Social Work and Mental Health - a Context Session. Student Connect Webinar 86

Summary

The 86th Student Connect Webinar, hosted by Siobhan Maclean, delved into the intersection of social work and mental health, featuring a diverse panel of experts sharing global perspectives. The session emphasized the multifaceted nature of social work in mental health, touching on the significance of trauma-informed practice, social justice, and cultural sensitivity. Participants discussed challenges such as resource limitations and the need for multidisciplinary collaboration to enhance mental health services, highlighting the critical role of social work in providing holistic care and addressing structural inequalities.

Highlights

• The session opened with a lively introduction, encouraging participants from around the globe to share their backgrounds. 🌏
• Helen Sheppard provided a foundational overview of the challenges faced in mental health social work, emphasizing the need for holistic care. 🏥
• Megan shared reflections as a newly qualified social worker, focusing on the importance of trauma-informed practice and language sensitivity. 🧠
• Soyeb explored the intersection of cultural and spiritual beliefs with mental health, sharing insights from the South Asian Muslim perspective. 🕌
• Tony captivated the audience with an A to Z of mental health social work, blending expert insights with practical tips. 📚

Key Takeaways

• Social work is pivotal in mental health services, offering more than just a support role by addressing broad social determinants of health. 🌍
• The webinar showcased the necessity of trauma-informed practice, focusing on compassion and understanding the impacts of past traumas. 💡
• Diverse cultural contexts significantly shape social work practices, making cultural sensitivity vital in providing effective mental health services. 🌎
• Resource constraints remain a core challenge, requiring social workers to innovate and collaborate across disciplines for the best outcomes. 🛠️
• Social work in mental health is a politicized field, emphasizing the need for systemic advocacy to enhance service delivery and reduce stigma. 🗣️

Overview

In the 86th Student Connect Webinar led by Siobhan Maclean, there's a deep exploration into the essential role of social work within mental health services. The event features an impressive panel of experts from various parts of the world, sharing insights and practical wisdom from different cultural contexts. Participants included social workers from the UK, USA, Maldives, Canada, and more, each providing a unique perspective on the diverse challenges and opportunities within the field.

The webinar highlighted several core themes, including the scarcity of resources and the crucial role of social workers in navigating these challenges with creativity and resilience. Discussions underscored the importance of trauma-informed care and the recognition of social justice and cultural sensitivity as cornerstones of effective social work practice. The interplay between medical, social, and spiritual models of health was also a focal point, illustrating the complex terrain that social workers navigate to support mental well-being.

A significant takeaway from the webinar was the acknowledgment of mental health social work as inherently political, with a need for advocacy at systemic levels to enhance care and reduce stigma. The session closed with a call to action for social workers to remain informed and responsive to evolving challenges, emphasizing the value of multidisciplinary teamwork and the integration of diverse approaches to support those experiencing mental health issues.

Chapters

• 00:00 - 03:00: Introduction and Welcome This chapter, titled "Introduction and Welcome," opens with a welcome to the webinar to all attendees. It marks the 86th webinar hosted and is noted as the second session focused on contextual topics. The specific focus of the evening is on social work and mental health. An impressive panel of guests with diverse areas of expertise and practice wisdom in mental health is introduced, setting the stage for a rich discussion and knowledge sharing.
• 03:00 - 08:00: International Participation and Chat Engagement This chapter provides an introduction to the role and challenges faced by social workers in mental health services. The session is planned to be quite busy, with a lot of content to cover. Participants are encouraged to introduce themselves using the chat function, ensuring that messages are visible to all attendees. The aim is to create an engaging and participative environment where individuals can share information about themselves.
• 08:00 - 12:00: Session Overview and Guest Introductions The chapter 'Session Overview and Guest Introductions' opens with a warm invitation to the attendees to share a bit about themselves, such as their location, their recent activities or meals, and their feelings about upcoming holidays. The hosts emphasize a welcoming and open atmosphere, encouraging participants to share as much or as little as they wish, thereby fostering a sense of community and engagement. This inclusive approach sets the tone for the session, highlighting the importance of personal connections and participant involvement.
• 12:00 - 19:40: Helen Sheppard's Presentation on Mental Health Social Work Helen Sheppard's presentation highlighted the diverse audience attending the mental health social work discussion, including international participants and individuals from various stages of the social work field, such as students, newly qualified workers, and practice educators.
• 19:40 - 33:00: Megan's Reflections as a Newly Qualified Social Worker The chapter, titled 'Megan's Reflections as a Newly Qualified Social Worker', begins with a warm greeting from the protagonist. She expresses her excitement about a diverse group of attendees, including international guests like Adriana, a social worker from America, and a social worker from a psychiatric department in the Maldives. The setting is inclusive and animated, indicating an upcoming discussion or presentation with a global social work focus.
• 33:00 - 43:10: Soyeb's Insights on Cultural and Spiritual Aspects of Mental Health The chapter discusses the diverse cultural and spiritual aspects of mental health explored through insights from different countries. It highlights the varying contexts of mental health in places like the Maldives, Canada, America, and the UK. The discussion aims to be vivid and engaging as it delves into these cultural differences, promising a lively session with much to cover on this complex subject.
• 43:10 - 55:10: Tony Dane's A to Z of AMHPs The chapter titled 'Tony Dane's A to Z of AMHPs' reflects on the image of packing for holidays in the UK, as discussed in recent news. The narrator draws a parallel between the notion of packing for a trip and the packed agenda for the evening, suggesting that everything has been meticulously planned and included for the night's events.
• 55:10 - 60:00: Conclusion and Future Webinars The chapter titled 'Conclusion and Future Webinars' introduces four amazing guests who will each present their part of the session. The program is packed, thus not allowing time for traditional Q&A. Instead, guests will engage with participants through chat, where attendees can ask questions and receive answers from the guest speakers.

Social Work and Mental Health - a Context Session. Student Connect Webinar 86 Transcription

• 00:00 - 00:30 good evening everybody welcome to our webinar this evening tonight is our 86th webinar it's our second context session so tonight we're looking at social work and mental health we've got an amazing panel of guests who are going to be sharing um expertise and practice wisdom um in lots of different areas of mental
• 00:30 - 01:00 health to give you a flavor of what social work in mental health is like and what some of the issues are for social workers working in mental health services so um it's going to be a very busy night we've got a lot to get through so um we're not going to spend very long in this introduction but you know that we generally just ask you as you come in to introduce yourself make sure your chat is set to everybody introduce yourself in the chat tell us a little bit about you tell us
• 01:00 - 01:30 where you are in the world and we like to see when we go international so tell us where you are in the world tell us what you've had for your tea if you like or tell us um if the weather's good where you are or tell us if you're looking forward to having a couple of days off some people might be having a couple of days bank holiday off some of you might be working through the bank holiday whatever you want to tell us i mean you can tell us your whole life story if you want to in the chat we are completely open to whatever you would like to share with us and hi m is
• 01:30 - 02:00 studying at uh i'm not sure how you pronounce that um university in canada that's fabulous so we've gone international already um and i can see that we've got people joining us from all over um the uk as well so if you're a student let us know if you're a student if you're a social worker if you're a newly qualified worker you're a practice educator um i can see david in the
• 02:00 - 02:30 audience it's lovely to see you again david um even though i can't actually see you um it's nice that you're here we've got um a social worker from america joining us tonight too um adriana so fabulous it's wonderful to have so many guests from um other contexts and countries as well um a social worker in a psychiatric department in the maldives that's amazing so what we're gonna have tonight
• 02:30 - 03:00 in the chat is lots of i think learning from um different countries we'll be still talking about the context of mental health but the context of mental health in the maldives in canada and america and the uk is going to be very different so i think the chat tonight will be very vibrant i can imagine um as we go through things so i'm gonna just get straight into the session tonight i think because there is so much to do and as i've said
• 03:00 - 03:30 i was thinking about this image because all over the news this week in england um or the uk there's been a lot of talk about holidays and people holiday in and all of that so i was thinking about packing like things being packed and actually tonight is an incredibly packed night um so the image there of literally taking everything with you on your holidays we have literally packed everything into tonight um we've got
• 03:30 - 04:00 four amazing guests who are going to introduce themselves one by one as we get to their part of the session that means that we're probably going to have such a packed program tonight we're probably not going to have time for questions and answers in a traditional way but all of our guests are here with us and they'll be joining you in the chat so if you want to ask questions in the chat then our guest speakers will be able to respond to you in the chat
• 04:00 - 04:30 and so do use the chat to connect with one another and i think our team will be helping you to think about how to use the chat and make sure that it's all set um appropriately but i'm not gonna mess about any longer i'm going to go straight on into our first guest as i said each guest is going to introduce themselves bought and i'm going to start off by just telling you about helen uh when we decided we were going to do a context session on mental health we thought we
