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From time immemorial, social science literature has documented welfare policymakers’ concern and interest in the psychological and emotional health of the UK’s citizens as influenced by family life (Land 2021, Abueng 2020, Aviv et al. 2021). This history has been depicted by contemporary research evidence, providing a clear picture of increasingly changing family characteristics in the UK and across Europe over time (Levin et al. 2022, Younghusband 2021).
In the United Kingdom, social workers with a formal responsibility to provide mental healthcare are primarily paid or employed by local governments to guarantee that they carry out their duties and responsibilities to local mental health systems (Land 2021, Abueng 2020, Aviv et al. 2021). According to Yip (2005), this means that social workers providing statutory services must ensure that anyone in need of social care facilities and benefits has access to them—effectively serving as gatekeepers.
Social work is an integral part of mental health care. As per Beasley et al. (2021), a well-managed social service may significantly improve the health and well-being of people experiencing mental health problems, making it a critical component of multiagency and interdisciplinary systems of care. Tudorel and Vintila (2018) said that there has been a desire for more clarity about the social work profession, its responsibilities, and its goals in the mental health field. This includes social workers, educators, employers, and other professionals.
In England, one in six children aged 6-16 is likely to have a mental health problem in 2021, up from one in nine in 2017. The current statistics for female young people aged 17 to 19 are particularly alarming: One in four were likely to have a mental health problem in 2021 (Levin et al. 2022). Since 2017, this increase in prevalence means that an estimated 500,000 young people aged 6 to 16 with a probable mental health problem require the support of child and adolescent mental health services (CYPMHS). Although the underlying causes are complicated, increasing ignorance about mental health problems, social isolation and disruptions to family and school life have undoubtedly played a role in the epidemic (Aviv et al. 2021).
But health social workers and governments have been criticised for too little or too much interference. Nonetheless, there is an increasing consensus among scholars that the behavioural and emotional lives of children and young people require more understanding and support than ever before. The increased severity, volume, and complexity of modern child and adolescent mental health problems has attracted much more concern and increased efforts to intervene. This study seeks to evaluate the role of social workers in caring for children with mental health issues. The study will be organised into chapters as follows: Chapter 1 includes an introduction to the study and background information. Chapter 2 includes the research methods and methodologies used to achieve the research objectives, while Chapter 3 presents the findings of the study. The findings will be covered in chapter 4, while chapter 5 will include discussions and conclusions from the study.
This study focuses on mandated, specialised social work in mental health with children and adolescents, notably those employed by local governments or the National Health Service. However, the concepts covered are applicable to mental health social work with other populations and in other situations. It is hoped that this study will serve as a resource for social workers in settings such as mental health services for all people with mental health issues, services for people with learning disabilities, and other mental health settings for children and adolescents. Indeed, this paper acknowledges that social workers transcend age and other barriers in their everyday practise, dealing effectively with the linkages between people and their difficulties in family and social contexts.
Social workers are increasingly employed in third-party organisations, social businesses, and the corporate sector. Diversified sorts of social care organisations may offer new chances to satisfy people's needs and to develop innovative responses in collaboration with citizens. Even though social workers in these circumstances may not wield statutory authority, the practise emphasis and priorities outlined in this study are applicable to them.
Social workers providing statutory child and adolescent mental health services are most frequently employed or paid by local governments to ensure that their duties toward individuals with mental health problems are satisfied and to contribute to the broader mental health support system. This implies that social workers in statutory services guarantee that eligible individuals have access to social care services and resources and frequently serve as gatekeepers.
However, mental health social work is about more than just the prudent deployment of scarce public resources. Social workers have a long history of utilising their professional talents to engage in cooperation with individuals and communities, frequently in extremely challenging contexts, to protect human rights, encourage self-determination of solutions, and empower individuals to effect change. Even when social workers employ statutory powers vested on them (for example the Mental Health Act), they should do so from a humanising approach that anticipates the possibility of change, always aiming for the least amount of restriction and interference in liberty possible under the circumstances.
Social work gives to mental health a unique social viewpoint. This entails acknowledging the social antecedents and drivers of mental distress across the life course, such as loss, abuse, and trauma, as well as childhood and adolescent experiences, which are sometimes overlooked in strictly medical, illness-based approaches. It also requires recognising how illness-based and medical paradigms can impede recovery and change by focusing on the illness rather than the person as a whole – their inherent human potential and the opportunities they must effect change.
Social perspectives are also anchored in the importance of service users' knowledge of their own experiences and requirements. Utilizing empathy and relationship-building abilities to hear and understand through the perspectives of the service user and their family is a common component of social work practise.
People respect a social work strategy that challenges the larger barriers they confront; they place a premium on the social approach, the social work relationship, and the personal traits they associate with social work. These include respect, warmth, non-judgmentalism, attentiveness, treating others with equality, trustworthiness, openness, honesty, and dependability, and effective communication. This shows that social work can contribute significantly to the mental health sector by humanising and individualising mental health treatments, involving service users, their caregivers, and their families, and by challenging the institutional, objectifying norms of certain clinical approaches.
Good social work is frequently characterised by the capacity to preserve its humanistic and compassionate approach even while working with extremely complicated settings of social need and risk, including the balance of competing perspectives and rights. In such circumstances, a high level of social work expertise and knowledge is required.
Frequently, social workers face complexities that touch not only people, but also entire families and broader social networks. It is perhaps appropriate to emphasise the significance of family-focused social work practise currently. The profession's profound understanding of the significance of family relationships, as well as the problems and complexity of family life, is central to our mental health expertise, as well as to our expertise in other domains. This includes, but is not limited to, an emphasis on the contribution and needs of mental health caregivers, particularly young caregivers.
In primitive civilization, often known as the "folk society," the broader family or clan supported those whose needs were not provided in the normal way (Laming, 2003). Without parental support, children were placed with relatives or adopted by childless couples. Food was divided among family members and neighbours. As the feudal system gave way to the labour economy over time, laws were put in place to compel the impoverished to work (Scottish Executive, 2002). Begging was punishable by caning, imprisonment, and sometimes the death penalty.
In Europe, during the early Christian era, the folk culture survived, and believers felt it a holy duty to care for those members of the community who were unable of caring for themselves. According to Department of Health, Social Services and Public Safety (2002) religion provided the strongest impetus for philanthropy. The church, particularly the monasteries, became the distribution centres for food, healthcare, and housing. Alms were collected in the parish and given by the pastor and other clergy who were familiar with the persons and their circumstances (Welsh Government, 2019).
The transition from church to government responsibility for aid is initially evident in the prohibitive legislation on vagrancy and begging. Between 1350 and 1530, England created a series of laws known as the "Statutes of Labourers" to compel the destitute to work (Creegan et al. 2006). Thereafter, a series of actions resulted in the famous Elizabethan Poor Law of 1601 because of the declining influence of the church and the increasing desire to shift responsibility to state authorities (Department of Eductaion, 2010).
