Involvement with service users is an increasingly important part of mental health social work training, but issues of funding and engagement with all communities risk holding it back. Raza Griffiths reports:
For student mental health social workers, involvement with service users can be a vital part of their training, especially for challenging perceptions and bringing a greater understanding of the issues people with mental ill health face.
“Our student evaluation [of involvement] is consistent that anti-discriminatory practice is enhanced. In mental health it is reported that barriers are broken down and stereotypes challenged,” says Julia Wassell, principal lecturer in service user and carer involvement at Buckingham New University.
The value of involvement for social work students is echoed by Joy Fillingham, service user and carer co-ordinator for the social work programmes at Birmingham University. She says that to be able to link theory to practice, and be ethical and reflective practitioners, students need to be in contact with service users and carers throughout the course so they can understand what it is like to feel powerless and unheard and mentally distressed.
“Former students who have become social workers say to me that the involvement activities were the best thing about their course and helped inform their working practice,” she says.
A different point is made by Daisy Bogg, a practice development adviser at the College of Social Work (TCSW). She believes “service users and carers can work from a position of more independence [than universities]”.
Service users and carers themselves can also benefit from involvement through gaining further employment or going on to higher education. So it may seem surprising that service user involvement has only been compulsory in social work education since 2003, although it had been well established on more progressive courses for some years previous to that.
Last year, the regulator for social work education, theHealth and Care Professions Council (HCPC), made service user involvement obligatory in England in all areas and all levels of pre-qualifying social work education. From the next academic year, this will also extend for the first time to other professions the HCPC regulates, such as occupational therapy and clinical psychology.
And, though some critics question the HCPC’s credentials to regulate social work, Laurie Bryant, service user and part-time lecturer at Hull University’s pre-qualifying social work programmes, says: “I was impressed with how rigorous HCPC has been in examining our claims for involvement and how inspectors looked at involvement at every level from A to Z.”
The levels or areas of involvement the HCPC says it will look out for include: development of teaching approaches, programme planning, teaching and learning activities, feedback and assessment and quality assurance, and monitoring and evaluation.
Meanwhile, TCSW, which can endorse but not regulate social work courses, also has “an absolute requirement” for service user involvement in all they endorse, including social work qualifying programmes, approved mental health professional courses and courses of continuing professional development, according to its education adviser, Kate Johnson.
However, it is unclear what the future roles of the HCPC and TCSW will be regarding regulation of social work education, following the publication of reports into the future of social work that gave conflicting opinions. In February, the Narey report said that TCSW should take over registration, whilst the Croisdale-Appleby report, which came out in March, concluded that the HCPC should keep registration while making TCSW’s endorsement of courses mandatory. Nevertheless, both value involvement highly.
Yet despite some of the recognised benefits of involvement in social work education, and the value the reports have put on it, there are issues which need to be tackled. These include lack of involvement of people from the most marginalised communities including homeless people, people with drug and alcohol dependencies and black and minority ethnic (BME) communities. This is concerning, given social work’s strong focus on reducing power imbalances.
June Sadd is a service user who has worked in involvement for more than 20 years at national strategic level, and has taught on the Mental Health and Racism module of the social work course at the University of Bristol. She says courses struggle to involve BME communities because they are suspicious of professionals whom they are likely to see as part of an increasingly coercive mental health system. Or, they may have come into the mental health system “through the psychiatric route without being in touch much with social workers who perhaps could offer more holistic solutions”.
She also believes that people from BME communities feel they won’t make a difference through their involvement to power relations either on courses or in professional practice.
Also, it is arguable whether some universities are doing enough to engage with these marginalised groups, or dismissing them as ‘hard to reach’. Some undoubtedly are, but this is often dependent on particular staffs’ interests rather than being seen as a requirement.
To bring in more people from BME and other marginalised communities, Sadd suggests long-term outreach needing money and time to build trust. But funding for such work is in short supply.
“Addressing issues of power in students’ learning is arguably the most important part of service user involvement and can help undermine structural oppression which social workers might otherwise inadvertently replicate in their practice,” says Sadd.
An involvement role that Sadd believes gives service users and carers real power is the practice educator. Practice educators help students on their first of two compulsory placements in voluntary and statutory agencies with their learning through mentoring, supervision and assessment. Placements make up half of the time students spend on qualifying courses.
Having service users and carers as practice educators can serve as a model for students of more equal power relationships that they can take with them into their future practice. But by 2015, TCSW has specified that to get its endorsement, all practice educators must have a social work qualification, which will exclude service users like Sadd from this role.
Some, such as Bogg, agree with this change, saying it is needed to ensure standards are kept high. But she is also strongly supportive of involvement in teaching and assessment on courses.
Finding the funding
Another major concern is the question mark hanging over funding for social work education generally. Currently, the Department of Health pumps £7,400 per course over 83 universities for involvement for social work courses. Though arrangements vary across universities, this money enables them to pay for such things as paying service users and carers for their work, training and supporting them using university resources and paying an academic staff member to act as key contact person around involvement.
But last December, a consultation looked at options for future funding for the Educational Support Grant which supports universities’ involvement work as well as employers in the statutory and voluntary sectors to provide social work placements. While the recent Narey and Croisdale-Appleby reports, which are part of the on-going review of social work education, say little about involvement funding per se, there is concern among academics over whether involvement funding will be cut.
“Reduction of funding will have a negative impact on involvement unless universities pick up the shortfall,” believes Sadd. Meanwhile, Peter Beresford, director of the Centre for Citizen Participation – social work at Brunel University, believes that the fear of cuts takes place in a worrying wider “political climate which is hostile to social work generally, and is part of the wider trend towards more traditional research approaches and narrower, more controlling and medicalised approaches to social work, which do not value service user and carer involvement so much.”
But Bogg argues that, while valuing involvement, addressing involvement funding also requires us to look at sorting out bigger issues within social work: “We need to evidence the need for more funding and more social workers more systemically, work on how to measure supply and demand and evidence a shortfall in resources better.”
About the author
Raza Griffiths is consultation and events officer at the National Involvement Partnership and a freelance writer.
This article first appeared in the March/April 2014 issue of Mental Health Today magazine. For more information on the magazine, and details of how to subscribe visit www.mentalhealthtoday.co.uk/mental-health-today/