Thinking about Think Ahead

The Institute for Public Policy Research (IPPR) today launched its report on meeting the workforce challenges in mental health social work. Think Ahead makes the case for a fast-track graduate-entry route to a social work qualification to engage people in mental health social work who would not ordinarily consider it to be a career option.

I went along to the launch today to find out a little more about the plans and the rationale for them. I’ll say a little more about that in a moment – after my thoughts on the report itself. (Although I’m cited in the report and I gave IPPR my thoughts when it was being put together, my views are independent of IPPR or any organisation to which I am affiliated.)

On a first read through, I thought it was better written and argued than the IPPR report which made the case for Frontline for children’s social work. However, I was concerned that it started with the solution and worked backwards. That was partly due to the commission from the Department of Health who asked IPPR to investigate the feasibility of introducing a fast-track programme to recruit the ‘best and brightest’ into adult social work along the lines of Frontline. It was disappointing that other alternatives to enhancing the status and attractiveness of mental health social work as a career option were not seriously considered, such as focusing in depth on working in mental health settings within existing qualifying programmes, improving continuing professional development or reinvigorating social models and interventions in mental health services outside of social work training, for example. The conclusion was clear from the outset: a fast-track route to a social work qualification akin to Frontline was needed.

The report talks interchangeably about ‘adult social work’ and ‘mental health social work’. The former is typically working with adults with a learning or physical disability, older people or other adults receiving social care services. The latter is typically working with people with mental health problems, usually in integrated multi-disciplinary community mental health teams (though increasingly in local authority specialist mental health teams as partnership agreements are reviewed and the reality of public sector funding cuts bits). IPPR don’t help their case by being imprecise about this. Further, it is not made clear in the report why they were commissioned to investigate the potential of introducing a fast-track programme in adult social work and then report only on its feasibility in mental health social work.

The definition of the problem they are solving is also not clear. Similar to the argument for Frontline solving recruitment and retention problems in children’s social work, this report talks about recruitment and retention problems for Approved Mental Health Professionals (AMHPs) (pp. 22-23). It is true that surveys have found high levels of stress and mental health problems among AMHPs, but most are resilient and find the AMHP aspect of their job the most satisfying. I hear that fewer AMHPs are being trained at present, but I think the problem is one of demand rather than supply. Posts are being cut as local authorities adjust to smaller budgets and existing AMHPs are shouldering higher workloads. Social work students trying to find work in mental health services struggle because there are fewer vacancies than in other areas of social work. This anecdotal knowledge runs counter to the Think Ahead report which provides the example of ‘Local Authority A’ which has high vacancy rates for adult social workers and poor quality applicants from newly qualified social workers (pp. 24-25). It does not specify that these social work vacancies are in mental health services. I suspect not. Mental health social work may have its image problems, but it is still a sought-after career path for many social work students. My experience is that vacancies are slow to appear because practitioners are committed to their jobs and want to stay, and if they do go they are not always replaced.

The speakers at the launch reinforced my impression that the report was starting with the solution and fitting the problem in around it. Andrew Adonis introduced Think Ahead in the context of Teach First and Frontline, both of which are largely his creations. He placed a strong emphasis on bringing ‘bright young graduates from Russell Group Universities’ into social work, who are ‘highly able and highly motivated’. ‘Think Ahead deserves to succeed’, he argued, and referred to the coalition of supporters who have been gathered around the cause.

Norman Lamb, Minster of State for Care and Support, referred to the enormous challenges the public sector currently faces, particularly in relation to thinking afresh about how we do things with fewer resources. Social work is frequently denigrated, he argued, but it is critically important. He argued that we need to attract the very best people to do this work. He cited figures in the IPPR report, taken from David Croisdale-Appleby’s review of social work education, which state that fewer than 8% of social work students have placements in mental health settings (he didn’t address the issue that this was a problem of supply of these placements rather than a lack of demand for them). Echoing Adonis’ introduction, he argued for more Oxbridge graduates going in to social work. The retention rates of Teach First graduates in teaching are ‘almost as good’ as those who followed traditional routes, making it a worthwhile investment.

Paul Farmer, Chief Executive of Mind, was then introduced as a stand-in for Alastair Campbell, who couldn’t come because of a family bereavement. He made a joke about sharing a passion with Alastair for the ‘promotion of lost causes’ (I’m not sure if he was referring to mental health social work, but if so it wasn’t a particularly apt comment!) He argued that working in mental health services was not an attractive or rewarding career option for many people. However, there are groups of graduates, including those who can’t get onto clinical psychology training programmes, who could be tempted into mental health social work. Think Ahead, he argued, could provide them with a fast-track route into the profession. He did acknowledge, though, that mental health social work is different from teaching and social work with children and families. For example, people with lived experience of mental health problems need to be at the forefront of the programme, and graduates with lived experience need to be encouraged to apply. Also, the third sector needs to be at the forefront of delivering mental health services and mental health social work has an important role in forging these connections.

Finally, Francis Turner, a Cambridge graduate who subsequently did the MA in Social Work, argued that Think Ahead will encourage Oxbridge graduates to go in to social work. She spoke about her decision to go into social work as she wanted a career to which she could sign up wholeheartedly to its values and ethics. Social work has changed her and shaped her identity and beliefs. Her MA Social Work course prepared her for the profession, but so did her time at Cambridge. The intellectual rigour of her course and the development of her analytic skills are required daily in her work. She argued that that Oxbridge graduates can bring a lot to mental health social work.

Overall, the argument presented is that Think Ahead can help mental health social work to become an attractive proposition for ‘bright young graduates’ who may otherwise choose other career options. Think Ahead is being presented as an alternative route to a social work qualification – it would have to be sufficiently generic to achieve Health and Care Professions Council approval – with a particular focus on mental health social work. Traditional routes into social work are not under threat, but the fast-track route is seen as the way to attract graduates who may be allured elsewhere by other graduate training schemes.

The focus on Oxbridge graduates brings significant diversity issues, as these universities are not particularly renowned for their inclusive admissions policies. This is a problem which Think Ahead is unlikely to address and I think is one which requires further consideration. However, social work leaders in the future could equally come from traditional routes, so graduate schemes such as this may not have a profound impact. As I’ve argued elsewhere, there isn’t the evidence one way or the other about this just yet.

Think Ahead has a board of trustees and an interim chief executive is being appointed. Like Frontline before it, it will happen. Bearing this in mind, I can see the benefit of critically engaging with discussions about it to ensure that mental health social workers play a role in shaping their own future. We have been struggling for many years with having our role and identity shaped by policy makers and other professionals. Let’s not let that happen again here. Together with the College of Social Work report on the role of the social worker in adult mental health services, perhaps here is another opportunity for us to define and shape what we do to the ultimate benefit of the people we came into the profession to work with.