The mental health dimension in the new social work degree: starting a debate

The Mental Health in Higher Education Project (mhhe) aims to increase networking and debate about the learning and teaching of mental health, both within and across the disciplines and professions in higher education. Despite the recent prominence that has been given to mental health in terms of policy development and new practice models, there has so far been little discussion as to what should constitute the mental health component of the new social work degree that is currently being introduced in England. This paper sets the context for the debate and reports on the outcome of an mhhe workshop on this theme held at the 2003 Social Work Education Conference in Warwick.     

Bridging the gap between social work practice and community based welfare agencies

This article argues that social work in the UK needs to renegotiate its relationship with community welfare agencies. It begins by examining what we mean by local community and how welfare needs reflect complex non-linear dynamics unique to the local circumstances. It is argued that these are not always recognised in centralised policy agendas. The article broadly draws a parallel between policy issues for the European Community and for the national state. The drive for both is towards uniformity, which potentially fails to acknowledge the unique circumstances at both the national level between nations and the local level between communities.

The focus of the analysis is the lack of engagement with the subtleties of the local within the arena of social work education and practice. With the opportunity presented by the introduction of a new social work degree in the UK, the authors describe how a social work programme in Liverpool undertook a piece of research with the aim of creating an appropriate place for community welfare agencies in practice placements, the academic curriculum and, ultimately, with the next generation of social work practitioners. Eight welfare agencies within the proximity of Liverpool University, an area known as Toxteth, agreed to participate in the research to investigate what kind of placement module would enable local welfare agencies to engage meaningfully in the social work degree. Out of this process emerged a model for research based curriculum development involving local community agencies and academic institutions. More specifically for Liverpool, it placed the notion of social work's relationship with local community welfare at the heart of professional development for qualifying social workers, paving the way in this region of England for closer links between welfare agencies associated with civil society and professional social workers.     

Pragmatic professionalism: micro-level discourse in social work

In recent years the welfare sector has encountered numerous and often challenging changes, such as marketisation, New Public Management, and demands for evidence-based practices. These changes can be seen as a shift between the two logics of creating and maintaining authority, and as a movement from occupational towards organizational professionalism. Perhaps the most important difference between these logics is that, in occupational professionalism, authority is built on trust in the professionals’ education and ethics, whilst in organizational professionalism it is grounded in regulation and control expressed, for example, in rules, regulations, and routines. The article focuses on the ways in which two groups of social workers in Swedish social welfare offices orient themselves towards organizational and occupational professionalism in constructing themselves and in the construction of each other, as well as the work that is carried out by each group. The aim is thus to elaborate on what these logics mean at the micro-level. In this respect, pertinent questions such as ‘How are they to be understood?’, ‘Regarded from the point of view of micro politics, what do these logics mean?’ and ‘How are the logics internalized by the social workers?’ are posed.     

Risk and new exclusions in community mental health practice

Abstract

Over the past two decades, mental health practice has become increasingly focused on assessing and managing the risks posed by service users. British researchers have made significant advances in studying the consequences of risk management for community-based health and welfare services, but in Australia this field remains largely undeveloped. Drawing on my experiences as a social worker in a Melbourne-based Crisis Assessment and Treatment Team from 1991 to 2008, the present paper offers a reflective analysis of the shift in practice orientation that has emerged through the growing prominence of risk as a foundation for intervention. Specifically, I argue that this shift has led to a narrowing of service provision and that “low-risk” clients are newly disadvantaged, often excluded from service.     

Families and Mental Illness: Contested Perspectives and Implications for Practice and Policy

Abstract

Mental health research, policy, and service provision over the last 50 years have constructed families and their connections with mental illness in various and contradictory ways. Three distinct but intersecting perspectives derive from the clinical mental illness literature, the family advocacy movement, and mental health policy. Within the clinical literature, the perspective of families is largely one of blame and pathology. By contrast, the family advocacy movement has generated the perspective of the burdened family, whereas mental health policy has created the perspective of the obligated caregiver. The result is an ambiguous understanding of the role of the family in both contributing and responding to mental illness. Implications for policy and practice include the need for a commitment to the principles of partnership with families, a recognition of diversity within families, recognising the difference between carer and family positions, and a need for policy to reflect the position of family as both intimately concerned, but not necessarily responsible, for patient care.     

Mental Health Difficulties and the Support Needs of Social Work Students: Dilemmas,Tensions and Contradictions

There are a growing number of students in higher education who experience mental health difficulties and have support needs. The behaviour of small numbers of students on social work programmes indicates also a need to examine the mental health difficulties and needs of social work students. There is only limited factual information on this topic. It is rarely discussed or written about. There is a danger of discriminating against those experiencing such difficulties, especially black or female students. Yet, at the same time, undertaking a social work programme is a demanding experience, as is doing social work itself. Furthermore, on courses leading to a professional qualification, such as social work, there is an obligation to protect the rights of, and assess possible risks to users, as well as to support students. Programmes should give particular attention both to the mental health difficulties and support needs of social work students at selection, during the programme itself and upon conclusion of the programme at a wide range of levels, both within the higher education system and outside that system.     

