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Stories from social workers and people they support

My job is to work out what makes a difference to people’s lives. It’s discovering what motivates them, what excites them, and what they love.

Harry Mental health social worker

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Harry is a Think Ahead trainee working in a community mental health service for older people in Durham and Chester-le-Street.

Growing up, we often had social workers in our house. My brother has special education needs and social workers were there to support him and our family. I knew from a young age that I wanted a career that gave something back; to do something that helped others. I saw the difference it could make.

I wasn’t sure what I wanted to do exactly. I originally trained as a teacher but have always been interested in mental health. My dissertation at university was on mental health and the use of screens and social media; then during the pandemic I read about the impact of lockdown – and I just knew I wanted to do something to try and help. So, I decided to apply to the Think Ahead programme, and was over the moon to be selected.

To be honest, when I first applied, I didn’t imagine I was going to work with older people. But now I’m here and doing it, I would not change it for the world.

I was a little worried at first. I had ‘imposter syndrome’. What did I know about working with older people? But the support I was given from day one has made it possible. The Think Ahead programme provided extra groups to help us learn about the specific challenges of working with older people. I have learnt so much.

My job is to work out what makes a difference to people’s lives. It’s not just about making sure someone can physically get out of bed, it’s discovering what motivates them, what excites them, what do they love – that is the reason any of us get out of bed in the morning. It’s no different for the older generation. They are individuals, with different life stories and passions, and I make sure my support is tailored to that. I hear such incredible stories every day. Everything from being a solider in war, to raves in the 1980s. A lot of ex-miners live here too. Tough, difficult, but rich stories. It is a privilege to listen to them.

Harry joined the Think ahead programme in 2021. He works in a service that provides support for older people who live in the community, who are experiencing depression, anxiety, dementia and other mental health problems.

I work alongside a remarkable team. Social worker is a job that sometimes has negative connotations, some misconceptions, but also lots of people just don’t know what we do. I wish more people could see the effort and compassion my team show every day. The determination, creativity, and expertise they use to make a difference to people’s lives. My Think Ahead Consultant Social Worker (CSW), Fiona, is wonderful and so supportive. The team always makes time for one another, I feel we are comrades really. We always make time to check in.

The impact of Covid-19 has been huge. Many older people have support systems of family and friends who could visit them, even if it’s just occasionally. And then one day, it was just cut off. For people who are already struggling with isolation, with depression, with cognitive decline – it was just devastating. It is our job to help them slowly come back into the world, to find motivation again, to find love in the little things. We do ensure we do home visits and see people face-to-face, even if we still need to wear PPE. We can’t rely on technology to support people, as there is so much digital poverty. It’s not because older people aren’t willing to try new things, but so many of them simply don’t have access to the technology to make it possible.

As a social worker, you may ruffle a few feathers along the way. It’s not always easy, but it’s incredibly rewarding.

Levi Mental health social worker

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Levi is a mental health social worker in Manchester.

I studied English at university, and I worked for a pharmaceuticals recruitment company after graduating. My career kept me busy and focused, but I didn’t feel like I was having a positive impact on people’s lives or society through my work, which is something that’s really important to me. I was looking for opportunities when I found out about Think Ahead. It was the first year of the programme, and I’d never really come across anything like it before. Mental health felt like an area where I could work with people who are disenfranchised, and have a positive impact on their lives. Meeting my fellow applicants, and the people who would later become my colleagues, I knew I’d made the right choice. For the first time in my career I was meeting like-minded people, who were passionate about the same kinds of things as me.

I work in the community helping people with a range of severe mental health conditions, including psychosis, personality disorders, and eating disorders. The role is really varied and no two days are the same, which I love. The support packages I put together are bespoke and as varied as the individuals I work with, helping them to identify what they feel would improve their lives. This ranges from practical support – for example sorting out somebody’s housing situation or helping them to access benefits – to reconnecting them with family members, or advocating on their behalf to make sure they can access services. As a social worker, you may ruffle a few feathers along the way, but you quickly learn that you have to stand up and speak out to get the job done. It’s not always easy, but it’s incredibly rewarding.

