Archive for ‘mental heath’

October 20, 2012

Home really is where the heart is

Home really is where the heart is.

My other  (less political) blog on health and social care. The above  post summarises a recent report  published on home care in England.

October 18, 2012

What I would say to Norman Lamb

Norman Lamb MP

Working in dementia services at the ‘frontline’ I often consider what messages I’d feed back to the local and national policy makers if I ever had the opportunity. Of course, I don’t have these opportunities as I’m not a manager so I thought I’d imagine I were at an important meeting with Norman Lamb, the minister for Care Services.

This is what I’d say.

Make policy practical. Making the right noises about setting up a wonderful plan to ‘challenge’ dementia is all well and good but I see nothing of that at the ‘frontline’.

What I see are cuts. I see respite narrowing in terms of ability to access. I see provisions which had been helpful, closing. I see a lack of beds in the local hospitals when they are needed and I see people who need support being denied it because there are no provisions left.

So take your pleasantries and policy ideas and come and spend a day with me in the community and you’ll see why I am impatient and unbelieving about the platitudes that emerge from those who don’t seem to understand what is happening ‘out there’.

I’m tired. I’m tired of saying ‘no’ to people whom I see need services because the provisions are so tight. I’m tired of saying ‘no’ to people at the early stages of need when I know it will prevent higher costs in terms of pain and suffering but also in terms of money in the longer run. I’m tired of logging targets that have no meaning in the lives of those whom I work with. I’m tired of jumping through artificial targets so I can ‘prove’ I’m doing my job when neglecting visits to actually talk to people because I have to catch up on the paperwork.

I have waited for years for a fair system of implementing personalised responses to care which include people with dementia but am still waiting because the entire focus on the programmes developed through personalisation have been on those who are more able to be involved in the processes or those who have involved family members to help them. I’m tired of wading through appallingly designed forms, self assessments and RAS (resource allocation systems) that focus entirely on physical health needs and marginalise mental health needs thereby ignoring equality legislation.

I want action and yes, sometimes, action includes money. I know what the people I work with ask for and I know I can’t deliver it – not through a lack of will – I want to be able to go home thinking I’m doing a good job and doing my best – and for the most part, I think I do – but the best I can offer is very sparse. The best i can do isn’t good enough.

We have few residential homes locally and are placing people further from their families. We have nothing ‘creative’ left to offer as those agencies which are helping with ‘support planning’ aren’t trained to offer support in non-directed advocacy and therefore if someone doesn’t ask, they don’t get.

So what would I do? I don’t have a budget and it’s probably for the best as I’d steam through it in five minutes – one of the many reasons I’m not and will never be a manager – but I would focus on trying to create a system of social care which offers equality of access to good and creative support planning.

I’d commission more non-directed advocacy into support planning. I’d roll out Individual Service Funds for people with dementia and I’d allow more time for carers – and for social workers to work with people who have dementia because honestly, that’s what’s needed.

However all we get is platitudes about how wonderful services will be without extra money being provided. Yes, I’m sure early diagnosis is important. It is. But please, please can the Department of Health and local government concentrate their minds on what is happening now and the poor services we are providing now and do something, anything to make them better.

I want to do my job well and I want to support people but all the tools I had available for doing so are being ripped away from me. It’s sometimes hard to keep the motivation up when you don’t believe you are helping anymore.

I’m the person saying ‘no’. Me, not the Head of Adult Services, not the Ministers responsible, not the councillors responsible. I sit in people’s homes and tell them what they are not entitled to anymore. I want those who make these decisions to take responsibility for that and to listen to us who go out there and who see.

That’s what I’d like.

picture by Liberal Democrats at Flickr

October 10, 2012

World Mental Health Day 2012

10 October marks World Mental Health Day. This year’s theme focuses particularly on depression.

Having worked with and known people who have suffered with depression, I think awareness raising in this context is crucial. The word ‘depression’ has moved into common parlance. I might talk about feeling depressed on a daily basis when something comes up that affects my mood negatively.

Actually suffering from the symptoms of depression is vastly different and in some ways, language isn’t a friend to those who do suffer from depression.

As we allow ‘depression’ to become almost synonymous with ‘sadness’ we misjudge a swathe of people for whom the illness is an immense source of difficulty. pain and distress. Depression isn’t sadness. Depression isn’t about the ebb and flow of mood. Depression can be debilitating and hopeless. Depression needs to be far better understood in that context and in the context that it can affect anyone and everyone – regardless of background, class or social status.