Minimising Coerciveness in Coercion: A Case Study of Social Work Powers under the Victorian Mental Health Act

The balance between care and control in mental health social work is one of constant tension. In the State of Victoria, Australia, the Mental Health Act 2014 gives coercive powers to social workers employed by public mental health services. These include the power to decide if a person needs to be assessed by a psychiatrist, to “take” a person using bodily restraint, to enter premises, and to search and seize a person’s belongings. This paper applies a doctrinal analysis to examine the law, then argues that the use of these powers by social workers, where safe, may be less restrictive than when they are used by police or paramedics. The exercise of these powers may be less traumatic and stigmatising to the people who are subject to them, and social workers may be both legally and ethically obligated to use coercion when appropriate.

IMPLICATIONS

• More social work literature on the coercive powers under mental health legislation is needed as well as more guidance on using these powers for social workers in practice.

• In some circumstances, these coercive powers may be better exercised by social workers than by other professionals.

• Social workers should carefully consider their legal and ethical obligations to use these powers in some circumstances.

     

Preparing social work students for policy practice: an Australian example

This paper presents an innovative approach to the teaching of policy skills across the two years of an Australian Social Work degree programme. It argues that placing policy back into practice and teaching the skills involved provides social work practitioners with a better capacity to effect change. Australian Catholic University, School of Social Work is located in Australia's capital city. The policy units have a clear framework within which to understand policy development and provide students with real hands‐on policy experience combining an experiential based learning approach with traditional teaching methods. The second year subject is structured around a number of policy workshops. Each workshop deals with a current policy problem and examines a different stage of policy development. It has as a consultant to the process a social worker who works as a policy practitioner providing a role model of practice in a policy area. Feedback from students has been extremely positive reporting increased confidence in policy skills and a recognition of the importance of these skills in social work. This teaching experience reinforces the need to focus on the educational considerations in teaching a subject where conceptual, theoretical and skill components are equally important if policy practice is to effect change.     

Risk,Recovery and Capacity: Competing or Complementary Approaches to Mental Health Social Work

Mental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination, and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. Therefore it is argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery-based approaches, which promote supported decision-making and inclusion; and the assessment of a person's ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.     

Social work and technology: Challenges for social workers in practice: A case study

Abstract

Social Work is just beginning to consider the full impact of technology on practice. In this paper the experience of social workers working in Centrelink, the Australian Government's service delivery organisation, is explored in the context of Centrelink's increased reliance on technology to deliver its services to six million Australians. The results of a survey that indicated nearly one half of Centrelink's social workers have received no formal training in how to use the technologies they rely so heavily on in their work are considered, as is the role of the social workers who are working as a part of Centrelink's call centre network. It is argued that social workers need to be careful not to confuse means and ends when it comes to utilising technology as a part of their practice.     

Community work and community care: Links in practice and in education

This article emphasises the individualising nature of much current community care provision and then discusses opportunities which may have been presented by the emphasis on user-empowerment within the community care changes. Drawing on personal experience and written from a perspective that we need a community care provision infused with the practices and values of community work, the article considers how community work needs to change and how community care workers need to change. The implications for social work educators are brought out throughout the article.     

Social policy and social work in the voluntary sector: the case of Ukraine

Over a decade has passed since the dissolution of the Soviet Union. This major political change has had profound effects on how social welfare is delivered in countries in transition from communism. Using material derived from the author's involvement in social work education projects in Ukraine, this article examines the changing relationship between statutory social welfare provider agencies and the burgeoning voluntary sector. A confusing and rapidly changing picture has emerged. Some prominent themes likely to shape future directions are identified, particularly the imperative to ensure that social work education continues to be sensitive to local political and cultural contexts, rather than relying on importing Western solutions.     

Professionalising social work in the Hashemite Kingdom of Jordan: processes and implications

This paper critically discusses the development of social work in Jordan. It introduces a range of social, cultural and political circumstances in Jordan, and the consequent strategies adopted in the process towards the professionalisation of social work and the growth of social work interventions with individuals, families and communities. The paper also considers lessons learned and some of the implications of professionalising social work that are also relevant for other human services engaged in international development.     

