What do service users want from mental health social workers? A best-worst scaling analysis

By Mark Wilberforce, Michele Abendstern, Saqba Batool, Jennifer Boland, David Challis, John Christian, Jane Hughes, Phil Kinder, Paul Lake-Jones, Manoj Mistry, Rosa Pitts and Doreen Roberts. (2020)

British Journal of Social Work, 50(5), pp. 1324-1344. 

Review written by Dr David Wilkins

What question does this study focus on?

This paper explores what service users most and least value about mental health social workers. 

How did they study it?

The study involved participants (n=144 from five different English regions) reading a series of case studies and selecting their most and least preferred outcomes for each one. The study was co-produced by a mixed team of academics, people with experience of mental health services and carers. Through a process of discussion, shortlisting and piloting, these case studies were designed to invoke ten social work attributes, as follows:

The social worker…

  1. Thinks about my whole life, not just my illness
  2. Protects my rights and entitlements
  3. Is non-judgemental
  4. Arranges access to other services
  5. Looks carefully for signs of abuse and neglect
  6. Understands why people become vulnerable
  7. Suggests different ways of helping me, and does not concentrate on medication alone
  8. Is a reliable and continuous point of contact
  9. Understands how people’s difficulties can vary from time-to-time
  10. Is compassionate

Each time one of these attributes was selected as ‘best’, it scored one point. Each time it was selected as ‘worst’, it scored one minus point. As each attribute appeared six times in the case studies, this means for each participant the attributes could score between -6 (chosen as the worst attribute every time) and +6 (chose as the best attribute every time). 

 What did they find?

The overall results indicated that participants ranked attribute 8 most positively, and attribute 4 least positively (see table for the full ranking). Some of the attributes, such as numbers 2 and 5, appeared to divide opinion, with some participants viewing them very positively, and others very negatively. 

Overall rankingAttribute
1Is a reliable and continuous point of contact
2Thinks about my whole life, not just my illness
3Suggests different ways of helping me, and does not concentrate on medication alone
4Understands how people’s difficulties can vary from time-to-time
5Looks carefully for signs of abuse and neglect
6Protects my rights and entitlements
= 7Is non-judgemental
Understands why people become vulnerable
8Is compassionate
9Arranges access to other services

What are the implications?

As noted in the article, the overring concern of participants was for social workers to be a reliable and continuous point of contact, and this was true irrespective of the individual characteristics and experiences of the service user. This suggests that services as a whole need to pay close attention to the importance of maintaining relationship-continuity, and not expect service users to form and re-form relationships with different workers unnecessarily. The second most important attribute was paying attention to the service user’s whole life, not just their illness. This highlights the continuing significance of the social model of mental health – seeing and understanding people in context, not as a set of symptoms. It also reflects the important contribution that social workers can make for people with mental health difficulties, not simply as care coordinators, but as reliable people with whom they can form an holistic relationship.  


Review written by

Dr David Wilkins

‘What the Public Think About Social Services’, a report from Scotland

Trish McCulloch and Stephen Webb, British Journal of Social Work, 50(4), 2020, pp. 1146 – 1166.  

Review written by Dr David Wilkins

What question does this study focus on?

In relation to social services, there is often expressed the view among social workers that, by and large, the public dislike them – or at least, they dislike the services they represent. But how accurate is this view?

How did they study it?

In this article, the authors report findings from a survey of 2,505 adults in Scotland, selected to represent the wider Scottish population. The survey was undertaken in 2016 / 17, and comprised of 43 questions, organised in relation to six themes – i) impressions and perceptions of social services, ii) understanding of social services, iii) issues associated with social services, iv) experience of social services, v) trust, value and confidence in social workers and vi) influences on perceptions. 

What did they find?

Half of the respondents had a positive view of social services, and one-third had a negative view. Readers of The Guardian newspaper had the most positive views, while readers of The Daily Express had the most negative views (make of that what you will). The most positive overall findings were that ‘social services play an important role in supporting the most vulnerable people’ and that ‘social services provide a valuable service to the people of Scotland’. The majority of respondents also said they had a good knowledge and understanding of social services, and generally felt that social workers support older people and work to keep children safe. Most of the respondents agreed that social work professionals could be trusted to do their jobs well. It is reasonable to ask how many of these respondents would have had personal experience of social services, particularly in relation to children’s services – yet the authors report that although first-hand contact did influence perceptions of social services, in general there was “nothing compelling in the results to suggest that access in itself is a consistent predictor of perceptions” (p. 1159). 

What are the implications?

These findings should help challenge the belief that the public primarily or even uniformly hold negative views of social work. As this survey shows, at least in Scotland, this is not the case. Perceptions can more reasonably be described as mixed, tending towards the positive.  

What a similar survey would find in Wales remains an open question.


Review written by

Dr David Wilkins