We can’t make judgements externally by looking at someone else’s life and decide if they ‘should be happy or not’ because depression doesn’t work like that. Life doesn’t work like that.

What we can do is look and see if someone is suffering and if they are, why should we do anything other than empathise with that experience of suffering and try to alleviate that in any way possible.

Having walked alongside, as far as possible, those who have and do experience depression, I have an admiration for the immense struggle that comes with each day and I learn from it.

My hope for this World Mental Health Day which seeks to increase understanding and reduce stigma is that depression isn’t seen as something is a decision people make about their lives. It can’t be ‘shaken off’ at will.

That needs understanding and that needs focus.

October 1, 2012

AMHPs and Stress

Dolly Stressed Out!

Back in January, Zarathustra posted a link to a survey for AMHPs on stress and burnout. This was for a piece of research being conducted by Janine Hudson, an  AMHP studying for an MSc in Mental Health Social Work at King’s College, London.

AMHPs are Approved Mental Health Professionals who, according to Wikipedia are ‘trained to implement coercive elements of the Mental Health Act (1983) as amended 2007′ so we (because I am one myself) make decisions with requisite recommendations from medical professionals, about whether someone needs to be admitted to hospital and treated without their consent. There are other roles for example in relation to Guardianship and Community Treatment Orders and certain tasks that are reserved for AMHPs legally but we have specific training around Mental Health Legislation and the implementation of it.  It is a role which does demand particular expertise, sensitivity, compassion and intellectual rigour to conduct well.

Janine and Dr Martin Webber who co-authored the study were  generous enough to share with us here (AMHP Survey 2012)  and while I am not entirely surprised by her results, I was saddened that my own gut impressions seemed to be more than just gut impressions.

Over 500 AMHPs responded to the survey and as many as 43% met the threshold for ‘common mental disorder such as stress and anxiety’. The threshold for burnout was much lower but it does raise the question about the amount of support and consideration given to practising within this particular role in local authorities in particular – whose responsibility warranting them (us) remains – but also within employing NHS Trusts. One of the aims of the study was to determine any differential in stress levels experienced by social work AMHPs and non-social work AMHPs but the findings were that there were still very few non-social work AMHPs and there was little differential. Locally, I know that there have been some issues around funding of non-social work AMHPs as it is a duty of the local authorities to provide sufficient AMHPs and as money is stretched, NHS Trusts have seemingly been less keen on sending people to train for a significant period.  It will be interesting to see how that picks up over the years but as the purpose of extending the role to non-social workers in the first place (we used to be Approved Social Workers and it was a reserved role which only social workers could take) was that there were too few AMHPs, it seems that issue hasn’t really resolved itself fully yet, four years after the switch.

71 AMHPs responded that the work as an AMHP had not had an impact on their non-AMHP role, however most of those worked in dedicated AMHP services because for the rest, the issue of managing AMHP and non-AMHP tasks with no workload concession, an increase in unpaid hours and pressure of work were contributing factors to increased stress.

I have certainly found personally that the AMHP work I carry out encroaches substantially on my ‘regular’ work as the amount increases. I am sometimes called out at very short notice to carry out assessments and these assessments take priority over all the other work I do due to the urgency and statutory nature of the tasks.  I have missed and moved visits at short notice and I can’t use any excuses to service users I work with (because obviously I can’t discuss my other work with them) so I apologise profusely and humbly but my stats aren’t as good as my colleagues in the same team and this is challenged. It is an additional pressure but any mention of removing some of my caseload responsibilities are met with a sad and sympathetic sigh. It’s just not happening!

Sadly familiar too, were some of the difficulties raised in terms of working and organising assessments across different services particularly as resources are stretched. Availability of ambulances, doctors and police are all  factors  in trying to manage and organise an assessment and certainly a factor that I recognise however the overriding issue was one of a lack of available beds.

Personally, I have found this to be much more acute as a issue over the last year and is getting increasingly worse. It isn’t wholly unrelated to the local Trust closing down wards to ‘save money’ however it has led to a massive increase in the provision of private beds at higher cost and further distance. This is the kind of ‘strategic decision’ that makes you wonder about the way snap decisions were made.