A Parliamentary Commission intended to amend the Elizabethan and post-Elizabethan Poor Laws in its 1834 report. Based on the committee's recommendations, the following ideas were codified into law: (a) theory of least eligibility, (b) centralization of control, and (c) reinstatement of the workhouse test (Department of Health, 2011).
The rule of least eligibility stipulated that the position of paupers shall never be as eligible as the condition of individuals of the lowest social class who live off the results of their own labour. In short, no recipient of assistance was to be as well-off (Klonowski, 2013). As per second principle, the able-bodied poor could ask for assistance at the public workhouse, but they were ineligible for assistance if they refused to take the workhouse's accommodation and food (Scottish Government, 2021).
The amount of outdoor relief was decreased to a bare minimum. According to the third premise, a centralised authority comprised of three Poverty Law Commissioners had the authority to integrate and supervise poor law services across the nation. No longer would parishes serve as administrative units. Between 1834 and 1909, various modifications to Poor Law legislation had the cumulative effect of shifting the entire system away from the 1834 principles. The most significant modifications were those that initiated the development of specialised care for disadvantaged groups (IICSA,2018). For dependent children, for example, district schools and foster homes existed. these institutions provided for the deranged and mentally ill. Moreover, specialised organisations were established.
The Poor Law Report of 1909 demonstrates a more optimistic approach to the poor laws. The report highlighted therapeutic treatment and rehabilitation over repression, and provision for all in lieu of the workhouse selection criteria. If the principles of 1834 constituted a "foundation of repression," the principles of 1909 may be referred to as a "structure of prevention."
Fast forward to a decade ago, social work for children with mental health has evolved in tandem with the development in child protection policies and regulations. In 2010, the working together guidance was published by the Minister of Children and Families, in which Local Safeguarding Boards were give the responsibility of publishing an overview report on all child abuse and child protection case reviews initiated after June 2010 (Tucker et al. 2021). In 2011, the review led to the development of the A child-centred system, which gave recommendations to the childcare and protection system – including the need to change the child protection system form being over-bureaucratised and compliant-oriented to one that focuses on children by ensuring that their problems are well-identified and addressed. Ultimately, the statutory child protection guidance was reviewed (Martinez et al. 2021). Thereafter, the understanding of the needs of children in Northern Ireland (UNOCINI) guidelines was established to enable social work practitioners working with children to meet the children’s and their families’ needs better (Jones, 2019).
In 2014, the national legislation and guidance in Scotland and Wales, as well as the Jay report led to the establishment of the Social Services and Well-being (Wales) Act 2014, which stood as Welsh own regulatory framework for children and adults social services (Hanley, 2021).
Section 130 of the Act compels "relevant partners" of a local authority to notify the local authority if they have reasonable suspicion that a child is at danger of abuse, neglect, or other forms of abuse. Section 145 grants Welsh Ministers the authority to issue codes of practise that provide direction, priorities, and requirements for the provision of social services by local governments.
In 2017, a UK-wide initiative was launched to address issues of child protection and child social work. The Children and Social Work Act 2017 contributed to several reforms including the Safeguarding Practice Review Panel tasked to review and report on child protection cases and replace the local safeguarding children’s boards model with local safeguarding partners model (Tucker et al. 2021).
Some of Munro's ideas have been implemented, as seen by the development of senior social worker positions and chief social workers in England. The establishment of "advanced practise" settings and "teaching organisation" status for agencies is an unrealized recommendation (Scourfield, 2019). Munro reasoned that placement agencies required to foster a culture of learning and practise to improve students' expertise (FitzSimons and McCracken, 2020). These suggestions undoubtedly link to the core of the Munro review. Munro argued that agencies and their social workers had become preoccupied with processes to the detriment of child protection, making children safe and guaranteeing their wellbeing (Anglin, 2019). It may be feared that creating innovative positions (such as principal and chief social workers) is insufficient to alter the organisational culture and practise. If professional growth is to be supported, organisations' commitment and support to learning are vital.
Michael Gove, the then-Secretary of State for Education, launched the Narey report to evaluate the modifications made to pre-qualifying social work education and to see if additional changes were necessary (Cleary, 2018). Because the Department of Education is responsible for children's social work, the focus was on children's social work (Lucas and Acar 2021).
Overall, Narey remained critical of the initiatives of the Social Work Reform Board. He categorically disputed the definition of the profession provided by the International Federation of Social Workers (2014). Narey noted that the International Federation of Social Workers' definition was 'very insufficient in describing the duties of a children's social worker in England.' (Narey, 2014).
Narey acknowledged that the Social Work Reform Board's Professional Capabilities Framework was useful but said that it required substantial revision to be applicable to children's social work in England. It is possible to claim that Narey's criticism of the International Federation of Social Workers and the Professional Capabilities Framework is predicated on three parameters namely:
Children’s social work in state agencies is child protection, the focus of child protection is maintaining child safety, and that a single social work profession no longer exists (Narey, 2014).
The Social Work Reform Board's modifications were based on a generic single profession, within which the Professional Capabilities Framework reflected the International Federation of Social Workers' definition. The implication of Narey's research is that the assumptions of a single profession founded on human rights, fairness, and human empowerment are irrelev,ant to current social work in children's services in England. Moreover, in statutory organisations, children's social work is essentially child protection. This is demonstrated by Narey's "list of things" that newly certified social workers must know (Scourfield, 2019).
Keeping children safe is, of course, a fundamental aspect of contemporary cultures. However, Narey's conception of child protection may be perceived as a relatively restricted paradigm. The phrase "list of things" (Narey, 2014, p. 10) may suggest that child protection social work in England has a limited scope. The risk posed by lists is twofold: they create the idea of a "common logic" without providing an overarching framework to link them.
Attempts to understand the causes of mental health issues among children and young adults in modern families have been made through social policy discourses across the broad subject of political philosophy. For instance, the patrician right attributes the problems to disrespect of authority and lack of traditional values, while the left (liberals) blames the socially divisive characteristics of capitalism (Lombadi et al. 2019). On the other hand, the libertarian right blames it on the meddlesome welfare of professionals for undermining the individual's choice of lifestyle, leading to stress (Banks et al. 2020). Apparently, all these positions are trying to understand the same predicament and are basing their conclusions on the same pieces of evidence. Whatever the conclusions they make, it is evident that the changes in family life, their impact on children's and adolescents’ mental health, and contemporary environmental contexts are all correlated.
The prevalence of divorces, the increasing number of single-parent households, and increased cases of cohabitation have led to a sense of structural change in modern family life. According to recent statistics, cohabiting couples are the fastest growing family form in the UK. Between 1996 and 2016, their number more than doubled from 1.5 million in 1996 to 3.3 million. Cohabiting couples make up around 17.5 per cent of families in the UK, and this number is expected to rise. (Lombadi et al. 2019). Moreover, the widening gap between the poor and the right illuminates the needs of the marginalised, socially excluded, and disempowered families. Apart from the increased number of mothers at work, the ageing population is increasing the demographic imbalance (Greenberg et al. 2018). The increase in alcohol and drug abuse among youth is also causing homelessness, leading to a sense of alienation and dissatisfaction among children (Walter-McCabe 2020).
