Contemporary mental health services

This chapter begins with a discussion of the development of the service user movement within mental health. It emphasises the importance of service user perspectives before going on to examine a range of contemporary concerns within services.

Deinstitutionalisation and the development of community care

This chapter outlines the development of the policies of deinstitutionalisation and community care. It discusses the work of theorists including Goffman and Foucault, who were critical of the oppressive nature of the asylum regime. The chapter concludes with a discussion of the failings of community care in the 1980s and 1990s. It argues that a moral panic led to the introduction of more restrictive policies and a focus on risk.

Madness and society

This chapter examines a range of historical perspectives. It outlines the development of psychiatry as distinct branch of medicine. It highlights the development of institutional responses to mental distress that resulted in the segregation and exclusion of individuals. The chapter considers medical and social models of mental illness as well radical criticisms of the power of the psychiatry as an agent of social control

Postscript

This postscript examines the Wessely review of the MHA that was completed in December 2018. It outlines the background to the review highlighting the increase in detentions under the MHA. The chapter then examines the principles of choice and autonomy, least restriction, therapeutic benefit and the person as an individual that underpin the proposed reforms. The chapter recognises the importance of these principles but argues that they cannot be properly enacted without structural changes to mental health services

Mental health social work reimagined

The final chapter summarises the key themes of the book. It outlines the narratives that have underpinned reforms of mental health legislation examining moves towards a rights-based approach. The chapter explores the impact of austerity policies on mental health services and services users. The chapter concludes with a call for new community based approaches and a rejection of risk and bureaucratic managerialism.

Contemporary mental health social work

The chapter contains an outline of mental health policy and legislation including the role of the Approved Mental Health Professional (AMHP). Trends in the use of the MHA are examined. Bourdieu’s notions of habitus and the field are used as a conceptual lens. The chapter argues that mental health social work, in common, with other areas of practice has become dominated by risk and risk management. This has occurred at the expense of relationship-based approaches.

Citizenship and mental health

This chapter examines broader notions of citizenship. It argues that the discrimination that people with mental health problems face amounts to a denial of the full rights that citizenship should bestow. It concludes by examining the impact of neoliberal social policies and austerity. These policies have increased inequality but have also targeted people with mental health problems.