There was one case that had a particular impact on me, and will stick with me forever. I was working with a woman who was socially isolated and experiencing severe depression, which continued to worsen. One day she attempted suicide and was admitted to hospital, where she remained for several months. I continued to visit her each week and we talked for hours, working out what she felt would help her. At the beginning it was emotionally difficult – seeing someone you’ve connected with so personally, so close to the edge was tough. Gradually, and with the right support, she began to improve.  We were able to set specific goals and targets for her to work towards, and I supported her to access time with a psychologist. Once she was well enough to leave the hospital, I helped her to reconnect with old friends and take part in activities in the community. She developed new interests and renewed her passion for some that had dwindled, including her faith. Each step she took was directed by what she felt would be beneficial. The turnaround was remarkable, from feeling so low and unable to go on, to feeling useful, valued and fulfilled. Seeing her progress along that journey was a pretty miraculous thing to be a part of, and something I will always be proud to have played a part in.

Mental health social work is so holistic, it lets you look at all of the social factors that can affect people with mental health problems.

Paddy Mental health social worker

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Paddy is a mental health social worker in London.

I studied Business and Marketing at university, and worked in marketing after graduating, but every Sunday I’d wake up dreading going back to work the next day, which was clearly a sign it wasn’t working for me as a career choice. I then spent a year working for an insurance firm in quite a lucrative job, mainly to pay to go travelling, but it was never my long-term plan.

I was looking for a vocation and I knew I wanted to support people with their mental health, so I carried on working night shifts for the insurance firm, but I took Mondays off. I used this time to carry out voluntary work for “Aim4Work”, a scheme helping people with mental health conditions get back into work. Then I came across Think Ahead. I loved the sense of satisfaction I got from volunteering, but I was really attracted to mental health social work. It’s so holistic, it lets you look at all of the social factors that can affect people with mental health problems – whether that’s employment, housing, or their family situation.

Now I work for a Recovery and Rehabilitation Team, where I support people living with psychosis. It’s a challenging role, because the people I support have been receiving help for a long time by the time I begin working with them. Because psychosis can mean people lose touch with reality, my role can involve questioning someone’s belief systems, which can be difficult, but I find it really rewarding. My full caseload is around 25 service users, and I work to build a relationship and trust with each of them, helping them to access services and support they wouldn’t have been able to before.

With everyone I work with, their conditions are personal and entirely unique to them. My role is to help them identify what recovery means for them personally and how best to achieve it. For many of them it’s about taking small steps, and setting realistic goals, and I can help them bring about the changes they would like to see in their lives.

One case that stands out in particular is a middle-aged gentleman with a diagnosis of schizophrenia and cognitive impairment. He lives alone and, over the course of a few months, he had been admitted to hospital for various illnesses and accidents in the house. Hospital staff were concerned that he would be unable to manage on his own, and they thought he needed to live in a secure and supported environment, such as sheltered housing. There were further concerns around his capacity to make the decision where to live. I’d worked with this man for six months prior to this, and I knew how much he valued his independence and that he wanted to return to his home. By lobbying on his behalf and working out a package of care that would address the concerns of medical staff – including ensuring he was able to eat safely, take his medication and care for himself generally – we were able to keep the man in his own home, with the proper support in place. He was discharged from hospital without any further problems, and visits from carers have since been reduced, because he is coping so well. Most importantly, his wish to retain his independence was respected and he felt empowered at having his wishes heard.

Building relationships is at the core of what I do - each person I work with needs something different from me.

Erin Mental health social worker

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Erin works in a Perinatal Mental Health Team in Leeds – she trained as a social worker through the Think Ahead programme.

Before I joined the Think Ahead programme I was working as a support worker with people with learning difficulties and mental health problems. I worked alongside social workers and I became interested in their role – but it was only when I came across the Think Ahead programme that I thought of mental health social work and decided that was the right role for me.

I trained and worked in a Community Mental Health Team in North Yorkshire while on the programme – our learning really focused on theories, research and values, which are so intertwined with the practical work we are doing. My current role is in a Perinatal Mental Health Team and everything I do is informed by theory and research.

Mental health problems can affect absolutely anyone, but are especially common in women who are pregnant or who have recently given birth. I can work with mums from when they are 12 weeks pregnant up to when their baby is one year old, and the women I work with are from the whole spectrum of socio-economic backgrounds. I have doctors and teachers on my caseload, but also women who are unemployed and living in a small one-bedroom flat. The range of diagnoses is also very broad – some may have experienced a psychotic episode (where they perceive or interpret reality in a different way), others may have depression, bipolar disorder or other illnesses.