The impact on the patient is significant but it is also increasing stress levels in members of staff.

Generally, the research study indicates that AMHPs broadly feel unsupported in the role – except (perhaps unsurprisingly) by other AMHPs but in terms of management support/supervision/debriefing, it can vary significantly.

The report concludes that employers should do more to recognise the important and often difficult role that AMHPs take and reward with workload relief and a pay differential that acknowledges how much other professionals are paid for the work too.

My thoughts on reading this survey are that I’m unsurprised. I think it’s hard to explain to someone who is not involved in the role what exactly it entails but there is an enormous amount of responsibility taken  by the AMHP and it does feel to me, personally, that this is not appreciated or understood by my employing organisation. I wonder if there is a general awareness of some of the stresses that can be placed on an AMHP (and I’m absolutely sure every AMHP has been in this situation) when there is a great deal of distress after a decision to admit has been taken and the doctors have gone and we are waiting for the ambulance – maybe with the police, maybe not – but there’s a great deal of responsibility being handed to the AMHP at that point. It’s important that we are given substantial support.

My best support has definitely come from other AMHPs.

Saying that, while I won’t ever say I enjoy the role because depriving someone of their liberty is a very difficult, challenging and distressing process – the learning that I have done as a part of being an AMHP  has been significant – in terms of my understanding of mental illness and in terms of my practical application of the Mental Health Act, Human Rights Act and Mental Capacity Act.

Being an AMHP has made me a better social worker without any doubt and being an AMHP has and does make me reflect constantly on what the ‘system’ does and doesn’t do to those who come through it – and my role within that system.

However benefiting from the knowledge doesn’t mean that we shouldn’t get greater support for the role. That’s clear from this report and thanks to Janine for sharing her research with us. I hope that it will be disseminated widely to all local authorities who engage AMHPs and if you are an AMHP or know one, take it to your next forum meeting and discuss it.

In order to care and plan best for others, we really do need to look after ourselves and our own mental wellbeing.

photo by kelvin255 @ flickr

September 20, 2012

Consulting on the CQC

Frimley Hospital UK

I’ve been generally critical of the CQC (Care Quality Commission) since it’s establishment. I’ve been particularly critical of what I have seen to be the failings of a regulator for health and adult social care services where I have felt that there has been an impact, by the lack of robust regulation, on the lives of people who use and need the services which are provided.

My main concerns have been about a move away from regular announced and unannounced inspections and a move towards desk-based inspections. However the CQC has been re-evaluating this approach and with a new Chief Executive in David Behan and an outgoing Chair – I wonder if it’s time for me to evaluate my own attitude to the regulator for health and adult social care services in England.

I could never understand how Cynthia Bower was appointed in the wake of the Mid-Staffordshire scandal. It seemed to be a strange appointment. Starting a new agency by merging the functions of the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission was always going to be hard. This combined with new responsibilities to regulate services in different ways seemed to have led the eye to be taken off the ball as far as current standards went with the focus being on bringing new regulatory frameworks in amid low staffing.

As far as social care is concerned (and that’s the area i know best) this move away from  regular on-the-ground inspection of services combined with cuts in funding both to the organisation and to local authorities who might have had their own, more robust, monitoring teams, led to concerns about quality in the services being provided.

However, the CQC seems to be moving on in terms of re-establishing consistent and regular unannounced visits to services and there seems to be a shift in terms of the priorities which they are placing on promoting quality of care over merely meeting the lowest acceptable standards.

I read through the consultation for the strategy of the CQC between 2013-2016 (and, incidentally provided feedback because it is, after all, a consultation!) and it left me more hopeful that the sector might be developing a regulator that it needs.

Six ‘priorities’ are laid out for the next three years.

1. Making greater use of information and evidence to achieve the greatest impact

In this section the CQC acknowledges the move back to regular unannounced inspections and explains the way that information gathered relating to risk has fed into the way that inspections are conducted and that this needs to continue and strengthen in the future.

‘Building an evidence base’ about what works in regulation includes looking at overseas models. Obviously, I’d welcome a fuller evidence-based approach with the caveat that sometimes past excellence can change to present mediocrity by one new member of staff and there will always be some random elements at play in this sector – an area where I think the CQC has failed in the past by simply judging future potential risk by past performance.

