Mental Health Social Work in Transition

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• Mental Health Social Work in Transition
• Peter Huxley PhD
• Sherrill Evans PhD
• University of Wales Swansea

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Transitions in social care 1996-2004
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Transitions in social care 1996-2004
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Transitions in social care 1996-2004
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Transitions in social care 1996-2004
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• Health Care Social Care
• NICE SCIE
• GMC , GNC GSCC
• Skills for Health Skills for Care
• Health Commission Commission for Social Care
  Inspection

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UK Mental
Health Services

• Health and Social Care Integration

Mental Health Services
Social Care Services
MHSW
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UK Mental
Health Services

• Health and Social Care Integration

Mental Health Services
Social Care Services
MHSW
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• Burns and Lloyd (2004)
• Multidisciplinary teams in mental health have
  developed in parallel with the demise of large
  asylums in the developed world.
• Their growth has been pragmatic, largely
  atheoretical and relatively unresearched,
  reflecting the clinical view that input from a
  variety of professions is required to meet the
  needs of people suffering from mental illness.

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Burns and Lloyd (2004) There are important
international variations in the composition of
mental health teams. In the United States and
German-speaking countries, for example, many case
managers are social workers, whereas in
Scandinavia and the United Kingdom they are more
likely to be nurses. The practices, structure and
leadership styles of these teams are inevitably
affected by their composition.
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CMHT
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Assertive Outreach Teams
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Early Intervention Teams
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Rehabilitation Teams
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Crisis Resolution Teams
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MHSW national survey
Results Staff retention

• 28 strong or very strong desire to leave
• 21 had specific plans to leave
• Having a strong desire to leave is associated
  with ASW status
• 33 ASWs cf 19 non-ASWs (?29.5(3) plt0.05)

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ASWIG/BASW Consultation Exercise

• Plans to leave
• National survey 21
• ASWIG/BASW 25 / 26.4
• Trust employed 28

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ASWIG/BASW Consultation Exercise

• Of those planning to leave
• Retire 48
• Other social work 31
• Education 11
• Others (chocolate shop, cattery, dry stone
  walling, electrician)
• Only 2 plan to go abroad, emigrate to Perth

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• Transition
• Approved Social Worker interest groups/forum
• Social Perspectives Network
• Inter-organisational support groups (eg London
  Commissioners)
• CSIP/NIMHE Social Inclusion Programme
• CSIP/NIMHE Social Inclusion Research and Evidence
  Coalition
• CSIP/NIMHE research groups, eg employment

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• Transitions
• Rick Bienecke
• Transitions leading to increased demand for
  mental health social workers and a
  bio-psycho-social perspective
• Increase in the proportion of chronic illnesses
  and
• More diseases with social and environmental
  determinants
• greater focus on outpatient care for clients with
  increasingly more severe illnesses
• more emphasis on mental health care in primary
  care settings
• greater integration of primary care and
  behavioral health
• improved neurobiological diagnosis and more such
  interventions with social consequences
• the explosion of genetics and need for genetics
  counseling and treatment
• the consumer movement and individualised payment
  systems

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• These changes will demand knowledge and skills
  in
• program planning
• administration and financial management
• ethical decision making
• biomedical information including medications and
  medical terminology
• comprehensive biopsychosocial assessments
• Training programs will need to teach these skills
  
• (Volland, Berkman, Phillips, Stein, 2003)

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• Planned growth is very different in the US to the
  UK why is the pattern as it is?
• Will the new UK degree promote professional MHSW
  or will it be like the Russian experience?
• Will a career path clinical supervisor/consultan
  t role be developed?
• How will the introduction of individual budgets
  alter the SW role?
• Continued public sector decline including health
  related social work continued growth in the 3rd
  sector how integrated?

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• Mental Health Social Work in Transition
• Peter Huxley PhD
• Sherrill Evans PhD
• University of Wales Swansea

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• New Ways of Working
• The Support Time Recovery Worker
• Bill Davidson
• Sarah King
• Impact Research

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• Workforce Action Team (2003)
• Support Time and Recovery Workers
• based on consultation with service users
• staff working in support roles not highly
  valued or supported
• people from diverse backgrounds had potential
  to fulfil role
• workloads of existing front line staff
  increasing
• existing staff having to find a balance
  between spending time with
• service users and other requirements of
  their role

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• The Mental Health Implementation Guide (DoH
  2003)
• STR worker role
• negotiated time with service users
• providing appropriate support so aiding their
  recovery
• workers should have an education and training
  pathway
• work in a variety of health service settings
  across all traditional barriers
• operating as part of a team
• under supervision
• contribute to individualised, flexible and
  holistic care
• work focuses on practical help empowering service
  users to live ordinary lives.

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SUPPORT TIME RECOVERY WORKERS
IMPLEMENTATION EVALUATION

• The Changing Workforce Programme (CWP)
  facilitated 7 initial pilot sites in setting up
  the implementation of the STR Worker Programme,
  assisted by 2 National Project managers
• Evaluation in 3 pilot sites
• Each of the 3 pilot sites organised the
  introduction of their
• STR Workers in a different way.
• 21 of the 38 STR workers employed across the
  three
• sites were interviewed (55), along with 16
  service users.

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