These external factors interact with familial factors such as increased prevalence of domestic violence, teenage pregnancy, and child abuse, all of which are considered evidence of the presence of strains and pressures experienced by the modern family. Xenophobia and racism have also increased across the UK and European Union, while population growth has led to increased rates of population migration. Moreover, armed conflict has resulted in an increased number of asylum seekers with social and economic dislocation, leading to more applications for refugee status to wealthier countries (Beasley et al. 2021).
These socio-geographical changes have led to hasty policy changes and moral panics to address the issues described, or at least forced social workers to address the problems associated with such sociological changes. However, services for families and children that attempt to prevent some of the negative consequences of these changes are relatively low. While adult mental health services have relatively been low, despite evidence that there is a link between disturbances in children and their parents' mental health problems, services for child mental health have generally been neglected and under-resourced, especially due to the confusion and ambiguity over who should deliver them and how they should be delivered (Kourgiantakis et al. 2022). Social workers are at the centre of the social, economic, and psychological factors related to child mental health and are therefore well-positioned to work with children and young adults facing mental health issues.
The person-in-context philosophy, the biopsychosocial approach, and social workers’ clinical expertise align well with the role of delivering social care to children (Tudorel and Vintila 2018, Bent-Goodley 2018, Walter-McCabe 2020), especially because such children are faced with complex psychosocial and mental health problems that can be resolved by social work interventions (Lloyd, 2018). Social workers provide a range of services in areas including addictions and mental health conditions, parenting issues, trauma, grief, housing issues, financial stressors, and a wide variety of other psychosocial issues (Johnson, 2020).
Some of the social care activities involved in social work include conducting psychosocial diagnosis and interventions, conducting comprehensive risk assessments, providing various types of counselling, sign posting service users to community resources, facilitating medical provider interventions, engaging in health promotion activities, engaging in care coordination, and improving the relationship between the provider and service user (Kourgiantakis et al. 2022).
The delivery of social work services in the context of children with mental health may be in various forms. They may provide patient care in a face-to-face arrangement, through schools, or through family appointments (Greenberg et al. 2018). Group therapy is another alternative where social workers facilitate a range of therapeutic and psychoeducational therapies. However, Kleinman and Biddinger (2018) observed that in cases where there is no need for face-to-face meetings, social workers can provide indirect interventions. Social workers can also facilitate a variety of activities within the context of primary healthcare related to child mental health, including community outreach and development, training and education, health promotion activities, and formal or informal leadership roles.
Despite the availability of many mental health treatment interventions for children, only a few with mental health issues access these services (Mugumbate and Chereni, 2019). At the demographic level, there is a need for a clearer understanding of the barriers to these services. According to Moudatsu et al. (2020), this can pave the way for the development of solutions addressing these barriers, resource allocation, and service delivery planning.
In the UK, primary mental health care remains the major provider of mental healthcare services, considering the scarcity of socially oriented providers (Celik and Icduygu 2019). As per Johnson (2020), primary care professionals (social care workers included) can easily identify mental health issues and provide initial care in case specialist care is unavailable. That said, in the context of child mental healthcare, there are several stages of help seeking, including the use of primary healthcare, perception problems among parents, mental health problem recognition within primary care, and use of or referral to specialist care (Beasley et al. 2021). This implies that within the child mental healthcare pathway, there are several implications for social work that can be drawn out.
Existing research reveal how social workers play a significant role in enhancing collaboration of care for children with mental health problems. Several of the publications emphasise the significance of teamwork as a means of enhancing the treatment of children and adolescents with complex mental health needs. Collaboration is recognised as a crucial instrument for preventing fragmentation, which poses a significant issue for social service delivery systems (Scourfield, 2019). Children and young people are at danger of receiving fragmented care that does not address their entire needs if coordination of care is not actively pursued. In their study of mental health treatment for children, Pavkov et al. (2012) examine professional attitudes toward other professionals within the care system. They identify barriers to collaboration between various stakeholders. For instance, each stakeholder group may be identified by its financing source, often known as "funding silos." According to Pavkov et al., financial silos drive care providers to safeguard their own organisations, resulting in "competing interests among child-serving systems." They also found a tendency of finger-pointing among the professionals. This indicates that stakeholders from various systems lack a grasp of each system's responsibility, resulting in a propensity to place blame for failures on other specialists. Therefore, extensive structural adjustments are required to motivate diverse stakeholder groups to collaborate towards a similar objective.
Studies by FitzSimons and McCracken (2020) also indicated that challenges may occur when social workers engage with, for example, health providers or psychiatrists, because the various providers lack a shared theoretical framework and could also occupy distinct hierarchical positions. She proposes two approaches for resolving these possible problems. The first is to negotiate cooperation processes. The second includes matching or coordinating treatment methods. Using complementary, congruent, or consistent therapeutic philosophies, according to FitzSimons and McCracken, (2020) may be a strategy to avoid possible conflicts and improve coordination if clinicians approach treatments from a similar framework.
Personal relationships between professionals also have a significant impact on teamwork; they promote the flow of information and referrals, which is beneficial to service coordination, especially over time. According to Anglin (2019) personal interactions between providers are a vital factor in good service coordination.
There are three ways to express collaboration and interdependence, which are pooled, sequential, and reciprocal, as described in (FitzSimons and McCracken, 2020). Pooled interdependence, according to Lombadi et al. (2019), necessitates the least intense connection; it emerges when each service provider works separately, yet the sum of their efforts contributes to the outcome. When various clinicians oversee screening and therapy, sequential interdependencies exist. The third type of interdependence, reciprocal interdependence, occurs when the outcome of cooperative effort depends on providers' ability to alter services in response to obtained or delivered resources. Case management is characterised in Lombadi et al. (2019) to improve the coordination of care services when care is offered by various disciplines or in numerous places. It is used to connect a client to different types of services, serving as a bridge to migrate clients from one service type to another. Case managers can provide care coordination in conjunction with discharge planning and other service transfers. Wraparound is a process of integrating assessment and planning and knits together services from all involved providers to meet the needs of the child and family.
