Mental Health and the Asian Communities: A Local Survey

Correspondence to Barbara Hatfield, Lecturer in Psychiatric Social work, Department of Psychiatry, 12th Floor, Mathematics Building, Manchester University, Oxford Road, Manchester M13 9PL Summary The survey of people from the Asian communities in ‘Milltown’included people who used mental health services, family membersof service users, and members of the Asian general public. Personaland social stresses of the group were explored, as were theirperceptions of the ‘causes’ of mental ill-healthand appropriate responses. Although most people saw family andsocial stress as central, a religious dimension was also prominent,in terms both of causes and treatment of mental ill-health.There was no evidence of rejection of mainstream services becauseof a choice on the part of Asian families or communities tobe self-servicing. A range of issues identified by respondentssurrounded the cultural acceptability of services in ‘Milltown’to Asian people. A lack of knowledge of service availabilitywas also apparent, with a heavy reliance upon GP services formental health care in the community. The findings of the surveyare compared with similar studies, where available, which focuson indigenous white British service users. Some findings arecommon; other issues are specific to this Asian group.     

A Consumer Study of Young People's Views on their Educational Social Worker: Engagement as a Measure of an Effective Relationship

Correspondence to Colin Pritchard, Mental Health Group, University of Southampton, Royal South Hants Hospital, Brintons Terrace, Southampton, SO14 0YG, UK. Summary This, the first ever consumer study of education social workers(ESWs), uses qualitative material and quantitative analysisby examining the views of 110 users of a county ESW service.Most pupils belonged to families with long-standing disadvantage;e.g. 53 per cent had unemployed fathers; over 70 per cent hadparents with disturbed personal and social relationships, 39per cent had a single parent; 30 per cent plus had mental healthproblems; and 10 per cent of parents had been in care as children,i.e. more than ten times the national average. The young people also had considerable disruption in their lives:for example 78 per cent frequently missed school; over 50 percent had school and peer difficulties; 30 per cent offended;over 30 per cent experienced bullying; 5 per cent were the subjectof child protection enquiries, 10 per cent had previously beenin care and 2 per cent had had an incident of ‘attemptedsuicide’ (50 times the national rate). They averaged sixmajor difficulties each. Despite these antecedents, 91 per cent of the young people demonstratedan ‘engaged’ relationship with their social worktrained ESW, with many examples of practical psychosocial helpbeing received. The concept of ‘engaged’ was statisticallyvalidated in the comparison of views between the ‘engaged’and ‘non-engaged’ research participants. The resultsindicate the value and effectiveness of a supportive rapport/relationshipas a vehicle to reach and to be of practical assistance to disturbedand disturbing young people.     

Responding to Youth Crime in Scotland

Correspondence to Bill Whyte, Director, Criminal Justice Social Work Development Centre for Scotland, School of Social and Political Studies, University of Edinburgh, Flat 1FR, 31 Buccleuch Place, Edinburgh EH8 9LJ. E-mail: B.Whyte{at}ed.ac.uk Summary Scotland’s Children’s Hearings deal with young peoplewho offend within an integrated system dealing also with youngpeople in need of care and protection, on the assumption thatthe difficulties of both groups have similar roots in multiplesocial disadvantage and social adversity (Whyte, 1998a). A government-fundedstudy, one of the first since the system’s inception in1971, was commissioned to examine the social characteristicsof over 1,000 children and young people referred for offenceand nonoffence reasons. This paper describes the characteristicsof 465 of the young people who were referred specifically foroffending. It provides the first ‘official’ datain twenty-five years on young people in the system. The studyfound that most of those referred for offending had characteristicsstrikingly similar to those referred for nonoffence reasons,as predicted when the system was first established, and similarto those present in the general literature on young offendersfrom other jurisdictions. The study poses fundamental questionstaken up by the Scottish Executive’s review of youth crimeon how best to design systems and develop social interventionsthat can address offending and social disadvantage in an integratedway.     

