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The role of modern social work in improving mental health services

Posted by: , Posted on: - Categories: Mental health

I’m delighted to welcome Mark Trewin as the latest guest blogger on my site. Mark is passionate about the role of social work in mental health services. He is currently seconded from Bradford Council to DHSC and NHSE as a mental health social care advisor. In his debut post, he explains the background and interests that have led him to this point and considers current and future milestones for mental health social work.

Mark Trewin: 'There is a real opportunity to further develop the positive role for mental health social workers in integrated teams.'

Mark: As a mental health social worker in both Local Government and the NHS, I have been an approved social worker and a manager of approved mental health professional (AMHP) services.

I have worked in training and development – particularly in relation to the introduction of the 2007 Mental Health Act and have managed specialist supported accommodation, community mental health services and forensic services.

For the last seven years, I have been the senior manager for local authority social care mental health services in Bradford – working across the whole system to provide integrated services alongside our partners.

The NHS, social care services, police, voluntary sector groups, housing and private sector providers all need to work in partnership. Each and every one has an important role to play in mental health services.

The point of partnership, however, is not just to improve organisations, but to provide better services to people within their own communities. The people we work with spend most of their time with their families and communities, at work and home. This is where the social model of mental health care and support is essential.

Local authorities commission or operate social work teams, residential and nursing care, substance misuse and public health services, housing and disability services, advocacy, supported accommodation and a range of services delivered in the voluntary and private sector.

Mental health social work is based on statutory responsibilities – the Care Act, the Mental Health and Mental Capacity Acts, equalities and human rights legalisation.

In the publication ‘Being mindful of mental health’ the Local Government Association (LGA) describes these roles and the substantial commitment of local authorities to mental health services through public health, housing and adults or children’s social care.

The vital role of social care in mental health has not always been fully recognised, I feel.

In November 2017, I wrote a blog for the Centre for Mental Health entitled ‘Why is Social care so invisible in mental health policy?’ At that time, we were struggling to see the wider role of local government and the social determinants of mental health. Eight months later, it does feel as if progress is being made in this area.

The social model of mental health is important because it reflects the lives of people who use services and their right to live independently in their own communities.

Medication and treatment can be useful – sometimes lifesaving – but it is within our homes and neighbourhoods, often following discharge from acute care, when the expertise of social work comes into its own – despite the ongoing pressures on these services.

NHS England Colleagues recognise this and are very committed to developing links with social work and local authorities as they review the Five Year Forward view and plan the next stage of this programme, including a new framework for community mental health services.

Within the Department of Health and Social Care, the forthcoming green paper is a consultation process that will, hopefully, lead to major developments in the way that social care is delivered and funded.

The main paper itself is for older people, with a parallel process for working age adults running alongside. It will contain a number of issues relevant for mental health social workers, including an integrated health and social care workforce plan for the next ten years and the development of future integrated partnerships between health and social care.

There is a real opportunity to further develop the positive role for mental health social workers in integrated teams. We are working with the social work for better mental health project to ensure that we learn the lessons from the front line on past attempts to bring services together.

The publication of the interim report of the independent review of the mental health act was based on a substantial engagement process and call for evidence in which there was a great deal of information provided by social workers and AMHPs.

The review is developing recommendations so that legislation can focus better on patient rights, safeguards and autonomy, and is engaging further with a range of people to get that right. Its report will be submitted to government later in the year. This will inevitably develop the role of the approved mental health professional (AMHP). The recent CQC report on AMHPs clearly demonstrated what needs to be in place for AMHP services to work well.

Finally, preparations are ongoing for Social Work England including exploring how high quality mental health social work can be supported through regulation, including that of Best Interests Assessors and AMHPs.

These developments give us an opportunity to think creatively about the way that mental health social work operates within a modern, integrated, service and the possibility of doing things in a different way in the future. It is an exciting time to be involved in mental health social work.

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  1. Comment by Felix Ogundeyin posted on

    This is an insightful post and gives that little boost when one is feeling a little jaded and asking the question "what's the point?"
    Well, the answer is right here - this is why we continue to do what we do: to imorove our services and service user outcomes...
    The NHS Trust to which I am seconded is currently going through a CQC inspection, and for all the daily corporate posts this is the honest and gritty perspective that our health partners need to recognise and give thought to.

  2. Comment by Trevor Ellis posted on

    It is evident that there is no place for complacency when it comes to looking after people with mental health problems.
    In recent times mental health is receiving more attention than normal
    which isn't a bad thing,
    but unless the central government starts to do more than talk about mental health
    while continuing to cut funding to fundamental services that vulnerable people rely on,
    how will that benefit the most vulnerable in our society?
    I still see people in and around London that are clearly 'unwell' mentally and they are evidently left to fend for themselves.
    This is a pattern that needs to be changed and the only way to do it is to put more money into mental services
    because it is pretty obvious that one of the most common reasons why people with mental health problems "fall through the cracks'' is because services are put under severe pressure by the central government to do more with less.
    The common response from central government tends to be along the lines of, ''we are putting record amounts into mental health services''
    whereas local councils tend to say that ''we are being pushed into an ever-tighter corner which leaves us with few options other than to close down services in order to balance the books''.

    Now that Jeremy Hunt is the new foreign secretary and Matt Hancock is the new secretary of state for health
    I can't see any reason for optimism because he (Mr. Hancock) will surely follow the footsteps left by his predecessor because the aim of the current Tory government is to do as much (or little) as possible on a tight budget.
    Unfortunately, time has proved beyond any reasonable doubt that cutting funding to mental health services ultimately hurts the very people that rely on the help provided the NHS and local councils.


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