pressing importance of transforming secondary treatment and support services, precisely those settings where most specialist mental health social workers, particularly approved mental health professionals, are located. Too many services and practitioners, the report
claims, are still dogged by institutional thinking and behaviour that restricts service users’ lives. It argues for more integrated use of funding so
that money – health, social care and other sources – can follow people flexibly to tailor what they need along different care pathways, and not be locked up in one silo service or another. One possible outcome of such funding flexibility,
and the overall emphasis in the report on ‘choice’, is the increased opportunity for people to directly buy or access their services – or the coordination of their services – outside of existing statutory organisations. It is recommended that this should include the
Particularly explicit is the report’s recognition of
the importance of taking the whole life-span into account and developing family-focused mental health services – an approach that should be welcomed by social workers in adults’ and children’s services alike. We know from our training, practice and evidence that an appreciation of life story and family history are crucial to understanding mental wellbeing and distress. The report returns repeatedly to the themes of working well with families stating: ‘….services urgently need to be based on a family-centred approach, not divided up between children and adolescents and adults...’ (p108)
Because social workers work at the boundaries of the environment, social relationships and emotional wellbeing, we have always understood the profound impact of trauma, abuse and deprivation on wellbeing and mental welfare. This is something that prevalent ‘illness’ models of mental health have often sidelined, but in this report the significance of trauma is given strong emphasis. Consideration of the shape and organisation
of secondary services is left to last in the report, as it focuses first on the themes of public mental health, trauma, equalities, prevention, family and early intervention. Here it is unequivocal about the
Dr Ruth Allen is director of social work at the SW London and St George’s Mental Health Trust and chair of the Social Care Strategic Network for Mental Health
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‘care coordination’ role within the Care Programme Approach itself – a role often taken up by social workers, alongside nursing, occupational therapy and other colleagues. In this vision of the future, that role would go – with training – to the voluntary sector, community interest companies, social enterprises etc. It is these agencies and practitioners that the report sees as having the creativity, lateral thinking, impartiality and energy to make the potential benefits of personalisation a reality for people. This proposal is bound to raise controversy and
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scepticism about the ability of the non-statutory sector to manage the risks and demands of care coordination for people with complex and enduring mental health conditions. However, this recommendation helpfully highlights the dissatisfaction with the current system. Social workers and local authorities could take this as an opportunity to reposition an enabling social work perspective within multiprofessional services. Social work should be an influential and distinct voice within mental health services, arguing for creativity and a whole-person approach, a key proponent of recovery focus. This information-rich report paints a compelling
‘whole system’ picture of the mental health challenge now. How to complete the revolution? Some of the insights and solutions offered might be enthusiastically embraced by social workers. There is a lot in here that we can use to reclaim the importance of our social perspective and our non- clinical focus on the empowerment of people with mental health problems. SWM