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Purpose – Over the last 12 years there have been substantial developments in UK law and policy relevant to mental health social work practice. The previous legal frameworks across the jurisdictions were very similar but the new laws have developed in different ways and provide greater opportunities for comparison. Across all the jurisdictions policy developments, especially in the areas of recovery and risk assessment, have influenced the way that mental health social workers practice. Design/methodology/approach – This exploratory study used case study vignettes with 28 respondents to examine how these major legal and policy developments impact on social work practice. Findings – There were variations in how levels of risk are defined and often a lack of clarity about how this informs decisions. There was a consensus that recovery is important but difficulties in understanding how this might apply in crises. Predictably, differences in legal and policy contexts meant that there were a variety of perspectives on how mental health social workers applied the laws in their jurisdictions. Research limitations/implications – The limited focus on research informed practice and the lack of transparency in decision making across areas of risk assessment and intervention, use of recovery approaches and the use of mental health laws suggest the need for a more evidence-based approach to training, education and practice. Originality/value – There is very limited previous research on practitioner experiences of the complexities involved in implementing mental health law. This paper provides some insights into the issues involved and for the need for more detailed examination of the decision-making processes involved. [ABSTRACT FROM AUTHOR]

There is an extensive body of research into trends in use of the 1983 Mental Health Act (MHA) and Crisis Resolution and Home Treatment (CRHT) teams, but only one study has examined the relationship between the two. The introduction of these teams led to the belief that use of the MHA would decrease as more people with mental health problems were treated in their own environment when in crisis and at risk of admission to hospital. However, in one county authority in south-east England, the numbers of MHA assessments continued to rise after the introduction of a CRHT team. To investigate this pattern, we examined a random sample of MHA assessments conducted in the catchment area of the CRHT team both in and out of office hours from two time periods—one before and one after the introduction of the CRHT team. The presence of the team was associated with a significant increase in the use of section 2 MHA, although the use of section 3 MHA decreased. To explore these findings, we held focus groups to obtain the views of mental health professionals on the reasons for the continued rise and how their views influenced decisions. We found that the role of the Approved Social Worker (ASW) was poorly understood in the new CRHT team and that communication between it and the ASWs was disjointed. Integration of ASWs into predominantly medical CRHT teams will assist joint decision making about use of the MHA and may help to reduce unnecessary compulsory hospital admissions. [ABSTRACT FROM AUTHOR]

The study reported makes use of an existing database in order to examine a group of individuals assessed by approved social workers (ASWs) under the Mental Health Act, with a view to detention in psychiatric hospital. The study aims to develop a profile of these individuals, their pathways to assessment and the outcome of the assessments, and to examine the social implications of the findings. The study also seeks to identify changes over a nine-year period. The role of the ASW is reviewed in the light of the analysis of the nine-year information. Key features in the social situations of individuals are identified that may be associated with mental health need. Specific aspects of gender and life-stage vulnerability are suggested, as are poor material resources, isolation and lifestyle issues such as drug and alcohol misuse. The close association of psychiatric severity and social disadvantage is evident, presenting assessing ASWs with challenging and complex assessments. Mental health social workers are uniquely equipped to identify issues in the social context that may contribute to mental health crisis. Interventions underpinned by social approaches, including social inclusion and the recovery model, have the potential to help provide services in the longer term that provide social support and minimize the need for crisis admission. [ABSTRACT FROM AUTHOR]

The 'nearest relative' and social work roles in mental health services share common ground. Although the social worker is a trained professional and the nearest relative is identified from a fixed hierarchy of kin, both roles were awarded the authority to make a compulsory order for hospital admission of a person with serious mental disorder warranting detention in hospital. Both roles will alter if amendments to the 1983 Mental Health Act in England and Wales come into force. This article considers the changing roles of relatives, carers and practitioners in the context of policy shifts in mental health legislation and services in England and Wales. Drawing on the interlinked tenets of anti-discriminatory and anti-oppressive practice, it presents an analysis of the interlocking powers of the nearest relative and the Approved Social Worker, and an overview of defunct and existing legal proposals. The article concludes that the lay and professional roles remain in flux but they are still interdependent in many instances. Note: The term 'patient' is used to describe a person who is detained or liable to be detained under the 1983 Mental Health Act. The term 'service user' is used to describe someone who uses mental health services. However, the authors acknowledge that both descriptors are problematic given the stigma associated with the term 'patient' and possible offence caused by defining people by the services they use. The terms are used to reflect the legal status implied and no prejudicial meanings or interpretations are intended. [ABSTRACT FROM AUTHOR]