I have to be very flexible and person centred in my approach – each person I work with needs something different from me, but the main thing is to show compassion. Building relationships is at the core of what I do, and I take a strengths-based approach, which means building on the strengths and support that the person already has. Mums put a lot of pressure on themselves to be perfect – I try to unpick that with them and help them to see that they’re doing a great job.

A lot of my role involves addressing practical social issues – it’s so crucial for the mum to be in a stable environment, so sometimes I am helping to address issues with finances or housing. I also carry out assessments with people who have been referred into our team to start to understand what support they might need. And once a week I am on the duty rota – which means I respond to people unexpectedly becoming unwell – so it’s very unpredictable work. Sometimes we’ll get a call from a hospital telling us that a woman who has just had a baby is experiencing a psychotic episode, and I’ll need to go urgently to see her with a psychiatrist.

I like the variety of the role, as it keeps things really interesting. There are also some really tough bits. It can be quite an emotionally challenging role, sometimes I am worried about the mums I’m working with, for example if they’re living in a really unsuitable place or if they are a vulnerable adult with limited support networks. And it can be hard to leave after a visit if a mum is really struggling and is quite isolated. Having a debrief with my team (I work alongside psychiatrists, psychologists, occupational therapists, nurses, social workers and peer support workers), and discussing those anxieties in my supervision sessions, is really vital for managing those feelings.

I also have a responsibility to report to social services if I am concerned about the wellbeing of a baby. That can be a really hard thing to balance because I am trying to build trust with the mum, and sometimes mums can be worried that social services might take their baby away. But in reality, within the perinatal team, this is rare and only happens in very severe circumstances. Both my team and social services teams want to do everything we can to keep the family together, and I try to make sure the mum understands that my role is to support them to be the mum they want to be.

The job is also incredibly satisfying and rewarding. One of my favourite bits is supporting mums and babies to bond. It is also really lovely when I see a mum who has been nervous through pregnancy with her baby for the first time. And discharging someone from our service is a really rewarding part – it can be quite emotional too because I’ve often worked with people for quite a while and have built up a good relationship with them. When someone is ready to be discharged, we’ll have a meeting where we can reflect on how far they’ve come. It is lovely to know that I have been a part of someone’s journey. I feel really lucky and proud of the work I’m doing.

Alongside my role I have also taken on the role of Associate Consultant Social Worker for the Think Ahead participants that are training in our team, which means that I play a role in their learning – for example I lead some of the weekly meetings where action plans are agreed, and I lead supervision with one of the participants. I was really keen to take on this role because I wanted to be a part of someone else’s learning – I’ve been through the experience and I know it can be challenging. It is also a really good way for me to keep developing, and to keep my skills fresh. I’ve learnt that it’s ok if I don’t know all the answers, which is an important message for trainee social workers too.

Before I met my social worker I wasn’t very stable. I was having frequent manic and depressive episodes. Bipolar disorder was a big part of me.

Lee

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I have severe bipolar disorder, anger management issues, and an eating disorder. A few years ago, before I met my social worker Helen, I wasn’t very stable. I was having frequent manic and depressive episodes. When manic, my spending would become out of control and I would self-medicate with drink and drugs. When depressive, I wouldn’t get out of bed, it would feel like I had a lead weight on me. Bipolar disorder was a big part of me.

When I first met Helen I was quite stand-offish. I was scared of being hospitalised, I saw it as me against the system. But after three or four meetings I realised that she was there to help me. To start with, she just listened and she waited until I was ready to talk. She made the effort to understand me, my interests, and what has and hasn’t worked for me before.

Helen helped me in lots of ways. In lots of situations she helped me make reasoned decisions by providing all the information I needed in a way that I could understand. She helped me to work with other professionals – for example I wasn’t confident speaking to my psychiatrist about medication, so I just went along with what I was given, but Helen noticed something wasn’t working for me. She spoke to my psychiatrist and then arranged for us all to have a conversation. She insisted that we all make the decision together, she wasn’t going to make it on my behalf.

She also helped me to develop a care plan, which is a kind of action plan covering all of my needs – including what medication I take, what my triggers are, where I can go for help in certain situations, and reminders of things I should do to take care of myself. It was very detailed but also straightforward – exactly what I needed.

Overall I worked with Helen for over two years until I moved – and I wish I could’ve taken her with me! She helped me in lots of ways, but overall she changed the way I manage my mental health. She made me realise that, although I will have bipolar for the rest of my life, I can manage it. She made me see things in a different light.

Lee

When I first met Tamsin, I hadn’t had a bath for five years, I was unable to see properly, my house was a mess, my garden was a tip, and I never went out, but she’s helped me to address all of that.

