Kate Karban looks at how mental health inquiry reports can inform the debate on mental health law reform and Trish Durkan on pressures on pregnant teenage women.

Mental health inquiries

A review of mental health inquiry reports, drawing out
implications for mental health social work

The reform of the Mental Health Act 1983 looks likely to alter
the role of the approved social worker, and in addition to these
possible changes, within the wider context of the shifting
configuration of health and social care services, the future of
mental health social work may also be open to question and
reappraisal.

This report features a review of mental health inquiry reports,
which highlights a number of implications for social work. In doing
so a number of important issues are raised concerning the role and
the professional identity of mental health social workers in the
multi-professional arena.

Key issues raised include:

– Their role in assessment, especially risk assessment, although
the authors rightly add a caution concerning the search for
certainty in predicting dangerousness and risk.

– Interprofessional communication (a key theme running through
many of the inquiry reports), and the need to promote and maintain
links between adult mental health and child care services.

– Relationships between service users and professionals, and the
contested territory of work with relatives and carers, which
Manthorpe and Stanley suggest has been “captured” by nurses.

The importance of the social work contribution to
anti-oppressive and ethnically sensitive practice in relation to
mental health is also raised, although it is suggested that
knowledge regarding race and mental illness has had only limited
impact on mental health services and there is more that needs to be
done. However, the impact on practice of limited resources and
caseload size are acknowledged.

This work makes a serious contribution to the debate on the
future of mental health social work. The inquiry reports offer a
valuable resource for anyone involved in mental health social work,
and as Stanley and Manthorpe assert, they provide a range of
evidence to support the unique and valuable contribution made by
social work to mental health services.

Source: N Stanley, & J Manthorpe, “Reading mental
health inquiries”, Journal of Social Work 1(1),
2001

Kate Karban is senior lecturer in social work &
mental health, school of health and community care, Leeds
Metropolitan University.

Teenagers, abortion and pregnancy

A qualitative study exploring the influences affecting teenagers
when making decisions around pregnancy and abortion

This study by Tabberer and her colleagues explore teenagers’
views on pregnancy, particularly the decision-making processes
involved in determining whether or not to continue with the
pregnancy.

The research focused on participants from Doncaster, chosen for
its high teen pregnancy rates, poor educational standards and
social deprivation. The project sets the scene by describing the
national problem and local epidemiology, then details the research
undertaken, followed by consideration of the findings and the
implications for future policies.

The research was conducted in four stages: 10 focus group
interviews with non-pregnant 13 to 26-year-old females drawn from a
variety of locations; individual interviews with 41 women who were
or had been pregnant under 18; seven focus group interviews with 14
to 20-year-old males, who had never being fathers; and 13
individual interviews with parents of teenagers who were not
pregnant.

The main finding was that decision-making and choosing to follow
through with a pregnancy is a complex process that depends on
interaction with parents, boyfriends, peers and wider
community.

The work is valuable in that it identifies the need for policy
makers to direct resources at supporting teenagers as early as
possible within their decision-making process (through
multi-professional input), and particularly regarding abortion, as
this was found to be the hardest decision for them to make due to
socio-cultural factors.

Source: Sharon Tabberer et al, Teenage Pregnancy and
Choice – Abortion or Motherhood : Influences on the Decision,
York Publishing Services, 2001

Trish Durkan is a senior lecturer in the school of human
and health sciences, University of Huddersfield.