Outline the key areas of knowledge, skills and values required to carry out an effective and anti-oppressive social work assessment. Illustrate your answer from ‘one’ of the following areas of professional practice: Mental Health
The key areas of knowledge, skills and values which are required to carry out an effective and anti-oppressive social work assessment within the are mental heath have been set out within the various theories of social work assessment and involve engagement, effective communication skills, good inter-personal skills, non judgemental viewpoints, planning skills, confidence, experience, knowledge of the service user’s case history and an informed approach to assessment of users (Williams, (2002) 1) (Cambridgeshire and Peterborough Mental Health Partnership NHS Trust (2006) 14). This list is by no means exhaustive and it certainly is the case that there are some skills which merely require common sense and a pragmatic approach to the practice of social work assessment (Cree, V. (2003) 40) (Payne, M. and Shardlow, S. (2001) Ch. 1). From the writer’s perspective, specifically within the area of mental health, these skills arguably need to be more attuned in the social worker who wishes to carry out effective and anti-oppressive social work assessment. The social worker within the area of mental health will also require a firm knowledge base of the ways in which mental illness may manifest itself, and therefore the social worker will be able to identify the symptoms of common mental illnesses such as depression, bi-polar disorder, schizophrenia and others more readily and accurately. In this sense a combination of a good knowledge of the theory and practice of mental health social work will be essential tools for the social worker who wishes to be able to carry out effective and anti-oppressive social work assessment.
An effective and anti-oppressive social work assessment in the area of mental heath is a complex process which requires an understanding of the complex socio-legal environment that the social worker often operates within (Beckett and Maynard (2005) 46). This means that the social worker will need to be familiar with the various regulatory and legal frameworks within which they must operate (Higham (2006) Ch 1) (Beckett, C. (2006) Ch. 1) (Davies, M. (2000) 1-20). The social work care ethos is also increasingly making the role of the social worker more onerous and this viewpoint is supported by the presence of more prescriptive practice guidance in the area (Beckett, C. (2006) 4) (General Social Care Council (2006) 1). The Department of Health has issued specific policy guidance in the area and in particular the policy guidance which is of relevance here is that which relates to vulnerable adults and the mentally ill. The General Social Care Council, which was set up in 2001, has issued guidance and codes of conduct for social workers outlining these frameworks and the context in which they should be adhered to, and this is particularly highlighted by the General Social Care Council themselves through their website (http://www.gscc.org.uk). Other bodies such as the Social Care Institute for Excellence have conducted sociological research which has shaped these contexts and frameworks. Within the sphere of mental health care assessment, the Social Institute for Excellence has issued guidance on how the needs of mentally ill older people should be assessed and they have given the following advice about mental health care assessment: ‘Everyone has mental health needs, though only some people are diagnosed as having a mental illness….older people are more likely to experience events that affect emotional well-being, such as bereavement or disability….Health and social care professionals should carry out an assessment of the needs of…people they are working with, which means talking…about…health and any illnesses or disabilities…finding out…any problems…. (www.scie.org.uk)’.
This above mentioned guidance has made the position of social worker more complicated. This rationale particularly applies to the area of mental health, because the skills needed to deal effectively in this area require an ability to relate to people across a whole spectrum of ages. In this sense, anti-oppressive and effective social work assessment is key. However, what are the ingredients of an effective and anti-oppressive social work assessment? Perhaps this is a question which invites an extremely broad response, which is open to subjective interpretation. Nevertheless, it is possible to argue that planning and effective assessment are two of the most important competencies when it comes to social work assessment. This is the case, perhaps primarily because the law requires the social worker to be aware of the legal duties which they owe to mentally ill and other patients (General Social Care Council (2006) 1).