Jackie

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I’d been experiencing depression for a long time when I started to hear voices. They began during a long legal wrangle over my house, which the council owned and wanted to evict me from after the death of my mum, who I lived with and cared for when she got cancer. When she first died, I used to see my mum’s face all the time and hear her voice calling me. I had been so depressed for so long, and I was on anti-depressants, but I just kept spiralling downwards.

I was forcibly evicted from my home and, although I went to the High Court and won it back, they kept trying to kick me out. I had a nervous breakdown and tried to kill myself more times than I can remember. After one attempt, I was taken to hospital and was kept there for two years. I’d known things were getting worse, but I was too scared of professionals to get support. I knew I didn’t want to end up back in hospital again and I thought that’s where they would put me.

I didn’t know what to do, so I called my doctors for help. They sent me to a local outpatient ward, where I agreed to see a social worker, and Tamsin turned up at my door one day. I didn’t trust her to begin with, but she kept coming to see me and she was so lovely, she didn’t give up on me. I’d been a complete lost soul sitting alone in my house all the time. I had agoraphobia and I never wanted to leave so, for around six years, I barely went out, other than quick trips to the shop at the end of the road to get food. My gas and electric had been shut off, and dialling the phone was enough to trigger the voices, so I couldn’t work out how to get the companies to switch them back on. This was during a very cold weather snap a few years ago, and all I had to keep me warm was a sleeping bag.

Tamsin got it all sorted out for me, she found a charity to pay off the gas bill, helped me get my winter fuel allowance, and even got a new cooker for me. Every time I saw her, it made a huge difference, and she was always so happy to see me. Tamsin would take me out to make sure I wasn’t lonely and isolated all the time, we’d take trips together to the library so I could use the internet, or I’d visit her at her office. She’s made me trust healthcare professionals again and I’ve been able to tell Tamsin things I thought I could never tell others. She also encouraged me to open up more with the therapist that she organised for me to see, which means they’ve also been able to provide me with better support.

When I first met Tamsin, I hadn’t had a bath for five years, I was unable to see properly, my house was a mess, my garden was a tip, and I never went out, but she’s helped me to address all of that. Life’s still hard sometimes, but things are a million times better now that I’ve worked with her, and I honestly believe I wouldn’t have made it through that period of my life without Tamsin’s help.

Jackie

What mental health social workers do

*The Think Ahead programme qualifies you to apply for registration with Social Work England. Your ability to practise as a social worker is subject to the regulator accepting you onto the register.

Mental health social workers empower individuals with mental illness—and their families, carers, and communities—to lead fulfilling, independent lives.

Through talking therapy, support, and advocacy, they enable people to manage the social factors in their lives—like relationships, housing, and employment—that allow them to get well and stay well. Building resilience in individuals, their networks, and their communities transforms people’s wellbeing and improves our society and economy.


People using mental health services can be of any age, and at varying stages of recovery.

They may be living with a wide variety of illnesses, such as anxiety, depression, bipolar disorder, schizophrenia, and personality disorders. Their mental health problems can sometimes be associated with other issues such as physical illness, addiction, or homelessness.


The Think Ahead programme focuses on adult mental health services.

Social workers can work in a variety of mental health settings. The Think Ahead programme qualifies you for any social worker role*, including work in specialist mental health settings like forensic services and child and adolescent mental health services, but the main focus is on experience in adult community mental health services. Teams within these services are multi-disciplinary, and can include social workers, nurses, support workers, occupational therapists, psychologists, and psychiatrists.

As a social worker in community mental health services, you will:

Build relationships with people

You will visit the individuals you work with regularly, usually in their homes (including supported accommodation and residential homes) or in hospital. By listening and building trust, you will come to understand their needs and aspirations.

As well as getting to know them, you will also build relationships with their families, friends, and carers.

Provide guidance and therapy

You will spend time working with people on a one-to-one basis, exploring their situation with them and looking together for ways to move forward.

This will include supporting and constructively challenging them to think about the social factors in their lives, and helping them to establish their own goals for positive change. For example, you might set goals together about maintaining and growing positive relationships with friends and family.

To give people the tools to achieve their aspirations, you will use socially-focused therapies and interventions.