• 04:30 - 05:00 have to ask helen to come along as a guest because helen has been a member of our webinar audience i think since the beginning and we see and helen's always there in the chat always joining in in the chat so we thought we're gonna have to ask helen to come along because when you introduce yourselves at the beginning and helen always introduces herself as a mental health social worker i think she's probably the mental health social worker who has been at the most sessions with us so i'm going to hand straight over to you helen if you're ready
• 05:00 - 05:30 yes thank you siobhan so really pleased to be here um tonight my name's helen sheppard um as siobhan said i'm a mental health social worker and qualified since 2003 um and worked across a number of different um teams including community mental health team assertive outreach team and early intervention in psychosis team
• 05:30 - 06:00 and currently supporting for thinker head trainee social workers so a variety of jobs and i have been an amp as well but i'm currently not approved um as a result of working for the nhs so that's a brief introduction to me so i'm really pleased to be here and i will start so i thought the to introduce the sort of session it'd be useful just to
• 06:00 - 06:30 think of some key facts around people with mental health diagnosis and the fact that they are more likely than the general population to be homeless to misuse alcohol and substances and apologies for the spelling error have a lower life expectancy which has resulted in a much more physical health monitoring within mental health services which is a
• 06:30 - 07:00 good thing um be a victim of crime so unlike the media would want us to think that people with mental health problems are more likely to commit the crime and just to sort of give an example um sort of a relative of mine who was unfortunately uh murdered had a mental health diagnosis of bipolar
• 07:00 - 07:30 and when the person that was convicted of the murder um appealed against this it was mentioned you know that he had a mental health problem that he had medication and that it was likely that he hadn't been taking it so therefore putting some of the blame on to him for the fact that he was the victim of an horrendous crime so that's just an example
• 07:30 - 08:00 um so be unemployed which within mental health services now we do have a lot of employment workers as well involved so um you know that's important within mental health services so next i don't want to say next slide but and then key facts continued include have experienced sexual abuse more likely to have been bullied
• 08:00 - 08:30 following on from the recent book launch more ex more likely to have been care experienced experience violence in the home or run away from home as a young person so they're the sort of an overview really and a very brief overview of the key facts and what i suppose what we're faced with when we're working in mental health so
• 08:30 - 09:00 i've found this quote that i thought was actually quite helpful in thinking about the importance of social work and a rights-based approach to mental health um so it's from the world health organization and it focuses on um the bruton predominant focus of care in many contexts continues to be on diagnosis medication and symptom reduction
• 09:00 - 09:30 critical social determinants that impact on people's mental health such as violence discrimination poverty social exclusion isolation job insecurity or unemployment so the list is long lack of access to housing social safety nets and health services are often overlooked or excluded from mental health concepts and practice and this leads to an over diagnosis of human distress and over reliance on psychotropic drugs to the
• 09:30 - 10:00 detriment of psychosocial interventions and this is a phenomenon which has been well documented over over the years so that sort of presents a picture that suggests that social work has a key role to play within mental health service so this again this is a quote that i found from us and survivor user network
• 10:00 - 10:30 so put in place in the importance of social work in mental health so social work's in a good position to consider the whole person rather than the dominant medical model when it comes to mental health social work the physical mental and social well-being of people social work looks at persons history not just their behavior and medication and can help service users think beyond the medical model relationship-based work is an important
• 10:30 - 11:00 role of social work and social workers are well placed to support people through a system so taking account of everything involved with the person the environment everything that was now mentioned earlier and the relationship-based work that we do as social workers that we we spoke about in the webinar last week um is key
• 11:00 - 11:30 so why why is social work important in mental health so thinking about our own knowledge skills and values within social work and i think and megan will bring in some of this as well focusing on social justice and human rights so for example making people aware of their rights especially um you know under the mental health act and care act mental capacity act
• 11:30 - 12:00 so having knowledge of those key pieces of legislation which um we learn about in our training and use every day at work so we best play well i feel we're best placed because we learn about those their core part of our training we have awareness of inequality oppression and discrimination and
• 12:00 - 12:30 bringing that into the work and being able to challenge that um when appropriate and needed and we have we promote recovery and social inclusion which is key to um recovery within mental health and some of the concepts within mental health now have actually you know have been not stolen but taken from social work so recovery strength based approach
• 12:30 - 13:00 um psychosocial interventions is what social work was doing before the whole of the mental health system took it on so um they're all key to working within mental health so in terms of like the and thinking about this social model it's um just some sort of key points there so we do promote the social model that
• 13:00 - 13:30 isn't to say that the medical model is you know totally not taken account of every approach is needed within mental health but as social workers working within mental health we promote that understanding of the structural inequalities that impact on people's mental health on people's lives and
• 13:30 - 14:00 like it says thinking about impact of relationships support networks and everything that's going on for that person so we need to understand mental in illness in the context of people's relationships and their environment so i just thought because i've heard siobhan speak so many times i had to mention what why and how and i know that
• 14:00 - 14:30 if we ignore the why that we're focusing on um medical models so i applied it to some work that i was doing and thought this might just demonstrate it it's sort of quite a brief example of applying this so i was working with um a woman so what she presented with
• 14:30 - 15:00 often was low mood suicidal thoughts and plans she had a lack of motivation and she was very isolated so the doctor prescribed some medication including an antipsychotic and an antidepressant and at one time point she was admitted to hospital under section two of the mental health act and it was very distressing for
• 15:00 - 15:30 um throughout this period but what i felt and i did discuss within the multi-disciplinary team was the why and to me the why was that she was an asylum seeker she lived in an appropriate housing which was basically a two-bedroom house for six people um which is basically her and her five children she experienced numerous losses
• 15:30 - 16:00 in terms of loss of status because she had a good job in the country that she'd left loss of income because she was dependent on the amount of money that um the government gave to asylum seekers loss of partner because he was currently in another country and the isolation due to covert 19 and they all impacted at the time on a mental health when she was talking to me and building that relationship with her the key
• 16:00 - 16:30 points were that she wanted she wanted to work but she couldn't work because of the law and her immigration status so the outcome was that once the covered restrictions were reduced we looked at accessing local resources within the community and she began volunteering at a local food bank and attended a photography group for asylum seekers and they did a
• 16:30 - 17:00 display of um photographs it was you know really positive to see um her mood improved without the need to change the medication again because the psychiatrist wanted to continually change the medication and my view at the time was medication isn't really going to do much keep changing it because she's
• 17:00 - 17:30 it's her social circumstances that are really impacting on your mental health at the moment and with everything that was going on so like i say without considering the why there would be focus on medication only and whether hospital was required so that that is just my brief brief example of um using that framework
• 17:30 - 18:00 and then so with it so what i thought was then just to very briefly mention how do we promote and keep our professional identity within a mainly health dominated um setting so what what we've done within bradford is we have a social work forum that meets each month and we meet up have training sessions we've made links with other trusts including
• 18:00 - 18:30 one of the other speakers tonight and we share training sessions share ideas we've introdu have think ahead trainee social workers which is raising the profile of the trust and social work within the trust and apprenticeships and we have a dedicated section now on the social worker role on the trust website and recently this week in fact we now have a
• 18:30 - 19:00 trust social work twitter page so and that's that's all from me so thank you thanks so much helen that really um gave us a really good broad introduction into um mental health in the uk as i was listening to it i was thinking about you know the people from other countries and whether the context is the same because i believe in america um you know social
• 19:00 - 19:30 work is um most mental health services are provided by social workers that's my understanding whereas for us we're more of a minority um in terms of mental health provision and i think that came through really clearly what i really liked though helen was your real focus on oppression and discrimination and social justice because for me when i started my career in mental health and i always used to think there's almost like this chicken and egg thing isn't there around depression and
• 19:30 - 20:00 discrimination because for me a lot of oppression and discrimination can lead into mental health concerns but mental health concerns will lead to oppression and discrimination and it becomes a vicious cycle really that only social workers can you know we can we can try and help to break that but sometimes we actually become part of that so um i think you really highlighted that really clearly so thank you very much for that that was great intro for us and we're going to go on now to again someone who's joined us very often um
