In mental health, the role of the social perspectives of care – the very approach that underpins our training as social workers – is under threat.
That will come as little surprise to many, if not most, social workers. We have warned about the creeping dominance of medical approaches for years. But now even high profile medics and psychiatrists are concerned that the influence of social perspectives in mental health is being eroded, to the detriment of people who use our services.
For example, a recent report by the Schizophrenia Commission stated: “We heard far too many cases where the social element has been lost in treatment and support planning. Occupational therapists, social workers, peer support workers and chartered psychiatric nurses have a crucial role in not letting health concerns eclipse the social dimension of mental illness.”
Time to defend the social perspective
Social workers, colleagues and the people who use our services need to defend and assert the social perspective in mental health. That’s why I was really pleased to be elected, alongside Patsy Staddon, as co-chairs of the Social Perspectives Network (SPN) last month.
A decade ago a group of likeminded people, concerned that social approaches were not getting the attention they deserved in mental health services, got together and starting talking. Out of those talks the SPN came into being.
Much has changed in mental health in the 10 years since the SPN published its first paper. But what remains is a group of committed and enthusiastic people from a whole range of diverse backgrounds, united in the belief that social perspectives are the key to responding to mental distress in its various forms.
The last few months show exactly why that commitment is needed. We’ve seen stories about the lack of mental health beds, the unlawful detentions of thousands of people under the Mental Health Act because some doctors section 12 approvals hadn’t been scrutinised properly, and numbers of section 136 detentions hitting an all-time high.
That is just a snapshot of stories, but none of them give any confidence that the experience of individuals in need of mental health services has led to the improvements that they should have. Social perspectives, we believe, hold the key.
The impact of mental health disintegration
While we would like to say that there is no longer any need for an organisation such as SPN, tha reality, sadly, is still a long way off.
Mental health services continue to be medically dominated. The integration/disaggregation of services – a subject of much debate among social workers – is fuelling the divide, and the impact of budget cuts is being felt most acutely among those in greatest need.
SPN is in the process of reviewing our original mission but we are acutely aware that there is as much need now as there was in the beginning for a critical friend for mental health. Social workers will know only too well that is very easy to get bogged down in politics; meeting targets and avoiding risk, with professionals, service users and communities all buying into the dominant view often because it’s easier than trying to swim against the tide.
But evidence has shown us that medication is not always the answer, and where it is useful it is very rarely a solution in and of itself. So we must continue to wave the flag and fight-the-fight. Mental health is a social issue and social approaches must underpin individual recovery.
Daisy Bogg is a mental health social worker, an approved mental health professional and co-chair of the Social Perspectives Network.