Social Work Evidence Based Practice Strengths and Weaknesses

Critically analyse the strengths and weaknesses of using an ‘evidence based’ approach to a specific area of social work practice, referring to recent research findings in this area. Specific area: Older adults and mental health

Outlined below is an analysis of the strengths and weaknesses of using an ‘evidence based’ approach to a specific area of social work practice, referring to recent findings with regards to older people and mental health in particular. Social work practice is split into various areas in order, to effectively assist with the problems of different individuals as well as social groups such as older adults with, or affected by mental health conditions and problems such as depression and dementia. Older adults with mental health conditions do and have benefited from well-focused social work practices. The use of the evidence based approach alone or alongside other factors has the capacity to shape social work practices designed to help and protect older adults with mental health conditions.

Of course to maintain relevance as well as professional effectiveness social work practices should reflect the needs of the people being cared for not to mention altering to better practices as empirically demonstrated by the most recent research findings.^[1] As mentioned below evidence based approaches to assisting older people with mental health conditions or issues have led to suggested methods to improve the social work practices that form the basis of the services provided for those vulnerable people that need to use them being made.^[2] Social workers that are tasked with assisting older people with, or affected by mental health problems ideally should use the social work practices that have been proven to assist vulnerable older people the most. Therefore evidence-based approaches can help social workers determine the best working practices to actually use.

To begin with it can be reasonably argued that using an evidence-based approach to the specific social work practices offers social workers working with older people linked with mental health issues strengths. The need for reliable and accurate research into older people and mental health for social work practices is undoubtedly becoming more important as the British population in common with many Western societies is ageing as people are generally living for longer. ^[3]

Past and recent medical research has frequently shown that there is a strong connection between an ageing population taken as a whole and mental health issues becoming more common for older people. An ageing population raises issues and concerns for the National Health Service (NHS), and the Department for Work and Pensions (DWP), which includes the Pension Service as much as it does for social work practices.^[4]

Limited parts of medical research points to some mental health issues or conditions in older people as being preventable, and even in certain circumstances reversible. Social work practices ideally should be altered if it is possible to assist older people that can recover from temporary or reversible mental health problems to do so.

However some mental health conditions and problems affecting older people such as vascular and senile dementia cannot be prevented and reversed, though medication can delay their full onset. In such circumstances NHS or private sector health care services not to mention social work practices have to be adjusted to cope with a higher demand for their use. When possible social work practices should be altered in order to prevent, tackle, or reverse the mental health conditions and that could possibly restore older people to full health. Social work practices should also help older people whose mental health conditions cannot be reversed.^[5]

When older adults are affected by mental health conditions whether upon a short – term basis or upon a long – term basis then social work practices arguably needs to be adaptable as well as practical enough to assist those older adults more effectively. Older adults with mental health conditions may previously have been active normal people used to doing everything for them that suddenly find things much more difficult once their condition or illness becomes well established.

Ongoing medical research is slowly finding new treatments that can in the right circumstances help older adults with mental health conditions and illnesses remain as healthy as possible for as long as possible. The basic assumption here is that when older adults with mental health conditions stay healthier for a longer period of time they could therefore be less reliant upon their carers, the NHS, social security benefits, as well as the social serves provided to them by social workers.^[6]

The reversing or the delaying of the worst or most debilitating of mental health conditions in older adults can help those people to lead normal and independent lives for as long as possible. Older adults that are able to resist or overcome the worst consequences of their mental health conditions will be more likely to retain their self-dignity as well as their independence.

It is the leading of independent lives by the older adults affected to varying degrees by mental health conditions that can potentially receive the most beneficial assistance from their social workers as well as all relevant medical staff. Social work practice that enables older adults to remain in their homes and were possible within their own families gives such vulnerable people a sense of stability as well as helping to keep them in familiar surroundings.

The strengths of using evidence based approach to guide and shape social work practices towards older adults with mental health conditions are therefore in many respects straightforward to understand. As in the majority of social work fields or areas, social workers make use of an evidence-based approach to increase the effectiveness of the social work services that they actually provide to the people who require their assistance the most. Using an evidence-based approach provides data or research that provided it is gathered efficiently and interpreted accurately provides information to social workers to point out the most effective social work practices.