• 20:00 - 20:30 in the webinars and i think um when we first said we're going to do a mental health context webinar then um megan contacted us and at that point megan and i think you were very newly qualified i think he'd kind of just graduated perhaps and yet now it's taken us so long to get round to this um context session because we planned so far in advance that actually i think you quiet our way through your um asye year now aren't you megan sorry
• 20:30 - 21:00 and over to you yeah sure um yeah i finished my asy in three months so it's absolutely flown by and i work within an inpatient mental health hospital within kent county council and so yeah i graduated in june last year uh then joined my role in july and started at asye in september so one of the things that shiborn and i discussed was really just the reflections that that i've made being newly qualified within the mental health services and my final
• 21:00 - 21:30 placement my 100 day placement was within a forensic mental health setting which sort of kick-started my passion for mental health really and yeah i can't really see myself going out men's health now i am it is definitely my passion i think um so one of the first things that i did want to speak about which you probably all hear about quite a lot um on the the first slide is about multi-disciplinary team working and one of things that this is one one of
• 21:30 - 22:00 the things we spoke about a lot at university um yeah it's just it was always emphasized to us at university and i think throughout my my esy it has really been proven how essential this is and within my role we work with him with a range of agencies so community social workers housing fire and rescue service health colleagues we work with everyone across the board really and i think the main point i wanted to make about mdt working for sure is
• 22:00 - 22:30 how important it is to have these opportunities to share the information with the other professionals that you are working with and it makes such a difference in safeguarding as well because there have been many times where somebody that i'm working with has disclosed information to me that we share with the safeguarding team under section 42 of the care act and having those other professionals involved as well with you know everyone has a different area of expertise so there may be something that might be
• 22:30 - 23:00 best managed by the gp for example or the police so having this team working together helps you to work towards better outcomes for the people that you are working with so i thought that was probably the best thing to start and really that sort of came out for me um but saying that i think that's linked quite well to my second slide um when we're talking about the best outcomes for people we work with unfortunately we do have a lack of resources which again is
• 23:00 - 23:30 probably something that is mentioned not just within mental health but within all parts of social work and i work with a lot of people that benefit from having support workers going into their home after they've left hospital just supporting them with regaining confidence and just having that independence again after their stay in hospital but something that we have found that is quite common unfortunately throughout my job so far is that the waiting list for these sport workers can be very long
• 23:30 - 24:00 and it's obviously frustrating because you know sometimes this these people are well enough to leave hospital but their social care needs may very well be the thing that that could bring them back into hospital if those needs aren't met and we work as hard as we can to find alternatives if possible but that isn't always possible so there is that constant frustration of trying to work as hard but as quickly as you can to to find those things that are desperately needed
• 24:00 - 24:30 and i think one of the the things that really highlights this is that i read um the waiting for care report that was published by ada i think it was early this month um and it shows from this report that within the first three months of this year almost 170 000 hours a week of home care could not be delivered due to a shortage of care workers which is a seven-fold increase in this time last year which just shows how
• 24:30 - 25:00 significant the needs are and they aren't always being met which is incredibly unfortunate but that is the the reality of of what is happening right now and with the people that i work with in hospital where if they have you know eligible social care needs then we would pass the information on to our community team so they can be reviewed when they're back at high and make sure the care and support is is still suitable for them and you know sometimes there are those
• 25:00 - 25:30 delays in getting that that support in place and yeah it just seems at the moment very common um having those delays unfortunately the next thing that i wanted to speak about which again is probably something that's very often mentioned um is trauma reformed practice and over you know the last few months that have been within this role is i've realized how much of a huge part this plays in people's lives and sometimes their mental illnesses and
• 25:30 - 26:00 the behaviors that are associated with that could be the reactions of the trauma that they either are going through now or they have already been through and i found that it is increasingly common for the people i work with to have gone through trauma whether that is a breakdown of relationships domestic abuse bereavement or anything like that i did complete my dissertation at university around the long lasting effects of emotional abuse
• 26:00 - 26:30 um on children as they go into adulthood and i think that has really put into context for me being in this job at how common it is for survivors of the abuse to experience these mental health difficulties and something i thought would be really good to mention as well is a study that a colleague of mine shared with me it's called a paradigm shift relationships in trauma reformed and mental health services but we can share that in the resources um this study i thought provided
• 26:30 - 27:00 a great amount of information about trauma and managing this within mental health settings and it spoke quite a bit about re-traumatization which i hadn't thought much about previously and they gave a brilliant case study of this as well which i thought i briefly mention um so it was about a lady who was anonymously referred to as claire and in this situation claire had been admitted hospital
• 27:00 - 27:30 the staff were concerned that she was either self-harm or attempt suicide again so she was put on what they call round-the-clock observations one-to-one observations she was naturally a private lady and she found the constant supervision to be humiliating the staff members didn't interact much with her and she felt punished rather than supported and she had throughout her childhood she had a lack of privacy and was constantly intruded on and this brought
• 27:30 - 28:00 back this trauma for her they then spoke about what it would look like for claire if she was to be within a ward that that was trauma informed and within this negative examples of that the ward would understand that round the observations can cause long-term harm that they would speak with claire to explain the reasons for the observations and what their concerns are staff are as interactive as possible and they attempt to validate her feelings so that she feels supported rather than punished
• 28:00 - 28:30 and i've found that this situation has been very relevant for the people that i work with as a lot of them have usually within the first week or so they're staying hospital have been in one town observations and it just really highlighted for me how traumatizing that can be which is something that i hadn't considered or really thought about for a while but it really opened my eyes to that they do have a paragraph at the end of the the study as which i thought was again really good something to really take
• 28:30 - 29:00 into account with them trauma reformed practice they listed some some principles of trauma reformed practice such as seeing through a trauma lens so knowing and understanding the prevalence the signs and effects of trauma appreciation of invisible trauma such as poverty and racism having sensitive discussions about trauma such as not asking them they're in crisis and also being trustworthy transparent collaborating with them and having that choice and control as
• 29:00 - 29:30 well which i think again is something that fits very well within with their mental hospitals so i think that sort of leads on quite well to my next slide as well around language now this is something that i do speak about quite a lot um with my colleagues and in supervision with my supervisor i think that's something that i've mentioned probably nearly every time um and i feel like it has it's been a very yeah it's been something that's just in my mind all the time i think we focus
• 29:30 - 30:00 on it quite a lot at university i feel like it was almost ingrained in us important languages and i'm so grateful for that because that has stuck in my mind ever since so one of the um the latest things i sort of reflected on with with my supervisor was how often i see the phrase this person suffers with this illness and as soon as i see the word suffer it just instantly creates this you know this negative depiction and that they don't seem to realize sometimes that
• 30:00 - 30:30 language can be really damaging i also often hear the phrases they didn't engage or they're displaying challenging behavior which again instantly puts the blame on other people as to how they're feeling when perhaps we need to change our approach to the conversations that we're having with them so that they feel that they can they can have those conversations with us more and again this links very well on to stigma as well i i find that people are often taken
• 30:30 - 31:00 aback when i speak to them about the fact that i work in a mental health i often hear like the phrase mental asylums or you're working with psychos so those types of really degrading language and i do find i do challenge this every time no matter who it is that says that to me i'm glad that it's not been anyone within the profession the house or something like to me it tends to be people that aren't in the profession i mean
• 31:00 - 31:30 i've had conversations with with my own family and friends and they're not within the social work sector or men's health sector and i've had these conversations with them and they have said that they felt like they've learned a lot from me which is great because i feel like i'm making even the smallest of differences having these conversations with people and just trying to lessen that stigma as much as we can the mental health foundation have some good information about stigma as well they did a survey a few years ago and i think around 90 of those who were surveyed have experienced stigma around
• 31:30 - 32:00 the men's health conditions and as well i think helen touched on this um but what you see in news stories over the years i've seen so many stories where people with mental health conditions are seen as evil and dangerous and that doesn't help towards the stigma of these people that we work with so any education i suppose or challenge in these these beliefs is really important to me as well so it has been a bit of a negative bit there but there are two things that i wanted to talk about as well the next
