Malcolm Golightley

Social work and mental health in Scotland

Since the inception of the Scottish Parliament in 1999, mental health law, policy, practice and ethos has changed dramatically in Scotland. This book examines the policy and legal contexts and provides a thorough grounding in key issues in mental health and by highlighting the skills and values important for effective intervention enables the reader to understand contemporary social work practice in Scotland.

Mental Health an Issue for Everyone

Mental health is a topic well worthy of a special issue of this Journal. As the dust settles over the number of articles submitted and we have had to make the choice of accepting some and not others, it by happenstance has coincided with the general election in the UK. The choice of who to govern the country and which policies have found popular favour would on the face of it provide editors with rich policy pickings. But if that was your thoughts then you would be wrong as sadly mental health services was not the prime issue and indeed mental health although mentioned never seemed to have the gravitas it deserved. Now that the country has settled on a majority Tory government somewhat right of centre a quick read of the key public sector policies is hardly more illuminating. Mental health waiting times are to be subject to targets and this will be applied across the sector. However, apart from this, there is little or no mention of what actually happens in the interaction between the person with mental health issues and the professional from whom they are seeking help. You may find this strange as it is fairly well accepted that mental health or lack of it will affect a sizeable number of people from all walks of life and perhaps up to one in four of us will experience mental health problems at some point in our lives. The lack of positive policies towards mental health services and the impact of cuts in public sector funding have created an abyss of indifference. Yet, as social workers we are privy to the backstage life of many who present with mental health problems and to learn what is important to them is by and large the same things that are important to us all. One of these is the centrality of relationships, with anybody but certainly with somebody. This may be therapeutic or it may simply be supportive and on occasion some relationships can be destructive. One of the characteristics of some people with mental health issues is the absence of a confiding relationship. Social workers can provide positive healing relationships and sometimes be the person (in the UK) who recommends admission to psychiatric hospital when deemed necessary. “All human beings are born free and equal in dignity and rights” (United Nations, 1948). So reads the first line of Article 1 of the Universal Declaration of Human Rights (UDCR). As we know too well, however, across the lifespan there are many instances where individual freedoms and rights may be curtailed and compromised in many different ways. Social work increasingly seeks to position itself as working on behalf of those who find themselves disempowered, alienated or rejected by mainstream society. It is no coincidence that, in the IFSW Global Agenda for Social Work and Social Development, one of the four key priority areas for social work rallies social workers

For the sake of ‘auld lang syne’

As this editorial goes to press, it coincides with the last few breaths of 2013 and many of us mark its passing with some sort of reflection about what events have impacted upon us and what we have done with our lives. Somewhat unsurprisingly, this is a common feature in many countries often linked with a festive spirit and over consumption of food and alcohol. In the UK, the further north of London the more celebratory and significant the arrival of the New Year and the passing of the old seems to become. Hit Scotland and it is a major event lasting often two days and called ‘Hogmanay’, a name thought to be derived from the old French word ‘aguillanneuf’ meaning new years eve or a cry from children for a gift. People will have their own reflections, often very personal, but we thought we would pick out just a few morsels to whet the appetite. In the UK, the NHS turned 65 in 2013, but far from considering retiring it is engaged in major change and in some areas perhaps fighting for survival. The Francis (2013) Report, a review of failures at the Mid Staffordshire Trust to provide even basic care to some vulnerable patients, some of whom were left to go thirsty on hospital wards, some in the absence of water jugs and glasses, having to drink out of plant pots, hangs like a shadow over a service in which many of us have a huge personal and professional investment. The importance of values about the dignity of people is a given for social work and social care, and these instances remind us of how vigilant we all need to be to challenge poor practice whenever we see it. Interestingly, the two professionals who ‘blew the whistle’ have both been recognised in the New year Honours List and perhaps this signifies government commitment to listening to ‘grass roots’ staff views about the service where they work. It remains to be seen if the appointment of an ex-government advisor who has spent the last decade as a senior executive for one of the US’s biggest private health-care giants, UnitedHealth, will kill or cure the patient that the NHS has become. Over the other side of the ‘pond’, the Affordable Health Care Act (Affordable Care Act (aka Obamacare) is the commonly used term for the Patient Protection and Affordable Care Act (March 2010) and enacted in 2013) has at last become a reality. Despite considerable opposition from the Grand Old Party (basically the Republican party), the ‘free’ healthcare for all, we in Europe take for granted, is the prize that

