Statistical Errors in Papers in the British Journal of Social Work (Volumes 1-14)

Summary This paper examines the statistical error rate in the BritishJournal of Social Work (BJSW), volumes 1–14. Half of thepapers (n=175) contain empirical data and half do not. Fifty-nineof the empirical articles are quantitative with statisticalanalysis; they account for 17% of the papers in the first 14volumes. Thirty-nine of these papers (66%) make 57 errors, arate which is comparable to that reported in the British Journalof Psychiatry. Nineteen papers (32%) make serious errors. Examplesof the type of errors are described. The wider use of reliablestatistical advice, prior to undertaking data collection, isrecommended.     

The Role of Social Networks in the Maintenance of Schizophrenic Patients

Summary The levels of social support available to the nearest relativesof a sample of 45 outpatient schizophrenics are measured interms of both the structure of their social networks and thequality of their network relationships. It is hypothesized thatthe level of social support available to the closest associateof the schizophrenic patient is linked to the level of functioningfound in the patient. Good social performance in the patient is found with the structuralaspects of the nearest relative's social network whereas goodclinical performance in the patient is related to the interactionalaspects of the relative's network. The results indicate that a view of maintenance in schizophrenicpatients which incorporates both social and clinical functioningneeds to consider the structural as well as the interpersonalcharacteristics of the networks of their closest associates.     

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.     

Accommodation and Employment: A Survey into the Circumstances and Expressed Needs of Users of Mental Health Services in a Northern Town

Correspondence to Barbara Hatfield, Mental Health Social Work Research and Staff Development Unit, University of Manchester, Department of Psychiatry, Mathematics, Tower, Oxford Road, Manchester M13 9PL. Summary A sample of 120 mental health service users in a Northern Townwas interviewed about satisfactions and expressed needs in arange of life domains. Most of the 120 users were male, in theolder age ranges, and not in current partnerships. Most hadservere and long-term conditions. Living situations includedhospital wards, hostels, a group home, living with family orfriends, and living alone. The domains of accommodation andemployment are discussed in this paper. The majority of peopleexpressed themselves as ‘satisfied’ with their accommodation,although a sizeable monority were not satisfied. Lack of choiceof alternatives emerged as an underlying feature of ‘expressedsatisfaction’. A sizeable group expressed the need forhelp in obtaining employment, particularly those living in thecommunity. It is argued that for consumer choice to have a realisticmeaning, people with severe mental illnesses need the experienceof choice from more than one alternative.     

A Survey of Approved Social Work in England and Wales

Correspondence to Prof. P. Huxley, Department of Psychiatry, University of Manchester, Mathematics Tower, Oxford Road, Manchester M13 9PL. Summary A survey of approved social workers (ASWs) was undertaken withlocal authorities in England and Wales, to review the provisionand organization of ASW services, and the contribution theymake towards the establishment and maintenance of a comprehensivemental health service. The findings show some variation in provisionwhich is in itself indicative of a variety of factors operatingto produce local and regional patterns of provision. Some ofthese are related directly to policy decisions, others to demographicand geographic variables, while still more are related to teamstructure, workload demands, and generic/specialist issues.The future pattern of mental health social work following theimplementation of the NHS and Community Care Act is consideredin the light of the findings from the survey.     

Case Management and Care Management in Community Care

Correspondence to Prof. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Mathematics Building, Oxford Road, Manchester University M13 9PL. Summary This paper reviews the purpose of case management, its introductioninto the UK, and its central components. While case managementhas empirical referents which have been developed over manyyears (largely in the USA) care management has, until recently,had none. The paper examines different models of case managementin terms of organizational structure, content, and outcome assessment.The importance of the distinction between clinical and administrativecase management is emphasized, especially in work with mentallyill persons. The review of existing evidence suggests that inorder to produce effective intervention services must have clearlyidentified objectives, closely specified target groups, interventionswhich match the objectives, and employ related outcome measurements.Some of the current issues in the implementation of care managementare considered.     

The Probable Extent of Minor Mental Illness in the Adult Clients of Social Workers: A Research Note

Summary A small scale pilot study was conducted in two area teams andfour part-time GP attachment schemes to test the use of a psychiatricscreening instrument (GHQ28) and social assessments. The instrumentswere administered at case allocation and again at three months.Few clinical and social changes were observed in the short term.It was found that 27 out of 40 cases (68%) were identified bythe psychiatric screening instruments as probable cases of minordisorder, on both occasions, and that a further seven clientscould have had a transient disturbance. On the basis of theseresults it was felt that a larger two-stage enquiry was warranted,and necessary, before definite conclusions could be drawn.