• 32:00 - 32:30 one is strengths based practice so it sort of flips on his head a bit which is good now this for me has been absolutely essential to building good relationships with people i work with and i do find that strengths aren't always easy to identify with within yourself if someone was to say to me what are your strengths and i'd probably go a bit blank i wouldn't really know what to say or you don't want to sound like a show-off i suppose so when i'm working within this strengths-based fashion people that
• 32:30 - 33:00 i work with you have to think of things differently or just word your conversations differently to be able to get these strengths out of people so it could be you know talking to them about what they enjoy doing about their support networks about their goals amongst many other things and these strengths i i find that i do i try to find anything as a strength whether it says conversations with their parents have every week having a pet having a favorite tv show they're like they're all strengths i feel like it's
• 33:00 - 33:30 so important to really recognize that for them and i think this links on quite well to the last slide as well which is about well-being and person-centered practice one of the things that i i always say is also never underestimate how much things can mean to people and i always think of this one example of a lady i worked with a few months ago she didn't have a large support network around her the nursing staff were concerned that she lived alone didn't
• 33:30 - 34:00 have any family around and she had only one friend so i decided to have an open and honest conversation with her she explained to me that she just enjoys her own company she likes being on her own watching her tv shows and that she'd actually be really unhappy if she was to have lots of people coming into her home and trying to help her and support her when she didn't want that and she didn't feel like she needed it either so under the the care act we do have a duty to promote an individual's well-being we should always have their well-being at
• 34:00 - 34:30 the forefront we're making these decisions and planning any care and support so i think my main point to take away from from well-being is that just to really listen about what matters to someone because that is what matters the most and i have added a quote onto this slide as well which you might recognize which says nothing about me without me so this was penned i believe by andrew lansley who was the then secretary of state for health when a publication was released around patients and collisions in nhs
• 34:30 - 35:00 about reaching decisions about treatment together we talk about work quite a lot so it is it's very my mind at the moment as well but it always sticks with me about the decisions that we are making with people regarding the care and support for them and i think it's just so that's such an insightful quote into you know making these decisions with people and not for them so i thought that'd be quite a quite a nice quote to end on me if that's one thing you remember remember that quote
• 35:00 - 35:30 always works for me thank you thank you so much for that megan that was fabulous it was really interesting just to hear your reflections as a as someone new to um social work with people with mental health issues i think that was really helpful and really interesting you picked out some really key points and and i also just like the way that you shared the reality for people i think that's important we have lots of students that are with us and hearing that reality matters what may i i always sort of whenever i'm listening to
• 35:30 - 36:00 anybody always think about what it might mean for me and it means different things to us on you know different stages of our journey but it really made me realize how mental health is political there is so many politics around it in the same way social work is political but i was thinking about you know you talking about the care crisis well of course um we've been told uh by our prime minister in the uk boris johnson the care crisis is solved it's all solved but the reality that we're living every day is actually things are getting worse
• 36:00 - 36:30 and things are getting more difficult so thank you very much for sharing that and that i really liked the learning about re-traumatization as well um because i think that's something that we need to learn a lot more about and reflect a lot more on as social workers how social work can re-traumatize so thank you so much for sharing um with us megan that was great thank you we're going to go um now and hand over to um a social worker again who will
• 36:30 - 37:00 introduce himself what uh soyeb is i've been doing some work recently uh with uh soybean i've always been uh just really incredibly impressed by soy episode um i'm handing over to you now if that's all right so i have straight to you yes thank you i'm really humbling to hear that i hope i can contribute something um i think it's hard to fall after megan and helen there so you've set a really good standard there um so yeah i'm a mental health social worker um i work within an house trust
• 37:00 - 37:30 um and i i work in a geographical area where there's a high south asian kind of muslim community as well um which is why i've got an interest in this area um so just to give some context to to the subject area really i think it's really important for us to remember why we come into social work and i always say to kind of students and you look qualified and they probably get sick of me saying this um i think as you kind of get old like me and start thinking about retiring um it's
• 37:30 - 38:00 always important to kind of remember why you came into social work and so i came into social sport because i had a disabled sister um who was um absolutely fine until she was about the age of eight then she suddenly developed um a physical health issue which the doctors never kind of worked out what it was but she just started to deteriorate basically one night she woke up and she couldn't walk um and then from then on it kind of just deteriorates to the fact that she
• 38:00 - 38:30 couldn't do anything she could have talked she could have feed herself um and my mom and dad they were from um originally from india and we we had a lot of um well i was a lot younger than my sisters i was quite young when this happened but i remember a lot of our cousins and friends would come to our house and advise my mum and dad to kind of seek spiritual treatment because because they were saying the doctors can't explain what's going on so you must be somewhat spiritual going on there must be some kind of
• 38:30 - 39:00 black magic or jean possession or something like that going on so very early on i kind of kind of cutting on to this um in terms of my mental health experience and i've worked in mental health for too many years now i think um nearly 25 years um and because i worked with a lot of south asian patients and service users we've seen people accessing services more and more initially when i came into service um
• 39:00 - 39:30 we had most most of the community visa they tended to go to spiritual healers the local police for mental health support and it was really interesting when i when i came into um a social work team as well because i think i was the first um south asian muslim social worker in the team the only male social worker as well um so i got dumped with all the cases that were forensics or risky in terms of physical assaults and things like that
• 39:30 - 40:00 because i'm male apparently i could handle that um so that terrified me um and i got um all codified all the cases where there was any element of language issues or cultural issues and i think people assumed i spoke every language under the sun so whether it was punjabi urdu gujarati so i very quickly had to learn some languages just so i could kind of interact with the with the service users i was being referred to um that was really interesting and i think i've just put this i think
• 40:00 - 40:30 it's really good for social worker niche and an interest as well i think it just keeps us going it keeps us motivated and it brings something to the team as well so if every member of the team kind of has a niche and an interest we can also have that kind of specialism in a certain area that we can bring to the team so again in the team i was in as soon as there was any mention of spiritual or religious or culture or spiritual healer anything like that that would get straight um come to me that those kids would come to me slowly which i didn't mind and i
• 40:30 - 41:00 think that is the reason why i developed that interest as well at the same time i think that can cause complacency as well because i've got that kind of um i come from a muslim background myself from the south asian background myself it can cause that complacency as well so i'll just put it out there if i say anything wrong today or you think i've said something into it please don't correct me um i think we're always learning and students always terrify me because they're always correcting me about something or teaching me something i think i learn more from them that they
• 41:00 - 41:30 then they learn from me sometimes um you'd be really nice for to see in the chat what people think what spirituality and culture actually is and i think i even struggle with with those two concepts still um recently we changed our i'm a bia as well and recently we changed our forms and on the form he actually asks um about the culture of the relevant person and and when i see previous assessments have been completed that section always says na um no one
• 41:30 - 42:00 ever seems to fill that in and i think it's simply because we get we confused ourselves about what spirituality and culture actually is and it would be really nice to see what what people think um the two the two things are um so things that i consider so i've worked with a lot of cases where um there's been elements of spirituality so you know we we get the foot every photo comes in there's mental health issues going on um
• 42:00 - 42:30 i gonna go and do the assessment as soon as um they see that it's somebody it's a social worker that's from the same background same culture same religion as them um as soon as i walk through the door um you can see that kind of sense of relief and and straight away they say oh well it's not mental health science it's actually um black magic for gene possession so very early on i kind of um was dealing with these kind of issues um and i'd say i mean i'll talk about some some of the cases a little bit later but
• 42:30 - 43:00 i think very early on i think i've probably dealt with about eight to ninety percent of cases where it was purely mental health and we had to go down the medical model and we was just kind of considering the aspect but there is that 10 where um i don't know how much people kind of or how spiritual people are but there's this 10 percent where i was just fascinated thinking this is not the medical model and i was kind of backed up by the medics and stuff there as well i'll come on today in a little bit so things that i do consider
• 43:00 - 43:30 this is just something i put together really for today um and really got me thinking about what do i actually consider in terms of when i'm thinking about the spiritual model versus the medical model because it's really hard isn't because we work especially working in the trust um he's the medical model yeah you know to have a fight with the psychiatrist you're you're very likely to lose especially if you're the only social worker in that team as well um so you've got to have really good kind of um research or evidence-based kind of
