‘Maybe a maverick, maybe a parent, but definitely not an honorary nurse’: Social worker perspectives on the role and nature of social work in mental health care.

By Tucker, L. and Webber, M. 

British Journal of Social Work 51, 545–563.

Review written by Professor Jonathan Scourfield

What question does this study focus on? 

What is the distinctive role of social workers in a mental health system that is multi-disciplinary but medically led? Surprisingly, perhaps, the authors of this paper say there has been little research on social workers’ own perspectives on their role – more research has been done on what other professionals think of social workers and on the Approved Mental Health Professional role. They set out to help fill this gap.

How did they study it?

They interviewed seven White British female social workers from multiple settings within one English NHS trust. Four interviewees were employed by the NHS and three by local authorities. 

What did they find?

Views of the mental health social work role tended to refer to the ‘context and intentions of practice’, more than to ‘tasks and responsibilities’. Recovery and social inclusion were not seen by interviewees as core to their practice – rather these aims were the responsibility of others, such as support workers. Working with and risk and family complexity was seen as central to mental health work in general, rather than just social work. Community work was not seen as everyday social work, but occasionally engaged with. Even then, it was seen to involve working with (other) statutory and voluntary services, rather than anything wider. 

There was a clear difference between those employed by the local authority and those working in the NHS in their views of statutory responsibilities, with the NHS employees not seeing social care law as part of their job.

Interviewees saw themselves as helping to bridge the health-social care divide, having a more holistic view and sense of the bigger picture for service users, as opposed to a narrower medical focus, and helping in a flexible way, in response to wider needs that are not directly or immediately about mental health. 

What are the implications? 

This was a study with a small and demographically specific sample in a single NHS trust. However, it raises some interesting issues. It suggests that national policy in connection with the mental health social work role may have had very little impact. Interviewees had either not heard of or were barely aware of the Strategic Statement from the College of Social Work. More work is needed at a national level in each of the UK nations to define the distinctive role of mental health social workers within a multi-disciplinary mental health system.


Review written by

Photo of Professor Jonathan Scourfield

Professor Jonathan Scourfield

Strengths-based practice in social work with adults

Price A, Ahuja L, Bramwell C, Briscoe S, Shaw L, Nunns M et al. (2020) Research evidence on different strengths-based approaches within adult social work: a systematic review. Southampton: NIHR Health Services and Delivery Research Topic Report. 

Review written by Professor Jonathan Scourfield

What question does this study focus on?  

This study summarises existing published research on the effectiveness and the implementation of strengths-based approaches within adult social work in the UK. These approaches are well-known in children’s services and are supported by recent legislation for adult care but little is known about their effectiveness and they are thought to be difficult to implement.

How did they study it?

They did a systematic review – that’s the most robust approach to summarising existing research. They looked in academic journals, with no restrictions on date or language, and they did some limited searching of ‘grey’ literature such as policy reports, although they acknowledge they may have missed some of these. They were only looking for studies from the UK, which is understandable given they wanted the research to be very relevant to UK services, but they will no doubt have missed some international studies that could also be relevant and important. Fifteen studies met the criteria to be included in the review, six of which were assessed as good quality.

What did they find?

There were seven studies of Making Safeguarding Personal – an outcomes-focused and personalised approach whose aim is for safeguarding to be done with, not to,

people. The other eight studies covered a range of approaches: Local Area Coordination, Solution Focused Therapy, Family Group Conferencing, Asset-based Community Development, Strengths-based with Relationship-based Approach, Asset-based approaches, and Motivational Interviewing.  None of the studies allowed the researchers to answer the question about effectiveness.

For Making Safeguarding Personal, the implementation issues were these:

  1. It was seen as demanding on practitioners at first but as having advantages over the longer term – e.g. improved personalisation and reduction in future referrals and burden on the range of services involved in safeguarding. Significant practice change was needed. The model needed adaptation for specific localities, which sometimes caused implementation problems.
  2. The approach required cultural changes in organisations, to move away from older practices such as being risk-averse and not engaging people in conversations about what they want from safeguarding. MSP requires a shift from process-led to user-focussed social work. More outward-facing and smaller local authorities tended to be most successful in implementing MSP.
  3. The knowledge, skills, creativity and confidence of service providers were important for delivering MSP. Practitioners’ willingness to embrace the model made a difference. 
  4. Successful implementation needed strong leadership – sound planning, engagement of staff across service boundaries and the active involvement of people receiving services.

What are the implications?

We need more evidence, which is so often the conclusion of systematic reviews! For this topic, there is a real need for comparative studies, to look at whether consciously strengths-based approaches actually result in different in the positive differences they would claim to bring, when compared with usual practice. The points about how MSP was implemented are useful for services that want to bring in practice changes.


Review written by

Professor Jonathan Scourfield

Identifying inequalities in child welfare intervention rates: UK comparative studies

RESEARCH REPORT

Authors: Martin Elliott and Jonathan Scourfield

Year: 2017

Summary:

This report is about the connection between social inequality and child welfare interventions. We analysed routine administrative data from Welsh local authorities on the children on child protection registers and in care (looked after) on 31 March 2015.