Arrange support and care

You will be responsible for assessing individuals’ needs and creating a unique care plan to help them achieve their goals. You will then work with colleagues in your service to put the right support in place. This could include:

  • Arranging funding to provide direct support, for example to allow easier travel to work or to see friends and family.
  • Consulting with and involving other professionals in your service, such as nurses, psychologists, or psychiatrists.
  • Bringing in help from other services, including the local council, the police, housing associations, charities, and faith groups.

Ensure people’s safety

A vital part of leading on someone’s care is keeping them safe. You will assess whether they are a risk to themselves, or at risk of abuse or neglect from others, and if necessary take action to safeguard them.

You will spend some of your time on duty as the first line of response in crisis situations – for example if someone’s mental health deteriorates suddenly, or if their support network of friends and family breaks down.

Stand up for people’s rights

You will take the lead on understanding the law and ensuring that people’s rights are upheld. It will be your job to be an advocate for the individuals you are working with, and stand firm when their rights are not being respected – including being assertive with other professionals.

To fulfil this role, you will become an expert on the legal framework, including the Mental Health Act, the Mental Capacity Act, the Care Act, and the Human Rights Act. You will have a formal role in Mental Health Act tribunals.

Improve community services

When there are unmet needs in the community where you work, you may be involved in changing services or designing and implementing new initiatives to meet those needs. This often involves working with other services, charities, and community groups.

Could you be a mental health social worker? Try our quiz

Mental health social workers face challenging decisions everyday. Based on the experience of practicing social workers, this quiz will take you through three typical scenarios.

Take the quiz

Quiz: Could you be a mental health social worker?

  • You are having a meeting with Callum regarding his employment benefit, and what you can do to support him. He suddenly begins to talk about some hallucinations that he has been having, and becomes increasingly animated. He talks about seeing faces in strange places in his everyday life. After telling you about this, he asks you: “Don’t you believe me?” Which action do you take?
  • You are in a meeting with two of your colleagues regarding the detention of a service user. Niraj, the psychiatrist, knows this individual and their condition well and believes that detention is necessary. However, you witnessed the incident that has caused this meeting and you believe it was not serious enough to merit this course of action. The discussion becomes rather heated as you debate the best approach. Which action do you take?
  • You have previously agreed a care plan with Achebe, who lives with her parents, and you have arranged a visit to their house to talk it through with all of them together. When you arrive you are met by her mother, who tells you she doesn’t agree with what’s happening and wants something different for her daughter. You know how important it is to keep her mother involved, but want to make sure you are focused on Achebe and her best interests. Which action do you take?
  • This field is for validation purposes and should be left unchanged.

Career development

Great social workers are great leaders. For example, you will have to understand and inspire people, make tough judgement calls, and assert your views with other professionals.

This means that as a social worker you will test and develop a wide range of leadership skills. Social workers follow three typical career routes – all of which will be open to you following the Think Ahead programme:

Become a leading frontline practitioner

If you want to focus on frontline work, you can specialise in a particular area – for example working with younger or older people, or in the criminal justice system.

You can also train and qualify to take on roles with greater statutory powers and responsibilities. You can become:

  • An Approved Mental Health Professional (AMHP) with powers under the Mental Health Act, including the final say in whether an individual can be temporarily detained in hospital for treatment.
  • An Approved Mental Capacity Professional (AMCP) with powers under the Mental Capacity Act to determine whether an individual can be deprived of their liberty – for example prevented from leaving a hospital or a care home. (A similar function is currently performed by Best Interests Assessors (BIAs), but is due to change in 2022 following new legislation).

As you become a recognised expert, you can increasingly get involved in promoting best practice and designing and implementing policies across services and organisations.

As they progress in expertise and responsibility, frontline practitioners can reach salaries of around £30,000 to £35,000, and up to £40,000 for the most senior roles (plus London weighting if appropriate). In most cases qualifying as an AMHP attracts a salary supplement, which varies from employer to employer.

Move into service leadership

If you want to create change in mental health services by taking on management roles, you can pursue a career in management – usually in the NHS or Local Authorities.

You could progress through positions managing teams, groups of teams, whole services, and entire organisations, taking on increasing responsibility for service delivery and strategy.

Your pay will increase with responsibility, typically reaching £40,000 to £50,000 for team managers, up to £60,000 for service managers, and over £70,000 for senior leadership positions. (Plus London weighting if appropriate.)

Use your leadership experience in an alternative career

Your unique experience and leadership skills will be invaluable if you decide to pursue an alternative career, whether in mental health (for example in public policy, academia, or the private or third sectors) or a different field.