The CQC is increasingly going to look at regulating different services in different ways with the same (presumably) framework as inspectors are professional regulators rather than experts in specific sectors. GPs and Dentists need to be monitored in a different way from a nursing home, a large general hospital or a private ambulance service. It seems to make sense.

Using information from different sources is also crucial. The CQC report mentions this. I expect they would feed heavily from local authority complaints in the field of social care and the information we (as LAs) get regarding care providers and particularly our contracting team which monitor quality and complaints. If someone from the CQC came into our LA and spoke to social workers directly about different home care providers and residential homes, I expect they might get a broader view.

2. Strengthening how we work with strategic partners

Here the CQC mention the changes coming in the NHS and the need to link with organisations such as ADASS, Monitor, presumably new Clinical Commissioning Groups and professional organisations.

I hope there will be a strong voice for Social Work in the form of the College of Social Work in feeding information back to the CQC. I might be on a bit of a theme here but I think the CQC can learn an enormous amount about adult social care from social workers and I think they really need to utilise the knowledge we have of local areas and areas around quality. While I will contact the CQC with major concerns/complaints about residential homes, I’m not asked to feedback about niggles or, for that moment about fantastic services. I’d love to see these links work not just at a managerial level but between inspectors and social workers in the locations they regulate.

3. Continue building better relationships with the public

For a regulator to have public confidence, the public have to know what they do, what they are responsible for and what they are not responsible for. The CQC can do their best but if people don’t know about it or have different expectations, they are unlikely to get the message across positively.

New ‘Healthwatch’ organisations will promote local links and input into inspections and the CQC is building on its ‘Experts by Experience’ programme building people who use services and carers of those who use services into the framework. I watched a video from an inspector where she talked about using an ‘expert by experience’ and referred to a carer of a person with dementia who helped her in an inspection of a residential care home. I’d hope that people who have dementia and may have cognitive impairments are also built into the process of being experts by experience. It is vital that users and carers are involved and different models built to encourage this involvement but that assumptions are not made that because someone may  have a cognitive impairment that they cannot speak for themselves.

Improving access to reports would also be good. Improving the searchability of the CQC site would be a massive bonus. It’s become increasingly difficult to search and find information and seems to constantly take steps backwards in terms of usability.

I think it would be helpful if there were comment forms under each service for public to send information from the website directly to the relevant inspector. Inspectors could have a greater visibility online and using broader social media to communicate with the public – not just through PR people.

I want to know what inspectors do every day. I’d love to see a regular blog from an inspector (without needing to mention any specific services but just with broad themes – generally frontline blogs are more interesting than management blogs!)

4. Building relationships with organisations providing care

This is an area I probably have less experience in. It explains that the organisation wants to provide quality reports and improve the feedback given to providers by inspectors. It’s often about links and nurturing positive links over time but not allowing that to impede judgement when there are problems.

5. Strengthening the delivery of our unique responsibilities under the Mental Health and Mental Capacity Act

As an AMHP (Approved Mental Health Professional) and a BIA (Best Interests Assessor) I have a particular interest in matters relating to the Mental Health Act and the Mental Capacity Act.

I feel particularly the CQC have disappointed me (I know that will upset them!) about their knowledge or rather their lack of knowledge about Deprivation of Liberty Safeguards. I think good and thorough knowledge of DoLs should be a core question in every single inspection in every residential and nursing home and hospital in which they may apply. I  have come across too many home managers who really should know better show an appalling lack of current knowledge about DoLs and believe that there are many many unauthorised deprivations of liberty that inspectors should be able to challenge homes and hospitals about.

Personally, I’ve made a number of third party referrals for assessments under DoLs and that’s just by people either allocated to me or situations I come across when visiting people in care homes or hospitals – there must be many many more that go unchallenged because the law is so fluid and complicated and I don’t have any faith that the CQC and those representing them on the ground know it.

I’d like to see better links between inspectors and Best Interests Assessors after all, we (should) have significant expertise in applying the DoLs and perhaps we could shadow inspectors and ask the questions that they don’t know to ask until they are trained up at least.

This is three years too late.

6. Continuing our drive to become a high-performing organisation

This section is about building a learning organisation and working out ways to measure progress. I know the organisation works with ‘professional regulators’ but I think something has been lost in not using people with expertise in health and social care to carry out inspections and to rely on generic ‘auditing’ experience but I can’t see that changing.

