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Top 500 Contributor
wizard Posted: 13 Apr 2010 6:34 PM

I'm currently on placement in a CMHT but I'd like to gather others thoughts on how the different professionals in their team/s come together.  Is there harmony, conflict?  How do the social and medical models of mental health mesh?  Does the medical model dominate, if so, to what extent? 

I'd like your thoughts in order to compare your own experiences with mine.

 

 

 

 

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Yeah I am also currently on placement in a CMHT. What i have found out is that social workers are required to diagnosis the service user if they carry out an assessment. They have to know the anti-psychotic drugs and come and feed back in the clinical meetings what the service users needs are/ is it depression/ dementia. the use of some of the tools such as the MMSE. which is to me the whole system is based on medical model and as they say is genetic workers.

Top 25 Contributor

wizard:

I'm currently on placement in a CMHT but I'd like to gather others thoughts on how the different professionals in their team/s come together.  Is there harmony, conflict?  How do the social and medical models of mental health mesh?  Does the medical model dominate, if so, to what extent? 

I'd like your thoughts in order to compare your own experiences with mine.

 

 

 

 

 

 

generally not good. interpersonal relationships are much the same as any workplace.

as you will see on this forum the medical model is utterly castigated and generally mocked by s/w's and the framework and models that s/w's work within is derided and mocked by the 'medical' staff (nurses,dr's etc.). in our cmht the s/w's do their own thing, the dr's and nurses do their own thing and the fights begin when they have to thrash something out.

joint working, mostly, is a sham.

Top 10 Contributor

I think it works well for individual cases when some one person is clearly "in charge" for that case, and their view is repected and accepted as over-riding. Health professionals, especially Doctors, find it difficult to be "told" by someone else, but over time they come round, provided the social care professionals deliver high quality work.

 

 

Top 25 Contributor

surfer:

I think it works well for individual cases when some one person is clearly "in charge" for that case, and their view is repected and accepted as over-riding. Health professionals, especially Doctors, find it difficult to be "told" by someone else, but over time they come round, provided the social care professionals deliver high quality work.

 

 

 

 

this is indeed the case, some individuals are more accpeting of being told what to do than others and you do need a primary care 'manager' for each case. it is pretty commonplace though for a s/w to throw the rattle out of the pram when the cpn is the care manager and tellinng the s/w what to do and dr's respond less well to being told what to do. is'nt joint working greatStick out tongue

Top 10 Contributor

I'm not at all sure that SWs are touchier than CPNs. Anyone care to comment?

Agree with you about Doctors!

 

 

Top 25 Contributor

surfer:

I'm not at all sure that SWs are touchier than CPNs. Anyone care to comment?

Agree with you about Doctors!

 

 

 

 

i hve to reluctantly admit that i have seen more strops from s/w's than cpn's when another doscipline is in charge of a case/situation. i have to say as well that s/w's do not respond as well as cpn's/health visitors when another discipline does not do what the s/w has suggested.

i thankfully very rarely get wound up.

but still at no.1 are the medics.they take hissy fits when they don't get their own way. 

Top 50 Contributor
Female

Mavu:

Yeah I am also currently on placement in a CMHT. What i have found out is that social workers are required to diagnosis the service user if they carry out an assessment. They have to know the anti-psychotic drugs and come and feed back in the clinical meetings what the service users needs are/ is it depression/ dementia. the use of some of the tools such as the MMSE. which is to me the whole system is based on medical model and as they say is genetic workers.

it's not like that in my cmht where i work, social workers do not diagnose they do assessments like the rest of the team and we can say what we think maybe wrong with the persons mental health but social workers should steer clear of labelling as much as possible - labelling theory. Psychiatrists normally do the diagnosing or psychologists and its something that cannot be done in a one off assessment, we do have to know about different medications that are used so we can help service users make informed decisions about medication they are on or maybe offered.

 i see my role as a social worker in a CMHT as amongst other things helping service users and carers identify needs and empower them to find solution's to any issues / problems they may have, the team is based mainly on the medical model due to the fact that there are many nurses and doctors in the team but that is why social workers are there to ensure the social model is taken into account, that is why its important SW's in a mental health team need to be confident enough to contribute and challenge where necessary, challenging and throwing your rattle out of the pram are different although they may not be interpreted as so

Not Ranked

I am writing my MA dissertation on the effect that the role change from Approved Social Worker to Approved Mental Health Professional (that you no longer need to be a social worker to take up this position) may have on service users, (positive and negative). I thought the discussion about the medical/ social model and how this works in multi disciplinary teams interesting and supporting a lot of what I have read, does anyone have any comments, thoughts or experiences about this subject? do you think that this role should be taken by a social worker, will it harm the profession, will the service user lose an autonomous, social assessment or is this move needed to enable more people to take up these positions and benifit the service user in increasing the worforce and bringing different perspectives to assessment etc...?

Thanks for any comments.

Top 500 Contributor

An AMHP is trained in the social model irregardless of professional background.

Top 25 Contributor

daz:

An AMHP is trained in the social model irregardless of professional background.

 

 

and the 'medical' staff are trained inthe medical model. and we wonder why joint working doesnae work..........................

medical miodel is best, no, social model is best, no medical, no socail, no medical, no social,no medical, no social.......................

medical model is oppresive, social model removes responsability...........yaddayaddayadda

Top 100 Contributor

I'm sure I don't work in the only functioning MH MDT in the country!

Having a fixed model is saying that all of our service users are the same.  Quite clearly not the case.

Have an open mind, don't reject outright a model because you disagree with it; reject it if it doesn't meet the service users needs by all means.

In any case you need to define what you mean by a specific model.

Not Ranked
I gave up my ASW role when the new Mental Health legislation became law and I have serious concerns about the ability of other disciplines to act independently of, or stand up to, the assessing psychiatrist - many of which will try and bully the ASW/AMHP into signing the papers. The primary role of the ASW was (and still is) to consider all the options and if, and only if, there was no other means of managing the risk to patient and the community use the mental Health Act to detain that person against their will. I think that the Social Worker was the best person available to fulfil this task primarily because few others have the extensive knowledge of local community resources or the ability to commission services. Social workers are usually employed by local authorities and do not see the psychiatrist as the boss - nurses, cpns and psychologists do and they almost always defer to the psych's wishes ! I wish ASW's had stood up for themselves more when the amendments were being discussed. The role of the mental health worker is slowly being eradicated and it is mainly the fault of the social work profession. In my trust CPN's are writing and presenting social circumstances reports to the Mental Heath Tribunal even though they have little understanding of how someone's social background influences mental health and recovery. Most of the social workers thought this was wonderful news because it was one less thing to do - they are not so happy now that managers are reducing the number of social workers because they "do nothing that a CPN can't do!". It is the service user that suffers.
 
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