A deliberative study into the impact of integration on mental health social work in England: merely a dialogue or activism?

Abstract

Purpose The purpose of this paper is twofold. First, to examine the impact on mental health social work of integrated care; and second, to explore the effectiveness of the use of deliberative research, a methodology which is new to mental health social work research. Design/methodology/approach Developed to enable examination of policy, deliberative research is underpinned by a desire to permit choice and change brought about through an iterative dialogue. This communication is based on informed and respectful equality between policy makers or implementers and those subject to that implementation. In order to achieve this equality, participation in debate by participants is viewed as essential, including as part of the process, participants becoming better informed about the phenomenon in question. Findings The findings show that effective mental health social work underpins successful integrated care which, in turn, is viewed as relevant. In addition, people who access services identified that mental health social workers are well positioned as facilitators and explainers in integrated care. The issue to be further explored by research, therefore, is not whether services should be delivered separately or in an integrated way, but how to keep improving and developing integrated care and especially the impact of ongoing power differentials. Research limitations/implications The use of deliberative research worked reasonably well as an underpinning methodology for this study in that it sought to achieve the opinions of the public, in this instance consumers who provided or accessed mental health social work. The ethical need to ensure no harm came to this particular group meant that their opinions were not debated with the whole. This limitation to iterative dialogue is undoubtedly a consideration when undertaking deliberative research on such populations. This study offered just this, a one-off event, as in reality the commitment from participants to attend more than this one session would have been prohibitive. Practical implications The test, practically, comes with the events for data collection. This is not just the debate as to whether these, as one-off events, bring about agreement and not deliberation, but also whether researchers can, with a group that has particular needs, effectively integrate them into the deliberation. Given that it is an ethical priority to ensure that the participants are not harmed, this is not always going to be possible where the “public” includes those who may be vulnerable. Originality/value Deliberative research methodology is a new approach in mental health social work research. The influential finding is activism: people who access services recognise and suggest a challenge to the normative power differential in integrated care, as embodied in mental health social workers, and it is this aspect that warrants further investigation.

The Importance of Participatory Communication in Development Planning Deliberations for Agritourism Village Enhancement

“…Throughout the development process, all parties, especially the government and the community, engage in reciprocal exchanges of messages or aspirations from the development planning stage through implementation and evaluation (Ilu & Olawale, 2014;Odoom, 2020;Wilkins, 2014). As a form of participatory communication, Development Planning Deliberation (DPD) involves all stakeholders/development actors, such as the government, civil society, and private sectors, in a series of interactions, lobbying, negotiation, or transactions to achieve mutual understanding and agreement regarding development planning formulated based on mutual problems, interests, and needs (Jain et al, 2022;Lowenstein, 2020;Palacios, 2016;Tian et al, 2023;Treisman et al, 2016;Vicary & Bailey, 2018;Zhao & Derudder, 2018).…”

The social worker in community mental health teams: Findings from a national survey

“…Within multidisciplinary teams they have been reported to support their non-social work colleagues to ensure the delivery of support that places the service user and their social and familial networks at the heart of practice, providing non-judgemental, strengthsbased input that promotes self-determination and long-term recovery (Abendstern et al, 2014(Abendstern et al, , 2020Allen, 2014;All-Party Parliamentary Group on Social Work, 2016). Evidence from service users and carers suggests that they value social workers for their ability to see them 'in the round', to work in partnership with them, and to provide clear communication (Allen, 2014;Kam, 2019;Vicary & Bailey, 2018;Wilberforce et al, 2019). Service users have reported that social workers, when compared with their health colleagues, deliver more personcentred support (Boland et al, 2019).…”

“…Boundary spanning requires professionals to take on so-called generic roles and tasks alongside those that are considered specific to their profession and others that might have traditionally been regarded as the domain of another professional group. Neither boundary spanning nor generic working have, however, been universally welcomed to date with the erosion of boundaries between professional groups, referred to by Brown et al as 'creeping genericism' (2000, p. 426) leading at times to role entrenchment (Vicary & Bailey, 2018). Those arguing against generic practice cite the loss or underuse of specialist knowledge and skills to the detriment of the service user.…”

What Do Service Users Want from Mental Health Social Work? A Best–Worst Scaling Analysis

“…However, whether these efforts have led to consolidation of understanding around specialist social work roles in mental health is unclear. For now, crystallising and protecting the distinct mental health social work role remain problematic (Vicary and Bailey, 2018;Morriss, 2017) Curiously, for a profession dedicated to empowering service users and carers, comparatively few empirical studies have investigated their perspectives of social work (Kam, 2019). In part, this gap may reflect the difficulties that service users have had in establishing a voice in academic circles (Beresford, 2013).…”