Describe how social work practice has responded to the changing needs of this particular group within the last two decades.
Mental health can present itself in many different way such as; anxiety, depression, and substance abuse. Mental disorders as suggested above may not only occur at times that could be a predictable reaction to a life changing event such as, bereavement (Colman, 2006). A mental disorder is a pattern of psychological symptoms that may show a common foundation or recognisable pattern, that will negatively affect important areas of functioning or significantly increase the risk of death (Colman, 2006).
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This essay will concentrate on the aspect of self-harm in young people. Self-harm is an act which consists of deliberate injury or pain being inflicted to one’s own body. Most commonly this takes the form of cutting, however, some other forms include; burning, scratching, picking, scraping, biting and sometimes pulling hair or eyelashes out. Self-harm is often used as a release of emotions that cannot be spoken and can offer the individual the means to attempt to deal with distress (Babiker et al, 2001).
Twenty years ago there was an emphasis on joint working however, this was not easy to achieve due to organisational cultures and professional language barriers, but research does show this to have better outcomes for young people and their families. This concept of joint work has continued throughout the last two decades. Government policy in recent years has supported joint work and also occasionally placed statutory duty upon agencies to achieve it (Southall, 2005). These barriers can be overcome by Professional Capabilities Framework (PCF) 8 which states the need to adapt to changing contexts and to operate effectively with in multi-agency settings. Within the Standards of Proficiency (SoP) standard 9 depicts the abilities to work with others, including those in a different role. Due to PCF 1 these difficulties should no longer be an issue because social workers should be committed to their own professional development, which should be enough to break down the barriers between the different professionals.
The ethos of mental health has changed immensely over the past two decades. Mental health is more open to the public as, an illness that affects many people and does not make these people a definite threat to those around them. According to Ray et al (2008) social work has a significant role to play in organizing efforts, to support individuals and groups who may often have negative encounters and perceptions of mental health services. Social workers need to maintain a broader social view of mental health problems, specifically in regard to concerns about discriminatory practices, civil rights and social justice these aspect are included in the PCF’s; ‘values and ethics’, ‘diversity’ and ‘rights, justice and economic wellbeing’. In accordance to the PCF 5 social workers have the knowledge, training and education that allows them to develop understanding and awareness of issues such as oppression, power and social exclusion and it has made social workers aware of their own abilities for oppression towards others.
The view of the service user for mental health is hard to define as organisational structures are changing, many service users do not receive services equally or evenly. Service users for mental health and young people would include families as well as the young person, many of these families value social workers that are able to provide counselling, practical help and advocacy on their behalf. They also value the non-stigmatising access to services and help provided by social workers (Ray et al, 2008). However, according to Lewis et al (2012) it is difficult for young people and their families to be involved in their own treatment and care as, they struggle to get their voices heard. SoP 9.4 specifically states ‘be able to support service users’ and carers’ rights to control their lives and make informed choices about services received’ therefore, their voices need to be heard as they are the people that can say what services are needed.
Social workers have a key role in providing an independent view in assessments and they have a distinguishing role in multi-agency settings. Providing critical perspective drawn from a range of social sciences has been paramount to the training of social workers in mental health services. Additional responsibilities will be likely for social workers employed in a mental health trust such as, care management and representation of social circumstances in mental health tribunals. Social work practise is underpinned to promote social justice and challenge oppression, therefore social workers are, in theory, well placed to aid other mental health professional’s working with service users and to collaborate on ways of recovery. As previously suggested, managing efforts to support groups and individuals who may see mental health services negatively is another significant role for social worker (Ray et al, 2008). These roles comply with the PCF of ‘interventions and skills’ and the ability to use these skills affectively along with SoP 9.1 and 9.2 which support sustaining professional relationships with service users to provide an informed assessment. The PCF ‘context and organisations’ and SoP 9.6, 9.7, 13.1 and 13.2 all show a reflection of working within a multi-agency setting. To promote social justice and challenge oppression the PCF’s of ‘Diversity’ and ‘Rights, justice and economic wellbeing’ and SoP 13.3 and 13.4 which state the need for awareness of cultural changes and injustice and their impact on demand for social work services.
Spicker (2012) recognised that after 1948 the main purpose of the ‘welfare state’ was to promote the delivery of the social services on the same foundation as the public services. An important element of the labour government was the Children’s Act 1948. However, amendments were made to this act in 1989 suggesting that a child is considered to be at harm if there is an impairment of health which includes mental health. The definition of a child in need is one that is unlikely to achieve a reasonable standard of health without the provision of services. The Health Act 1999 contains an extensive section on partnership with other authorities, which suggests that the NHS will exercise their functions along with other authority bodies and they will cooperate with one another to secure and advance the health and welfare of people in England and Wales. The white paper ‘Modernising Social Services’ (1998) suggests that the launch of the Quality Protects programme will transform the whole of the children’s social services by improving protection with eight regional Commissions for Care Standards and working to national standards. The white paper ‘Modernising Health and Social Services-National Priorities Guidance’ (1998) commits to reducing waiting times for services along with contributing to the development of outreach teams. This paper also wants to increase and improve services for children and adolescents including early intervention and prevention programmes for children. The Metal health act 2007 suggests a new definition for mental disorder which abolishes references to categories of disorders. Alongside this is another amendment that will directly affect the services provided for young people with mental health disorders, the act now suggests that patients under 18 must be accommodated in an age appropriate environment.
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The department of health (2010) states, in September 2010, the coalition government announced a new strategy, ‘No health without mental health’ with the aim to promote good mental health and well-being and prevention of mental ill health. Along with this strategy they published a framework which sets out how organisations can meet the six objectives made by the strategy. The main part of this framework that will affect young people that self-harm would be the early intervention of services. Schools will promote good mental health for all young people and those that are at risk will receive targeted support (Department of health, 2011).
According to a public survey (Prior, 2010) a vast majority of mental health sufferers have experienced discrimination regularly. The government is working with partner organisations such as ‘Time to Change’ to improve mental health outcomes and reduce social barriers for people with mental health issues. The department of health has become the first organisation to sign up to the ‘Time to Change’ scheme. The aim of this scheme is to stop discrimination towards people with mental health issues and to educate the public. They have launched an advertisement that suggests that it is acceptable to talk to people about mental health and that it should not be kept secretive (time-to-change, 2008).
With many different changes continually occurring, that involve the whole of the United Kingdom, there should be an impact on social workers and their role when working with young people that self-harm. If the scheme suggested works to its full capacity then the amount of young people that self-harm could reduce, however, this could be detrimental to the service that is provided because if the service is not widely needed, it may not be fully funded and then the best possible service will not be given to the young service users.
This research suggests that there have been changes within the field of mental health and young people over the last twenty years. With the PCF and SoP in practise, difficulties suggested with partnerships, should not happen in the future. As social work training slowly evolves and incorporates the PCF and SoP, the knowledge that social workers obtain has changed immensely within the last two decades. One massive change has come from society’s view of mental health, with organisations along with the government these views have, and are being changed. The government has released an number of acts that have enhance the structure of the mental health field, these acts along with strategies and frameworks still in their early stages should hold great hope for the future of the services provided for young people with mental health issues.
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