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Making sense of mental health problems
Making sense of mental health problems

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4.1 A social worker’s perspective

Figure 7 Owain from the interactive ‘A Support Net [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] ’ which is associated with this OpenLearn course

Social workers tend not to play a key role in psychiatric diagnosis and are likely to start working with service users after they have been assessed by a medical professional (most likely a psychiatrist). However, some social workers are appointed as AMHPs (a role that can also be filled by some mental health nurses, occupational therapists and practitioner psychologists). An AMHP (as they are commonly referred to) takes part in assessments where the likely outcome is detention or compulsory treatment under the conditions laid out by mental health legislation. As highlighted by Dr Sarah Matthews and colleagues, social workers are thought to be well suited to the work of an AMHP, as their professional skills include the assessment of the effect of social factors, skills which are acquired via their social work education, and it is upon this educational foundation that the AMHP training is based (Matthews et al., 2014). Although most AMHPs are social workers, they do not tend to undertake AMHP duties full-time once qualified. Their role as an AMHP is to provide a balance to that of the medical practitioner who is also involved as a ‘responsible clinician’. 

Social workers who are AMHPs (as well as social workers who are not AMHPs) will undertake a range of other professional duties. For example, social workers will work with a range of vulnerable people, many of whom may have mental health problems, but not at the level that would require rather intensive support (e.g. a hospital admission). In carrying out this work they will assess their client’s or service user’s situation and their needs, such that social workers in community mental health teams can be involved in producing a care plan based on an assessment of the service user’s needs (e.g. by conducting a Camberwell Assessment of Need – a type of need assessment).

Activity 9 A social work perspective

Timing: Allow about 1 hour

Spend some time looking at the websites cited below in order to explore the social work approach to mental health, so that you have a clear understanding of the context in which this practitioner operates. As you read, make notes on what you see as the key features of what a social worker might offer to someone with a mental health problem. Whether or not you already know much about the role of a social worker, it would be useful to think of the notes as an aid that could be used to inform a group of people who are unfamiliar with social workers' involvement in the mental health field. 

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As your notes may reflect, social workers have the opportunity to take a holistic view of their client’s or service user’s situation. They may share an interest in the psychological formulation approach in which the ‘story’ or narrative of the person experiencing mental health problems is felt to be a valuable tool in working out what to do next. Social workers can also help with practical aspects of a person’s life, such as their housing and financial needs.

Social workers who are qualified as AMHPs have a particular role to play when assessing whether someone should be detained and treated against their will under the terms set out in mental health legislation. However, social workers (many who are not AMHPs) also provide support to people who are not being treated compulsorily. In the next activity you will have the opportunity to hear from a social worker about how they would work with someone like Mandy.

Activity 10 A social worker’s approach

Timing: Allow about 40 minutes

Following on from the group discussion in Activity 2, you will now discover more about a social worker’s analysis of Mandy’s problem.

The social worker’s view: Sonji Mitchel

Figure 8 Sonji Mitchell

As you read Sonji Mitchel’s comments, keep in mind what you have written about Mandy in Activity 1, revisiting your notes if necessary, and view this not as a passive learning exercise but as an active experience in which someone else in the room is giving their view on a situation for which you have already formed some opinions. As you read what she has to say, think about and note down key ideas covering the following points:

  1. Where does the social worker’s approach agree with yours?
  2. What has she introduced that had not occurred to you?
  3. What aspects of her approach would you like to challenge?
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In the next section you will look again at what could be argued is the dominant mode of assessing mental health problems – psychiatric diagnosis. You will also consider some alternatives to diagnosis.