulties. University researchers have access to administrative support to work out their costs, but user/survivor researchers don’t generally have access to these support resources. So, the three of us have had to spend extra time addressing administrative access issues when we could have been developing the proposal itself. For some of us, at times, that has felt a bit too much like navigating the mental health system!

Any new initiative is potentially fraught with difficulties, particularly when user/survivor and non-user university researchers are working together in the context of implicit power imbalances. However, the three of us are able to be open with one another about problems as they arise so that we can address them before they harm our working relationship. Co-production is not always easy, but if it is then it is possible that we are not doing it properly!

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May Day is traditionally a celebration of hope and anticipation of summer. Fertility rites involving maypoles, may queens and ‘Obby ‘Osses (OK, only in Padstow) spring up across the country. Ancient customs such as morris dancing and running into the sea naked (reports that the two are connected are yet to be confirmed…) are revived amidst heady celebrations of the end of winter.

May Day is also International Workers Day (and Labour Day in the UK), an international celebration of the achievements of workers and an opportunity to campaign against injustice and oppression. The annual march in London this year highlighted widespread discontent about the government’s austerity measures, for example.

It is perhaps unsurprising that the Tory-led government is seeking to move the May Day bank holiday to October. Proposed in order to extend the tourist season, this move is widely viewed as an attack on the history and traditions of the labour movement. Along with the surge in right-wing protest votes at the local elections, this is further evidence of the zeitgeist of individualism and denial of our shared humanity.

Against the grain, May Day 2013 was marked by psychiatrists calling for a renewed focus on social perspectives in mental health. Editorials in two of the Royal College of Psychiatrists’ journals published on May Day called for psychiatry to embrace a social paradigm and to support the development of ‘identity communities’ of people with mental health problems.

Leading social psychiatrists Stefan Priebe, Tom Burns and Tom Craig argued in an editorial in the British Journal of Psychiatry that significant investment in genetics and neuroscience has not led to any significant changes in psychiatric practice in the last 30 years. While groups such as the Social Perspectives Network have made this point for many years, it is perhaps significant that a leading international psychiatry journal is now highlighting this.

Priebe, Burns and Craig argue that mental health problems are expressed in social interactions and relationships are at the heart of treatment, care, support and recovery. The social context in which people live is inextricably connected with the cause and continuation of mental distress and a focus on symptom-reduction is hampering recovery. Attention needs to be paid to connecting people with the communities in which they live (which is what we are doing in the Connecting People study).

The dominance of the neurobiological paradigm in psychiatry, and the profession’s connections with the pharmaceutical industry, are unlikely to permit wholesale changes in the practice of psychiatrists. However, it is good to have allies within psychiatry who can work with mental health social workers and other practitioners working in mental health services and third sector agencies to support individuals’ recovery by focusing on their whole lives and not just their symptoms.

In its sister publication The Psychiatrist, James Mandiberg and Richard Warner, argued that mainstreaming is not always the answer. ‘Mainstreaming’ refers to supporting people with severe mental health problems to live, work and socialise in the ‘normal’ community.

The authors argue that communities largely do not want people with severe mental health problems in their midst and that the latter prefer to be with others who have had similar experiences. Given the stigma of mental distress and the discrimination which people who have these experience face, it is not surprising that communities can be unfriendly and unwelcoming places.

Drawing on their experiences in the US, Mandiberg and Warner argue that publicly-funded services for people with mental health problems are not successful at engaging people with communities and visa versa. They propose the creation of ‘identity communities’ for people with mental health problems whereby people with similar experiences support one another. Such communities can stimulate the creation of social enterprises, but they exemplify their arguments with reference to dated models such as clustered housing and the US-led clubhouse movement.

Mandiberg and Warner draw parallels with enclave communities, which are created by immigrants as they adjust to living in a new country. I fear that the ‘identity communities’ which they propose are at risk of creating enclaves for people with mental health problems, increasing stigma and promoting social exclusion. Peer support is of course important, and many people find it beneficial to their recovery processes, but many people also want to move beyond their identity as a user or survivor of mental health services to live a ‘normal’ life in the community.

Both editorials are welcome contributions to the debate about social models in mental health services. However, they are rehearsing arguments which have been aired frequently over the last 30 years and are arguably anachronistic. Recovery communities based on asset models are thriving in the UK, but have community engagement and not segregation at their core (see Kingston RISE for a good example). It is good to have allies within psychiatry who promote a social paradigm, but they need to fully engage with community development models to realise its potential.

Fundamental change is required for mental health services to be able to implement social models. But these editorials do not challenge the one thing which holds this back: the dominance of psychiatry.

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This week we announced funding for a new project to explore the feasibility of adapting the Connecting People Intervention model for use in Sierra Leone. The project is funded by the Wellcome Trust and the University of York via the Centre for Chronic Diseases and Disorders (C2D2).

The grant will fund the Connecting People study researcher, Meredith Newlin, in collaboration with Dr Susie Whitwell from King’s Centre for Global Health, to visit Sierra Leone in July 2013 to explore how social interventions can help to meet the needs of people with mental health problems. The study will use ethnographic methods to evaluate the feasibility of adapting the Connecting People Intervention model and developing a sustainable training programme.

Early discussions with the Government of Sierra Leone, the Ministry of Health and Sanitation, service providers, NGOs, and the Mental Health Coalition, indicate the need to strengthen skill training in Sierra Leone to support existing services with evidence-based solutions. Findings from the study will be used to enable us to co-produce interventions with collaborators in Sierra Leone, which will ensure that Western approaches are not imposed where they may be inappropriate.

There is increasing evidence to suggest that the application of knowledge in developing countries is failing. A gap exists between what is known from research and what is done to apply it. To address this gap we aim to evaluate the knowledge transfer of psychosocial interventions for adults with mental disorders in low and middle income countries using a systematic review and preliminary data from this feasibility study in Sierra Leone.

The World Health Organisation has long been concerned about the gap between the high numbers of people with mental health problems and the limited availability of medication. This treatment gap is particularly large in low and middle income countries. However, Western medicine and therapy is arguably not universally appropriate.

Social interventions can help to fill the treatment gap for people with mental health problems in low and middle income countries. They receive a low priority from funding bodies, but have the potential to improve the quality of life, social participation and well-being of people experiencing mental distress. Our exploratory work will determine whether or not it will be possible to adapt the Connecting People Intervention and co-produce a version for the local context in Sierra Leone. Working with collaborators in Sierra Leone led by Dr Carmen Valle (University of Makeni), we aim to see if this is possible.

This first project for the new Centre for Mental Health Social Research at the University of York is an international collaboration involving Dr Elizabeth Hughes (Mental Health and Addictions Research Group, Department of Health Sciences, University of York), Dr Oliver Johnson (King’s College London), Professor David Morris (University of Central Lancashire)  and Dr Lynette Joubert (University of Melbourne, Australia).

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