Approved social worker (ASW) numbers in England and Wales were compared on the basis of two national surveys conducted in 1992 and 2002. These data were supplemented by reports published by the Employers’ Organisation in the intervening years. Although raw numbers suggested a modest absolute increase over this time, rates of ASWs per 100 000 population declined by over 50%. Possible explanations for this dramatic fall are explored. The authors conclude that specific and targeted action needs to be taken by the government and public sector employers to determine the numbers of mental health social workers needed in modernised community mental health services. [ABSTRACT FROM AUTHOR]

The Human Rights Act 1998 adopted the European Convention on Human Rights as a benchmark by which people's fundamental rights are to be respected and enforced. Before the passing of this Act recourse to the Convention was possible, but remedies were not always effective and influence on legislation was variable. With the passing of the Human Rights Act 1998, legislation itself and all public bodies' activities are potential areas for scrutiny by the courts. The implications for professional practice in certain key areas are profound, these being compulsory intervention, detention and treatment, protection of the vulnerable, privacy, and rights to family life. This article explores how the Convention may influence professional practice in the area of mental health. It does so by exploring key points of intervention at which professionals need to be mindful of the context for decision making set by the Convention and identifies a number of core principles for mental health practice already established by the European Court. The article is intended as an introduction to the role of the European Convention on Human Rights as it applies to practice and assumes no previous knowledge of case law or the Convention itself. It is not intended as an exhaustive account of the full implications of the Convention for all areas of practice. [ABSTRACT FROM AUTHOR]

Social Role Valorisation theory, advanced to enhance the lives of disadvantaged groups of people, has addressed community care and lay advocacy for patients and users but has ignored the roles of relatives and carers. [In this article, the term 'patient' is used to describe a person who is detained under the Mental Health Act, liable to be detained, or in hospital on an informal basis. The term 'service user' describes someone receiving psychiatric services but who is neither hospitalised nor subject to compulsion. J The nearest relative was introduced as a legal category under the Mental Health Act 1959 without a theoretical base, although it was perceived as a safeguard and a way of supporting advocacy for patients. If recent proposals to reform legislation come into force, the role of patient advocacy will be enhanced whilst the nearest relative will be replaced by the new roles of nominated person and carer. This paper reinforces the importance of using governing principles to guide legislation, as supported by the most comprehensive in-depth research recently conducted into the nearest relative role. [ABSTRACT FROM AUTHOR]

This article reports on the first extensive survey of Approved Social Worker (ASW) activity in Northern Ireland. It begins with a review of literature that identifies the complexity of legal and professional functions expected of ASWs, in the context of mental health legislation in the UK. Findings include high levels of perceived competence reported by practitioners, but diversity in the management of the service, and some problems in multi-disciplinary working. The emergency, out-of-hours duty teams in which many ASWs were employed appeared to vary in organization and operation. Service users and carers were generally dissatisfied with the responses to crisis services and appealed for adequately funded community supports. At a time when the review of the Mental Health (England and Wales) Act, 1983, is taking place, the authors suggest that ASWs can still perform an important statutory role, on condition that there is a more consistent approach to training, re-approval and funding of community-based services. [ABSTRACT FROM AUTHOR]

The government green paper, 'Reform of the Mental Health Act 1983', was published in November 1999, for consultation by end of March 2000. This article offers comment on the operation of the Mental Health Act 1983 and the proposals for change, from an approved social worker perspective. Under the Mental Health Act 1983, approved social workers undertake social assessments of mental health crises, deciding upon the need for compulsory admission and treatment. To the debate on legislative change they bring a detailed social perspective on the processes and outcomes of statutory mental health intervention. Approved social workers' main concerns relate to the social context of mental health need, the availability of social resources, civil liberties, protections for people subject to statutory mental health interventions and the effective regulation of practice and services. Current proposals include options that would significantly reduce approved social worker involvement in decisions about compulsory admission and treatment; the implications of this are discussed. [ABSTRACT FROM AUTHOR]