Open Forum

Under the care programme approach (CPA), social workers are directly involved in treatment of mental illness. I work in a community mental health team and all professionals in the multi-disciplinary  team share the title of care coordinator to provide client-centred care, at least in theory.

But the CPA tends to be interpreted and implemented in a narrow fashion and I am party to this practice. However, in reality, CPA can make a difference if social  workers take the time to revisit the spirit behind it.

The multi-disciplinary team is potentially a rich resource providing clients with varied world views from which to choose the model that suits them best. So, for example, a woman suffering from depression might attribute it to chemical imbalance and benefit by taking anti-depressants. Or she might attribute it to the way she relates to people and seek treatment via counselling. This approach does not undermine any one particular method but presents the choices necessary to make a tailored care plan.

The process of recovery is largely guesswork. Was it the medication, the day centre, the part-time job, or the pet, which helped? Or everything? In a client-driven plan, there is not so much guesswork and more emphasis on facilitating this process of discovery.

So if a person is having panic attacks, the assessment can identify systems that make the person feel both anxious and helpless.

Community mental health teams work largely within the medical model which ignores the crucial link between social deprivation and mental illness – 80 per cent of people on my caseload receive state benefits.

In my practice, I encourage people to monitor the effects of medication or any other treatment. This helps them gain more insight and control regarding recovery. I often hear the refrain “the doctor knows best”.

Rather than reinforcing this state of disempowerment, I see social work as  informing people about choices and rights.

Raksha Sidhu is a mental health social worker, Kingston Council, London

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