Reviews of Social Work Education, Binary Opposites and Therapeutic Approaches

As editors we are trying to produce a journal that both reflects our distinctive contribution while striving to reach a wider audience and reflects contemporary concerns and issues. Part of our role is to encourage the writing of high quality articles that fit in with our mission. The journal has an author record that represents some of the best-known writers in social work. We also know just how difficult it is to publish in the present day and how important it is to provide support for up and coming writers. We will happily provide feedback on articles and welcome any suggestions that might be forthcoming as to how we can encourage early career academics and professionals to write for us. One way is to review submitted papers (with others) and if you feel able and would like to review articles for us we would like to hear from you. This issue is a general one and the articles reflect a wide-ranging set of views about social work as it is practised but also new areas in which social work may be able to contribute. We try to balance out specialist issues with general issues and the usual ratio is 1–3. We are always looking for ideas and contributors for special issues, which by their very nature often have a long lead in time. In the planning cycle at present is a special issue on mental health with a view to publish in late 2015 and for which ideas and articles are most welcome. In previous issues we have commented upon the challenges to social work education and we welcome the publication of the report in England: Re-visioning Social Work Education: An Independent Review by Professor David Croisdale-Appleby and think that this is the outcome of a rigorous and thoughtful approach by Professor CroisdaleAppleby in considering quality and reform in social work education for both qualifying and qualified social workers. We note that this report comes shortly after the publication (13 February 2014) of Sir Martin Narey’s report (Making the Education of Social Workers Consistently Effective), a more controversial report, and there are areas where the reports’ conclusions and recommendations both overlap – and differ. The challenges that social workers face are such that few of us in social work believe that when someone graduates with a social work degree, they will be the finished product. But there are too many employers and perhaps too many new social workers and students who think that their education is not always what it should be. The assessed year in practice (AYSE) was introduced to respond to exactly this position, and previous attempts to reform social work education have refocused attention on professional standards and capabilities.

Challenges: a rich selection of ideas and experiences

We are delighted to be writing our first editorial as the new incoming editors of this journal and wish first and foremost to thank the outgoing editors for their good wishes (Editorial, vol. 27, no. 1, March 2013) and to acknowledge their sustained work over many years which has resulted in them being able to hand on a firmly established, widely recognised and highly regarded journal. We are looking forward to working together along with editorial board members in the UK and overseas, our colleagues in GAPS and at Taylor and Francis to sustain and enhance the reputation of the journal. Aswe begin this new editorial era, what are the issues that the social work profession is facing? Globally, the impact of economic austerity and high levels of unemployment, particularly amongst young people, is reverberating across national boundaries, manifested in increasingly prescriptive, bureaucratic and austere social and emotional responses to human distress. International conflict and unrest, most acutely active, as we write, in Syria, afford indisputable evidence of the profound capacity of human beings to inflict pain and to act sadistically towards each other. Our international editors identify the impact of the ideology and enactment of policies of neo-liberalism in North America, Norway and Europe that have challenged the role of social work within the state and the extent of service user–provider relationships. Of course the practice of social work takes places not only in public agencies but also in voluntary, not-for-profit and private profit making settings. But for many vulnerable people, it has brought about the need to compete for scarce resources and worse to make them feel bad about even requesting help. No wonder that the focus on ‘what works’ as a child of neo-liberalism and the commodification of care brings with them themarginalisation of therapeutic practice and diminishes the importance of the therapeutic relationship. In the UK, the pace of change within the social work profession continues unabated. In England, recommendations and reforms from earlier reviews of social work education and the change of regulatory body are only now being realised in the revalidation of qualifying social work programme curriculums and recalibration of the training bursary scheme. Despite the fact that these initiatives have yet to be firmly embedded, a further Government commissioned review is currently seeking views on the quality of education and training for children’s social workers. Coinciding with these developments, the announcement of Frontline, a new initiative to ‘fast track’ able graduates through a Masters level social work programme, represents a potentially seismic shift in the configuration of social work education and has generated considerable debate within the social work academy about the appropriate constituents and location of qualifying programmes. Within the workplace, the pressures and shortcomings of highly bureaucratised professional practices continue to prevail with

The Legal and Policy Context (I): The Mental Health (Care and Treatment) (Scotland) Act 2003

Modifications etc. (not altering text) C1 Act applied (5.10.2005) by Mental Health (Cross-border transfer; patients subject to detention requirement or otherwise in hospital) (Scotland) Regulations 2005 (S.S.I. 2005/467), reg. 46 (with reg. 2) C2 Act applied (with modifications) (3.11.2008) by Mental Health (England and Wales Cross-border transfer: patients subject to requirements other than detention) (Scotland) Regulations 2008 (S.S.I. 2008/356), reg. 33(1) (with regs. 2, 33(2))