Keyworkers Re-examined: Good practice, quality of care and empowerment in residential care of older people

Correspondence to Rosemary Bland, Department of Applied Social Science, University of Stirling, Stirling FK9 4LA, Scotland Summary Social work definitions of ‘good practice’ in residentialcare which were originally developed in work with children andyoung people have also been applied to residential settingsfor other user groups, including older people. However, anylink between such elements of practice and positive outcomesfor users has not always been demonstrated. The introductionof market principles and orientations into social welfare inthe 1980s re-defined the social work ‘client’ asa ‘consumer’ with the associated power to make choicesin the area of social care. The success with which such an approachcan be applied to services for people who are very often, notin a position to exercise much choice, is debatable. Alongsidethe notion of the ‘consumer’ or ‘user’of services has grown the ideology of ‘empowerment’of people who use social work services. Drawing on findingsfrom a recent study, this article explores the contributionof the keyworker role to good practice and the empowerment ofolder people living in residential homes. It concludes that,because their understanding of the concept and practice is largelyundeveloped, the role as currently interpreted is not consonantwith good practice and tends rather to reinforce the power ofstaff.     

Care Management and Professional Autonomy: The Impact of Community Care Legislation on Social Work with Older People

Correspondene to Mark Lymbery, Centre for Social Work, School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham NG7 2RD, UK. e-mail: Mark_Lymbery{at}nottingham.ac.uk Summary The 1990 National Health Service and Community Care Act appearedto herald a new dawn for social work with older people, whichhad previously been a relatively neglected and undervalued areaof social work practice. The legislation proposed a new rolefor social workers as ‘case managers’, with considerableautonomy and flexibility about the way in which the ‘casemanager’ responded to need. By the time community carepolicy was implemented, the role of ‘case manager’had been transformed into that of ‘care manager’,with a focus which emphasized procedural and managerial requirementsrather than a more flexible professional practice. This paper explores the extent to which this shift has substantivelyaltered the nature of social work practice with older people.It outlines key theories of professions and their applicabilityto social work, and critically analyses the impact of the ‘newmanagerialism’ within social services departments. Thepaper also examines the nature of social workers' practice witholder people following the impact of community care legislation,and concludes that the impact on the social work professionhas been to locate an increasing control of practice with socialwork managers, with potentially serious consequences for thecontinuation of a distinctive social work role in relation toservices for older people.     

Group Work in Intermediate Treatment

Summary This article is concerned with the development of group workin a specialist intermediate treatment project. Using the techniqueof participant observation the author describes the use madeof groups over a six-month period with young people, all ofwhom presented problems of disturbance and/or delinquency. Thepractice portrayed is not ‘model’ but illustrativeof the dilemmas of practitioners beginning to work with groupsof young people for the first time. The evidence of the studypoints to the difficulties that an over-simplified view of participationand democracy can create, and indicates the need for group workersto define their purpose and objectives and to establish a contractor working agreement with group members. In relation to thedebate about ‘talking’ and ‘doing’ inintermediate treatment, it is suggested that a model of groupwork practice that distinguishes between ‘activity asan end in itself’, ‘activity as a means to an end’,and ‘focussed discussion’ may be helpful to groupworkers in conceptualizing the totality of their task. Socialwork with groups is still more talked about than practised.This article describes the attempts of a newly established teamof intermediate treatment workers to practise group work withyoung adolescents whose behaviour and social circumstances wereregarded as problematic. As a part-time researcher attachedto the project team, the author had access through participantobservation to groups over a six-month period and he also hadthe opportunity of listening to group workers discussing theirwork at review meetings.     

Adolescents in Care and their Social Workers: A Research Note

Summary There has recently been an increasing concern that young people,and especially those in residential care, should be encouragedto express their views, and that the views expressed shouldbe used in improving the care which they receive. The publicationof the Who Cares? booklet (Page and Clarke¹), and the emergenceof ‘Who Cares’ groups and the ‘Voice of theChild in Care’ organisation, is evidence of this concern.In sympathy with these developments has been a study of adolescents'perceptions of social workers, and a part of this research hasincluded a pilot study of the views of adolescents living intwo family group homes.     