Existing literature also reveal that social workers also significantly engage in relationship building practices when serving children with mental health issues. Studies by Greenberg et al. (2018) and Walter-McCabe (2020) on customer satisfaction among children and young people with mental health needs highlight the association between young people's perceptions of the quality of their professional relationships and treatment outcomes. Young people perceive good quality in relationships as experts relating to them in an ethical and professional manner, i.e., with genuine concern (Cleary, 2018), and in a non-judgmental manner (Lucas and Acar 2021). Strong interpersonal skills may lessen the possibility of practitioners alienating parents and other professionals, so facilitating the process of child support. Identify some essential aspects that contribute to a strong client-staff interaction in youth safe residential care. Positive adolescent-staff relationships are facilitated by those treatment skills among care workers that cause the practitioner to be regarded as someone who demonstrates commitment, stands by the service user, and is dependable. Walter-McCabe (2020) emphasise the importance of professionals' interaction style and relationship building skills, stating that practitioners working with children and young people with mental health needs should informally interact with the service user, indirectly reaching out to them out of the office and persistently connecting with them through alternative means. Additionally, Greenberg et al. (2018) argues that in some instances, the youth's behaviour makes it impossible for professionals to develop positive relationships with the children. Here, the issue is confined to the child, who is portrayed as more problematic to engage with due to "aggression issues" or "antisocial behaviour." According to Walter-McCabe (2020), solutions to this difficulty can be addressed by collaborative efforts amongst professions with diverse areas of knowledge, and on a micro scale, through the interaction styles and interpersonal skills of the professionals. Interpersonal skills, such as social warmth and non-authoritarian communication style, are noted in this study as crucial criteria for good treatment outcomes when a young child is classified as having antisocial tendencies. Certain relationship-focused techniques are based on certain therapies, such as trauma-focused therapy. In trauma-informed therapy methods, the ability of the professional to establish trusting relationships with children is viewed as particularly crucial (FitzSimons and McCracken, 2020). Walter-McCabe (2020) examined a trauma-specific multimodal therapy, Trust Based Relational Intervention, for children in mental residential care suffering from serious trauma because of repeated neglect in early life. The three guiding elements of this therapeutic programme are empowerment, connection, and correction. The technique is influenced theoretically by attachment theory and tries to minimise trauma by fostering a trustful relationship between therapist and client.
Therapeutic Alliances (TA) are a term identified by Kourgiantakis et al. (2022) to describe relationships between young people receiving therapy and their therapists that are both emotional and collaborative. In their research of practises among parent counsellors and case managers, Tudorel and Vintila (2018) define "children personal alliances," "children task alliances," and "parent alliances" that are created between the interdisciplinary team, children, and their parents. They also discovered that strong children-staff alliances related to improved child functioning, and that strong parental alliances could also play an essential part in the therapy's success.
A review of literature also revealed that social workers participate in empowerment-oriented activities when handling children with mental health needs. Empowerment-oriented approaches address issues pertaining to the child's participation in decision-making and services, and often involve the child’s family. Several studies address the issue of power imbalances, where children are frequently not properly involved in decision making processes (Johnson, 2020, FitzSimons and McCracken, 2020, Cleary, 2018). FitzSimons and McCracken (2020) establish a strong positive association between the service quality and treatment result for children receiving several psychosocial therapies. In addition to consistency in approach and ease of access to services (Johnson, 2020), the strongest indicator of treatment effectiveness is whether the client perceives the services as engaging his or her own agency (Lucas and Acar 2021). FitzSimons and McCracken (2020) emphasise person-centred care coordination and the practitioner's individualized consideration approach as a crucial aspect in empowering the child. According to Cleary (2018), interactional techniques that should be used by professionals to empower young people include focusing on their skills and strengths, providing them with opportunities to express their opinions, informing them of their options, and allowing them time to decide. However, practises that promote empowerment must not leave young people entirely alone in the decision-making process. It is the responsibility of social workers to firmly advocate for the child’s best interest; consequently, the social worker should discuss decisions with the child’s parent if they end up making less useful decisions. Empowerment also involves enhancing the child’s development. Services should provide tailored life skills-related activities. Mentorship by peers and professionals is often cited as an essential technique for enhancing necessary life skills.
Compared to adult mental healthcare, there is less knowledge about the interface between child mental healthcare and social care. Walter-McCabe 2020 states that mental healthcare pathways for children are more complex and are more reliant on adults, such as teachers and parents, to enhance service use (Walter-McCabe 2020). In the Goldberg and Huxley (1992) care model, various selection processes are involved in the presentation, recognition, and referral of adults with mental health disorders. It identified the critical roles of social workers and other interprofessional teams within primary care as the most common care pathway. The model allows for the differentiation of various service levels as it applies to children’s service use. This study will look at this care path to figure out how social workers help care for kids with mental health problems.
However, Levin et al. (2022) contend that social work encompasses more than resource allocation. Rather than that, they leverage their professional expertise to collaborate with communities and citizens to address societal issues such as human rights protection, establishing healthy communal changes, and promoting self-determination. It doesn't matter if social workers have to use their control powers (like under the Mental Health Act), they must do so in a way that is humane, doesn't interfere or constrain, and encourages community freedom (Younghusband 2021).
Thus, social viewpoints enrich the role of mental healthcare in a variety of ways. For example, Banks et al. (2020) indicated that social workers are critical in empowering individuals and fostering partnerships to enhance the welfare of mentally ill individuals and their families. As a result, they help people with mental health issues deal with their own risks by resolving conflicts (Lombadi et al. 2019).
As public sector austerity remains a primary policy objective, there is now a significant shift in the organisation of healthcare services, marked by professional revitalization and reformation (Walter-McCabe 2020). As a result, the moment has come to articulate the specific purpose and benefits of social work in mental health. Likewise, Bent-Goodley (2018) recognised the emergence of a new set of healthcare models because of healthier reform efforts, the majority of which involve multidisciplinary collaboration of health providers, social workers, nurse practitioners, and other professionals engaged in a concurrent search for mental and physical health solutions.
This encompasses issues of mental health such as substance misuse and addiction, stress, and anxiety. As a result, a critical question arises regarding the role of social work in enhancing child mental health services to ensure improved services for service users, their families, and the broader community. The purpose of this paper is to analyze social work practises and paradigms using research findings. The study is intended to accomplish the following research objectives:
1. To identify the social work services available to children with mental health issues.
2. Explore the challenges and impact of social work services on the wellbeing of children.
What is the role of social workers in supporting children with mental health issues?
In the United Kingdom, several government policy initiatives have resulted in a reorganisation of mental health services for children and adolescents who are experiencing or at risk of experiencing mental health problems (Kourgiantakis et al. 2022). The current study evaluated existing empirical evidence on the efficacy of various modes of organisational service delivery and a variety of treatment and prevention support. The functions and tasks of social work in this field of practise will be addressed and analysed considering the numerous social policies and rules that define social work.
Additionally, this study examined the implications for social worker practise, specialised training, supervision, and education to emphasise the importance of maintaining community-based, culturally appropriate social work with children as well as other young people who have mental health issues. Ideally, gaining such insights will pave the way for the development of an emancipatory social work practise, partnership with parents, and a framework for children's rights, all of which will contribute to the advancement of social policy on inclusivity.
