So why did I become a social worker in the first place?

 

So why did I become a social worker in the first place? It's the little, but significant, life experiences that plant the seeds of your future career.

Having been a social worker for approaching 45 years, now that I’ve actually retired I’ve had time to think about what led me into social work in the first place.

I have written in the Guardian in the past about what led to my first social work post, and spoken about it here. It was almost accidental. After all, children tend to have ideas about being doctors, or nurses, or train drivers. For one thing, it is not generally a high visibility profession, unless something goes wrong, and then social workers always seem to be identified as the guilty parties.

But there were a couple of incidents in my adolescence, long before I ever thought about becoming a social worker, that with hindsight first  planted the idea in my mind of being able to help people and make some sort of difference to their lives.

The first incident was when I was 16, when I was still at school studying for A Levels. The Post Office were wanting temporary assistant postmen to cover the pre-Christmas period. I managed to get one of these jobs, to earn some pocket money.

I was assigned to assist Bill, one of the permanent postmen, on his round. This involved carrying a huge bag of post around a housing estate, while he went here and there in his van.

But part of his round involved having to drive to more remote houses. He stopped outside a rather dilapidated looking bungalow and asked me to deliver a small bundle of what appeared to be Christmas Cards and a couple of parcels. He said that he didn’t want to do it himself as the occupant would keep him in conversation for hours.

I knocked on the door and after a while it opened. An elderly and frail looking lady was standing there. I noticed that she had dried food attached to the whiskers on her chin. The bungalow beyond was dirty and ill cared for, with random piles of newspapers and cobwebs hanging from the ceiling.

I gave her the cards and parcels.

She seemed desperately disappointed.

“Isn’t Bill delivering today? Such a nice man. We always have such a nice chat.”

“No,” I replied. “He’s … busy, what with the Christmas rush and everything.”

“Oh, well, never mind.” Her voice petered out, and she closed the door.

I felt for the lady’s loneliness, and her disappointment at not being able to have a conversation with the postman. How many people did she see in a week? The experience haunted me.

Surely there must be services that could help someone like her, I remember thinking.

The second incident was both different and similar.

I was 17 years old, and trying to be a hippy, with long hair, a beard, bell bottomed jeans, and sandals. (Give me a break. This was the early 1970’s.)

It was the summer, and I was hitch-hiking in England. I don’t remember where I was going to. It may have been a pop festival. I had a rucksack, and a sleeping bag, and was hoping for some sort of adventure.

A large Volvo stopped to give me a lift. When I got in, I was surprised to see the driver was an immaculately dressed woman in her 40’s. Women never usually stopped for a young male hitch-hiker who looked a bit like a hippy.

I couldn’t help noticing that her face and bare arms were covered in a blotchy rash.

We drove off. Looking straight ahead at the road, she said, “I expect you’re wondering what’s wrong with my skin.”

She didn’t wait for a reply.

“It was my husband. The person I love most in my life. He went to the doctor one day because of a pain in his head. The doctor sent him for tests.

“My husband had a brain tumour. It was inoperable. Within 6 weeks he was dead.

“The funeral was 2 months ago.

“I thought I was doing fine. I thought I was managing. But a couple of weeks later I woke up one morning and saw that my whole body was covered in this rash.

“The doctor told me it was nothing to worry about. It was a reaction to the stress.

“Nothing to worry about.

“I‘ve lost my husband, the love of my life.

“Nothing to worry about.”

She continued to tell about her life with her husband for the rest of the journey. When it came time to drop me off, she looked at me and said, “You don’t know who I am. I don’t know who you are. We’ll never see each other again. Thank you.” She smiled for the first time during the trip.

Even though I was only a 17 year old self-absorbed teenager, I realised that something significant had happened. She needed to tell someone how she was feeling, someone she did not know, who was nothing to do with her family or social circle, someone who would not judge her, who would not argue with her, who would just listen. She just needed to talk.

So simply by being there in the car with her, I had helped her in some way to come to terms with her bereavement.

I realised that making a difference to people might not be so difficult after all. And it was oddly satisfying to realise I had helped in some way.

My First Mental Health Act Assessment: the 1983 MHA

 This is about the first assessment I did under the 1983 Act. On 28^th September 1983 the 1959 Mental Health Act was rescinded. I ceased being a Mental Welfare Officer and became an Approved Social Worker. It sounded much more modern, as did the 1983 Mental Health Act itself, which incorporated more human rights safeguards in the process of compulsory detention in hospital.

As well as having some experience under the 1959 Act, ASW’s to be had actually had some basic training in the new Act, so this time I felt a little more prepared when I received my first request for an assessment under the 1983 Act a week later.

I was on out-of-hours duty, and the request came in the early evening. Her name was Emma. She was in her 30’s, married with two young children, with a diagnosis of bipolar affective disorder. She had been seen by her GP earlier in the day, but had abruptly left when it looked as if he might be considering admitting her to hospital.