• 43:30 - 44:00 suggest um even a hint of any social work intervention or any spiritual intervention for that matter um so you've got to take some kind of hits um being the only social worker in the team like that so culture definitely one um and in terms of culture i think there's things like you know um depending on who you're working what's what's the understanding of medication you know do they do they accept medication do they understand what medication actually is do they actually actually understand what medication is used for um
• 44:00 - 44:30 and and then even real things like the word depression and sad you know i work with a lot of interpreters where we go out and um you know i'll ask the question you know do you feel depressed and the interpreter will ask them and do you feel sad and i'll say to the interpreter i didn't ask that um i actually asked them if they feel depressed which is completely different feeling sad um and i think in some cultures and within a lot of cultures i'm not just saying this within the south asian culture there's still that stigma um around mental health as well um so very you know early on when i first went um into
• 44:30 - 45:00 social work again we'd go and and parents would say to me well you can't diagnose my son as having mental health issues because we will struggle to find him um a suitable wife and nobody will want to marry him because he's got mental health issues so we have kind of those kind of issues um even up to recently you know our ib service there they had a discussion with me around the fact that we're struggling to get referrals in for the iap service from the south asian community and i said to them one of the reasons is because there's actually a lot of stuff
• 45:00 - 45:30 especially um the first and second generation they don't fully understand the concept of ayat and what talking therapy actually is so we need to kind of change that a little bit so that is more acceptance to a wide variety of of um the community we serve um so that's a really kind of interesting thing but i'm not going to go into that because i'll start talking too much um diversity as well um so think about again you know people offices they say to be sure we don't need medication we
• 45:30 - 46:00 don't need mental health services because whatever happens whether it's good or bad it comes from god so we need to accept him happy with it um and prayers will kind of resolve this issue so if you continue praying and that will can solve our problems so then you're kind of trying to educate people around the well actually what religion actually says that you should be accepting medication the medical model as well um and i think parents background is really important so um again often we see this and i used to work in eip um i think hallelujah she's working
• 46:00 - 46:30 ip as well you know what where it's supposed to be early intervention side courses so you're supposed to intervene early um to to try and um support people and we're tickling further on and they'd say yeah the first episode they've just been hearing voices for the last few months nothing nothing else and they they get to know you a little bit they understand you you're from the same culture background and then you suddenly wonder they'll tell you oh yeah you know smart they've had mental health issues for the last eight to nine years but we've been accessing spiritual support um because that's what we thought it was so
• 46:30 - 47:00 and and then you're doing education work with the family around the need for for medication and the medical model as well so you've got that spirituality again i think is really important i think um if if you can um capture someone's spirituality it's it's a huge benefit especially mental health because that's what motivates people that's what keeps people going um and often when i'm doing risk assessments and especially people are feeling suicidal or having thoughts of self-harm and things like that if i can tap into the spirituality and see that actually
• 47:00 - 47:30 people use their spiritual beliefs or their spirituality to kind of prevent themselves from from committing space and having themselves i think for me that reduces the risk significantly you know in all cases but in majority of cases i think that that's really beneficial and there's some research gonna back that up as well um then i'll i'll kind of take a step back and look at my own kind of unconscious bias and privilege as well so like i said i think because i come from similar background um to the community i serve and have similar religious beliefs and
• 47:30 - 48:00 cultural beliefs um i need to kind of make sure that i'm interpreting what they're saying correctly as well because i've had the privilege of being lucky that i have actually been to india myself actually seeing the culture that that that that happens in uh where most of the communities that i work with come from actually at the same time i've done a social work course i've been to university i've been up brought up in the uk as well so i've got that understanding as well and sometimes i think i get frustrated when i'm working with individuals that haven't had that privilege and and
• 48:00 - 48:30 i get frustrated when they say oh we don't need meds um and i've got to kind of take a step back and think myself actually uh i need to understand where they're coming from with this as well and kind of take on board what they're saying um equality is really important i think it's still a massive issue um i think um we because it's the medical model i think is i think we still struggle especially in the nhs to even consider the social work model um never mind kind of the spiritual model as well so i think that
• 48:30 - 49:00 quality of services is the lacking and we'll be quite creative in how we provide that kind of equality of service which i'll come into again in a little bit um and then kind of capturing all of that as a social worker we're always covering our backs that way unfortunately that's that's the kind of time that we work in so you probably think okay if i'm going to consider the spiritual model here um this person is really risky what research what legislation what evidence faith is there for me to be able to evidence that this spiritual model that i'm using is justified and
• 49:00 - 49:30 it's gonna work as well um so yes you've gotta kind of think about that as well next slide okay again just to get that conversation going a little bit um what's your understanding of black magic and gene possession do you actually believe in black magic do you believe in jinns um do you think it's just kind of make believe um and what's yeah what's your own videos now so really be really interested to see that as well um
• 49:30 - 50:00 okay next slide okay so yeah so um i think one of the things i find when i've worked with cases where there has been elements of spiritual beliefs around gene possession black magic i think a lot of kind of reflections come in a lot of aspects coming things like language um culture religion and like i said the medical model conflict um i think she once said there's social can be political sometimes and there's a lot of politics scheduled that goes on with mdt meetings as well um so
• 50:00 - 50:30 if you're the only social worker and if you're the only south asian muslim social worker in that team that kind of has similar beliefs or is the only one that kind of believes in black magic and dean possession and stuff like that yourself before really stand up and and and be able to kind of shout around the need for considering someone's spiritual needs especially if the case is really risky and there's a lot going on um medics especially can be
• 50:30 - 51:00 quite risk invasive and they so you have to really kind of convince people that we need to kind of consider that as well safeguarding can come in again because of that kind of stigma prejudice lack of understanding um a lot of cases that i work with where there is elements of spiritual spirituality especially where you're working with a young age group and the parents are kind of um doing most of the kind of talking and negotiating um there can be you know a lot of um colleagues will say to me oh shall we
• 51:00 - 51:30 need to refer this to safeguarding because the parents are not accessing and the medical model they're refusing admission enough they're refusing medication um so we need to go to go down safeguarding rule and i think all that does is sometimes causes even bigger distance between one and the people you're trying to kind of help and support as well and working with families it's really important to kind of do that two-way education as well so you're trying to educate them or work with with the team that you're with to kind of get them on your side to say we need to consider the spiritual model
• 51:30 - 52:00 here but you're trying to kind of convince the families to say you need to consider the medical model as well um so we need to kind of think about both um and i think again when i've kind of talked about that kind of research and um evidence base there is stuff and there's loads and and usually i do a full discussion on this um so i've kind of tried to really kind of minimize it three different things so you know stuff like mental health that talks about appropriate medical treatment so um one
• 52:00 - 52:30 side of my argument is that if if somebody's saying that they want to see an exorcist um or they want to see a spiritual healer um is that appropriate but we don't have access to that so is that appropriate medical treatment is there isn't i don't know that's that's an open argument for reflection really we've questioned the human human rights act which talks about freedom thought belief and religion and it's really interesting isn't it because where the mental health reform coming out and you know i think they will be saying that we need to have
• 52:30 - 53:00 spiritual healers in the team we need to have exorcists in the team um i'm kind of saying that sarcastically i think we'll see what comes of that but you know he talks about the mental health requiring both legislative change and systematic change as well and that's really interesting and the systemic change that's needed in mental health um and the need for why the community commitments to improve access experience and outcomes of minorities mental health care so you know this is something i was saying 20 25 years ago we are still saying the same thing again
• 53:00 - 53:30 um so that's really interesting um so in terms of cases um how i'm so tempted to talk about some of the cases that i work with just to kind of tell you about those interesting but i know a car because there's um because there's so many kind of people involved in this webinar and i'm quite kind of conscious that somebody might know something or someone um i've worked with cases like i said which have really kind of got me thinking um there was a really interesting case once i worked with somebody um a family that had um
