It’s 1976, and I begin work as a social worker: #2 in a series

 

One Monday morning in the early autumn of 1976 I turned up for work at Charwood Social Services Department, along with 3 other people who had also succeeded in getting jobs as unqualified social workers in Charwood.

Social services functioned very differently 45 years ago. In 1974, only two years before I started work as a social worker, there had been a huge national reorganisation of social care provision, precipitated by the Local Authority Social Services Act 1970. This in turn had been inspired by the Seebohm Report, published in July 1968, which had proposed the integration of disparate social care services into single, generic departments overseen by local authority social services departments.

Until then, social care had been administered in a range of guises. For example, mental health had Mental Welfare Officers, defined by the Mental Health Act 1959. Services for children and families had Children’s Officers. Hospital social work was done by Hospital Almoners. In 1974, all these people were moved into these generic departments, and all became known as “social workers”.

This video discusses the impact of these changes.

Section 4: for emergency use only

 

I’ve looked at section 2 and section 3 of the Mental Health Act on this channel, so I’m now going to look at section 4, which is the other civil section for admission to hospital.

Section 4 is explicitly referred to as “an emergency application”. The AMHP, when completing their form, has to state:

In my opinion it is of urgent necessity for the patient to be admitted and detained under section 2 of the Act and compliance with the provisions of Part 2 of the Act relating to applications under that section would involve undesirable delay.

This means that the AMHP only needs one medical recommendation to make the application rather than the two required for section 2 or 3.

The Code of Practice states:

Section 4 should be used only in a genuine emergency, where the patient’s need for urgent assessment outweighs the desirability of waiting for a second doctor.

In this video I discuss circumstances in which use of section 4 might be justified.

Reminiscences of an out-of-hours social worker #2: Sam & Stuart

 

Between 1983 and 1997 I worked shifts on the out-of-hours standby duty team, as it was the only way for a social worker to earn extra money. I had a mortgage and 3 children under the age of 5, and a social worker’s pay did not go very far.

We dealt exclusively with emergencies and crises that arose outside normal working hours, covering nights, weekends, and Bank Holidays.

Out of hours, two social workers covered the entire county. It was a large geographical area of over 2,000 square miles, and it could entail a journey of 40 or 50 miles to reach the far ends.

Some of these incidents entailed creative thinking to resolve them.

Which brings me to a Bank Holiday weekend and 2 13 year old boys, Sam and Stuart.

Section 3 and "appropriate medical treatment": the Video

 

In a previous video I looked at section 2 and section 3 of the Mental Health Act and when each can be used. 

When an AMHP is considering use of section 3, which specifically allows detention in hospital for treatment, two medical practitioners have to provide medical recommendations.

It is not enough merely for the doctors to say on their medical recommendations that the patient needs medical treatment in hospital. They also have to state that appropriate medical treatment is available, and also state the specific hospital (or hospitals) where that treatment can be given.

This is where it can get very complicated...