She was now in a police station, detained under Sec.136, having been removed to a place of safety from a public place by a police officer who had reason to believe she may have been mentally disordered. She therefore had to be assessed by an ASW and a medical practitioner.

Before I went out to see her, I took the precaution of visiting the GP, who was still in surgery, and got more information. She had been going high for a few weeks, and had managed to obtain a bank loan, purchase a franchise with an international cosmetics chain, and had opened an office in the town, despite having no experience in this field whatever.

I obtained from him two medical recommendations – one for Sec.2, and another for Sec.4 – just in case – and then set off for the police station.

When I interviewed her, Emma seemed quite calm. She was clearly extremely tired, having not slept for several days, but sensibly recognised that it would be a good idea to go home, take some medication, and get some sleep.

I didn’t think she needed detaining, and could therefore be discharged from the Sec.136. The police sergeant thought otherwise. As the wording of Sec.136 stated that the patient had “to be examined by a registered medical practitioner and to be interviewed by an approved social worker”, since she had not been examined at the police station by a medical practitioner, he could not allow her to leave the police station.

He was right. However, the Act had only come into force the week before, this was my first experience of using the new Act, and I decided that since she had been assessed by a medical practitioner that very day, she did not need assessing again by another in order to fulfil the requirements of Sec.136.

After a considerable and sometimes heated discussion, he acceded to my superior knowledge and allowed me to take her back to her home town, with a female special constable as an escort.

What an interesting journey that was. Once we had set off, Emma started to go high again. I realised that she was rapid cycling. As we drove, she became more and more charismatic, and even appeared to physically increase in stature. It was an awe-inspiring sight. A messianic glow seemed to emanate from her being as she told us about her plans for world domination through the cosmetics industry.

I was becoming steadily more alarmed the more I drove – would the car be big enough for the three of us, or would she continue to inflate indefinitely until the car burst asunder? The female special constable however, with very little experience of mental illness, was drawn completely under Emma’s spell. Not only did she take issue with my opinion that Emma was mentally unwell, but she was even considering investing her life savings in Emma’s scheme.

At last we arrived at her home. By then I had serious misgivings about leaving her with her husband and children in this state, and when her husband saw her, I could tell he was even less happy than I was. She had no intention of taking her medication and going to bed; she was instead going to her new office to order even more of the cosmetics, right then, and then she was going to see her solicitor to get a divorce.

I knew that chaos would ensue if I were to leave her, and in those days without mobile phones I suddenly felt extremely tired and lonely and isolated. Why on earth did I ever decide I wanted to be an ASW?

In an attempt to regain control of the situation I calmly but firmly indicated to her that this was not a wise thing to do, that she was extremely unwell, and that she really had no option but to go to hospital.

“All right,” she said suddenly. “I’ll go to hospital if that’s what you want.”

Before she could change her mind we got back into the car, again accompanied by the female special constable, who by now had realised that something was severely amiss with Emma and was reluctant to sit next to her, or even be in the same vehicle, and I drove the 15 miles to the hospital, knowing that if I could get her safely ensconced on the ward, then if necessary we could keep her there on a Sec.5(2).

By 11.00 pm we arrived at the hospital. I sat her down in the nursing office with the admitting nurse, beginning to allow myself to feel relief. This was when she drew her trump card.

“I’m not staying,” she said.

“But you agreed that you would go to hospital.”

“I agreed that I would go to hospital. I didn’t agree that I would be admitted!” She gazed at me in triumph. She had outwitted me.

But I had my own trump card. I left the room for a few minutes, filled in a form, and returned.

“Emma,” I said to her, “you are now detained under Sec.4 of the Mental Health Act 1983. That means that you have been admitted for assessment for up to 72 hours.”

This was converted this to a Sec.2 the following day. She duly apopealed, and two weeks later I had my first Mental Health Review Tribunal of the 1983 Act. But that’s another story.

Social work in the 1970’s: Robina and Cyril: #4 in a series

 

Within a few months of starting as an unqualified social worker in Charwood Area Social Services Department it was decided that I could take part in the Area on call rota.

Charwood provided a local out of hours emergency service. Every social worker in the team had to be on the rota. This meant that about once a fortnight I was on call during a week night. About every three months I had to cover a whole weekend, from the end of the day on Friday until the following Monday morning. Being the late 1970’s, there was no such thing as a mobile phone or even a pager, so your home number was placed on the office answer phone and you could not leave home as long as you were on duty – unless, of course, you had to respond to an emergency.

I was on call one cold February Saturday when Robina phoned. What she told me led to tragic consequences.

Social work in 1976: #3 in a series

 

Social work was very different in the 1970’s -- even the concept of “social work” as a single profession was novel. The social work task certainly seemed more straightforward back then – generic social work implied that you could be equally competent to practice with all service users, whatever their problems. 

