Social workers should be given more scope to practice their skills in order to help prevent mental health crises and help people make lasting change, a Parliamentary inquiry into mental health services in England has found.
The All-Party Parliamentary Group on Social Work (APPG) took evidence over a 4-month period from mental health service users, families, other professionals, researchers, government officials and politicians, and found that outside of AMHP (Approved Mental Health Professional) or BIA (Best Interest Assessor) roles, social workers are often required to act in more limited ways and are unable to use all the professional skills they are trained for.
The inquiry report recommends maximising social workers’ skills and working with people who need services and their families in order to prevent people’s mental health from deteriorating to the point of crisis and to help people to make lasting change. The concept of ‘co-production’, where services are mutually developed and delivered by professionals, people using services and their families, was also found to be of paramount importance.
With demand for mental health services growing, the inquiry explored if the social model of mental health should be promoted on an equal footing with medical and other clinical approaches, and what the benefits might be for people using services. It heard evidence of systems becoming more complex, fragmented and harder to navigate. Prevention is underdeveloped and specific marginalised and excluded groups remain particularly under-served. The experiences of black and minority ethnic groups continue to be poorer overall. The report also makes a case for developing services for individuals with dual-diagnosis, such as mental health issues and substance use or complex needs such as homelessness.
The report also supports the establishment of a professional and service user-led standing commission to scrutinise and promote progress on parity of esteem for mental health within national and local funding and delivery of social care and health, as well as a national campaign to increase public understanding of mental health.
Other recommendations include:
• A national framework of effective, practical co-production and partnership between service users and professionals developed and promoted throughout the NHS, local authorities and other providers
• Co-production should be a core skill requirement within all multidisciplinary professional mental health training
• Ensure every acute and rehabilitation ward and crisis team has a dedicated family liaison social worker
• Ensure social workers and multi-professional colleagues in mental health are trained in the requirements and ethos of the Care Act 2014 in respect of carers and families
• Health and social care commissioners should be required jointly to develop and implement dual- and multiple-diagnosis service strategies and operational plans
• Instead of relying solely on third sector providers, statutory mental health teams should be empowered, resourced and skilled to conduct outreach to homeless people
• Local commissioners of offender mental health services should work strategically with local courts to promote non-custodial solutions integrated with local mental health support.
Emma Lewell-Buck MP, chair of the APPG on Social Work, said: “The current medical model treats the person as a patient, not an individual, and is overly dependent on budget restraints and workplace targets. Our new vision of a better mental health system is one that is holistic and person centred; a system that recognises the person, not the just the diagnosis; a system that offers a continual, seamless support network that stays with the sufferer for as long as they need.”
Dr Ruth Allen, mental health social worker and chief executive of the British Association of Social Workers, said: “The medical model alone cannot erase stigma about mental health, bring about parity of esteem or support recovery for individuals or communities. Social workers often provide practical help to people who use services and their families as well as emotional, health and legal support. These are often the things that people using services say are most important to their recovery and so social work must be placed at the heart of service delivery.”
Read the full report here