Mental Health

News, practice information and opinion on mental health social work

Top Story

NHS sign

Mental health staffing problems linked to ward suicides

Research on suicides of patients under observation raises concerns about dependence on inexperienced and agency staff


Cafcass PLUS model promotes better working with parents

The government will provide an extra £25m in 2015-16 to help local authorities manage the pressures on Deprivation of Liberty Safeguards caseloads triggered by the Cheshire West judgement.

The funding, announced today by care minister Norman Lamb, is about one quarter of council leaders’ estimates of the costs of the judgement for authorities and will only be available for one year only, on a non-ring fenced basis.

However, it marks a victory for the Association of Directors of Adult Social Services and Local Government Association, who have argued that the judgement has put local authorities under immense pressure by triggering a ten-fold increase in Dols cases.

In an article for Community Care, Lamb said:

Local authorities, best interest assessors, Dols teams and providers have been working tirelessly over the last year delivering the independent scrutiny of Dols to tens of thousands more vulnerable individuals than in previous years. I pay tribute to their great efforts.”

The Supreme Court’s ruling

The Supreme Court’s judgement in the linked cases of P v Cheshire West and Chester Council and P&Q v Surrey County Council in effect lowered the threshold for what constitutes a deprivation of liberty in care, making many more people eligible for Dols.

The court’s “acid test” said that a person who lacked capacity to consent to their care arrangements was deprived of their liberty, under Article 5 of the European Convention of Human Rights, if:-

  1. they were under continuous supervision and control;
  2. they were not free to leave, and;
  3. their care arrangements were the responsibility of the state.

Considerations laid down in previous case law that had restricted Dols case numbers – for example, by stating that a person was not deprived if their care arrangements were relatively normal for their level of disability – were rendered irrelevant.

Huge increase in caseloads

The result has been a massive increase in caseloads for Dols teams. There were eight times as many applications from providers to deprive people of their liberty in care homes or hospitals from April to December 2014 than in the whole of the 2013-14 financial year, according to official figures. This means average monthly referrals were ten times higher in 2014-15 than 2013-14.

Every Dols application requires local authorities to commission six assessments in order to decide whether to authorise a deprivation of liberty and apply the safeguards required by the Mental Capacity Act to protect people’s rights. Applications should be authorised where a person is, or is likely to be, deprived of their liberty, eligible for Dols, and their detention is in their best interests, necessary to protect them from harm, and a proportionate response to the likelihood and seriousness of that harm.

Mitigating action

The Department of Health, in partnership with the Association of Directors of Adult Social Services and Local Government Association, have taken steps to mitigate the pressures on Dols teams, including:

Councils have also taken steps themselves to mitigate pressures, including by pooling training resources to train more BIAs, diverting social workers from case work to work on to Dols cases and setting up dedicated Dols teams.

£100m shortfall

However, concerns have been raised that these measures may adversely affect the quality of practice, both in Dols cases and in other areas of social work, and Adass and the LGA have continued to warn that councils needed additional resources from government to managed the increase caseload.

In a briefing ahead of a House of Lords debate this month, the two associations said that the shortfall they faced in 2014-15 was likely to be, at a minimum, £96.8m, that this cost pressure would continue into subsequent years and that government needed to fund it in full.

In response to today’s announcement, the associations said it was pleased with the additional resource but that it was not sufficient.

‘Hugely damaging’

“The government has rightly recognised the hard work of local authorities to put people at the heart of decisions about their care,” said the associations. “Referrals of people who lack capacity and have been deprived of their liberty have increased ten-fold since March last year and councils estimate the additional cost to be close to £100 million each year – four times the amount of this one-off commitment. While this remains the case, councils will continue to face difficult decisions about what services need to be cut to make up the gap between costs and funding.

“The LGA and ADASS will continue to call on the government to fully and properly fund any new cost pressures so that councils have appropriate time and money to ensure people are protected by the safeguards. Failure to do this will have a hugely damaging impact on crucial social care services.”

