Mental health social work in the NHS

You know we look at medicine – some medicine is really quite narrow. It’s about narrow treatments for well-defined diseases and outcomes. But real life isn’t like that. It’s not just about what’s going on in your body, important though that is. It’s also about what’s happening in your mind and what is happening in society around you. And real life is also about the way in which society itself can make you sick, and how society can also help you get better. I think it’s literally impossible to imagine a caring, compassionate and efficient mental healthcare system that does not have social workers in it. They have an absolutely central and fundamental role in the delivery of mental healthcare particularly to those who are most severely ill. Social work concerns itself with every aspect of a person’s life and seeks to make sure that you don’t lose the person in the diagnosis or a medical model. It teaches you so much about what human suffering or difficulties may look like across age, across culture. For me it’s very important that things are done for the right reason and that people’s human rights are protected. Challenging stigma and discrimination so it’s about breaking down barriers and being able to kind of reach out It’s about treating people the way you want to be treated yourself And that is actually a very unique thing that social work brings to health to see people in a different dimension, to see them in a different way, not as just a patient. I think it’s really important that we play such a crucial role throughout the organisation, because at times of change in the NHS, we can really influence the transformation of services to be much more person-centred, focusing on strengths working with communities. Being a carer, you fade into the background, especially when someone’s very bad, very unwell, because you’re just someone that sits there and the psychiatrist talks to the person, or whatever health professional you’re dealing with talks to them. and you are invisible to a point, and sometimes your feelings don’t count, because it’s not about you, it’s about them, isn’t it. But in family conferencing it does count. So rather than a professional coming in and evaluating the situation and deciding I know what’s wrong and this is what needs to happen, you work to generate conversations, you work to generate a dialogue within that system, so creating a safe space for people to start to explore what’s happened is the primary goal of practitioners. One exciting thing is that they are starting community forensic teams – that’s a new part of the plan of the NHS moving forward. And I would say maybe start off in the community and then come into forensics in mental health services. I definitely would encourage new social workers to come into the field. As mental health professionals we’re not always going to have the same point of view. That’s why we have MDTs and that’s why we have AMHPs. Although it can feel very oppressive that we’re detaining people against their will and removing their liberty, actually, we’re doing it because it’s right for that person at that moment. And if it’s not right, then we need to assert that and put other things in place. So I see it as a protective role. We’ve got specialist knowledge and experience that we can bring to the wider MDT to think about, particularly legislation, and the impact of that on what the community teams are trying to do. I think when teams get under pressure they retreat, and they defend their referral criteria and the way in which they work. And what’s important is that we don’t do that. We come forward, we share, we communicate effectively and help each other understand what it is we’re facing. So that we’re not looking to blame, we’re looking to support. One of our priorities is to make sure that our social workers within an integrated service understand their identity, understand their role. And you know our role is to actually reinforce this for them, because it can get quite lost, you know. We are a minority. What we’re talking about is actually what’s important for that person. And having those conversations on a day to day basis, whatever level you are in the organization makes a big difference. It does and I really think what we can do is demystify the process of how to meet people’s social care needs. The evidence-based skills of social work alongside the evidence-based skills of health professionals, alongside the views and wishes and assets of individuals that we’re serving makes for a perfect balance in terms of how we can have the best chance to get things right for people.

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