• 53:30 - 54:00 their father was admitted into hospital um you know really kind of um psychotic and the even the hospital really struggling to kind of um do anything in terms of treatment there was no improvement after four to five weeks throughout the whole thing the family were constantly saying look my dad needs to spiritually include like me spiritually that he's been possessed by jin that's the only way we're going to resolve this issue um and he went that case even went down the same padding group and and this family somehow
• 54:00 - 54:30 managed to get actually a spiritual healer onto the ward um and as soon as they've got a split wheel on the world the next day this man completely transformed um his he his mental health improved he was talking engaging um so yeah so there's an argument there that maybe the medicine just started kicking in the day after or the fact that he's finally his knees around spiritual um treatment were considered just the fact that he was listened to that kind of difference um and there is research there so there's um
• 54:30 - 55:00 you know uh mcnico talks about um a consultant recommending a spiritual consultation as well as a psychiatric evaluation and after the spiritual needs were considered um this person much more receptive to psychological interventions she engaged more did not fit either diagnosed with discipline or depression the study also felt that in many cases religion succeeds much more brilliantly leaves those who seek um psychotherapy interventions and and that kind of says they all doesn't do um so religion is really important for people for the identity as well um
• 55:00 - 55:30 another kind of research by graham talks about spirit possession axism in in treating a patient who was diagnosed again with colonized um schizophrenia um and and in this case the book they use both the medical model um and they use the spiritual healer as well and and he says the family and the social worker read that the patient should remain in the supervision of both the the spiritual heater the device and the social worker to enable continuing treatment by the by both as well and in
• 55:30 - 56:00 conclusion the right that is possible and beneficial for practitioners to be involved in both systems and act as a broker between the two and how important it is to underpin to know the patient and the background now kind of that summarizes what i've been talking about today one of the things i tend to do is um we're really lucky working in a trust that we've got access to the chaplaincy service so i know in my capacity i can't really refer somebody to a spiritual healer for example because spiritual leaders are not registered they're not overseen by anybody and if you went to a
• 56:00 - 56:30 spiritual either you referred somebody and something went wrong there's potential that that would come back to hit you um so i tend to go through the chaplaincy service because they're there for that spiritual kind of treatment and they've got access to spiritual healers and and they can they can do some referrals as well um to links that they've got with and i've just put this in as one slide because i think it's really important that um whether you're whatever social book you are you need to be aware of working in adults and children because the same
• 56:30 - 57:00 issues affect both so mental health um even if the children you're working with might not have mental health issues that parents might have mental health issues and vice versa so you might you might be working adults with mental health issues but then the adults might have children so you need to be aware of both sectors in terms of working with adults and children and you know we've seen um cases where even with children you know there's there's been safeguarding and really serious incidents you know where children have died because um individuals have felt that even children have been possessed by genes and they've
• 57:00 - 57:30 tried to kind of do an exorcism or somehow and and you know we've seen kids of colombia and things like that as well um and i just saw this slide on twitter last week and it kind of just i thought i'd kind of put it in as a as a ending slide really kind of kind of that kind of summarizes what i've been talking about um in terms of that equal of equal access to services and because we do have services um and we say that it's accessible to everybody but is it equitable and is it kind of just this in terms of the way we offer
• 57:30 - 58:00 it because not everybody has the opportunity to access what they actually wanted in terms of spiritual treatment and that's it thank you didn't get myself off mute in time there thank you so much soya i think that gave us lots and lots to think about there was very uh really thoughtful so thank you very much and i do love this slide i think it's great as well we are we have an absolutely packed night i told you
• 58:00 - 58:30 it's so packed tonight so we're going to move to our final speaker now who's going to give us um well you're going to do as a whole a to z tony aren't you so um there's so much going on sawyer i think you've got some questions to you as well in the q and a and there's lots of things going on in the chat so thank you so much for that sorry i'm going to hand straight on to you tony if that's okay at a gallop i almost remember going mute myself ian and there's no truth to the rumor that i'm in the pub okay absolutely known
• 58:30 - 59:00 unfortunately uh i'll introduce myself uh my name is tony tony dane i am the principal social worker at dcci uh i'm also i usually produce myself as good natured good humored and occasionally grumpy okay and i have a secret life let's let some of these know uh and i'm i i'm i'm a social worker okay i sometimes forget i'm a social worker but i'm a particular type of social worker and i'm an approved mental health professional okay so we do matter of
• 59:00 - 59:30 fact assessments most people they refer to our children children and child protection uh colleagues as child snatchers we're adults not just of course we don't that's okay we don't have to go to court we do mental health access i don't have to go to court i can like my signature on a piece of paper remove someone's liberty i can infringe your human rights so illegal and above the word so the eight is out of amping sonia there's a tune isn't there
• 59:30 - 60:00 you gonna play the turn does it play it's not playing all right okay never worry about it so next slide please see oh and it worked when we were practicing and then it just stopped working it did you have to be old not to remember it but anyway data's out of bumping blockbusters
• 60:00 - 60:30 right so uh ma i always at this point the my dad's name was actually bob okay so you get a p please bobby ask for an a so what does amp stand for most people have no idea what an amp does never mind what it stands for and this the in joke is around uh approved mental health practitioner approved mental health anything approved mental health but the p stands for professional allegedly i think there are probably other wraps in the room allegedly i'm a professional
• 60:30 - 61:00 what does that mean that means i went off damn school okay uh when i went down to school it was in-house no it is a post-graduate course at least uh [Music] people forget that it's amps at the ten people okay at least initially under the mental health fact it's not doctors okay it is it really is amps and we have an awful lot of power and authority invested in us and we don't always feel like that but we
• 61:00 - 61:30 really do uh so i often talk about that's been overworked and underpaid mostly local government civil servants or all powerful able to walk on water and remove your liberty with a signature i often think amps are left up the creek without a paddle or boat think beds think sex and drop doctors think uh whatever you like going to somebody's house and doing a mental health tax assessment is no easy task i often ask amps why would you do it why do you still do it in 2007 the mental health act was
• 61:30 - 62:00 amended to allow other other people to do it ots psychologists nurses of a certain ld nurses and uh psychiatric nurses uh they've rushed to join us they've absolutely rushed to join us there are less than 4 ounces in the country there's about forty nurse humps there are a handful of occupational therapy amps and there are allegedly two psychology amps hiding somewhere i've
• 62:00 - 62:30 never met them i've met someone number six i've met some of the otms why would you do it be beds we're obsessed with beds okay the nhs is obsessed with beds i'm so obsessed with beds bed managers friend or foe are they helping us or not uh i just remind people at this point in reminding nhs and i go to these big meetings with uh nhs or department of health and social care around the methodology i remind you that amps don't attempt to turn people
• 62:30 - 63:00 to beds i have to turn people to hospitals and my second favorite section of the mental health act is section 140. if it was interactive i would say does anybody know what sexual 140 is hell and you must know what section 140 is it's part of the solution okay it means it has absolute urgent circumstances it's been part of a law since 1959 uh amps and special urgent circumstances should be allowed to make an application there were 53 239 detentions under the
• 63:00 - 63:30 mental health act last year okay in england uh that's not 53 000 people that his people detained several times on section two and people detained from section two to section three so it's probably 35 000 people and it doesn't include section 136 depending where you look at your figures they're either twenty eight thousand one three sixes or forty two thousand forty thousand one three sixes c stands for the code of practice mental
• 63:30 - 64:00 health fact cover practice people need to read it it's got guiding principles the recent mental health act with you has said that the principles in the code are really good we should bring them into the act they're probably not going to be able to do that but the principles talk about being least restrictive people treating people fairly etc etc if more people i always think that more people where uh who were involved in commission of this stuff
• 64:00 - 64:30 actually either went and did mental health act assessments with amps or read the mental health accurate practice the service for people on the receiving end of what this stuff or what we do would be better you're only supported supposed to depart from the the code for courage and reason okay because most people have never read it custody cost today is a interesting place to go amping okay the link on that slide is a link to a bbc report by
• 64:30 - 65:00 a reporter called sean billy that reckons that between four and five thousand people every year are languishing in police cells for the lack of a bird okay these are people who have not be who've been arrested for offenses or assessed in cells by doctors and amps the decision is made that they need to be detained but because there's no better or no hospital available the amp cap can't make the application the pace clock picks and these people stay in the cells under no legal or lawful authority that's an
• 65:00 - 65:30 infringement of human rights it's an everyday experience you see it also in e-days emergency departments see coroner's reports unfortunately we're involved in this stuff i've been unlucky enough to be the corner to be the coroner's report you should read some of them this originally it is that was police officers so uh i do quote some uh cases uh r versus monttas in ashworth hospital