Using an evidence based approach has the strength of allowing the social workers who form social work practices to alter those practices to help larger numbers of older adults with mental health conditions to receive the social work services that should benefit them the most. It should also follow on logically that using an evidence-based approach would allow the resources and also the social services by the social work providers to be used most effectively. Older adults with mental health conditions can influence the type of social work provided to them by highlighting the best as well as the less effective social work practices.^[7]

At the end of the day social work practices are only there to help the most vulnerable older adults amongst other social groups and isolated individuals even though these social work practices might not always be popular with social workers themselves. The strength as well as the point of using the evidence-based approach is therefore that the best interests of the most vulnerable older adults with mental health conditions should always is taken into account.^[8] Indeed the best interests of the most vulnerable older people as revealed via the use of the evidence-based approach are incorporated into both completely new as well as revised social work practices. In theory, and also to a very large extent in practice the use of the evidence based approach is that it has the strength of providing social workers with information and indications about, which older adults that need help due to their mental health conditions and issues.^[9] The evidence based approach means social workers know where to concentrate help as well as guidance as to what kind of social work service would be most useful for these older adults.^[10]

There are actually as well as potentially sources of weakness when using the evidence based approach in forming and subsequently amending when necessary social work practices in relation to older adults with mental health conditions or issues. The evidence based approach to providing information with regard to older adults with mental health conditions is only useful in many respects when combined with other information or procedures that form the basis of social work practices.^[11]

To begin with social workers might have to make decisions with regard to the help or social services that individual older adults with mental health conditions or problems and whether or not to offer them help before the evidence based approach has provided enough information about these specific older adults.^[12] It can and indeed does take time for the evidence based approach to be gathered and evaluated before it is strong enough to alter or perhaps even entirely replace all the relevant social work practices. Social workers need to have social work practices set in place all of the time in order for them to be always able to offer vulnerable older adults their help and advice with regard to mental health conditions. When or if existing social work practices are deemed to be highly effective in helping as well as protecting older adults with mental health conditions there would have to be convincing evidence. Without wide ranging proof that the findings and suggestions from the evidence-based approach could offer profound improvements to the social work services they need not take place. It could improve the social services available for older adults that need or could eventually need to use them in the future.^[13]

One of the weaknesses of using the evidence based approach to assist in the formation and the subsequent shape of social work practices for older adults with mental health conditions is that such an approach does not take other factors or organisations into account.^[14] An over reliance upon the use of the evidence based approach to drawing up social work practices to assist older adults with mental health conditions is that a narrowly focused concentration on such an approach could lead to an underestimation of other actors.^[15] Social workers could underestimate the importance of other private sector and public sector bodies, groups, and organisations that offer services to older adults. Other private sector and also public sector bodies, groups, and organisations offer services to older adults with mental health problems either because the government tasks them with doing so, or because they can make money from doing so.^[16]

In reality this weakness of using the evidence based approach when drawing up social work practices is not really a problem. This weakness is not a profound or serious problem because social work departments are used to working with private sector as well as public sector bodies, companies, groups, and organisations when they set out to deliver social services to the general public taken as a whole.^[17] Providing the appropriate services for older adults with mental health conditions really is an example of public services being delivered by a whole host of private sector as well as public services groups, organisations, and agencies.^[18] Alongside social work departments, the DWP, the NHS, private sector care homes, local authorities, as well as charities for older adults and people with mental conditions provide services.^[19]

The weaknesses of using the evidence based approach for developing social work practices for assisting older adults is that the evidence might not be as complete as would be helpful to social workers. Research into the affects and consequences of mental health issues or problems for older adults has arguably proved insufficient until recently given the ageing populations within the majority of Western societies.^[20] Older adults with dementia or similar mental health conditions frequently need a great deal of care and support as do their carers, and also their families in order to cope with the consequences of severe mental illnesses. Sometimes it is the spouses, the children, or indeed other relatives of the older adults with the more pronounced mental health conditions who can be most adversely affected by the worst consequences of their loved ones’ illness.^[21]