'No Irish Need Apply': Social Work in Britain and the History and Politics of Exclusionary Paradigms and Practices

Correspondence to Paul Michael Garrett, Centre for Social Work, School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham NG7 2RD, UK. E-mail: paul.garrett{at}nottingham.ac.uk Summary In Britain, Irish people have continually been excluded fromthe discourse of anti-discriminatory social work theory. Themain reason for this centres on the dominant tendency to exclusivelycentre on ‘race’ and visible difference. Recentpolicy documents in relation to social work with children andfamilies illustrate the fact that Irish people are omitted indiscussions seeking to promote culturally appropriate services.Conceptually this approach is founded on implicit ideas aboutBritish identity and erroneously suggests that white ethnicitiesare homogeneous, unified and clearly demarcated from a (new)black presence. Historically, ideas associated with ‘theproblem family’ can be related to the racialization ofIrish people. Archival research examining responses to unmarriedmothers travelling to Britain to have ‘illegitimate’babies adopted also highlights how Irish women have been subjectto exclusionary social care practices. Whilst rejecting an essentialistconceptualization of ‘Irishness’, the article goeson to suggest that the mainstream and hegemonic discourse on‘race’ needs to take specific account of Irish peopleand other minority ethnicities not identifying as ‘black’,particularly during a period of globalization and new migrationinto Britain by refugees and asylum seekers.     

The Psychiatric 'Caseness' of Clients Referred to an Urban Social Services Department

Correspondence should be sent to Dr. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Manchester University, Stopford Building, Oxford Road, Manchester M13 9PT. Summary Of 158 clients referred to two area offices and six generalpractice attached social workers, 141 weré interviewedusing standardized social and psychiatric research interviews.The General Health Questionnaire (GHQ) was completed by 138clients. Their social worker completed the Case Review Form.Scores of 5 or more on the PSE Index of Definition (for theclient) were used to indicate psychiatric caseness. Using IDscores of 5 or more, 53% of the sample were identified as ‘cases’.The GHQ (cut-off 4/5) identified 73% of the clients as cases;and the GHQ (cut-off 10/11) identified 51% cases. Morbidity was significantly greater in the general practicesetting. Social workers' judgement (about the presence or absenceof mental illness/emotional disorder) was not significantlybetter than chance in the identification of specific disorders,but was significant in relation to the whole sample. The results are discussed and further studies are being conductedusing more sophisticated judgements of ’caseness’,and extending the enquiry beyond an inner city population.     

Outline of a Critical Best Practice Perspective on Social Work and Social Care

Correspondence to Harry Ferguson, Faculty of Health and Social Care, University of the West of England, Blackberry Hill, Stapleton, Bristol BS16 1DD. E-mail: harry.ferguson{at}uwe.ac.uk Summary This article seeks to lay the foundations for a new, more positiveperspective on critical practice, research and learning in socialwork and social care. A ‘critical best practice perspective’seeks to move the literature beyond a ‘deficit approach’where the focus is on what does not get done (well), to createa perspective where learning occurs in terms of best practicewhich is set out as a model for developing systems and practicecompetencies. This requires a focus on the actual critical practicesthat are ‘best’ demonstrating the very practicethrough which positive outcomes were achieved. A detailed case-studyis offered drawn from a large scale research study which typifieshow a critical best practice perspective can provide for learningin key areas such as how to engage service users, advocate ontheir behalf, promote protection, establish empowering relationshipsand conduct longer-term therapeutic work in an antioppressivemanner. The research method uses critical theory as an interpretativeframework for reaching an operational definition of 'excellence’and what is ‘best’, which is drawn from the perspectivesof the range of stakeholders who construct practice. This requiresa broadening of the concept of evidence-based practice to includequalitative research methods and the experience of professionals,service users and the production of ‘practice-based evidence’.     