• 65:30 - 66:00 basically means you should only depart from the code for conclusion reasons okay and that'll be the same on the note and the new code the code is out of date horribly by the way chapter 16 is completely out of it day for doctors we need doctors to do mental health act assessments uh section 12 doctors i'm always surprised that mental health assessments are actually dependent on the attendance of a very well renewed re-enumerated
• 66:00 - 66:30 volunteer when people are asking apps to come the amp has to find a doctor the amp has to do some background reading the amp just can't rock up and do the do as well what they're told and in terms of the uh how much it's costing i won't sat in front of a parliamentary group for social work and explain to them that uh if we're doing if we're doing 53 000 detentions how many people are we actually assessing well no one counts no one knows how many assessments actually do but the reagan's between 140 or 150
• 66:30 - 67:00 000 if we take the 140 000 figure it says two things once one that amps are generally not detaining people they're retaining people about two-thirds of the time about a third of the time and two-thirds of the time saying no you're never gonna get credit for that by the way okay no one ever mentions that but we say no we're very good at saying no apps are very pesky i quite liked it when so i've said about having to deal with doctors uh yeah i quite like i quite like dealing with doctors i enjoy saying no too i'm sorry i do
• 67:00 - 67:30 uh but it costs about 25 million quit in section 12 fees a year i i said that i said to these people i could save the nhs 100 million over four years organize your sex and 12 doctors differently i also remind people that the doctor is like that the bed is actually the bed is actually the doctor's job not the amps job although the amp is often the last one standing and i describe the system within which we work with anyone who's involved in the mental health system will know that
• 67:30 - 68:00 it's dysfunctional it doesn't work very well for the people on the receiving end anyone who thinks different feel free to tell me tell me on twitter e stands for experts i always say i get wheeled out sometimes as an expert you know i'm not and i always say i'm never an expert i have been around the block several times i was younger slimmer out here okay i was in asw but the only experts are the people on the receiving end of what we do remember the mental health act has no wage limit
• 68:00 - 68:30 okay the youngest person i've been asked to assess is seven the oldest person over 100 uh if all the experts were right they wouldn't need helps psychiatry psychiatry would work if psychiatry worked i wouldn't have a job everyone became up to see the doctor and would be taking the medication and everything would be ground okay in terms of treatment uh they reckon that about a third of people respond well to treatment a third of people and immediately will get better anyway without it and i thought
• 68:30 - 69:00 people will be chronically unwell uh over a period of time f stands for forensic part three of the mental health act it's a real thing i have been a forensic social worker i spent a chunk of my time reviewing out of area patients placed in uh high security hospitals uh it's quite exciting when you're a young social worker you get to ask worth of mountain and uh what's the other place from that's what rampant can't remember there's a place in
• 69:00 - 69:30 scotland called casters which takes scottish patients and patients from northern ireland northern ireland and scotland have separate legislation okay so you need to remember that sometimes when you're dealing with cross-border border issues social supervision section 37 41 patients social workers do that uh used to always fall to sort of uh amps and they asw to do it but more and more they're asking social workers to do it because they're running out of amps
• 69:30 - 70:00 so you'll be asked to do that stuff g stands for ccgs soon to be integrated care boards uh again these are the people are commissioning this stuff they're the people who are paying for it you know that they're not reading the code of practice when you have made the decision to detain someone and you ring the ambulance and say can you come and convey the person to hospital please they go you can wait
• 70:00 - 70:30 i say how long do you have to wait we say that we don't know we're prioritizing our physical health all that chat about uh all that chat about part party of a steam seems just going out the window hitch hospitals beds emergency departments are places of safety okay the mental health act says so the mental health act finds a place of safety in section 1356 and then section
• 70:30 - 71:00 55 one okay i've been to conferences and i've been to all sorts of places where the nhs is arguably it's blue in the face that the a e is not a place of safety it might not be an ideal place of safety it might not be all sorts of things but it is legally a place of safety okay trust me i'm a help human rights act always mention that we forget we do that stuff we're involved in infringing people's human rights because it's a due process
• 71:00 - 71:30 we do it because there's protection the app is one of the safeguards nearest relatives one of the safeguards the tribunal is one of the safeguards but we're involved in infringing people's human human human rights and got like me can sign a form um i determined i'd attain someone in 2007 and i happen to know they're still detained that's a long time i interview in a suitable manner uh that means i just don't turn up and do
• 71:30 - 72:00 as i'm told okay if i'm in a police station or having an ed department or i'm anywhere i have a legal duty to try and be the person in a suitable manner hear their story hear their side i often just talk about apps being isn't is invisible okay arms are invisible in their own mostly local local authorities and within the nhs the only the only type of amps the nhs templar wants are the ones that say yes doctor thank you doctor
• 72:00 - 72:30 they don't get those acts very often so the law says i just don't walk up those i'm told by the doctor the cosplay sergeant or anybody else okay and i i have a legal thought i have the legal duty to be professional to be uh individually accountable for what i do some people have talked about this notion earlier on eye epigenetic harm it's the thing that we do okay sending people to either various beds is something that we do young black men are overrepresented in
• 72:30 - 73:00 in the uh mental health system in the mental health system four times more likely to be detained ten times more likely they end up in a good community treatment order we're involved in that uh i have cut and pasted something into the chat about a uh on our article uh about about the mental health acne view and what that might look like and what it might mean and notions around therapeutic intervention and substantial risk and whatever it is you
• 73:00 - 73:30 know they're trying to get us to tms people i'm not sure how it's going to work j stands for jones i have a collection of them okay i have 20 all of them okay because that's how long i've been sw now but the jones is the law again lots of people don't read it if you're going to get involved in this stuff read it and read it again lots that's how you understand it also talk to your colleagues
• 73:30 - 74:00 okay a little knowledge goes a long way it's back to reading and stuff uh lots of people become social workers because they want to help people but actually what happens when people don't want your help okay social work exists because the uh local authority has certain duties and responsibilities sometimes we have to use the law so if you're not all social worker you've got to know about the care act the mental health act and the mental
• 74:00 - 74:30 capacity act okay the mental capacity act was in 2005 enacted in 2007 and people still don't know their way around it okay uh you need to learn it if you're going to be an adult social worker legal literacy it's a really important thing you know if we're going to be involved in people's lives we need to know what laws
• 74:30 - 75:00 we're using and how we're doing it i'm laboring the point read the mental health acne called part practice it's part of the solution it allows you to be able to have those arguments with doctors discussions multi-disciplinary team meetings things like understanding section 117 things like understanding when you can use the you mean that these things go to court sometimes there's recently been court issues around can you use the mental health act to provide people of their liberty when
• 75:00 - 75:30 they've got way even when they're consenting to it and they've got capacity no you can't you can't use section 41 you can't use a guardianship and you can't use a cto to restrict someone on their pay of their liberty not had to go to court because people didn't have the required legal literacy part of the solution m stands for multi-agency partnership working i haven't talked about multi-agency partnership working not actually working okay between us and the nhs the police the
• 75:30 - 76:00 ambulance uh all sorts of things m star stands for the interface between the mental health act the medical capacity act you know a minefield m stands for moral panic moral outrage somebody must do something if anyone ever rings you up and tells you you need to do something ask ask them why and really and ask them how they expect to do it and that takes it back to legal literacy
• 76:00 - 76:30 okay moral panic is an old-fashioned term when people object to what people are doing people are entitled to do what they like uh you know but we're the sort of people that get phoned to say you know mrs biggins is doing something can you do something about it well i might be able to do something about it but i'm quite keen on the old the old-fashioned radical law the old-fashioned idea of radical non-intervention okay sometimes doing nothing's the right thing to do i reference my friend the picture is my michael brown if you're interested in
• 76:30 - 77:00 the interface between the police and uh mental health stuff look up mental health cop he's got a web website really useful he has just cycled from the land's end to from john group from jonah groves to lanza by the way they just finished they did in eight days yesterday and stands for nearest relative really really nerdy happy stuff but actually really important he's probably going to become the
• 77:00 - 77:30 nominated person it pays to know who your nearest relative is an important safeguard your nearest relative can continue under the mental health act your nearest relative can ask you to be discharged can order your discharge most amps tell a really good nearest relative story i would tell you man but i'm going to run out of time so i'll save it but it's quite often uh psychiatry is a social construct to a
• 77:30 - 78:00 degree okay and there's a brilliant poster somewhere if you can look it up look up the reasons the reasons for detention in an american asylum in the very 1800s very interesting poster master basin figures highly in it uh for the reasons for detention and it's also about uh you know the reason that women get detained as well uh all married mothers get detained the man that the father never gets detained