I do think there are hopeful signs though in these new priorities and wish the organisation well – we need a good, strong regulator that has the faith of the sector and I feel we will need it all the more as the NHS changes.

I am increasingly thinking that more link, better conversations and more co-production are the ways forward for the CQC and for health and adult social care in general.

Do feedback on the consultation though – we need lots of voices. The CQC say that they welcome feedback through social media – so this is my own response!

photo by vivido @ Flickr

September 19, 2012

Vote in Mind’s poll on the most important mental health issue

Mind are getting ready to head to the party conferences, where they’ll be lobbying on a variety of mental health issues, including mental health at work, the benefits system, discrimination and crisis care.

They’re asking people to vote in their online poll as to what are the issues that matter most to them. The poll is illustrated with a handy infographic to help people make up their minds.

Personally I voted for “fairer benefits” as the most important issue in mental health at the moment, though all the issues mentioned are deeply important. Arguably, given the current government’s barely-disguised contempt for the most vulnerable in society, there’s never been a time when it’s more important for people to stand up and shout about mental health issues.

Go vote.

 

September 12, 2012

Shortlist announced for Mind Media Awards

It’s that time of year again, and Mind have just annnounced the 2012 shortlist for their media awards.

Last year The World of Mentalists co-editor Pandora won the Mark Hanson Award for Digital Media for her Confessions of a Serial Insomniac blog. This year there’s at least two of my favourite bloggers nominated – namely Inspector Michael Brown aka Mental Health Cop and Independent blogger Ilona Burton. Both of those are very deserved, and I’m looking forward to browsing the other nominees and getting to know their work a bit better.

Other than the Mark Hanson Award, I’m also pleased that the superb This is England 88 is nominated for Best Drama, and that Patrick Strudwick has been shortlisted for Journalist of the Year for his coverage of psychotherapists offering “gay cures”.

Back in July Mind asked me to write a blog post encouraging people to submit nominations. At the time I wrote,

I’ve submitted a nomination in the Digital Media category. I won’t say who I’ve nominated, other than it’s not any website that I work on. Feel free to submit your favourites too.

Now that the shortlist has been announced, I’ll say that it was Chaos and Control. I nominated her for a saga in which she was stopped by staff from blogging while an inpatient. After some considerable wrangling with the NHS trust PALS service, she seemed to spark some genuine reflection on the part of the trust. She didn’t make the shortlist, but I certainly appreciated it.

Good luck to all the nominees.

September 10, 2012

World Suicide Prevention Day 2012

Today is World Suicide Prevention Day. This is a day to raise awareness and reflect on the causes of suicide and way that services and support is available or not to those who may be considering suicide.

While it is not difficult to approach the notion that suicide prevention is something that should be promoted, it is hard, at least in my mind, to detach this thought from the need for services to be provided – not just in specific mental health sectors but in broader terms because while it is easy to categorise ‘suicide prevention’ as a specific mental health need, there are those who may choose to take action to end their own lives who do not have what might be categorised as mental health problems.

So what would broader suicide prevention services look like? I think there is clearly a case for formal support (but then, I would say that) through supportive and longer term work through mental health systems. We are struggling in the NHS Community Mental Health Teams at the moment. We aren’t equipped to work with anything except the most acute needs due to decreasing funding. Fancy talk about policy pushes towards prevention mean very little in frontline posts away from Whitehall where these documents are drafted.

Waiting lists for talking therapies can be extensive and the choices between types of therapies (and for that matter, particular therapists) can be limited.

While I would argue (again, I would really) that there are practitioners who want to provide good services, it is becoming more difficult in a climate of cuts and those who pretend otherwise in the government are fooling themselves. Support has to allow time and therapeutic relationships to develop in order to understand what is needed and how. Support has to be provided extensively to family members and friends who support and care for those who have mental health needs in order to reinforce informal support networks. Personal budgets can help but only if they are implemented flexibly and with time and care rather than sped through to meet increasingly harshly imposed local authority and central government ‘targets’ and tick boxes.

My work should always be about people as individuals with wholly different needs, wishes, desires and aspirations but it feels as if it is increasingly turning into a ‘tick box’ culture in mental health services. That is wrong and it only serves to remove an element of humanity from a system that so desperately needs it.

