Alistair Gaw: We must invest in Mental Health Officers

MENTAL Health Officers (MHOs) are social workers who support people who are very unwell with mental health problems but their focus is the same: individuals within their own context. MHOs have a specific role to promote a social model of mental health support and to advocate on behalf of people who are very unwell, some of whom may pose a risk to themselves or others.

MHOs hold a Statutory Appointment under the Mental Health (Care & Treatment) (Scotland) Act 2003 and, importantly, are separate from health colleagues. The role is a challenging one. It epitomises a tension at the heart of professional social work – the balance between care and control. Each day they make complex judgements about whether a person can be supported to be well and to manage their mental ill health in the community; or whether the risk they pose to themselves or others is so great that they should be detained in a secure hospital or a locked ward.

MHOs are a highly qualified and skilled group of social workers, a small part of the social care workforce, who for some time now have found themselves under increasing pressure for a variety of reasons. Firstly, MHOs are an ageing workforce. One third are over 55. Secondly, the demands of the job are increasing as new legislation requires them to be involved in more and more decisions. Thirdly, there are not enough of them. Too few social workers are completing the required postgraduate Master’s Level Award.

These are not issues that are unique to social work, but they are concerning because of the implication of not having enough MHOs to make the decisions that only they can make. Without an available MHO workforce we will face situations where more people are wrongly and unlawfully detained; where scarce hospital beds fill up with inappropriate admissions; and, crucially, where people are not getting the treatment they need.

When integration of health and social care was first discussed Social Work Scotland strongly advised the Scottish Government to keep MHOs within local authorities. We were absolutely clear that the medical and social approaches to mental health had to be separate and complementary. It is well established that medical interventions in the lives of people with mental illness are rarely a solution in their own right. Without MHOs advocating the social dimension of treatment very unwell people are at greater risk of not being treated properly.

These decisions are life-changing for individuals. MHOs are a fundamental part of the social work profession and we need to invest in these skills now to avoid a crisis in the future.

Alistair Gaw is president of Social Work Scotland