Organisations Working Separately and Individuals Working in Isolation are no Longer an Option
This paper will consider the key ideas and theories underlying organizations. In doing so there will be particular concentration on the areas of mental health and social services. There will be an examination of the legislative context and policy changes as they apply to the chosen areas. Since the 1990 NHS and Community Care Act there has been considerable emphasis on partnership working and the importance of this to mental health and social services will be examined. Attention will also be paid to the experiences of users and carers, particularly as it relates to issues of power and inequality. The paper will begin with a general introduction to the areas under consideration.
It is no longer an option for organizations to work in isolation, this is particularly the case with organization concerned with services to the public. The organizations which come under the umbrella of what is known as human services operate in both the public and the private arenas. The introduction of market principles into areas that were once the sole responsibility of the state welfare system, has meant that an increasing number of human service workers are employed in the private sector. Human Service organisations are comprised of medical staff and others such as administrators, cooks and cleaners employed by the NHS or in private practice, the police and probation services, the prison services, social services, and to a limited extent those working in education. Certainly the pre-school sector could be described as a human service organisation because of the many different services the sector performs. Many of these are voluntary organisations. The voluntary human services might also include organisations that help the disabled, organisations such as Adaction which work with alcoholics and people with drug problems, and Mind, a voluntary sector organisation which caters for people with mental health problems.
People seeking to work in the human services usually do better if they have had some prior experience. This might be through undertaking work placements or by undertaking voluntary work for a time. In social work, this is likely to be even more the case because prior community involvement is seen as a valuable asset. This may be a result of the fact that the social services has its roots in the voluntary charity work of the late nineteenth century. The role of a social worker is primarily defined by what used to be known as personal social services. This is because on the whole social workers are concerned with individuals and the care they may need.
In the field of human services social work may be seen as both typical, and untypical , firstly its aim is to provide a personal service that benefits other people, social workers are more likely than other human service workers to be involved with people on an individual basis, often for a prolonged period of time. In other areas of the human services contact with the public is usually more fleeting. As a result of current Government policy a social worker who may be involved with clients with mental health needs, may find themselves in partnership with the NHS (or community mental health team) and a voluntary organisation such as Mind. More importantly, Government expects social care and health professionals to work closely and collaboratively with service users. What social work consists of is decided by Parliament. This is because the Government defines the statutes that outline social workers responsibilities and the people towards whom they have that responsibility, also the manner in which such responsibilities should be undertaken, and the legislative framework that underpins the professional practice of social work (Brayne and Martin, 1995). Social workers have to abide by the code of practice set by the General Social Care Council, and are bound by the 1970 Social Services Act as it applies to local authorities. Since the Human Rights Act of 1998 social workers are bound by law to respect the inherent rights and dignity of every human person.
Social workers are bound by the 1990 Community Care Act and subsequent legislation. Local Authorities are also by the Disability Discrimination Act and social workers whose clients who have mental or physical disabilities Social workers have to be familiar with this Act as well as the Chronically Sick and Disabled Persons Act of 1970. Social workers also need to be aware of what defines a person with mental or physical or disabilities and how their needs might best be addressed. Local authorites have to regulate services to deal accommodate both their own financial restraints and people’s needs and disabilitie. The social worker is bound by the same terms as their employer. Local Authority Social Service Departments have a legal duty to find out if there are people with disabilities in their area, what the number is, and what help the Department is able to offer. Details of services should be published and the department has a duty to inform clients of their rights in relation to the services they provide. The Local Authority and also the social worker have to take into account the major implications of the 1995 Disability Discrimination Act when dealing with people who have mental or physical difficulties. Disability is defined under this Act disability as:
Disability is defined as a physical or mental impairment which has a substantial and long-term adverse effect on ability to carry out normal day-to-day activities (Brayne and Martin, 1999:460).