The study is highly beneficial to social workers and their employers, commissioners, leaders, managers, educators, and other professionals that provide social work services in the mental health system. It will conduct a critical review of the available research about social work's role in child mental health that has significance for these stakeholders. Additionally, the study will benefit health policymakers by identifying a few ways in which social work can support the political and societal goals for mental health services—to make them more customised and pre-emptive while putting more emphasis on stigma reduction and physical health promotion.
The study contributes considerable knowledge to specialised social workers in child mental illness, particularly those employed by the NHS and local governments, even though a few of the themes explored herein are also relevant to social work in other settings. Greenberg et al. (2018) say that social workers must be able to care for mental health patients no matter what their age or background is. This means that social workers must be able to work with people regardless of their family and social circumstances.
Additionally, the study is relevant to social workers who practise in non-statutory psychiatric settings. According to Golightley & Goemans (2020), social workers are increasingly required to operate in non-statutory settings such as non-profit groups, the commercial sector, and social entrepreneurs. Such diverse organisational structures provide social workers with a unique opportunity to satisfy the social needs of juvenile psychiatric patients. While social workers in these settings lack formal authority, the proposed study's aim and purpose apply to them as well. A more idealistic part of the planned study is how social workers may collaborate with communities to improve mental healthcare while eliminating the barriers and inefficiency that limit convenient access to care.
In this study, mental health problems refer to emotional or behavioural problems or those associated with mental impairment. Even if the problems do not meet the criteria for being a disorder, they influence the outcomes and are associated with the use of social care services. This study differs from previous studies (Mugumbate and Chereni, 2019) because it focuses on studies that involve younger children under the age of 12 years. It is also unique in the sense that it highlights the role of parental perception as a salient factor influencing service seeking and use. It also separates the stages of parental recognition or perception of mental health problems from help seeking, as these factors are different, and the former does not influence the latter. Furthermore, the study takes up the authors’ recommendations that future studies should distinguish between the two.
This study is based on the theoretical constructs of integrated care. Social work in mental healthcare is theoretically situated within the context of integrated care (Mugumbate and Chereni, 2019). According to Moudatsu et al. (2020), integrated care is the delivery of numerous healthcare services in a coordinated manner. It is a multidisciplinary field of practise that encompasses both behavioural and physiological health. While some countries (e.g., the United States) practise integrated care primarily through integrated financing of the system (Land 2021), the United Kingdom and many European countries practise integrated care through a reorganisation of healthcare and social service delivery structures and governance (Celik and Icduygu 2019).
Integrated care encompasses several components, several of which are constrained by organisational, clinical, or policy limits. This means that clinically integrated care is contingent on a variety of contextual circumstances, including the degree to which services are horizontally or vertically integrated (Aviv et al. 2021). Meanwhile, integrated care is composed of three key components: clinical components, organisational components, and policy components.
The clinical level components are defined by comprehensive standardised evaluations and universal screening systems that comprise treatment procedures tailored to the unique needs of each patient (Levin et al., 2022; Younghusband 2021). They include care management, shared clinical data, psychotherapy, regular team communication, joint care planning, and continuous patient monitoring (Banks et al. 2020). Components at the organisational level, on the other hand, include an integrated information system, service allocation, interprofessional training and education, care networks, and a common organisational mission and culture (Lombadi et al. 2019). Finally, Beasley et al. (2021) note that integrated care policy components include resource-shared information technology and systems, reimbursement methods, and resource mobilisation and sharing.
The current study situates social work services for children who seek mental health treatments within the organisational functions of integrated care, which include interprofessional collaboration, colocation of services, and interdisciplinary teamwork. The study used a collaborative care paradigm within an integrated care framework.
A systematic literature review (SLR) was conducted to compile all the information known on APs' experiences with post-adoption contact. This type of research necessitates a thorough, detailed, and reproducible technique to assure high-quality and impartial conclusions (Snyder, 2019). For a review to be systematic, it must be completed in accordance with a set of norms that guarantee exhaustiveness (Mohajan, 2018). Therefore, the SLR was conducted utilising the known Cochrane principles (Aveyard, 2014).
"Evidence-based practise" is a popular word in social work, however it originated from the medical field, which lacks the ambiguity inherent in social matters (Newman & Gough, 2020). Researchers have questioned the applicability of Cochrane SLRs to a social care context because they are primarily intended to influence heath care decision-making rather than social work (Brown and Tidy, 2019). Nonetheless, the technique provides objectivity and rigour, so reducing the likelihood of inaccuracies or bias.
SLRs typically have consequences for social work because analysing all the available research on a certain topic permits the discovery of new information and insights, which can then be implemented in practise (Boland et al. 2017). Information acquired from SLRs can be useful for directing funds to the most effective treatments (Ayed et al. 2019). it is also expected that practitioners rely on research evidence to inform their decision-making; a practice that social workers are also expected to adopt before they are registered (Aveyard, 2014).
The main aim of this review was to evaluate the role of social workers in supporting children with mental health. First, the research question “What is the role of social workers in supporting children with mental health issues?” was formulated. This was specific and clear in accordance with Cochrane standards (Lubbeke, 2018). Then, a variety of searches were undertaken to identify any papers that could aid to answering the study question. The databases were chosen based on their applicability to both the social work and adoption fields. Because not all research articles were identified (Jennings et al. 2018), we additionally conducted manual searches and reviewed grey literature. It was vital to conduct a comprehensive search because any overlooked research could have contributed to bias in the reporting of the results (Aveyard, 2014).
It was determined that studies limited to the United Kingdom would be the most appropriate since social work support for children with mental health issues varies by country. This area of practise is determined by the legal, political, and cultural circumstances. However, exploratory searches included foreign publications to determine if this is viable.
The inclusion and exclusion criteria for dates were modified as the search progressed to find an adequate variety of studies. Nevertheless, initial searches yielded very few papers published since then, possibly because it was too soon for research to incorporate the policy reforms. It was decided to include papers published between 2005 and the present.
When doing an SLR, it is crucial that the analysis is thorough and well-balanced, as opposed to the researcher simply selecting the most appealing or handy results (Ayed et al. 2019). After identifying the articles, thematic network analysis as outlined by Attride-Stirling (2001) was utilised to identify common themes in the literature.
Thematic analysis is the process of systematically analysing qualitative research to uncover themes and describe the data in depth (Aveyard, 2014). The technique is extensively used in qualitative research to find, analyse, categorize, interpret, and report themes found within a set of data, with the goal of generating perceptive and trustworthy insights (Boland et al. 2017).
But systematic literature review method has several disadvantages; first, according to Snyder (2019), the flexibility it allows might lead to inconsistency. Secondly, it does not permit the researcher to make semantic assertions (Brown and Tidy, 2019). However, as a beginner researcher, I found thematic analysis to be the most accessible technique of data analysis due to its ease of learning and lack of prerequisite scientific or analytical expertise (Newman and Cough, 2020).
