Roger Manktelow, is a lecturer in social work at the University of Ulster, Magee College, Derry; Phil Hughes is an assistant principal social worker with lead responsibility for mental health training in Homefirst and Causeway Trusts, Co Antrim; Frank Britton is an approved social worker and senior social worker in Enniskillen, Co Fermanagh; Jim Campbell is a lecturer in social work at the Queens University Belfast; Bernadette Hamilton is a senior social worker and coordinator of the approved social work training programme in Northern Ireland; George Wilson is now M.S.W. Course Co-ordinator at Queens University Belfast and was an assistant principal social worker and lead trainer in mental health in the Southern Health and Social Services Board at the time of the research.
Correspondence to Dr Roger Manktelow, School of Social and Community Sciences, University of Ulster Magee College, Derry, BT48 7JL, Northern Ireland.
This article reports on the first extensive survey of Approved Social Worker (ASW) activity under the Mental Health (Northern Ireland) Order 1986. The integrated health and social services organizational structure, the adverse effects on individual mental health of the legacy of thirty years of civil conflict and the move from hospital to community care are significant features which have influenced the delivery of mental health social work services locally. The practice and experience of ASWs was surveyed by postal questionnaire and user and carer experience of compulsory hospital admission was investigated by a series of focus groups. The study revealed that two-thirds of ASWs had experience of acting as an applicant in compulsory hospital admission during the past two years. Nearly half (42 per cent) of these ASWs had reported experience of between one and five admissions and one-tenth had completed over twenty admissions in the two-year period. In only a small minority of cases did joint face-to-face assessment with the General Practitioner (doctor) take place; nearly half of ASWs reported difficulties in obtaining transport; and only one-fifth of ASWs had experience of acting as a second approved social worker. Half of ASWs reported experience of guardianship, either as applicant or in making the recommendation. Both service users and carers reported a lack of understanding about the role of the ASW and complained about the lack of alternative resources that ASWs could use to prevent hospital admissions. These findings are discussed and a number of recommendations are proposed for improvements to approved social worker practice.