Social workers have a duty to assess the service needs that disabled service users may have and decide whether they can help the person with that need. There is also a considerable emphasis within social services on encouraging the user to participate in decisions regarding their care. At the same time social workers are encouraged to lessen the power differential between themselves and service users, this means engaging in anti-oppressive practice e.g. accessible language, and doing what they can to empower individuals.
Changes in Government social policy during the 1970s and 1980s resulted in significant changes to those organizations which provided services for people with disabilities, people with learning disabilities, and older people (Kirk, 1998). As a result of Government spending cuts numbers of institutions were closed and this resulted in care being increasingly focused on the community. The Griffiths Report (1988) was commissioned by the Government and it recommended that local authorities should be ‘enablers’, who organized and directed community care. Local authorities would no longer be the sole providers of care, but would have their own budgets to purchase care from the private and voluntary sector.
This policy became a matter of statute under the 1990 NHS and Community Care Act. The Act stipulated that individual care packages would be organised by local authorities with input from voluntary and charitable organisations. The terms of the Act resulted in an increase in the burden of care for the social work profession. Under the 1990 Act social workers are required to make initial assessments and then refer clients to the appropriate services. The Act emphasized partnership working in all areas and social workers now have to consult with professionals from all walks of life in order to adequately provide for their clients needs. The Government has been committed to this idea of partnership working and has regularly updated the terms since coming to power, and produced a white paper on the delivery of integrated health and social care in July of last year.
When it comes to clients with mental health needs many social workers may find themselves working in conjunction with the organization known as Mind.
Mind is the leading mental health charity in both England and Wales. Mind has over 200 local associations which run drop in centres, help lines, give housing advice and work with mental health professionals and social workers to improve the lives of people with mental health difficulties. The aims of Mind are as follows
Advancing the views, needs and ambitions of people with mental health problems
Challenging discrimination and promoting inclusion
Influencing policy through campaigning and education
Inspiring the development of quality services which reflect expressed need and diversity
Achieving equal rights through campaigning and education.
Their aims demonstrate that Mind is geared towards the minimalisation of inequalitites and the promotion of the needs and rights of people with mental health difficulties. Mind aims to empower its users and to encourage their participation in assessing and providing for their needs.
Mind campaigns to improve the lives of those with mental health problems and to raise awareness in the wider community so that the public and the Government are more accepting of people with these needs. Mind also advises Government, Health Authorities, and Social Services Departments on what is best practice for addressing mental health needs. In this way Mind might be said to be a good advertisement for partnership working which, as Molyneux (2001) reminds us can sometimes be problematic.
Social Services and Mind
Mind is aware of the contribution that social workers make and points out that the right kind of social care can go a long way to alleviating the stress that mental health difficulties may bring. At present mental health users receive only a small amount of social care and are often referred for medical help alone. However, this course of action neglects the enormous social consequences that mental health difficulties can have and how it affects family units. Greater availability of social care would go a long way to alleviating such difficulties. The increasing Government emphasis on partnership working should lead to a greater connection between those who work for social services and the staff of mind. The two of them together could be of considerable help in assisting sufferers to reintegrate back into society after a long hospital stay.
This paper has examined some of the theories and structures underlying social service departments and the charity called Mind. It has looked at the legislative and policy contexts as they apply to people who need social care and who may also have mental health problems. It has looked at partnership working and how the responsibilities that are incumbent upon social workers are intended to minimalise inequalities and to substantially lessen the power differential between service users and service providers.
Banks, S. 2003 From oaths to rulebooks: a critical examination of codes of ethics for the social professions European journal of Social Work Volume 6 No. 2 July 2003 p. 133-144
Brayne and Martin 6th ed. 1999 Law for Social Workers London, Blackstone Press
Molyneux, J 2001 “Interprofessional team working: What makes teams work well?” Journal of Inter-professional Care 15 (1) 2001 p.1-7
Disability Discrimination Act 1995 http://www.drc-gb.org/thelaw/thedda.asp