Sometimes, indeed, often, it is not about traditional ‘formal’ services as much as promoting more social interaction and quality networking structures which can thrive  (and are often better) as peer based groups.  We have greater tools now to create different layers of social interactions now – we can build communities on the basis of interests as well as geography through and combat isolation and loneliness. If a shared interest in Dr Who or football or coffee can create communities around them, we are on the cusp of making it easier to find engaging and accepting communities to be a part of.

Perhaps though, with the greater opportunities come greater pressures to ‘find groups’ or to ‘be a certain way’. I am generally an advocate of the positive power of the internet and new communication forms to promote greater support networks and social interaction but there has been a rise in more public bullying and targeting which is the negative side of living life in the open.  I think a greater understanding of the role of those who use these new platforms negatively and to gain a greater platform for negative and unpleasant outlets has to be another focus. Why do people ‘troll’? What are the needs of the bully and what are they missing in terms of their social support in order to use negative outlets to target others?

There are many ways we can and should be looking at suicide prevention but while it remains a very important issue in mental health services, it is not an issue exclusively for mental health services.

We can all take a role in being more open, kinder and more understanding of the needs of others – we, collectively, are not able to prevent all suicide – but there has to be a wider awareness of a different paths to take – whether  formal or informal routes, they all need shoring up.

August 28, 2012

NHS trust advertises clinical post as unpaid internship

Working for nothing, it seems, is the new having a job. There’s currently an advert on the NHS Jobs website for an “honorary assistant psychologist”, for which the pay scheme is euphemistically described as “other”. [Hat tip: @DrPhilHammond]

We are seeking an enthusiastic and committed individual to join a community service within the Addictions & Offender Care Directorate. You will be based in a Substance Misuse team, a multi-disciplinary team, under the supervision of a Clinical Psychologist. You will need to be able to commit to working in an honorary capacity for at least two days per week for at least 6 months. We would look favourably on individuals who can make a greater commitment.

You must be willing to work with individuals with substance misuse problems, many of whom also have complex mental health needs. You must possess the relevant skills and attributes to facilitate service users to engage in the service. You must have a strong commitment to teamwork and be able to work sensitively within a culturally diverse environment.

The successful applicant will possess a degree in psychology, and be eligible for Graduate Basis for Registration with the British Psychological Society.

We offer regular, high quality, clinical supervision and strong professional support. The psychology department has close links with UCL, UEL and Royal Holloway DClinPsych courses.

Please Note: These are UNPAID positions.

Oh Lord, is this how it begins? The world of unpaid internships, sorry, “honorary” posts migrating over from business and the media into actual clinical roles in the NHS?

It’s perhaps unsurprising that it’s an assistant psychologist post that seems to have attracted this method. There’s lots of keen, bright psychology graduates out there desperately scrabbling about for a few jobs as assistant psychologists, which they hope in turn will make them more appointable to the fiercely competitive doctorate programmes in clinical psychology. Plenty of the nursing assistants and support workers I’ve worked with in mental health are psychology grads trying to get relevant experience. Quite a few of them eventually give up, and go back to university to train as mental health nurses.

In other words, a field where you’ve got a good chance of finding someone of sufficient quality who’ll do it for free.

No doubt it’ll save Central and North West London NHS Foundation Trust a bit of cash, but it’s yet another kick in the teeth for social mobility. There’s going to be a lot of psychology graduates who won’t be able to apply for this – not because they aren’t good enough, but because they can’t afford to take two days off a week from stacking shelves at Poundland.  If this turns out to be the shape of things to come, this could be yet another deepening of class divisions where a whole slew of top jobs are simply closed off to everyone except the offspring of the wealthy. Welcome to the new aristocracy.

August 20, 2012

Keeping up with Research while in Frontline Practice

Gizmo studies Maritime Law

Being based in an ‘integrated’ team alongside NHS staff, I have been frustrated at some of the differences in attitude towards conducting, assessing and discussion of current research as a frontline practitioner. However, this is a better situation to be in than when I was working in a social work team. At least now, I’m aware that there is a difference and by not being given particular time and space to access research articles and journals, I’m being impeded.

While I see colleagues being actively encouraged to undertake research projects, there are no possibilities ever raised for social workers to work in similar ways. This may be wholly about work culture and attitude to research by employers or it may be about professional attitudes to the importance of being updated regarding research but there is a noticeable difference.