Thematic networks were chosen as a method to facilitate the thematic analysis; it is proposed that they produce more relevant and insightful results by identifying patterns that underpin the emergent themes (Mohajan, 2018). A meta-analysis was explored as a part of the review, but it was not feasible due to the heterogeneity of the included studies and the inconsistency of the measured outcomes (Boland et al. 2017).
To guarantee that the review's conclusions were objective, any bias in the data of the included articles had to be disclosed. The 'Critical Appraisal Skills Programme CASP (2019) checklist' was utilised as a systematic tool for evaluating the research articles' value and credibility. This process was not intended to eliminate low-scoring studies, but rather to provide transparency in accordance with SCIE criteria (Aveyard, 2014). The procedure assisted in determining how much weight each individual study should bear when forming generalisations.
Approaches to social studies must align with the profession's core principles. Participants should be treated with respect and decency, considering the influence of power dynamics and repression (Boland et al. 2017). Because all the included studies were publicly available, no formal ethical approval was required. However, ethical considerations were provided to each study under the SLR to assure compliance with the "Code of Human Research Ethics" (British Psychological Society, 2010). Additionally, care was made to ensure that the findings were reported objectively and did not contain any terminology that could be stigmatising or cause injury or distress to any group or individual.
The study drew on a comprehensive search and analysis of published literature (i.e., a systematic literature review). This comprises a systematic method of discovering and collecting evidence-based data from previous secondary and primary studies, analyzing their findings, and applying those findings to the study objectives at hand (Aveyard, 2014). The study examined various bits of evidence and how they could be used to accomplish the study objectives through a systematic search and review of existing research. According to Boland et al. (2017), systematic literature reviews made it easier for other researchers to do the same thing and make the study more credible.
Relevant literature sources were identified and retrieved from internet repositories and online databases. This was advantageous for the research since it enabled the use of specific phrases (relative to the research topic) to locate literary items simply and rapidly—far more efficiently than would be possible in a physical library (Carey, 2009). The literature resources were gathered from online databases such as MEDLINE, PubMed, and EBSCO. These databases were chosen because they are important to healthcare research and because they have a lot of literature about integrated care (Gough et al. 2012).
The study employed different search terms to identify relevant literature. These search terms include behavioural health, physical health, integrated care, primary care, and social work. During the search process, the search terms were customised (by combination and separation) to fit within the medical subject headings (MeSH) terms so that the words could easily be associated with the study topic in each database. Appendix 1 illustrates the search results table.
Primarily, the inclusion and exclusion criteria were applied to the titles and abstracts of the retrieved publications. The complete texts of any abstracts identified as having the potential to be included in the systematic review, or abstracts where the information was ambiguous, were read for clarification.
After unsuitable studies and duplicates were eliminated, the 'qualitative research checklist' was used to assess the credibility of articles that met the inclusion criteria for the SLR (CASP, 2019). Consideration was given to the external validity of the included studies as well as the possibility of bias due to any omitted research publications.
Appendix 2 illustrates the study selection process using the PRISMA; and in accordance with the inclusion/exclusion criteria. It demonstrates how the 10 studies included in the review were selected. Most of the studies were secondary research while a few were primary research.
Appendix X illustrates the details of all the included studies. Most of them were conducted in the UK even though they did not identify the specific areas within which they were published. Numbers are used for purposes of convenient referencing.
All the included studies were subjected to a systematic critical evaluation that sought to ascertain their respective relevance and trustworthiness.
The review generated three major (global) themes that centred around Facilitating assessment and overseeing compulsory hospital admission, protecting the child’s welfare, and Human rights protection. Below is a discussion of these themes. The following table illustrates the global themes and sub themes.
Most minors admitted to mental hospitals or units are outpatients. They do not have access to the same protection as adults held under the Mental Health Act of 1983. Even though they may not be in favour of being admitted, children under 16 years of age with mental health problems often get admitted by their parents. This is called "de facto detention" and is against relevant legislation such as the Mental Health Act of 1983 (1, 10, 12). Reports by the NHS indicate that there has been an increase in the number of children admitted with psychiatric problems since 2009, which was 6161 in number during the 2009-2010 NHS report compared to 2018-2019 of 26,593 (Lintern, 2020). This is a concerning trend that is reflected in the adult statistics for mandatory admissions. Health and Social Care policy is intended to shift resources away from institutional-based provision and toward community care. However, in the context of children with mental health issues, the opposite appears to be true.
Sections 2 and 3 of the Mental Health Act 1983 provide for mandatory admission and continued detention where a young person or a child is considered to have a mental disorder. Ideally, according to the law, a mental disorder must be classified as a learning disability, psychopathic disorder, severe mental impairment, or mental illness. It is the role of social workers to assess the child and ensure that mandatory detention is only awarded to children who fall under these categories of mental illness (6, 5, and 9). Whether the social worker is a volunteer or not, they have the responsibility of safeguarding the rights of the child in these acute and rare episodes (2, 5, 6). Specifically, the social worker must apply the following sections of the regulations based on each respective context of care: Section two of the Act specifies the assessment of possible admission for up to 28 days, while Section four specifies conditions for emergency assessment for up to 72-hour admission.
While overseeing admission, it is the role of the social worker to ensure that the child’s rights regarding consent and confidentiality are protected (4, 7, 9). During times of stress and unhappiness in their life, children and adolescents seek the aid and counsel of a variety of sources. They find it easier to approach statutory, private, and voluntary agencies as well as family and friends than their parents (8). They may want to discuss troubling emotions or behaviours in confidence. In these cases, the legal position is unclear, and social care agencies and professional associations rely on voluntary standards of practise for guidance (6,9,8). When children evaluate the acceptability of a helping service while personnel are compelled to reveal information to others in specific situations, such as when child protection concerns are raised, a dilemma frequently occurs.
The social work agency should inform the children of the available policies regarding the limits of confidentiality (5,6, 7). However, in doing so, according to (8, 9, 10, 11), many social workers know that they could be discouraging the children from sharing important information about their feelings. Social workers are acutely aware of the significance of establishing confidence and trust among vulnerable children and must continually walk a fine line between allowing sensitive dialogue and determining what must be shared with colleagues, parents, or third parties (10,4,6,8). When disclosure must be made against a young person's preferences, it is best practise to inform the young person beforehand and give him or her the opportunity to reveal the information first (5, 6, 9,10).
The Access to Personal Files Act 1987 and the Data Protection Act 1984 give children the right to have information about them, even though with some levels of limitations. Children with ‘sufficient understanding’ have the right of accessing such information, except of certain circumstances. It is the role of the agency, through the social worker, to ensure that the child has access to their information, except for when the information would lead to the disclosure of another person’s identity, when the information is contained within reports of the court, when the information is prohibited or restricted from disclosure in cases of adoption , and when the information states the child’s special education needs as per the Education Act 1981 (10, 11, 8).