Understanding Adolescent Female Prostitution: A Literature Review

Correspondence to Dr Jill Jesson. Aston Business School, Aston Triangle, Birmingham B47 7ET. Summary Sexual behaviour and sexuality are currently topical issuesof concern for child care social workers. Social workers arespending more and of more of their time with children who comeinto care because of sexual abuse, or who have an involvementin the ‘rent’ scene or Prostitution. In additionmany teenage young women come into care because of social orparental concern over their lsquo;promiscuous’ behaviour.The review of research on adolescent prostitution offers severalexplanations for involvement in prostitution. which vary accordingto the discipline of the author. Explanations vary from pathologicaland personal psychology factors to the wider social aspectsof the family and local environment. This literature reviewwas used as a basis for research which examined the incidenceof female prostitution for a social services department. Thisis a relatively new field of interest and consequently thereis very little British research published on the issue of adolescentprostitution, or on under age (16) prostitution. There is nopublished research on girls in care and prostitution. We needto know much more about the reality of young people's livesbefore social workers can offer a meaningful response.     

Social Work as Uncommon Sense

Summary Social work needs to resist pressures to identify itself solelyat a superficial level of common sense responses to social problems.It has to go beyond this to recognize its use of ‘uncommonsense’ as the means by which social workers cross therelationship gap and respond to their client's needs. The importanceof doing this in the early stages of relationship, as in crisisintervention, are considered, and stress is placed on holdingtogether both the explicit task-related aspect of the relationship,and the less obvious emotional interchange. By means of theiruncommon sense, social workers are enabled to reflect for, andshare with clients their areas of pain, in such a way as torender them more tolerable.     

Going missing from residential and foster care: linking biographies and contexts

Summary The findings discussed here derive from a Department of Healthfunded study into young people who go missing from foster andresidential placements. We found going missing to be a widespreadphenomenon especially, though not exclusively, in residentialcare. The risks encountered by young people included involvementin offending, substance misuse, rough sleeping and sexual exploitation,including prostitution. However, patterns of going missing werecomplex. Different patterns were identified for those who wentmissing to be with friends or family as compared to those whoran away, the latter group tending to place themselves at greaterrisk. Those who went missing repeatedly were at risk of increasingdetachment from substitute carers and school and were more likelyto have offended in the past. However, these longer-term risksdiffered significantly from those who had first gone missingfrom home when compared to those first missing from substitutecare. The complex motivations that prompt young people to gomissing are also discussed and the balance between individualand environmental factors in explaining this phenomenon is explored.     

Regulation or fragmentation? Directions for Social Work under New Labour

Summary This article reviews the modernizing agenda of New Labour forsocial work which has been articulated in the various changesfor social work and social care announced in the ‘QualityStrategy’. Focusing predominantly on arrangements foreducation and training, the article argues that, rather thanpresenting a coherent strategy, the structures and proceduresare fragmented and unco-ordinated at many levels. A major weaknessis that New Labour has failed to clarify where it places socialwork in the structures of a ‘modernized’ welfarestate.     

A Role for Anyone? A Description of Social Work with the Elderly in Two Area Offices

Summary This article analyses information from Case Review Forms completedby social workers on 199 allocated elderly clients. These peoplewere very frail, most were considered to be ‘at risk’and to require regular, reliable and frequent care. The questionof the client moving to a tafer setting arose in two-thirdsof the cases, concerning which there was often some dispute.It is argued that social workers require a high level of professionalskill in dealing with clients, and others involved, faced withsuch questions and that this requirement will remain with thedevelopment of ‘community social work’.     

