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