However, the assessment of mentally ill patients is often associated with a minefield of difficulties. One piece of legislation which is relevant in this regard is the Mental Health Act 1983 which is often instrumental to social workers in their efforts to deliver appropriate care within the area of mental health. However, this piece of legislation places legal responsibilities upon social workers as well as other social care professionals who deliver frontline services to mentally ill people. It is a controversial piece of legislation and it is also regularly invoked by professionals within the field of social care. This makes the responsibilities which are owed by social workers to their service users even more crucial, and it makes good values such as understanding, non-judgemental behaviour and views and honesty even more important within the sector of social work assessments.
It is the case that many controversial issues come to light when the Mental Health Act is invoked in the interests of a mentally ill user who lacks the mental capacity to care for themselves. Firstly, there is the issue of deprivation of liberty by virtue of the Mental Health Act, and a social worker will often be asked for their opinion in the execution of the provisions of the Mental Heath Act, or they will be required to support service providers such as doctors who may not know a patient as well as the social worker does. This legislation allows for a mentally ill person to be ‘sectioned’ and brought to an institution against their will in order to receive treatment for mental health problems. In this particular regard, the principles of effective and anti-oppressive social work assessment are very important, not least because the input of social workers will often be considered key where a doctor or other senior health care professionals will be required to invoke powers under the Mental Health legislation.
A mentally ill person often may not appreciate what care is best for them, and interventions are often necessary to deliver the care that is required. However, this power of intervention can be abused, misused and conversely it may negligently not be invoked when it should have been. This is where effective communication and interpersonal skills are pivotal to the social worker who wishes to carry out an effective assessment. The powers which may be affected under the Mental Health Act require the support of two of more health care professionals, one of whom must usually be a doctor. This means that the social work must be capable of communicating their opinions on the most sensible intervention, the service user’s history and background, to the various actors who will be involved in the process whereby the need of a mentally ill person will be assessed (Scottish Executive (2006) Section 1.3) (Hill, M. (1991) Ch. I) (Philpot, T. (1998) 1-10). Communicating their opinions may not always be a direct process, which is why social workers are often required by law to keep adequate records and case histories of their contact with vulnerable people in their capacity as social workers, so that information can be communicated to other professional actors who need to rely upon it through record keeping.
On another level and in terms of communication and interpersonal skills, the social worker must also be able to communicate with the service user themselves. This is particularly difficult for the social worker, as they will often be the first individual who will be informed that a mentally ill service user is perhaps in need of the intervention of social care providers. In this context, and from the personal point of view of the writer, planning the interaction between social worker and service user through reading the background and case history of the person involved, if this information is available will be pivotal. This process is all the more difficult as the service user may lack any communication, and or inter personal skills. Mental illness is often a very absorbing process, and the service user may also be frightened or delusional, and consequently not capable of effective or any communication. Therefore the social worker’s communication and inter personal skills are often tested immeasurably within the context of a mental health care assessment, and are crucial tools if assessment is to be carried out effectively and anti-oppressively.
The interpersonal and communication skills which are needed must also be non judgemental, and this is very important if an anti oppressive assessment is to be carried out. The social worker must be prepared to distance themselves personally from the situation, and not to take any unwarranted criticism from the service user with mental health too personally. The person will inevitably feel very threatened by interventions from outside agencies and actors, and this will often lead to an angry reaction from the service user involved. It must also be remembered that communication between social worker and user may not always be through language, and therefore a calm outlook on life, as well as confidence and experience are also key factors which must be considered by the social worker who wishes to carry out appropriate assessments. These factors will often be picked up on, even sub consciously by the mentally ill service user, who may feel more threatened if they feel that the person who approaches them to assess their needs is not entirely confident of their own abilities.
In conclusion therefore, there are many skills which are critical when the needs of a mentally ill person are to be assessed and these may often be described in terms of knowledge, skills and values. This essay has argued that out of all the competencies that a social worker must have, communication skills, interpersonal skills, record-keeping and planning are arguably the most important. Sound values and skills such as administrative and managerial skills are also pivotal, but this essay has argued that without good communication skills, in particular a social worker’s ability to carry out effective and anti-oppressive assessments will be compromised.
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