Background to the Research

• In NI, the compulsory admission to hospital of people suffering from mental disorder is governed by the Mental Health Order (NI) 1986. The Order created a new designation, the ASW, and provided them with a statutory framework in relation to compulsory admissions to hospital.
• This article reports on the first extensive survey of ASW activity under the 1986 Order.
  

Research Approach

• A questionnaire was sent to the total population of currently registered ASWs in NI (sample =243/response rate of 84%).
• Three focus group sessions were held with 30 service users; a focus group session was held with 6 carers of relatives suffering from severe mental illness.
• Interviews were carried out with managers from each of the 11 community health and social services trusts in NI.
  

Main Findings

• Two-thirds of ASWs had had experience of acting as an applicant in compulsory hospital admission during the previous 2 years. Nearly half (42%) of these ASWs reported experience of between one and five admissions and one-tenth had completed over 20 admissions in the same period.
• Joint face-to-face assessment with the GP took place in only a small minority of cases.
• Nearly half of ASWs reported difficulties in obtaining transport.
• Only one-fifth of ASWs had experience of acting as a second approved social worker.
• Half of ASWs reported experience of guardianship, either as applicant or in making the recommendation.
• Both users and carers reported a lack of understanding of the role of the ASW and complained about the lack of alternative resources that ASWs could use to prevent hospital admissions.

Conclusions

• The findings demonstrate that the involvement of mental health social workers in the use of compulsory powers is an indispensable part of quality mental health services. Their involvement provides an independent voice outside the medical establishment and ASWs can protect civil liberties and prevent institutional excess.