About mental health social work

Amy works with people with personality disorders in an NHS Trust in Lancashire. She was part of our 2022 Cohort.

I did my degree in psychology and as part of that worked as an assistant psychologist in a forensic unit which I really enjoyed.

I hadn’t considered social work before, but I remembered hearing about Think Ahead during my first year at university. It was the first time I’d heard about social work and mental health together – then it was always in my mind as something I wanted to do.

The role of a social worker can really vary between local authorities and NHS trusts, but working in an NHS team fits me perfectly. I’m still in the same team that I qualified in because they’re so good! At the moment I work in a more specialised role supporting people with personality disorders. The role is multi-faceted, so I get to use my previous knowledge and experience from psychology to complement my social work practice.

I work with people for one to two years depending on their needs with the hope of transferring their care back to the GP. These can be adults with or without a diagnosis of personality disorder, but they will be experiencing emotional difficulties. I meet with people weekly for an hour and complete care plans, risk assessments and safety plans with them collaboratively.

Alongside this support, there are also weekly group sessions on topics like impulsivity, enhancing relationships, mood management and problem solving. Forming relationships with people and having strong communication is the key to this work. I really do enjoy my role – I get a lot of one-to-one time with the people that I work with.

Once a month I do initial assessments where I assess people who have self-referred or have been referred into the service by another team. I’ll also be on duty once a month, responding to things that come in when other staff might be on leave and sometimes working jointly with the crisis team.

One of the challenges of being a social worker in a community mental health team is that it can be quite medically led. I think social workers can offer a different perspective in NHS teams and more holistic approaches to working with people that aren’t focused solely on their diagnosis and ‘what’s wrong with them’. It’s good to see that attitudes have started to change since we’ve had more social workers in the team and that services are becoming more progressive towards people’s care.

For me having empathy, understanding and advocating for people is at the heart of social work. Supporting people means making them feel seen and heard, and understanding people’s lived experience and social context to inform my work.

The best part of my job is how much variety there is when working with the people I support. They have often experienced so much adversity but continue to be motivated to overcome their difficulties. It is about being adaptable, genuine and caring, – and mostly giving people hope that they can recover in whatever way is meaningful to them.

Jamie works in a recovery team in an NHS trust in North Somerset. He joined Think Ahead as part of our 2023 Cohort.  

Before joining Think Ahead I had a few different roles in mental health – I’d been a support worker in a mental health team and I’d worked on a mental health inpatient ward.

I knew I wanted a more qualified role – I wanted more responsibility and the ability to change things for people. I considered mental health nursing but I realised that social work aligned with my values more. I wanted to work holistically rather than taking a medical approach.

My role now is in a recovery team – I work in the community with adults of working age who are experiencing mental health challenges. That could be psychosis, complex emotions, anxiety, or depression for example.

I tend to see the people I’m working with about once a fortnight, and I could be working with someone for anything from six months to a year, or more. It depends on the person and their needs. At the start I’ll be looking to build a relationship with the person. We’ll look at the basics – are their needs being met, for example with where they live. We’ll talk about their mental health and their mood. Over time, we’ll look more at their relationships with friends and family, their work, their interests, and what their goals are.

I’m always working with the person towards their own goals and aiming for them to become more independent, improve their networks within the community, and have good mental health. When someone no longer needs the support of the services, they are discharged, and that feels like a happy moment.

In my role I have learnt to embrace uncertainty and accept that unexpected things will happen. When I’m working with service users, sometimes it’s difficult to win their trust, but that’s ok. I try not to be deterred by a difficult meeting or situation – things are not always a linear journey.

Outside of meetings there is a lot of work – for example, updating databases, carrying out risk assessments and creating care plans (which detail the type of support someone needs and how it will be provided). I make referrals to other organisations, for example charities that might be able to help the person, and I carry out assessments to find out what support people need and make sure that support is put in place.

Dealing with all the different processes and databases is one of the more difficult bits of the job. There is always so much to learn. I have stayed focused on developing my understanding of how things work, rather than getting frustrated with it. I work with a range of colleagues including psychiatrists, psychologists and nurses, and they are all really kind people. When things are difficult there’s always someone I can speak to.

The best bit of my job is building relationships and working with people who are quite marginalised. It’s a real privilege to know these people, sometimes I am one of very small number of people they actually see and speak to. Becoming part of their journey is really meaningful – there are ups and downs, but it’s really worthwhile.

Sanjiv works in a social work review team in a local authority in Suffolk. He joined Think Ahead as part of our 2023 Cohort.  
I’m on my fourth career as a mental health social worker – I’ve previously worked as a teacher, in construction and as an electrician.

I’ve never done a job for the money – I’ve always been looking for something I enjoy, and enjoyment for me comes from challenge and curiosity. After working as an electrician I was looking for something where I could have a positive impact in the community.

Social justice had always been important to me, and I realised that some of the most rewarding work I’d done in the past was supporting children and families as a teacher and head of year. I knew that I wanted to return to helping people, and that was what led me to apply to Think Ahead.

I now work in a review team in a local authority. The main part of my role is doing reviews with people who have been in hospital due to their mental health, but have now left hospital. My role is to manage their aftercare – so I get to understand their circumstances and then I work to put in place any support they might need. This might be making a referral or signposting them to another organisation, or it might be that they need some support that would be funded by the local authority, like someone to come into their house to help them with personal care. If that’s the case, I sometimes need to go to a panel and make a case for the funding to be provided.

I usually meet people I’m supporting face-to-face once, then I follow up with phone calls. Once the support is set up, they are looked after by a different team.

Every person is different and that means every day is different. It feels like a real privilege to do this job. I meet people who are really vulnerable – sometimes it’s the lowest time of their life – and they let me in and I have the privilege of trying to help them. As well as setting up support for people, I’m talking to them and really listening to them. Listening is a massive gift we can give to someone.

In my organisation we have meetings with colleagues from the NHS – for example psychologists and psychiatrists – to make sure that the care we are providing for people is joined up with the care they are providing. But the people in my team are all social workers, and everyone is really proud of their role and their professional identity.

One thing I find challenging about my job is that I would like to be able to do more direct work with people. Social workers in local authorities tend to do more short term work, there’s lots of assessments, making referrals, dealing with agencies and generally advocating for people to make sure they get the support they need.

But there’s no doubt that the work we’re doing is really impactful. The support I’m putting in place can help the person to stay in the community and not need to be readmitted to hospital. It can empower people to be able to live their lives more independently, the way they want to.

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.