Unitarian ideals and professional diversity in social work practice—the case of Sweden

Attempts to articulate a common core of social work are numerous as is the claim that there exists a ‘true’ or general social work. This article presents results from research on the organisational settings of Swedish social work. Social work managers in 100 middle sized municipalities have been interviewed by means of an extensive interview manual. Data are analysed using quantitative methods. The results demonstrate that since the 1980s specialisation has become the strongest organisational trend. Functional specialisation (division of child welfare, social assistance and social work with substance abusers) is the standard way of organising social work and in many municipalities specialisation has gone much further. An integrated or generic organisational model, which was the imperative of the 1970s, seems to exist only in the smallest municipalities. Some of the organisational changes can be described as short-lived fashions. Specialisation as such seems, however, to be an institutionalised strategy to solve social problems and as a response to expectations from the environment. These results are discussed against the background of the notion of social work as a coherent profession with an identifiable common core and a mutual arsenal of methods.     

On the evidence for viruses in social work systems: law,ethics and practice

The purpose of this paper is to explore an apparent disjunction between espoused professional ethics and ethics in practice, and between law in statute and law in action. Social work in England is used as the main case study, however, research from other jurisdictions is drawn upon to demonstrate wider concern about departures from moral and legal rules. The evidence of the disjunction is presented, drawing principally from judicial review cases, investigations by the Commissioner for Local Administration (Ombudsman), inquiry evidence and government reports. The article critiques the current regulatory apparatus in England and the mechanisms by which staff and service users can hold public organisations, particularly councils with social services responsibilities, accountable. The interface between law and ethics is reviewed. The paper concludes with observations about strengthening legal and ethical literacy in practice.     

Social work education and political conflict: preparing students to address the needs of victims and survivors of the Troubles in Northern Ireland

This paper reports on the evaluation of a European PEACE III sponsored teaching and learning project that was designed to enable social work students to better understand the needs of victims and survivors of the conflict in Northern Ireland. The paper begins with an introduction to policy, practice and educational contexts before reviewing the literature on social work, conflict and trauma. It also summarises key, innovative pedagogical approaches used in the teaching, including the use of ground rules, teaching teams consisting of lecturer and service user dyads, learning exercises and case studies. The paper then explains the evaluation methodology. This involved two surveys which returned 144 student and 34 practice teacher questionnaires. The findings revealed that students were generally committed to this form of teaching and engagement with victims and survivors of the conflict, although some students reported that their attitudes towards this subject had were not changed. Some students also discussed how the conflict had affected their lives and the lives of families and friends; it is argued that such biographical details are crucial in developing new pedagogical approaches in this area. Practice teachers who supervised some of these students on placement reported general levels of satisfaction with preparedness to work with conflict related situations but were less convinced that organisations were so committed. The paper concludes with a discussion of the study limitations and a recommendation for more robust methods of teaching and evaluation in this area of social work education and practice.     

Invisible from View: Leaving and Aftercare Provision in the Republic Of Ireland

Abstract

The adequacy of provisions for young people leaving care and in aftercare in the Republic of Ireland has been the subject of recent policy attention. A landmark report, the Ryan Report (2009), into historic abuse in state institutions recommended strengthening provisions in this area. However, the legislative basis for aftercare remains relatively weak and services for young people leaving care remain ad hoc and regionally variable. This article outlines the current context of leaving and aftercare provision in the Republic of Ireland and traces some of the recent policy debates and recommendations in this area. A genealogical analysis of leaving care and aftercare provision highlights that this issue has historically only emerged as a concern in the context in which young people leaving the care system are perceived as a “threat” to social order. It is argued that the failure to adequately reform leaving and aftercare provision is reflective of wider social inequality and of a context in which young people in care are largely invisible from view.     

Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

The rights of the child enabling community development to contribute to a valid social work practice with children at risk

This paper presents a way of thinking about and doing child protection work using community development (CD) principles to guide practice. It suggests that a useful addition to CD can be found within the rights of the child provisions in Human Rights conventions. Using examples from the authors' three countries to illustrate the work that practitioners do in their work with children at risk, we argue that social work practice can be enhanced by the inclusion of these principles and practices which are essentially core generic social work practice. However, much of social work with the protection of children is bound by ‘risk’ perceptions which result in investigatory approaches being used as a first action, often to the exclusion of preventive approaches. This article demonstrates that in very different situations from different environments, CD in concert with the principles of the rights of the child can assist good outcomes with children at risk. A model is presented for unifying the worldview of human/children's rights with social work's core concern, the protection of children, using generic social work skills.     

Developing Advanced Practitioners in Mental Health Social Work: Pedagogical Considerations

Advanced social work practitioners in mental health services daily face the challenges of working alongside the more powerful professions of psychiatry and psychology. Advanced post-qualifying programmes in mental health social work equip practitioners with the knowledge, skills and expertise to confidently work alongside both psychiatrists and clinical psychologists in multi-disciplinary teams. This includes training in empirical research methods, which are used to develop the evidence base for psychiatry and psychology, although social work practitioners find this particularly challenging. This paper explores the importance of research methods teaching in the development of advanced practitioners in mental health social work. Using learning theory to explore possible reasons why practitioners find it so difficult, it offers some solutions which may enhance the learning and teaching of research methodology to experienced social workers.