“A social worker will ask: have you got food and warmth, is your accommodation okay, are you sleeping well, and could you get more support or benefits? Social workers can really help you to navigate through systems and services that you need but aren’t even aware of. They can also help you to accept who you are.” – Harris’ story
Social workers can be a lifeline for people living with severe mental illness. Taking a social approach – looking at people’s broader needs in terms of housing, employment, rights, and navigating health systems – they make a big difference to people’s quality of life.
However, a recent report from the organisation Think Ahead emphasised that mental health social workers are repeatedly ‘overlooked and undervalued’ members of the mental health care workforce. It finds that there are currently around 8,700 social workers in adult mental health services in England, just under half of them in the NHS. This makes them just 2% of the mental health services workforce.
In our 40 years of work at Centre for Mental Health, the value of social work, and social interventions more broadly, has always been apparent. Mental health inequalities are social and economic inequalities. The social determinants of mental health play a fundamental role in all of our lives. And so social interventions are crucial, both to the prevention of mental ill health, and the treatment and support required by people living with mental health difficulties.
There is clear and ever-growing evidence about the importance of social factors in our chances of having good or poor mental health throughout life, and in outcomes for people using mental health services. Having enough money to live on; being in a home that is secure, where you are safe from harm, that’s warm and dry; having a good job; living in a neighbourhood that’s safe and where you feel connected: these are all foundations of good mental health that too many people don’t have today.
Instead, we know that people living with a mental illness face high levels of poverty, housing insecurity, and fear. Half of people with a mental illness are in food poverty in England. Around a third are not in secure accommodation. It’s not surprising that life expectancy is cut short by up to two decades.
It’s only by addressing the social elements of living with a mental illness that health and care services can hope to meet people’s needs adequately. That means supporting people to get work when they want a job. Providing advice and help to navigate the social security system, to get the benefits they’re entitled to, to deal with problem debts and poor quality housing. And helping people to build social connections and have a life that has meaning for them.
Social workers don’t have sole responsibility for these matters. Every mental health professional can be attuned to people’s social needs and offer relevant help and support. And for some areas – such as employment and benefits advice – specialist workers are essential to provide the right support. But social workers create a culture where people’s social needs are front and centre of mental health care, complementing clinical and experiential knowledge and expertise, and holding the rights of people using services in mind at every step.
Social workers are also still a majority of approved mental health professionals (AMHPs) with a pivotal role in the application of the Mental Health Act in England and Wales. AMHPs secure people’s rights and provide essential scrutiny over the use of state powers. With reforms of the Act in progress now in Parliament, AMHPs will be at the heart of their implementation, ensuring that improvements to the Act translate into people’s lives and experiences.
Mental health social work, and social workers, are too often overlooked and taken for granted. It’s time we all valued their unique contributions. We must plan now for a future where social perspectives are embedded universally as routine business in every mental health service nationwide.
