Mental Health 2019924 1920

Mental health, social work and the times they are a-changing – some thoughts from practice

Author Amanda Richards

Bob Dylan sang in 1964 that the times they are a-changing, this feels pertinent now as we adjust to the ‘new normal’: whatever that means.

I recall as a student social worker being told that ‘living with uncertainty’ would come to define the professional parameters of my job and that I should get used to it! I was taken back to that conversation when I recently reflected on how easy it is in these times to feel overwhelmed by uncertainty and, curiously, how anxiety can become an all too agreeable bedfellow. It seems that ordinary human worries experienced by us all are somehow becoming magnified by this disruption to our daily lives, with individual frailties and fracture lines cruelly exposed. In times of uncertainty, it's more important than ever that we take care of our mental health, but this is also a good time to re-evaluate our lives. Remembering that we are all in this together, we can emerge with a renewed sense of community and become more awake to our inter-connectedness and interdependence. 

Adapting to working in different ways

Talking to former colleagues working in community mental health settings I was minded to how they are working positively with feelings of uncertainty and change. In Devon, much like everywhere else, social workers are maintaining contact and undertaking assessments by phone and using technology. This way of talking, reassuring and troubleshooting has allowed individuals to feel that they can talk through their concerns and work with the feelings of isolation they are encountering. For social workers, this method allows them to asses people’s changing (or increasing) needs as they emerge, this is forward thinking and strategic.

Currently, there are an abundance of tools online for becoming technologically and digitally more capable, with local authorities encouraging the use of tech wherever possible. A recent Research in Practice blog on Top tips for getting started on video conferencing provides recommendations.

Bucking this trend, a social worker told me with pride how she had hand written a letter to an individual (this method was considered the most effective way of communicating as the use of tech presented challenges). In this way, she remarked that never before in her professional career had she hand written a letter, but that this ‘old school’ approach was person-centred, appropriate for the individual, and had enabled her some much-needed reflection time out from her day. So often social workers prove to be adaptable and strengths-based in their approaches with people.

Social workers have raised concerns around the issue of working from home and being able to find appropriate space to hold conversations of a confidential nature.

  • Try and find an unoccupied room or space that can be utilised for private calls.
  • Consider a place where confidential paperwork might be locked away.
  • Speak with your employer around any organisational policies to support you to manage this issue.
  • Ensure that people’s names are anonymised when they are being referred to during discussions.

Using time to consider some additional learning

During this period of isolation I have reflected on the inter-play around neuroscience and social work, as a way of exploring and explaining thoughts, feelings and behaviours, and to better understand the human condition (Rutledge, 2014). Becoming better acquainted with how the function of the brain impacts on the development of mental illness, addiction and other psychosocial conditions is helpful for social workers, as a further tool to support change, recovery and work with relapse (Rutledge, 2014). Grasping the notion that human behaviour is driven in part by a fizzing mass of hormones, such as: cortisol (stress), testosterone (aggression, dominance, confidence, concentration) and oxytocin (bonding, eases stress, feelings of attachment) is a great universal leveller for us all.

A public health approach to understanding resilience during COVID-19 (Amor, 2020) considers ‘resilience’ from a number of positions: supporting people to recognise their own ‘window of tolerance’ (Siegel, 1999) creates space to acquire the skills to regulate in times of stress; processes of change that look to give individuals choice feels empowering and increases the potential for building tolerance over time. A key message asserts that a trauma-informed/trauma responsive approach to resilience will underpin recovery and most effectively respond to this crisis (Amor, 2020). It is surely the case that mental health resource planning requires a strategic focus now, with one eye on what types of aftercare services will be required for a traumatised nation, once we have exited out of our current predicament. Strategic commissioning needs to begin early and in earnest.

Embedding trauma-informed approaches in adult social care: Frontline Briefing (Sweeney and Taggart, 2019) supports the capacity of practitioners to understand how complex trauma affects people, aiming to build confidence in applying trauma-informed approaches in work with people across the life course.

Becoming attuned to the legislative changes and brushing up on existing legal frameworks

Faced with easements to the Care Act 2014 and Mental Health Act 1983 (not yet in force) created under the Coronavirus Act 2020, a robust legal literacy approach is critical now more than ever. As decision-making in health and social care settings becomes increasingly complex, and potentially contested, there is a need for strengthening professional identity and value base in order to be accountable with confidence. There is a wealth of online learning to support changes to practice, some of which can be accessed here:

Amanda Richards

Amanda Richards is a Research and Development Officer at Research in Practice and a qualified social worker.