The Role of the Mental Health Social Worker: Political Pawns in the Reconfiguration of Adult Health and Social Care

The contribution of mental health social work (MHSW) to multidisciplinary care delivery has been subject to political pressures for change since the introduction in the UK of the National Service Framework for Mental Health in 1999 and subsequent New Ways of Working (NWW) initiative in 2003. Culminating in the new 2007 Mental Health Act for England and Wales, Approved Social Workers have been replaced by Approved Mental Health Practitioners (AMHPs) with the role and remit extended to other disciplines. Given this political context, this study uses an ethnographic methodology to draw together qualitative data from four reconfigured mental health teams to describe and debate the MHSW contribution to NWW. This contribution was of particular interest to the authors, as both were mental health social workers by background, with one of the authors having worked as a MHSW in Sri Lanka and the other having practised as an Approved Social Worker (ASW) and supervised ASWs in a multidisciplinary team England. Participant observations of team meetings/activities, together with joint home visits and interviews, provide an understanding of the social work contribution from a range of perspectives. Thematic analysis of data reveals that MHSWs experience a clash between their unique social work contribution and their role as generic care co-ordinators. Furthermore, there is stigma and reduced status associated with being a MHSW when compared with colleagues from other disciplines. Political issues beset the roles and responsibilities of MHSWs impacting at the level of pay and conditions of employment. The paper concludes with recommendations for managing the political schism in a service that is dominated by health and where local authorities play an increasingly peripheral role in managing and supervising seconded staff.