The other theme that emerged from the review is that social workers play a significant role in protecting children from harm. Children with mental health problems may behave in ways that stretch their caregivers' or parents' coping capacity, and this might expose the children to potential harm. Conversely, a child who is being neglected or abused may come to the attention of social workers who were initially concerned with their mental health. As such, the interactive nature of child abuse and mental health presents a critical challenge to social workers who are charged with the responsibility of assessing the needs of mentally challenged children and their families. However, in practice, the provisions of the Children Act 1989, alongside other practise guidelines, have attempted to simplify the rather complex challenge. The duties of a social worker under the Children Act are underpinned by protecting the child’s welfare as follows (9,10, 6, 8): First, whenever possible, children should be raised and cared for within their own families. Secondly, children who are at risk should be safeguarded and protected by means of appropriate interventions. In addition, courts should avoid unnecessary delay and issue orders only when doing so is preferable to not doing so. They should be kept aware of what is occurring to them and should be included in any choices that affect them. In the end, parents retain parental responsibility for their children even if the children no longer reside with them.
The emphasis shift ushered in by the Children Act, from investigative child protection to needs-based evaluation for family support services, is especially relevant for social workers engaged in mental health work with children (3, 2, 1, 4). As a result, family support is experiencing something of a resurgence, and social workers can implement psycho-social treatments in tandem with a wide range of economic and social policy initiatives and neighbourhood renewal programmes. The Children Act therefore requires social work agencies and authorities to collaborate towards providing family support services, especially those targeted at children living with the effects of racism, the homeless, those living in poverty, those separated from their parents, and delinquent children (1, 6, 7, 10, 9). Some children from this group may be getting involved in criminal activities, truanting from school, or have specific behavioural problems at home or school. Through social workers, social work agencies would address some of these problems by developing community-based interventions for them (4,6, 2, 8). While earlier on, social workers relied on static, deficit-oriented, and cursory methods of identifying needs, the development of needs assessment frameworks such as the Framework for the Assessment of Children in Need (2001) enables social workers to easily identify the mental health needs of children (5, 8, 9).
The local authorities are obligated to investigate if they suspect a child is suffering or is likely to suffer serious harm. The goal of such a probe is to establish the facts, determine if there are reasons for worry, identify risk, and determine preventative measures (10, 4, 5, 6). A child’s behavioural and emotional problems are usually interpreted by a child psychiatrist, who may be consulted based on Section 43 of the Children Act due to a lack of parental cooperation (7, 4, 8, 5). In situations like this, a social worker plays a crucial role in balancing the need to protect the child with the consequences of oppressive intervention and investigations on them and their families.
Prior to the Children's Act of 1989, professional social work practise was viewed as intrusive, bureaucratic, and prejudiced towards child protection investigation. The new law attempted to address the imbalance between assessing the needs of children and youth and offering support to their parents to avoid neglect or harm. Contemporary discourse over the Children's Act continues to focus on how to transform the law's broadly supported ideals into practical assistance for child welfare service providers and users (2, 7, 5). In the context of child and adolescent mental health, social workers must optimise their professional knowledge, abilities, and values in a very complicated area of practise.
In this context, one of the most crucial roles of social workers is advocacy. While this may seem contradictory in cases where the local authority is acting in the child’s best interest, supporting a complaint is beneficial in establishing trust, building relationships, and cultivating respect (9, 7, 8, 12). Section 26 of the Children Act establishes a complaints mechanism via which children and adolescents may appeal social workers' decisions. There are formal and informal phases to the procedure, with an independent party expected to be present throughout the formal phases. Upon the exhaustion of these procedures, the complainant can file for a judicial review within three months of the decision being appealed against. However, for the judicial review to succeed, the social service department must have had the power to decide, the decision must have been reached under unfair circumstances, and the department must have failed to consider all relevant matters, failed to properly consider the law, or did not sufficiently consult.
Social workers also make a significant contribution to the protection of children’s human rights. In accordance with the Human Rights Act 1998, through their respective social workers, the agencies are responsible for the health and welfare of children and adolescents throughout the United Kingdom. Article 3 addresses the prohibition of torture and cruel or humiliating treatment. Children and adolescents who have been subjected to confinement, isolation, or imprisonment due to frightening behaviour may file complaints under this section of the Act.
The importance of children and adolescents detained under a provision of the Mental Health Act, the Children Act, or the youth justice system cannot be overstated.Social workers engaging in this type of work should ensure that custody is based on reasonable opinion, follows a clearly outlined legal procedure that is understandable to the individual, and is limited to the duration of the mental health crisis. Specific care must be taken, in the context of adolescent justice work, to the clarity and language of pre-sentence statements, which can be stigmatising. This is because the pre-sentence statements and reports may have a formulaic structure that does not enable the social worker to assess the child effectively and accurately under strict deadlines (6, 4, 8, 11).
The social worker is also responsible for guaranteeing the child’s right to family life and privacy as per article 8 of the Human Rights Act. Families of asylum-seekers and refugees might become mired in complicated citizenship and eligibility procedures. This provision can be utilised for determining whether a person should be deported from the United Kingdom (10, 9, 7). In the case of children affected by the anticipated deportation of a parent or in circumstances where a parent is not permitted, humanitarian grounds may be invoked. Social workers who are familiar with the attachment relationships of young children can use this information to support Article 8 procedures (10, 7, 12). In such situations, the preservation of the family unit is of crucial importance. Social workers who are involved in such procedures have the responsibility of carefully assessing whether such arrangements corroborate with the child’s human rights convention and whether they are in the child’s best interest (7, 8, 5). For instance, the Convention underscores that care interventions should be transitory and that, whenever feasible, children should be reconnected with their families as quickly as possible. If a parent with a mental disorder was locked up in a psychiatric facility, the Convention could be used to make regular visits possible if they had been denied (10, 7).
In the context of children’s mental health, the social worker is also responsible for protecting the child’s basic rights to freedom of expression. As per Article 10 of the Human Rights Convention, social workers are required to actively ensure that children with mental health issues have the freedom to express their opinions about services provided to them (6, 3, 6). So, social workers can recognise that children's rights and partnerships are important and put them into practice.
In the process of guaranteeing the children’s rights, social workers are expected to ensure that all the children have equal claim and access to their rights, irrespective of their guardian or parent’s race, language, sex, social or ethnic origin, religion, political affiliation, or disability (12, 11, 2). This implies that social workers must ensure that children with mental health issues receive the best quality of diagnosis and treatment services that are non-prejudicial. Also, social workers must make sure that they provide their services in a way that isn't biassed or racist and lets children and teens know their rights, stay in touch with mental health services, and get help from people who fight for children's rights (6, 8, 9).
Social workers operating within various care settings, either as volunteers or as agency employees organised as specialist or generic teams, must develop the requisite skills for child and adolescent mental health practice. While fulfilling their roles, social workers operate within specific principles and organisational frameworks that enable them to effectively intervene in children’s and young people’s lives due to the children’s disturbing or disturbed behaviour.
