By Michele Abendstem, Mark Wilberforce, Jane Hughes, Andelijia Arandelovic, Saqba Batool, Jennifer Boland, Rosa Pitts and David Challis.
Review written by Dr David Wilkins
What question does this study focus on?
Social workers have long been part of community mental health teams (CMHTs), yet in recent years and in some areas, the make-up of these teams has been changing. This study explored the current position and role of social workers within English CMHTs, and how this might be changing.
How did they study it?
In 2018, the authors undertook a national survey of CMHT managers in England. They did this by obtaining a list of NHS mental health trusts in England (n=54) and finding contact details for their CMHTs. In total, they located 421 teams from 50 of the Trusts (they were unable to contact two, and two withdrew). Surveys were distributed to the team managers. In total, 188 surveys were completed (a 44% response rate), spanning all 50 Trusts and nine English regions.
What did they find?
The average size of a CMHT was just over 25 people. All of them included a team manager, nurses and at least one consultant psychiatrist. Four-fifths also included a social worker, while nearly 90% had an occupational therapist. More than half of the team managers said that social workers made a ‘good’ or ‘very good’ contribution to the team. Most of those who were more negative also described losing social work staff from their teams in the previous 12 months. The more social workers there were in the team, the more likely their contribution was to be rated positively. Social workers acted as care coordinators, or enhanced CPA (Care Programme Approach) coordinators, and in most teams conducted initial assessments. In a very small number of teams, social workers prescribed or administer medication. Social workers were also the largest professional group involved with making funding decisions and acting as Approved Mental Health Professionals.
More than half of the managers described major changes for their teams in the previous 12-months. These involved restructurings, more integrated working between health and social care professionals, the loss of staff, including social workers, and changing roles. Where social workers had been lost from the team, managers often described a loss of experience and knowledge, increased workloads for other staff, and a negative impact on people using services.
What are the implications?
These findings point to the important role that social workers have within many CMHTs, but also their changing roles and in some cases, their absence. Team managers expressed concerns about losing social workers from their teams, and in particular how this could limit or reverse attempts to integrate health and social care service provision.
Review written by