About mental health social work
What I find really rewarding about mental health social work is that you get to work with people to give them a voice and to ensure that they feel empowered in their own lives.
Nicola Mental health social worker
Nicola is a mental health social worker in the London Borough of Bexley.
I always wanted to do something that included helping or caring for people, but I wasn’t sure what my options were. So I did odd jobs after school – including working in pubs, as a waitress and as a dental nurse.
I took on a role as a support worker for people with eating disorders at an inpatient unit. I loved it because it involved helping and making a difference. I worked in a multi-disciplinary team with various other healthcare professionals, and I noticed that the social workers were the ones who seemed to make a real difference. They would always speak up for service users and advocate for them – and they put the cat among the pigeons sometimes! I thought it looked great. So I went to university and studied to be a social worker.
What I find really rewarding about being a mental health social worker is that you get to work with people to give them a voice and to ensure that they feel empowered in their own lives. You get to support people to create real change – whether that’s to do with housing, benefits, friendships or just feeling confident enough to go on a bus or sit in a coffee shop. To me it’s a real privilege being able to support people in that way.
When I was working in an Early Intervention in Psychosis team, I worked with someone who had experienced a psychotic episode while studying at university. She had to go to hospital but didn’t seem to get much better. People thought she would never be able to finish her studies. When I began working with her, I involved her family and the university in her efforts to recover. She wanted to live independently again, so I helped her to arrange benefits and student loans. I also supported her to build her confidence and take ownership of her mental health. With all of this support, and the right relapse prevention strategies, she was eventually able to return to university and passed with flying colours!
It was a very rewarding experience, but things don’t always go as smoothly. Mental health social work can be very unpredictable, and the earlier you learn that that’s ok, the better. You have to be able to respond to change quickly, but in a considerate way.
Nicola became a Consultant Social Worker for Think Ahead in 2017. In this role, she supervises a team of four Think Ahead participants who are placed within her team. She and the participants manage a shared caseload together.
When the Think Ahead position came up I thought it looked like the perfect role for me. With the participants I work with, I encourage them to become brilliant social workers, not just to qualify. I encourage them to think critically. They can shape things for the next generation of social workers, and having great new people coming into the role is really valuable to the profession as a whole. They add a whole new lease of life.
I think being involved in Think Ahead has helped the whole team and the organisation understand the value of social work more. Social work can benefit so many situations – it’s all about empowerment, advocacy, connecting with people and making the most of their strengths.
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
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
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
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.
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.
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.
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.