Mental health social work is a broad, rather than a rigorous, church. Since the 1980s social workers have gained in professional status by the introduction of the roles of the approved social worker (or licensed to carry out civil commitment in the American context), care co-ordinators, managers of managed care facilities, or psychotherapists. These gains have come at a price outlined in the text above. Often the cost of closer collaboration within the multi-disciplinary framework has led to the risk of giving up the attempt to hold on to, and further develop, an alternative and complimentary perspective from that of psychiatrists, nurses, or psychologists, as well as raising doubts as to the uniqueness of MHSW. The increased narrowness of the role is not simply the byproduct of the legal framework. It is also due to increased specialization within mental health on the one hand, and the effects of neo- liberal policies globally on public sector funding on the other hand. The move to privately contracted work, either in managed care or in psychotherapy so apparent in the United States, is yet another outcome of neo-liberal policies which fragments MHSW. As a trend we are likely to see growing beyond the United States, the increased concentration of mental health social workers within the private sector does not bode well for a profession whose value base focuses on the need to protect the more vulnerable and stigmatized populations, and to provide the dual perspectives of psychosocial input. Mainly due to governmental pressure related to fear of risk and its potential political fallout, the focus on working exclusively with people experiencing long-term severe mental illness has contributed to the increasing narrowness of the role of social workers in most First World countries. The paralleled withdrawal of social work involvement with people who have milder forms of mental distress within public sector and not-for-profit services, and its increased availability only to those who can afford it, is a reflection of this situation. The core qualities of belief, optimism, and caring of MHSWs identified in a cross-national research coupled with the ability of MHSW to innovate as highlighted in this chapter, illustrate the optimistic scenario for positive change within this branch of social work. However, unless theory building and research aspects are given the importance they deserve within MHSW globally, including an inevitable critical dimension of the existing system, mental health social work is likely to be no more than a reflection of the developments in other professions. This will not only mean curtailing its autonomous potential, but also the impoverishment of the multi-disciplinary framework as a whole of a crucial dimension necessary for its comprehensive work, as exemplified in some recent work on the social aspects of MHSW. In addition, mental health social work will have to develop a much stronger policy making function, if it is to provide a more responsive, effective, and comprehensive service to users, relatives, and the communities in which these people live.
Mental health social work in multidisciplinary community teams: An analysis of a national service user survey