The Think Ahead report published by IPPR in May has prompted much discussion among social work educators and practitioners. It has re-ignited the debate about fast-track programmes in the wake of Frontline and the appropriateness
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The Think Ahead report published by IPPR in May has prompted much discussion among social work educators and practitioners. It has re-ignited the debate about fast-track programmes in the wake of Frontline and the appropriateness of training social workers in a little over a year. This debate will no doubt rumble on.
After attending the launch of the Think Ahead report I felt that the solution of a fast-track programme was retro-fitting the problem. Actually, I wasn’t entirely convinced that mental health social work was the problem. I blogged at the time that mental health remains a popular career option for social work students and the supply of graduates often outstrips mental health social work vacancies. My view is that the problem lies in community mental health services which do not always allow mental health social workers to practice social work. Moreover, people with mental health problems usually need 24-hour assistance like NDIS Support Sydney.
It was clear at the time that Norman Lamb wanted a fast-track programme for Russell Group graduates to enter mental health social work and funding was made available from the Department of Health. I argued that it was important for us to engage with this to ensure mental health social workers play a role in shaping our future. That is what I have done.
I responded to a call for social work educators to become involved in developing the Think Ahead curriculum. This requires having a vision for the future of mental health social work. Of course, there is no guarantee that Think Ahead will deliver this vision, but it’s important to have a road map to guide it.
I wrote a discussion paper which outlined where I thought mental health social work needs to go in the future. The argument I offered was that through organisational transformation in community mental health services and the social work profession over the last 40 years, we have diminished our therapeutic potential. This needs to be rekindled through a focus on social interventions within an ecological framework of a person within their social environment.
I characterised this as intervening at the micro (with the individual), meso (with the individual and their family or people close to them) and macro (with the individual and their wider community) levels. Although a rather crude over-simplification, it illustrated how mental health social work needs to engage systemically with a person’s immediate and wider social networks to effectively support an individual’s recovery. Interventions must be evidence-informed to ensure that mental health social work practice can be as effective as possible. This is a radical vision as it will require community mental health services to change to permit it to happen.
I talked to social work practitioners, managers, leaders, educators and students about this vision. I am very grateful to all those who took the time to read the discussion document and provided me with their feedback. There was considerable agreement with my argument, which I have now presented to the Think Ahead team. I hope that the Think Ahead programme will have a positive impact on mental health social work in the years to come.
Hi Martin
I have left Kent out of disillusionment with services and now sit on tribunals and am an external PE. Many of my Kent colleagues have done the same or have migrated to Medway where MHSW is a stand alone service and not integrated.
It seems the integration and secondment was a root cause here and Trusts have expected MHSWs to assess, diagnose, advise on treatment and gate keep to their criteria regardless of the local LA’s criteria.
Re “This needs to be rekindled through a focus on social interventions within an ecological framework of a person within their social environment”. Oh yes it does! – but cannot while MHSWs are being used to man the barriers, meet health KPIs and make decisions about mental health that they were never trained to do (albeit they do as well as any other professional without the MRCPsych to protect them).
I never thought I would say this but feel that LA’s need to pull them back.
Don’t ask me about Trusts managing AMHP services! They are treated as just another commodity.
Regards
Sheila
I agree with everything Sheila has said in her comment. The same has happened here in Hampshire. Except the county council have taken back the control of the mental health social care agenda and MHSWs are being re-focused (not before time) on the social care dashboard of early intervention/wellbeing, personalisation and safeguarding. However, the trust will still want us to do the tasks Sheila describes. The two don’t add up and far from being more resources HCC is having to cut £98 million this year! The trust has to deal with a deficit/overspend of £25 million themselves. I understand why Sheila has got out and I only wish a route would open up for me too!
Hi Martin, fast question for you on your depiction of the “macro.” I do like how you frame macro as occouring as an overall approach – asset/capacity based – involving services or organizations, but are you also implying perhaps national departments – like social services, health etc. — really suggesting policy implementation levels?
Hi Bill,
‘Macro’ is used here to denote the wider community surrounding an individual. I am suggesting here that social work predominantly intervenes at the individual level and, in the UK, rarely at the community level. We predominantly practice with individuals and, occasionally, with families or groups, but rarely with communities as ‘need’ is conceptualised in a very narrow way. It’s understandable as this fits with our contemporary welfare systems, but often solutions to social problems lay beyond the individual and the challenge is for practitioners to identify this and intervene at a more collective level.
I’m aware that ‘macro’ can also refer to policy implementation or the organisational level, but this isn’t what I’m talking about here.
I hope that this clarifies this for you.
All the best,
Martin
Hi Martin,
thanks for the information. I’m from Canada and in the system context I had always thought that Great Britain was that it had a much more focus on policy and the individual at the community level.
This was based on many things, your countries’ historical policy efforts to address social determinants of health; on the Mental Health Competencies framework, for example for social inclusion; a general sense that “community” based care was foundational principle of how the system operated; how social work profession took a national approach.. Thanks for the reality check on my “projections” of the ideal society, for social work in mental health.