Some processes were certainly much simpler than they are now. If you visited an elderly or disabled person and thought that they needed home care, all you had to do was talk to the “Home Help Organiser” in the team. She would then undertake her own assessment of need, decide how many hours and what sort of care was required, then arrange for an in-house “Home Help” to go in. The service user paid for this service, if necessary, by buying stamps from the local post office.

There was undoubtedly a sense of optimism, especially among the hordes of new social workers who were appointed then (as well as a naivety that would be quickly dispelled). There was quite a lot of money going into social work – local authorities then were actually going through a period of immense budgetary growth. 

New services were being created: “Intermediate Treatment” was being mooted as a way of tackling juvenile crime, social workers were getting involved in dealing with young offenders; family centres were being set up in their dozens, based on the philosophy of tackling the problem of teenage alienation by targeting early deprivation and proactively working with families where children were considered to be at risk of future offending. 

Some social problems were really rather rare, particularly out in the rural parts of the Charwood area; far from there being the extensive drug and alcohol problems, and associated services, that there are now, in Charwood back then, the numbers of registered heroin addicts could be counted on the fingers of one hand.

Other problems, however, especially in Charwood and its surrounding area, were very common. Isolation and difficulties accessing services were serious issues for the people in the outlying villages. Having said that, even the smallest hamlet had a post office; this was extremely important when trying to find “Dingley Cottage, Golden Corner, Hempland St Giles”, as comparatively few people had telephones and the local sub post master or mistress could always give you directions (“Oh, you’ll be wanting Edna Boggis – her arthritis has been playing her up terrible, you know.”)

Charwood itself contrasted markedly with the surrounding countryside, having a bizarre preponderance of inner city type problems. This was because of its status as a London Overspill town. People moving up from London brought their London problems with them as well as finding new problems when they arrived. It never ceased to amaze me how many Charwood people claimed to have been associates of the Krays; some of them, I suspected, were laying low in the town to avoid possible “unpleasantness”, and might even have had assumed names.

Many of those who moved to Charwood from London found it very difficult to adjust. While I was delighted that I could walk out of the back gate of my house on a GLC estate and immediately find myself walking down a path beside a river teeming with fish into the middle of a wood full of deer, woodpeckers, and edible fungi, many of the people I started to see could not get over the lack of any significant night life, the dearth of takeaways, and the absence of any leisure activities at all apart from bingo at the local cinema, not to mention the difficulty of finding public transport that would take you anywhere more cosmopolitan.

Our threshold for services was rather different then, and some of our social work tasks would seem completely alien now. One example was the arrangement we had with the public utilities companies (water, gas, electricity). If they were planning to disconnect someone and had reason to believe they were vulnerable, for example, if they had young children or a disability, they would write to us to give us notice. We would then go out to visit them, and if necessary would loan them a calor gas heater or cooker. We had a store room at the office full of such equipment.

We also used to get sent out on trivial errands – I can remember driving 10 or more miles simply to deliver a bendy straw or a non slip tablemat to someone with a physical disability!

In those days one of the perks of being a social worker was that you were designated an “essential user” and therefore entitled to quick installation of a telephone. You have to remember that British Telecom back then hadn’t been privatised and had a monopoly for provision of phone lines and equipment. They were in short supply, and ordinary members of the public often had to wait 6 months to have a phone connected. As well as jumping the queue, you had your quarterly standing charge paid for.

There was no countywide out of hours emergency service; emergencies outside normal working hours were dealt with by the local area. This meant being on a duty rota for evenings and weekends. Your home phone number was put on the answer-phone message at the office, and police, doctors, or members of the public could ring you directly at home. Being on duty over the weekend meant that you could not be out of ear shot of your phone at any time over the entire 48 hour period.

Our filing system consisted of huge cabinets full of paper files, into which all our visits and contacts were recorded. We had a large typing pool whose job it was to type up our handwritten notes and insert them in the files. 

It must have been an onerous job, although the typists never complained. Some social workers were into “process recording” – this entailed not just writing down the bare facts of a visit, but also including your thoughts and opinions, and even your speculation as to what the service user might be thinking. 

I was particularly struck by the notes I found in one child’s file by the previous social worker.

“Little Lorna was nervous about meeting her new foster parents. She gazed up at me, her lip trembling, an apprehensive tear in her eye, and held my hand tightly as we walked up the flower bordered path towards the Jones’ front door. The green painted door opened as we approached, and Sally Jones knelt down on the doorstep, her arms held wide in welcome. Lorna looked up at me again, spotted the doll in Sally’s hand, and gingerly reached out to it... As I drove away, I looked into my rear view mirror, and saw Lorna waving with one hand, the doll clutched firmly under her arm. She will settle in well, here, I thought, and felt a lump in my throat.”

I decided that I would attempt to be more concise in my own recording.