Social work diary: ‘The loss of staff is seeing our team spread too thinly’

By a social worker in a mental health team

Monday

Today started gloomily; a meeting with the director of adult services outlining the devastating cuts to adult social care planned for the coming years. On my return to the office, I am informed that a service user I worked with died over the weekend. The morning was filled with phone calls to the family and the Department for Work and Pensions.

The afternoon was blocked out for completion of a tribunal report. I managed to avoid the requests for duty visits to service users in crisis who have no care coordinator due to long term sickness. Bullets dodged for one day, at least.

Tuesday

I visit a service user on the ward who had taken a significant overdose last week. He is homeless, has a personality disorder and mild learning disability. He is also being exploited by a local sex worker but he has capacity and is refusing intervention. I leave feeling frustrated as is often the case with trying to safeguard vulnerable people with capacity.

I get back to the office to complete a joint social care and NHS funding panel request for a complex dual diagnosis service user. The required information is immense. My brain is starting to frazzle.

I finish my day by visiting a service user in a nursing home with complex needs. She is distressed and very depressed as it’s soon to be the anniversary of a relative’s death. I spend a very intense 45 minutes of trying to help her contextualise her feelings and provide a brief intervention; the core social work skills I enjoy.

Wednesday

This morning I take a phone call from mental health crisis team at A&E. They were visited in the early hours by a service user I work with who has a personality disorder. He was feeling suicidal but received assessment and brief intervention and was returned back to his supported accommodation for me to follow up this morning. We’re trying to break to pattern of admission that is developing, but he is resisting input.

I visit a service user I recently supported to move into a supported flat after years in long stay hospitals and a number of failed shared housing projects. A lot of hard work has gone into this. It reminds me that I can revel in relative successes now and then. The visual change in his demeanour and in him as a person is a joy to experience.

Thursday

Today we have our multi-disciplinary team meeting where we discuss complex cases and screen new referrals coming into the service. Due to cuts in staffing over the last 18 months in particular, we’re all feeling we have a single nostril above the water. None of us are workshy at all, but find ourselves grimacing and adding another case to the unofficial waiting list.

Friday

A busy day; three service users to see today who are on the Care Programme Approach and require regular monitoring of their mental health. These appointments can often require CBT-based approach in order to provide some intervention to maintain stability; medication is only part of the picture.

The late morning and all afternoon is consumed with a safeguarding investigation that raises issues of Female Gential Mutilation (FGM) risk to a child. A strategy meeting is arranged with the police to share information for intelligence purposes at this stage. I make a referral to children’s services to highlight the FGM risk. I’m glad that my investigation will lead to protective action for the child. This keeps me late, but that’s hardly unusual for a social worker! I’m more than ready for a weekend…

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