Letters published in the 15 October 2009 edition of Community Care

Mental health and homeless people

In the wake of World Mental Health Day we want to highlight the continuing lack of adequate mental health support services for rough sleepers and homeless people in the UK, and those at risk of homelessness.

Research paints a bleak picture. A third of rough sleepers in London are recognised as having mental health problems. The Seeds of Exclusion research from The Salvation Army revealed that more than a third of homeless clients they surveyed nationally had attempted suicide at least once, with around six out of 10 having paranoid personality disorder.

Homeless Link’s national Survey of Needs of Provision shows that a third of clients in homelessness services experience poor mental health, with this rising to 43% of day centre clients. St Mungo’s research points to this being the tip of the iceberg if significant psychological disorders are also taken into account.

How can we continue to allow people with a mental illness to sleep on our pavements? Why do those recovering from traumatic childhoods of physical, emotional or sexual abuse make up such a high proportion of rough sleepers and homeless hostel residents? Why aren’t we able to offer the best mental health treatment and support to those who need it most?

We urge care services minister Phil Hope to include in the New Horizons mental health strategy a commitment that specifically recognises the needs of homeless people – and a commitment that no one with a diagnosed mental illness should be left rough sleeping by 2012.

What do homeless people themselves suggest? From St Mungo’s peer research produced in July, they want more specialist support when and where they need it, through drop-in centres and on-site mental health workers and better tailored long-term care from front-line services working together more effectively than they do now. They deserve nothing less.

Charles Fraser, St Mungo’s ; Leslie Morphy, Crisis; Jenny Edwards, Homeless Link; Howard Sinclair, Broadway; Jeremy Swain, Thames Reach; Major Ray Irving, Salvation Army

Anna Gupta’s misconception

I can’t imagine many would argue with Anna Gupta when she explains that the removal of a child from their birth family is a huge professional responsibility for a social worker, but she goes on to say that ‘professionals have to balance the competing needs and rights of the child, their siblings and their parents’.(“We’ve got the balance wrong”, 8 October, https://www.communitycare.co.uk/112764).

This is not only incorrect, but also a common and dangerous misconception which we must quash. The Children Act 1989 is clear; the welfare of the child is the paramount consideration. This principle is woven inextricably into the whole act and is broken down into ‘the welfare checklist’. This says that the child’s wishes and feelings must be considered (but not above their welfare) whereas, most importantly, the parents wishes and feelings are not to be considered, just their capacity to meet the child’s needs.

It is not the law which is wrong, simply our failure to follow its principles. My comments on earlier intervention, which have been welcomed by the media and social workers, are centred around enabling social workers to be braver when making these complex decisions. However, it is not surprising that social workers may be emotionally swayed by parent’s wishes and feelings when this erroneous approach is reinforced by a senior university lecturer in social work.

Martin Narey, Barnardo’s chief executive

Will Deidre recant?

Deidre Sanders has now been a member of the Social Work Task Force for a number of months (news, p8, 8 October, www.communitycare.co.uk/112754).

During this time, by her own account, she states she has been able to speak to many social workers and therefore must have had the opportunity to learn much about the difficulties of child protection work.

In the light of this is she now prepared to condemn the aggressive reporting in The Sun of the Baby P case? If not then she has learned nothing and is in no position to build any bridges and should not be invited to the GSCC conference.

Andy West, Child care social worker


Cafcass cuts hit frontline

I see the situation at Cafcass rather differently to how chief executive Anthony Douglas sees it (news, p7, 1 October), www.communitycare.co.uk/112686)

The “deleting” of the three corporate director posts merely returns Cafcass to the position it was in prior to its last re-structure when the three corporate directors were operational directors.

Meanwhile, the number of people leaping on the gravy train in backroom services continues to grow. The human resources department has expanded to 35 staff (one per 57 staff when the civil service average is one per 300 staff) and the number of people in the IT department has increased four-fold during the past year.

Practitioner vacancies in the south area are frozen and training for practitioners throughout the country suspended. Practitioner capacity is reduced in London by not using self-employed staff. This reduces staff by 50%. None of that adds up to the frontline being protected against cuts.

While the increase in proceedings following Baby P is part of the cause of the backlogs, it is not the only one. During the past year the priority at Cafcass has not been tackling backlogs. It has been achieving good Ofsted reports. Practitioners now spend most of their time maintaining perfect records and much less time with children.

The simplistic solution in London has been to blanket-allocate seven new cases to all London practitioners who have been waiting for the promised detailed guidelines telling them what they should and should not be doing so that they can cope with the additional cases.

Thus far these include vague suggestions about talking to people by telephone rather than visiting them, and not attending local authority meetings.

The solution of senior managers at Cafcass to the crisis they and Ofsted have largely created is to dump more and more work on practitioners and service managers, leaving them to either work way over the hours they are paid for, or do an inadequate job.

Paul D Bishop, National vice-chair, Napo

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