• 78:00 - 78:30 uh oh stands for ordinary residents really important to come to section 13 and really important to come to section 117. if you're really lucky you'll never get involved in a section 117 conversation again recently just in stockton court has sort of half clarified it but you don't really want to get involved in that stuff but section 117 is really
• 78:30 - 79:00 important because it means you get free aftercare okay i've said to my colleagues if they ever come for me please don't mess about the section two i would like to be detained under section three please and then the house will have to be sold under me and my kids will they'll be able to uh have their inheritance o stands for obstruction section one two nine it's actually an offense to obstruct me dear officer then people aren't being nice to me i often find myself wondering who's actually obstructing me back to the bed manager
• 79:00 - 79:30 back to the doctor back to the ccg everyone everyone actually thinks that the amp's job is is difficult because of the people we're seeing okay at this point i put my hands up and said i have done two thousand two hundred and thirty mental health act assessments okay the vast majority of those have gone well the vast majority of the problems i haven't not been the people of the families have been the system with the dysfunction in it
• 79:30 - 80:00 hey i mean okay the police are involved in this stuff because they only have certain parts the law gives them certain part under 135 136 135 is a warrant i can get a warrant the police officer can come and use the big red key on your door 136 ever increasing in the area that i live and work in birmingham there are a thousand one
• 80:00 - 80:30 three sixes every year there are probably four or 500 referrals from costly and counting no one actually counts though no one knows how many referrals come from custody not just in birmingham all over the country we don't divide it up that way pay stands for parking no one ever cares whether you're parks they're always ringing me and telling you need to get there really really really quickly can you get there quickly can you get to the hospital quickly i say something what would you like my colleague to park because your car parks
• 80:30 - 81:00 really expensive and it's really full custody won't let you in where do you want me to park if people were taking amps seriously they would always think about where they park okay cue questions ask them lots of students in this room there are no stupid questions this was designed for police just ask them okay your best your best resource when you're an amp is your colleagues when you're newly qualified ask
• 81:00 - 81:30 are know the difference between recalling and revoking a cto know what it means and who can do it social workers we always say we're into reflection so our stands for reflection the mental health act review it's coming it's done the white people will be out next year there are i always talk about ctos there are two advantage ctos ones to the amp we don't recall you
• 81:30 - 82:00 then it just has to do that itself when ctos first come out i used to get phone calls then tony you need to recall someone and i go no no you need to do that you get them back to the place of safety and then i'll see them more consider the revocation there's also a an advantage to the patient it's really hard to get recalled and revoked another very bad not a good reason to be on a cto but it is a thing sections everyone thinks they know what a section is okay but there are 149 of them most people
• 82:00 - 82:30 think of section 2 and section 3. there are 149 sections in the mental health act my favorite section is section 149 it's literally called the silly section it means you can use them at the hot pack on silly i happen to go to silly on my whole days that's why i know it okay and i am going to mention i can't even say the word serenity serenity integrative mentoring look what stops him okay sometimes we get this stuff terribly
• 82:30 - 83:00 wrong sim was inviting the police to use the criminal justice system to deal with work with whatever word you want to use what are called high intensity users these are people that are being 136 and presented in crisis all the time the nhs backed back this thing called sim uh you should look it up uh and look up the stop sign campaign it's one it's an example of how a
• 83:00 - 83:30 group of people are able to challenge something on a national level from it's sort of like uh you know a small group of people who are disempowered bonding together and actually managing to do something about something but sim has disappeared well the official stuff has disappeared whether people are stopping subject the sort of things that are going on who knows t stands to treat treehouse street triage is it the answer everyone likes it but is it the answer
• 83:30 - 84:00 putting a police officer and a nurse in an amp in a car sounds like a good idea what's not the like but is it part of the solution are we asking the right questions is the right answer to the wrong question i don't think street sharia's needs amps i think they need better access to ramps and i don't think street trails needs cops i think crisis server i think is filled with gap in crisis services 70 percent of streets realize he's in people's houses police officers have no power in yours
• 84:00 - 84:30 she's rushing me online u stands for team team 999 again about multi-agency agency parking multi-agency teamwork not working i'm starting part of team team 999 we don't have radios we don't get cars with go faster stripes and blue flashing lights but sometimes we're asked to step into that space it's incredibly difficult to do it people want you now
• 84:30 - 85:00 go back to find trying to find that section 12 doctor go back to trying to you know do your background information find and finding out about people go back to you know you can't just arrive at something cold and make a really important decision about someone's liberty you know in in in in in a very short space of time v stands for baldwin attendance and baldr admission yeah you keep seeing people here vulgar attempting uh uh any any departments sometimes in leg restraints
• 85:00 - 85:30 why is that a thing you know sometimes people accuse the police of overusing their authority sometimes they don't use authority they've got they're making stuff up too many people are making stuff up uh i'm 131 i remind my i meant bad managers remind everybody else the section 131 is a real section of the mental health act it's a longer admission to hospital i would like the mental health act to be used in a less course of way i would
• 85:30 - 86:00 like amps to be used in a less course of way uh i would like us to be seen as a positive intervention uh not wheeled real digestive extinct to which people will be are going to be detained because it's only us to entertain them w stands for warrants do you know the difference between section one three five one section one three five two i'm still most people don't one three five one is for someone who is
• 86:00 - 86:30 in the community and not always subject to attention one three five two is for someone who's unlawfully at large either a detained patient who's gone a wall or a cto person who's been recalled i say to the police go and help us out here please because they complain about us we never we don't we very rarely ring the place you know but when we ring them they say have you got a warrant i go yes and they still don't help us uh and i always remind the place that no
• 86:30 - 87:00 one ever no nowhere ever did michael brown ever say no warrant no police okay he never said that that's what they heard but he actually never said that sometimes we can't get warrants sometimes there isn't time sometimes multi-agency partnership working needs to work ex couldn't think of anything so there's a picture of my dog that's the ampound dixie's her name she's a patterdale terrier she's as cute as you like much cuter than me
• 87:00 - 87:30 why always ask why why are we getting called to it why is the thing failing it's often about systems it's often about resources and it's often about people okay people talk about bias earlier on etcetera etcetera those are all in the mix i went to a mental health conference in 2017 and it was chaired by simon cool who was the chief constable of
• 87:30 - 88:00 leicestershire simon cole he's an idea maybe took his own life yet the big come out but simon cole stood at the front of this conference and said people should be angry about the system and how it treats people people should be angry about how we feel people how we end up in corners courts because the corners courts keep saying the same thing multi-agency agency partnership didn't work communication was poor section 140 isn't the real thing
• 88:00 - 88:30 uh all that sort of stuff and i often end with with with a poem i'm not sure you've got time for it i'm not sure it'll play but i i always encourage people to listen to dylan thomas uh do not go gentle into that good night if you're going to be an amp do not go gentle into that good night do not become a yes or no sir three bags full sure know your mental health act stuff know your mental capacity act and go out and
• 88:30 - 89:00 protect people's human rights there you go sonia dead on time siobhan sorry even you don't have to play anybody it'll overplay it'll be over time fabulous thank you so much tony thank you for that it was tonight i mean literally every speaker could have filled the whole session tonight there was so much going on um so great um oh to zeb there thank you so much from the not so grumpy but i know one of the kindest amps that i know um is just
• 89:00 - 89:30 something i would want to say and uh we can tell people another time why and thank you so much to all of our um speakers tonight one of the things i just realized was we've actually got a lot of um bradford people here tonight we have two bradford students on our team and then we've got helen and sawyer both kind of around the bradford area as well i was thinking about bradford got the city of culture i can see why there's been so much uh
• 89:30 - 90:00 really rich stuff been joined uh shared tonight so thank you ever so much for everybody coming and it's been one of our longest ever webinars but there was so much in it i just felt like i couldn't keep brushing people through and i feel like i've rushed people but everybody was fabulous so thank you so much everybody tonight and on this slide you will see we've got four more sessions this season before we take a break for the summer next week we're going to be looking at reflective practice doing a back to basics what we're going to do is look at reflective
• 90:00 - 90:30 practice in the concept of complexity we're actually going to look at in social work how do you find the simplicity in the complexity and so there'll be lots of threads coming through from this week into next week so if you want to join i think the team will probably be putting into the chat um the um link for next week's session but thank you so much to everybody all of our speakers tonight it was i can see everybody's saying in the chat it was a
• 90:30 - 91:00 a brilliant session tonight so much and i think everybody bought a different angle and giving us a really rounded view of mental health social work because after all in many ways mental health social work is the most generic of all social work because we all have mental health mental well-being and so it's something for everybody so thank you so much and tonight and hopefully we'll see you next week good night everybody goodbye