The Impact of the First Term of the New Labour Government on Social Work in Britain: The Interface between Education Policy and Social Work

Summary This paper considers how far the New Labour educational policyrepresents a clear shift in focus from the policies of the Conservativeadministrations of the 1980s and 1990s. As in other areas ofsocial policy, the paper concludes that current government policyowes as much—if not more—to ‘New Right’ideology than to that of the ‘Old Left’. With anew emphasis on social inclusion, the paper considers the contributionof, and implications for, contemporary developments in educationpolicy and practice for child and family social work in general,and education social work in particular.     

The Treatment of Enuresis amongst Child Clients of a Social Services Department

Summary The adoption of an ‘outpatient’ model of supervisingthe treatment of bedwetting amongst child clients of a socialservices department is described. The treatment technique usedwas the generally effective ‘enuresis alarm’, or‘bell-and-pad’. Fifteen out of a total of 25 concludedcourses of treatment were successful, with an average treatmentduration of 14.9 weeks. Both this outcome, and the rate of drop-outbefore completion of treatment (ten cases) are comparable withthose obtained with non social services clients, and the useof the enuresis alarm with children in care (including thosein residential establishments) was found to be quite practicable.A high relapse rate (43%) was, however, found for social servicesclients, relapse usually following a placement change or othermajor stress.     

Government, Social Services Departments and the Health of Children and Young People: Which Way Forward?

Summary Despite the dearth of research into the health of children andyoung people in contact with or ‘looked after’ bylocal authorities, a series of official and quasi-official reportshave begun to raise awareness of this issue. There are goodreasons to believe that this group of children will be disadvantagedin terms of health as they are in other aspects of their lives.The evidence suggests that local authorities do not live upto the standards of ‘good parents’. Current notionsof good practice are critically appraised and the article concludesthat social work is unable to do more than mitigate the effectsof Government policies which affect health and social servicesand which have lead to widening social inequalities.     

Social Work Students' Perceptions of Child Abuse: An International Comparison and Postmodern Interpretation of its Findings

Correspondence to R. James Christopherson, School of Social Studies, University of Nottingham NG7 2RD, UK. Summary The decision about whether behaviour with children is acceptablehas far-reaching consequences for those involved. Social workersmust decide what behaviour leads people into the child protectionsystem. This study aims to identify how far social work studentsachieve a consensus on the acceptability of behaviour, and whethersimilar items achieve agreement between groups in Sweden andEngland. Forty-four vignettes of behaviour with children whichmight be seen as unacceptable were administered to 52 first-yearsocial work students in Ume, Sweden, and 50 English students.They were asked to rank the behaviour on a 5-point scale, where‘1’ represented ‘Fine’ and ‘5’‘Totally unacceptable'. Key findings were that there is little consensus within societiesabout what is acceptable behaviour towards children, and significantdifferences between them. It is argued that this is the resultof the many different discourses operating in the field. Theauthor points out the difficulties this can cause, and arguesfor the acceptance of a postmodern approach, which though stressingthe importance of consensus in decision making, ultimately positsthat effective and ethical practice must be based on relationship.Such an approach would resolve paradoxes which have challengeda more modernist understanding of social work.     

Mapping Child-Care Social Work in the Final Years of the Twentieth Century: A Critical Response to the 'Looking After Children' System

Correspondence to Paul Michael Garrett, c/o, British Journal of Social Work, University of Warwick, Coventry, CV4 7AL Summary This paper explores aspects of the Looking After Children: GoodParenting: Good Outcomes system (LAC) (Parker et at., 1991).It is suggested that the scheme, to be used with children andyoung people who are ‘looked after’ by local authorities,needs to be subjected to greater critical scrutiny. The paperseeks, therefore, to situate the LAC system in a social andpolitical context and highlights how it also relates to thedominant operational modalities of social work interventionin the late 1990s. In addition, the paper explores how ‘troublesome’children and ideas centred on ‘parenting’ featurein the LAC discourse. The discussion concludes with an examinationof Action and Assessment Records (Ward, 1995b), the centrepieceof the LAC system.