Continue Reading Comments { 0 }
Picture: Marie.L (Flickr - creative commons)

‘Staff are firefighting, service users suffer’: views on the mental health funding shortage

March 20,2015

Social workers, psychiatrists and mental health campaigners give their take on news of mental health funding cuts

Continue Reading Comments { 2 }
Supreme Court UK

Government finds extra funds to help manage Deprivation of Liberty Safeguards pressures

March 27,2015

£25m falls well short of local authority demands but will help manage caseload pressures triggered by Cheshire West judgement

Continue Reading Comments { 0 }
Norman Lamb

Lamb: Why we are providing £25m to help staff deliver the Deprivation of Liberty Safeguards

March 27,2015

One-off investment for 2015-16 will help local authorites use Dols to protect rights of vulnerable people, says care minister

Continue Reading Comments { 0 }
substance abuse

First ever substance misuse framework for social workers launches

March 23,2015

The national substance misuse guidance sets out what social workers at every stage of their career should know

Continue Reading Comments { 8 }
Mobile phone

‘You work with a constant sense of anxiety because you can’t do your job properly’

March 20,2015

A mental health social worker reveals the impact an under resourced mental health system has on frontline staff

Continue Reading Comments { 3 }
A flyer from a mental health event held earlier this month in Manchester

Mental health trust funding down 8% from 2010 despite coalition’s drive for parity of esteem

March 20,2015

Research suggests that NHS trusts' income for mental health services has dropped by 8.2% over past five years despite rising demand

Continue Reading Comments { 4 }
Care home

Deprivation of Liberty Safeguards cases in Wales hit record high in run-up to landmark ruling

March 17,2015

Applications rose by 20% in 2013-14 but will have increased even further in wake of Supreme Court ruling in ‘Cheshire West’ case

Continue Reading Comments { 1 }
Norman Lamb new pic1

Mental health social work fast-track scheme backed by £1.6m of government funding

March 16,2015

Care minister says the Think Ahead scheme will help bring “very best people” into social work

Continue Reading
Albanpix ltd/rex features

Vulnerable children detained in police cells as ‘substitute’ for health and social care

March 10,2015

Review finds local authorities failing to meet statutory duties to accommodate children and raises concerns over AMHP delays

Continue Reading
Picture: Burger/Phanie/Rex Features

Safeguarding fears over children’s mental health bed shortage

March 10,2015

Royal College of Psychiatrists survey reveals doctors' concerns over safeguarding and suicide risks linked to delays accessing beds

Continue Reading
Care and support minister Norman Lamb

Give people with learning disabilities right to a named social worker, says Lamb

March 6,2015

Consultation launched by care minister also proposes changes to Mental Health Act in bid to strengthen rights of people with learning disabilities

Continue Reading
Photo: Image Source/Rex

Social work employers that partner fast-track scheme will get £7,000 per student

March 4,2015

Think Ahead mental health social work scheme invites bids from councils to become 'host organisations' for participants

Continue Reading
Amy Black. Photo: Nottinghamshire police

Coroner criticises police and social care for out of hours failings

March 2,2015

The coroner in the inquest into the death of baby Zoe Black said an urgent social services visit should have been made

Continue Reading
A mental health campaigner's t-shirt Photo: Jonathan Nicholson/Nurphoto/Rex

Government rejected proposals for four-hour waits for mental health emergencies

February 26,2015

Documents released to Community Care show the mental health access standards options that were dropped after consideration last summer

Continue Reading
Friern hospital in 1983. Photo: Alan Denney/ flickr

‘It’s hard not to feel sometimes that this government has a policy of literally driving people mad’

February 19,2015

Historian and author Barbara Taylor describes her journey through the mental health system, and why it wouldn't be the same today

Continue Reading
Photo:Garo/Phanie/Rex Features

Social worker killed herself after fearing she would be discharged from a mental health bed

February 18,2015

A failure to manage Charlotte Faux's perception of her discharge contributed to her death, the coroner said

Continue Reading
Photo: Jane Stockdale/Jorvik Viking Centre

How a Vikings-inspired project is boosting outcomes for people with mental ill health

February 17,2015

Converge, an arts programme for people who use mental health services in York, has teamed up with the Jorvik Viking Centre for its latest project

Continue Reading