There are weaknesses that the evidence based approach towards setting social work practices for older adults with mental health conditions relating to the limited scope of that approach. Research into older adults with mental health problems and conditions has not always examined the ill affects that such conditions have upon the carers and the relatives of the people with the illnesses or health complaints. ^[22] On a practical level social work practices can be as much about supporting tired or distressed close relatives and carers as it is about assisting the older adults afflicted with or by poor and worsening mental health conditions.^[23] When mental health conditions, issues, or problems adversely affect older adults then it can strain their relationships with their close relatives, especially their spouses or children, which in turn causes stress to all of them. Strained relationships between older adults with mental health conditions and the close relatives caring for them can lead to those older adults moving into care homes and hospitals rather than been cared for at home. Helping older adults with mental health conditions get better can have the benefit of allowing some of them to continue working or indeed to start working again.^[24]

To conclude it has been argued that the use of the evidence based approach to draw up and shape social work practices in relation to older adults with mental health conditions can offer strengths as well as weaknesses to social workers. The evidence based approach to drawing up or shaping social work practices for older adults with mental health conditions offers the strengths of providing social workers with relevant information and data to draw effective policies. The information and data from the evidence based approach research allows social work departments to increase the effectiveness of their social work practices towards older adults with mental health problems. The main weaknesses of using the evidence based approach towards forming and amending social work practices is that it can cause a delay in relevant information being used by social workers, and that it can underestimate the part that other organisations play in providing services to older adults.

Bibliography

Audit Commission / Better Government for Older People – Older People, independence and well-being: The challenge for public services, Public Sector Briefing

Bowers H, Eastman M, Harris J, & Macadam A (2005) Moving out of the Shadows – A report on mental health and wellbeing in later life, Health & Care Development Ltd, London

Brooke L and Taylor P, Older workers and employment: managing age relations, Ageing society 25, 2005, 415-429, Cambridge University Press

Department of Health, A Sure Start to later life, Ending inequalities for older people, January 2006

Estes, C.L. Biggs, S. and Phillipson, C. (2003), Social Theory, Social Policy and Ageing – A critical introduction, Open University Press, Maidenhead

Maria Evandrou and Karen Glaser, Combining work and family life: the pension penalty of care, Ageing and Society 23, 2003, 583-601, Cambridge University Press

House of Commons Committee of Public Accounts, – Improving Public Service for Older People, Twenty- Ninth Report of Session 2003-04 (May 2004)

Riseborough M & Jenkins C (April 2004), Now you see me…now you don’t – How are older citizens being included in regeneration? Age Concern, London

Vincent, J., Phillipson, C. & Downs M., (eds) (2006) The Futures of Old Age, Sage

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Footnotes

^[1] Vincent et al, 2006

^[2] Brooke and Taylor, 2005

^[3] Vincent et al, 2006

^[4] Brooke and Taylor, 2005

^[5] Vincent et al, 2006

^[6] Brooke and Taylor, 2005

^[7] Evandrou & Glaser, 2003

^[8] Brooke and Taylor, 2005

^[9] House of Commons Committee of Public Accounts, May 2004 p. 10

^[10] Vincent et al, 2006

^[11] Department of Health, 2006

^[12] Audit Commission / Better Government for Older People, p.2

^[13] Riseborough & Jenkins, April 2004 p. 6

^[14] Evandrou & Glaser, 2003

^[15] Department of Health, 2006

^[16] Brooke and Taylor, 2005

^[17] Riseborough & Jenkins, April 2004 p. 6

^[18] Audit Commission / Better Government for Older People, p.2

^[19] Vincent et al, 2006

^[20] Riseborough & Jenkins, April 2004 p. 6

^[21] Brooke and Taylor, 2005

^[22] Riseborough & Jenkins, April 2004 p. 6

^[23] House of Commons Committee of Public Accounts, May 2004 p. 10

^[24] Department of Health, 2006