A Mental Health Social Worker

the Mental Health Tribunal

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today was my first experience of a Mental Health Tribunal, it was an anxiety provoking experience for me and so i can only imagine what it must be like for service users.

i was there with two hats on, one as a social worker who prepared a social circumstances report and the other as the servce users care coordinator.

i will begin with the social circumstances report, initially i  wrote this at the end of the last year, the service user concerned is subject to a supervised community treatment order   and at the end of the summer she became unwell and was recalled to hospital as a condition of the order. it was then revoked and turned back to the original section 3, as it was revoked the rules dictate that the case then automatically gets sent to the tribunal, the tribunal was then all set to go, i wrote the report and then for circumstances beyond anybodies control it could not go ahead. the service user was then discharged and the CTO was reinstated however as the rules state the tribunal still needed to go ahead and i had to rewrite the report as the service user was no longer an inpatient and back in the community doing really well. the report felt harder to write as the service user was in the community, we have a proforma in our agency that we can use for the report but that is as an inpatient so i had to adapt so it was suitable for the community. writing the report which was five pages long reminded me why i wrote so many essays and why it is so important that we as social workers can write at degree level with good grammar and spelling, it had to be a professional piece of work as it was scrutinized by the panel. 

the actual tribunal was a strange affair, its there to protect the rights of the service user however it was an hour and a half of fairly intense conversation and at times the service user was discussed like she was not in the room and that she was deficit in some way, there  was a lot of medical langugae and labelling going on, the service user did have their say however when asked questions such as do you think the support you get from your care coordinator is satisfactory when i am sat in the room does not really give them the chance to say no, i said this afterwards to the solicitor but he said that people do say no sometimes but i still think that service users can  get worried that if they say the wrong thing they may affect the support they recive in some way.  i have read research concerning how service users feel their views are interpreted and some believe that if they complain then services ,may be removed or they wont be believed as they have a mental illness.

the tribunal for people who don't know consists of a tribunal judge, a tribunal psychiatrist and a lay person. as it was in the community for a CTO  there  was also myself who was the author of the social circumstances report, the RMO which i think stands for registered medical officer, the service user and their solicitor, the RMO also submitted a report and the solictor who had met with the service user previously spoke on their behalf. i was hoping it would be an empowering process for the service user, protecting their rights but it did not feel like that and when i asked the service user they said they found it disempowering and depressing listening to people talk about her like she was unable to make descions for hierself and reminding her that she was mentally unwell.

i am sat here wondering if i would do anything different next time and at the moment i cannot, i am not saying my performance was faultless but it is a fairly perscriptive process and there is not much room for error.

 

 

Comments

Zander said:

Hi,

I found this an interesting read. I'm a social work student on placement as a Independent Mental Health Advocate. I truly understand and empathise about even the best intentions within this process can make it dis-empowering for the service user. Usually at mental health review tribunals my role is one of mainly supporting the client in the process and preparing them for it.  

# February 18, 2010 9:16 PM

lizzer said:

thanks for your comment, your placement sounds interesting, is there enough work for you to meet your NOS?

what do you think of the tribunals you have been to?

# February 18, 2010 10:18 PM

Zander said:

Yeah there is plenty to meet my NOS in ward rounds and a lot of the other areas where I can fully participate on behalf of the client. Main difference is learning not to work in in the individuals best interests but in the interests of the clients expressed wishes. That's where issues with the NOS and COP can be tricky. All the tribunals I have been too no matter the outcome always seem to end with the service user feeling rather uncomfortable. Whilst as IMHA we have no real role in tribunals or participation, just one of moral support.  

# February 19, 2010 4:42 PM