I try to remedy this myself and while there will not be time to actively carry out any of the research projects I ponder about – there is nothing as frustrating as seeing the same evidence being published in different ways that tells us nothing that will actually make a difference to the way we practice – I limit myself to literature reviews and trying to keep myself updated with journal articles. Sometimes we discuss them as a team – sometimes I collate the information myself and keep notes on the articles I find. I may even publish some of these literature reviews as blog posts in the future if they would be useful to others.

I used to make considerable use of the British Journal of Social Work but seeing as my access to research literature is limited (possibly like many local authority social workers) to the SCIE (Social Care Institute of Excellence) Athens scheme and they no longer are able to subscribe to that journal, I have turned to other journals to find and source information that is useful to me. It makes me think less of a journal that would play political games with allowing access or not but it is a sharp and important lesson about the need for practitioners to have good access to information.

I have though through the SCIE scheme found

Aging and Society, Journal of Social Work Practice, Practice and the Mental Health Review Journal have been particularly useful for me. It’s worth checking out the resources available via SCIE as any social worker in England and Wales working for a local authority with a gov.uk email address can gain access to them.

The College of Social Work also enables Athens access for members if the email address is a problem but I believe the list of resources available are the same and there is still a block on the British Journal of Social Work being made available.

SCIE provide useful resources generally and RiPfA have some good outlines and policy updates which can be an excellent way to start discussions and conversations in a local service area. I don’t know much about Community Care Inform as it focuses on Children’s Services but it may be something useful if there were a parallel type service for adult social workers – indeed, I’d be happy to pay, individually, for just such a service.

As an AMHP (Approved Mental Health Professional) and a BIA (Best Interests Assessor)  it is crucial that I am constantly aware of both the latest developments in terms of case law and the new interpretations as they arise – I’d say that it is necessary for anyone working in Mental Health to have a good awareness and understanding of current interpretations of the Mental Health Act and the Mental Capacity Act.  I find the 39 Essex Street Court of Protection newsletters very useful to ensure that I am aware of the latest developments. although I do attend both formal and informal training and workshops regularly which focus specifically on case law in these areas.  It is the one area particularly that I find social media enormously helpful – not just in terms of awareness of cases as they arise but as opportunities to discuss them.

Even in the toughest, busiest teams we have to take responsibility for our own learning and ensuring that we do not leave the information and research evidence to pick up cobwebs in the ivory towers of academia. Being a practice educator helps with this as I encourage students to source and discuss recent, relevant research with me in supervision but also try and find some useful and interesting articles myself to discuss.

The benefits of being up to date and knowledgeable about current research are that firstly it encourages competent practice – I don’t think it’s possible to work in a silo of information and evidence that may have been presented when you (we) last studied formally, even if that was a year ago. Things change quickly.

An awareness of research can affect policy and the development of services – I’ve been able to feed into consultations both locally and nationally using references and information that I have gleaned from recent papers and it has added a more authoritative quality to my input. I’ve also been able to discuss and reflect in my own supervision sessions some of the disconnect between what might be positive ways of organising services and the ways things happen in practice.

It has also allowed me to garner a louder voice within the system in which I work. I can build a professional reputation as someone who will invest in my own learning and progress and when I have concerns about the way the organisation might be approaching something, I can back it with references, I’m far more likely to be taken seriously.

We want to create learning organisations but they have to be filled with learning practitioners and standing still is not an option. It doesn’t have to take significant amounts of time although it can if we want it to. It can be about reading through an article with an interesting title and reviewing it mentally before deciding.

One of the chief things I’ve learnt is that just because an article is presented in an academic journal, doesn’t mean it’s well-written or useful. We shouldn’t idolise academics as there is as great a variety in quality as there is in practitioners but there is no doubt that having an active interest in current academic research and debate is the next best thing to being able to be actively engaged in contributing to research.

Perhaps that’s the next step – one day I’d like to see more effort all round to integrate active research into practice but in the meantime I’ll make all the effort I can to ensure that my practice is current and informed.  It helps keep me hopeful and it helps keep me interested.

I’d love to know if anyone else out there has other information or resources that they use to make sure they keep up to date with research while practicing. It’s a vital way of keeping our knowledge fresh and active.

pic by jmatthew3 at Flickr

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