Shaping the Future of Mental Health Policy and Legislation in Northern Ireland: The Impact of Service User and Professional Social Work Discourses

This paper explores the complex interrelationship between service user and professional social work discourses and provides a critical commentary on their respective contributions to the recent review of mental health policy and legislation in Northern Ireland. The analysis indicates that dominant trends in mental health care, as mediated through service structures and institutional identities, have tended to prioritize the more coercive aspects of the social work role and reinforce existing power inequalities with service users. It is argued that such developments underline the need for a ‘refocusing’ debate in mental health social work to consider how a more appropriate balance can be achieved between its participatory/empowering and regulatory/coercive functions. Whilst highlighting both congruence and dissonance between respective discourses, the paper concludes that opportunities exist within the current change process for service users and social workers to build closer alliances in working together to reconstruct practice, safeguard human rights and develop innovative alternatives to a traditional bio-medical model of treatment.

Models of Mental Health

A good understanding of the different theoretical models is essential when working in the field of mental health. Not only does it help with understanding experiences of mental health difficulties and to find meaning, but it also provides a framework for expanding our knowledge of the field.

As part of the Foundations of Mental Health Practice series, this book provides a critical overview of the theoretical perspectives relevant to mental health practice. At the core of this book is the idea that no single theory is comprehensive on its own and each theory has its limitations. Divided in to two parts, Part I explores traditional models of mental health and covers the key areas: bio-medical perspectives, psychological perspectives and social perspectives, whilst Part II looks at contemporary ideas that challenge and push these traditional views. The contributions, strengths and limitations of each model are explored and, as a result, the book encourages a more holistic, open approach to understanding and responding to mental health issues.

Together, these different approaches offer students and practitioners a powerful set of perspectives from which to approach their study and careers. Each model is covered in a clear and structured way with supporting exercises and case studies. It is an essential text for anyone studying or practising in the field of mental health, including social workers, nurses and psychologists.

Regress? React? Resolve?: An evaluation of mental health service provision in Northern Ireland

Report prepared for Action Mental Health by Queen’s University Belfast

Mental health social work in Northern Ireland and the Republic of Ireland: challenges and opportunities for developing practice

Drawing on their experience of mental health social work in Northern Ireland and the Republic of Ireland, the authors examine the impact of current legislative and policy change in both jurisdictions. The paper applies Lorenz’s theoretical framework to develop a comparative analysis of how global and country specific variables have interacted in shaping mental health social work. The analysis identifies linkages between factors and indicates similarities and differences in mental health social work practice. The paper highlights emerging discourses in this field and explores the impact on practice of developments such as de-institutionalisation, community care, and ‘user rights’ versus ‘public protection’. The article concludes with a review of key challenges facing social workers in both jurisdictions and identifies opportunities for developing mental health social work in ways that can positively respond to change and effectively address the needs of mental health service users and their carers. The analysis provides an opportunity to evaluate Lorenz’s theoretical framework and the paper includes a brief critical commentary on its utility as a conceptual tool in comparative social work.

Mental Health Social Work and the Troubles in Northern Ireland: A Study of Practitioner Experiences

• Summary: During the last decade increasing attention has been paid to the impact of the Troubles1 on social work in Northern Ireland. In this paper, the authors describe the first survey used to test some of the assumptions which exist in the literature. An 87-item questionnaire was applied to a range of social work staff currently working in, or associated with, mental health settings. One hundred and one questionnaires were returned: it is estimated that this represented over 70 per cent of mental health social workers in Northern Ireland. • Findings: The design of the questionnaire elicited both qualitative and quantitative data. The findings reveal a workforce with complex religious and national identities and many of the respondents have experienced relatively high levels of Troubles-related incidents whilst carrying out their duties in a variety of organizational and geographical settings. High proportions of respondents received minimal agency support and training to equip them to deal with Troubles-related problems faced by them during this period. • Applications: The authors conclude that the profession and employing agencies should pay greater attention to past and present effects of the Troubles on social work practice and develop appropriate strategies for supporting, training and resourcing staff in this neglected area.

An Examination of the Use of Coercion by Assertive Outreach and Community Mental Health Teams in Northern Ireland.

In mental health services over recent decades, the positive move away from hospital-based care to community-based services has entailed that people with higher levels of need are being supported by community mental health services. This paper begins by reviewing the literature on coercion in the field of community-based mental health care and treatment. It is argued that the lack of a critical understanding of the concept and how it is used by practitioners and agencies can have serious repercussions for the rights of service users. Using a quasi-experimental, longitudinal design, the authors then seek to test some of the ideas about coercion by comparing the activities of assertive outreach and community mental health teams in Northern Ireland, particularly the key ideas of perceived coercion, workers’ strategies and engagement with services. Key findings were that assertive outreach appeared to be more successful at reducing perceived coercion, minimizing the need for coercive strategies, engaging high-risk clients and reducing inpatient bed use. These findings are compared with other studies in this area. The authors also argue that there is a need for greater transparency in the way that practitioners use coercive measures and more explicit guidance is required in this crucial area of mental health practice.

Labor and Place: The Contours of Freedpeoples' Mobilization in Reconstruction South Carolina

Important advances in scholarship on the post-emancipation South have made possible a new synthesis that moves beyond broad generalizations about African American agency to identify both the shared elements in black life across the region and the varying capacity of freedpeople to assert their interests in the face of white hostility. Building on a number of recent studies of Reconstruction this article seeks to demonstrate that the varying capacity of freedpeople in South Carolina to shape and defend the new society that would emerge after the end of slavery was rooted in their relative strength at work and in their communities. In Charleston and its lowcountry rural hinterland, demographic strength combined with deeply-rooted traditions of collective assertion to sustain a remarkably vibrant grassroots movement that persisted beyond the overthrow of Reconstruction. From very early on, by contrast, former slaves dispersed across the rural interior found their freedom severely circumscribed by a bellicose and heavily-armed white paramilitary campaign.