SOCIAL WORKERS AND MENTAL HEALTH SERVICES (Hansard, 22 December 1981)

§ Lord Elton

The tasks which the 1959 Act assigned to "mental welfare officers" (ie people, normally from among their social workers, appointed to undertake these tasks by the Social Services Department) relate to the making of applications for hospital admissions under Sections 25, 26 and 29 of the Act. It is already normal practice to interview the patient before such an application is made, and most local authorities already try to prepare the people they designate for these special responsibilities through a special training course, but neither of these are legal requirements.

The new Bill will alter the situation in two ways. 404WA In the first place, under Clause 43, only social workers who have been approved by the authority as, having appropriate competence in dealing with persons who are suffering from mental disorder", will be eligible for appointment for these tasks (and in approving such people a local social services authority shall, have regard to such matters as the Secretary of State may direct", the intention being that the Secretary of State will be able to advise on training needs etc). Secondly, Clause 16 will create a specific obligation for the approved social worker to interview the patient, before making an application for admission, to satisfy himself, that detention in a hospital is in all the circumstances of the case the most appropriate way of providing the care and medical treatment of which the patient stands in need", As an interview is already normal practice the duty to inquire into the "appropriate way of providing care and medical treatment" provides a clarification of role and function, rather than an additional burden.

We expect that the effect of the requirement that only approved social workers should be appointed will be to reduce the number of social workers involved in making these applications and increase the amount of training given to each. The cost burden of the increased length of training will in general be offset by a reduction in the numbers to be trained. Guidance is proposed suggesting that each local authority should identify the number of people they will require for this work, but information now available centrally does not allow us to form a precise estimate of the number who are likely to be so identified, and therefore to need training; nor is precise information available about the numbers now receiving some training, or the extent and cost of such training.

DHSS statistics show, however, that about 15,000 applications for hospital admissions under Sections 25, 26 and 29 were made in England and Wales in 1979. Of these a few will have been made by the patients' relatives without a mental welfare officer being involved. The number of occasions on which social workers were called out as mental welfare officers to interview prospective patients in their homes, et cetera, because a compulsory admission was under consideration, would of course have been greater than 15,000, because after some interviews no such application was in fact made. We believe that local authorities will see advantage in concentrating this limited volume of work so far as practicable into the hands of a limited number of social workers, so that the people appointed may build up wide experience, and wide contacts with the other services which are involved. In small local authorities, however, there may be only one or two compulsory admissions per week. Approved social workers will, of course, have other duties, as mental welfare officers do now. The cost of providing in-service training, offset against what is spent on comparable training at the moment, is expected to remain a relatively small item in the training budget of social service departments. We do not, therefore, propose any special financial provision for the particular form of in-service training directed towards approval under Clause 43.

The department is currently preparing draft guidelines on the training and approval of social workers for 405WA this purpose. It will be circulated to local authority associations, relevant training and professional bodies, and other interested organisations early in 1982 for their comments; the training proposals take the form of a general framework within which local social service authorities will develop their own training programmes, perhaps in co-operation with each. They will be able to make an early start at this task and should have little difficulty in taking training far enough to implement the proposed new requirement two years after the Bill becomes law.

It is envisaged that the training will be modular in form and that individual social workers who have already had some training will need to undertake only those parts of the training judged necessary to equip them effectively to carry out their legal responsibilities. Additionally some local authorities may choose to use some modules of the training set up under the Bill to enlarge the mental health knowledge and experience of other staff of social services departments, who are not expected to undertake responsibilities under the Bill but are doing relevant work. It is hoped that local authorities will find that the proposed training programme for the approved social worker will make a substantial contribution to development of their mental health services as a whole.