This study has revealed that social workers have the role of consulting with and fully informing the child, thus considering their views and wishes when delivering care. In the absence of explicit statutory restrictions, children acquire the freedom to make their own judgments when they have "adequate knowledge and awareness." They are also obligated to respect the child's personal right to consent or withdraw consent to treatment, as suitable; and, if a child is unable to provide informed consent, to seek the parents' consent, except in emergency situations. Social workers are entrusted with ensuring that any therapy is the least restrictive choice and results in the least possible isolation of the child from his or her family, friends, society, and regular school. Children lacking family or friend support in treatment decisions should ultimately be in the reach of independent experts, counsel, and advocacy organisations. If a parent wants to treat a child even though the child doesn't want to, the parent may need to go to court if there is proof that the parent is not acting in the best interests of the child.
However, a substantial amount of social work will include performing or arranging family support work related to official or unofficial assessment procedures meant to determine the optimal intervention to prevent children from being removed from their parents' care or denied their liberty. Even if the signs and symptoms of mental health disorders are apparent, alternative, and even punitive, explanations for a young person's behaviour may conceal an underlying psychological condition.
Consider the function of social work in relation to other professions working with children and families as a method for achieving this goal. What is it about social work that other agency employees do not or rarely perform? The first significant distinction is the statutory authority vested in local authority practise contexts, which differentiates the social work role in multi-agency collaboration. The inherent ability to coerce punishment affects the nature of social work and the connection with the service recipient. The second significant distinction is likely the training in broader social science and social policy views, which enables an understanding of repressive and discriminating societal processes. The third important difference is that it is clear that community-focused interventions are a good way to give people and broader interest groups more power.
These three components can influence social work practise with children and adolescents who have or are at risk for mental health problems. With the aid of a mental health model that incorporates these features, social workers can criticise medical, institutionalized, and punitive solutions to troubled children. The social policy demand for closer interprofessional collaboration and the elimination of barriers between personnel from different agencies presents an opportunity to reaffirm the fundamental principles of good social work practice. This study has investigated how child mental health is defined and how social workers might help in the development of a humanistic and holistic paradigm for comprehending the world of problematic children.
The guiding principle of social work is to safeguard human rights, act to prevent or abolish prejudice and inequality, and safeguard vulnerable individuals from harm. In mental health, social workers frequently need specialised knowledge of the Mental Capacity Act of 2005 and or the Mental Health Act of 1983. Social work expertise with the Mental Health Act (MHA) has been well-defined by the AMHP role, but there is now the potential for social workers to also move into the Responsible Clinician (RC) role, providing a highly specialized role opportunity under the Act that the profession has not yet fully explored.
Outside of the 'Best Interest Assessor' function for Deprivation of Liberty Safeguarding, there are fewer requirements for social work knowledge under the MCA compared to the MHA. The MCA is an essential area of separate practise that offers the ethical and legal basis for several interventions in the lives of people and helps to defend their autonomy and dignity. Yet it is frequently implemented insufficiently in mental health services. Expert social work positions could be a more advantageous source of MCA leadership and advanced mental health practise.
Social workers have had a significant impact on mental health care through the provision of leadership and expertise in the protection of children, another challenging field of work. Slowly, mental health services have embraced adult protection practises and procedures. This is sometimes attributed to the delegating of social work and social care in many places to NHS organisations that have only recently acknowledged the importance of safeguarding as a key part of their responsibility. The public and political outrage over safety gaps, blatant abuse, and carelessness in the NHS and other healthcare organisations has increased awareness and led action about safeguarding in the NHS and mental health services.
As suggested by the preceding discussion, social workers in child mental health continues to play a crucial role in managing risk and complexity and decreasing harm. Modern social work in mental health, as in other fields, must also emphasise prevention, earlier treatment, resilience building and self-care, lowering and delaying dependence, and helping to reduce unnecessary acute demand for care and health services. This entails enabling children to take any necessary positive risks that could promote their wellbeing.
Social work entails utilising the available support structures and the clients' capacity to assist them in resolving their own problems and establishing their own self-sustaining support systems, regardless of whether they utilise extra health resources and social care. Some traditional approaches to social care have encouraged dependency, both in mental health and in other fields. This has included professional limits on access to knowledge and abilities, as well as the denial of experience's expertise. With its ethical foundation strongly entrenched in the belief in human potential and in accompanying service users and families on their journeys of change, the professional identity and discourse of social work are characterised by their emphasis on working in collaboration with service users whenever possible. Social workers should be in a strong position to assist mental health services in shifting from professionals being "on top" to being "on demand" as a collaborator and a resource, rather than a controller.
This does not diminish the fundamental function of social work in recognising the realities of inequalities and oppression that individuals may endure. This may be the result of racism, homophobia, and other forms of discrimination that exacerbate the marginalization and shame that persons with mental health issues frequently confront. Social workers actively combat abuses of power and discrimination while promoting empowerment, equality, and social inclusion.
Working alongside service users, caregivers, and communities as they face difficulties resulting from welfare and housing changes, supporting avenues to employment self-sufficiency even within a constrained job market, is a very realistic and modern component of social work's function today. As mental health social workers attempt to encourage social inclusion and eliminate fundamental material disadvantages, socioeconomic challenges such as poor housing and unemployment, as well as inability of parents to manage their money and cope with debt, will continue to pose significant practical obstacles.
Community capacity building
Community capacity building entails reviving community social work skills, working with networks and groups of people to enhance public social capital and mutual support, for example, to promote more tolerance of mental health problems. It also necessitates developing an understanding of diverse societies and their networks to achieve early engagement of people on the mental health and wellbeing subject, particularly those communities and persons who might be traditionally excluded from support, perhaps undergoing the most isolation and stigma. To accomplish this, social workers must utilise advanced relationship-based skills, collaborating with service consumers, caregivers, and the larger community to comprehend community dynamics and social networks.
This social work emphasis on community capacity, coordinating various communities, and aiding in the development of social capital is congruent with the reform required throughout the entire mental health system. For reasons of sustainability, quality, economy, and user experience, the mental health service provision in England must become more preventative, individualised, and sensitive to the varying needs of the population. For longer-term healing, it must enable autonomy, choice, social inclusion, and self-determination. It must promote community well-being and recovery and combat the stigma and social isolation challenges.
To realise this future vision of mental health services, co-production principles are progressively implemented. This presents a practical and theoretical framework for how social workers and authorities might collaborate with citizens to effect permanent change. This involves allowing individuals to be deeply involved in the services they directly utilise and to be active contributors by creating their own care. However, it also entails allowing people to participate in the design and provision of future services, as well as being encouraged to contribute to society. Co-production ought to be the natural habitat of superior, contemporary social work.
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Appendix 1: Search Table
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