Tuning In to Direct Contact with Service User

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Introduction – Information specific to the service user

D is a 27-year-old woman with a diagnosis of panic attacks. She has recently given birth to a baby girl. She also has a history of alcohol misuse though denies any alcohol intake since she found out she was pregnant. She is described as having frequent panic attacks since the birth of her daughter 10 weeks ago though she has a history of these since she was 18 years of age. There is a past history of sexual abuse and sexual assault. According to the referral from D’s GP, she is suffering from insomnia, only managing to get 2 hours sleep per night.

Phase of Work

This is my first contact with D. I will be completing an initial assessment using the agency assessment tool. This is a general form covering a range of issues that may be problematic for D. Parker and Bradley (2005) suggest that the exchange model of assessment is likely to be the most successful. Although the agency tool does promote the exchange model of assessment, as it encourages open discussion, it also incorporates the questioning model, as quite often it is the worker asking questions and the user answering them.  Smale, Tuson and Statham (2000) state the social worker should not act as expert, questioning service users and following agency procedures, they should be “collaborators, facilitating service users to identify their needs” (Parker and Bradley 2005).

General Category of Service User (including legislation and theory)

There is various pieces of legislation that apply when working with service users in any field. Obviously as my Practice Learning Opportunity is in the Community Mental Health Team, The Mental Health (N.I) Order 1986 is the primary source of legislation. This legislation allows the detention, guardianship, care and treatment of patients suffering from mental disorder. Mental disorder is defined as “mental illness, mental handicap and any other disorder of disability of mind” in Article 3 of The Mental Health (N.I) Order 1986 (B.A.S.W). Before this Order was introduced in 1986 mental health was not considered a priority in Northern Ireland. We were in the height of the troubles and other things tended to be more pressing that mental health. However, after the Order was introduced, a code of practice followed six years later. The Government were now concerned with how mental health practice was being implemented and a number of strategies were introduced  to “promote mental health and wellbeing” including the “promoting mental health strategy and action plan 2003-2008” ().

The Bamford Review of Mental Health and Learning Disability “sought to address how best to provide services to people with special mental health needs or learning disabilities” (. This was a vital piece of work that released significant money into mental health services. It focused on promoting social inclusion and providing the best quality of care in accordance with the Northern Ireland Act 1998 and The Human Rights Act 1998.

Another piece of legislation that provides provision for intervention is The Health and Personal Social Services (N.I) Order 1972. White (2006:419), states it “concerns persons who suffer from grave chronic disease or, being aged, infirm or physically incapacitated, are living in unsanitary conditions”. Although D’s does not seem to fall into any of these categories, as a worker you should be prepared for the unexpected when meeting a service user. I am unaware of how D lives, the state of her house, or how ill she really is. I need to be aware of this legislation in case any issues regarding these areas were to arise.

The Human Rights Act 1998 provides protection for a person’s autonomy. For example, Article 3 states, “Prohibition of torture and inhuman and degrading treatment”. This applies to the issue of detaining, seclusion and restraint. Some will argue therefore, that detention under The Mental Health (N.I) Order 1986, is a violation of this order. However, Article 40 (1) of The Mental Health Order would not be a violation of this Human Right, as it states “failing to detain him or her would create a substantial likelihood of serious physical harm to him or herself or to other persons” (White 2006:414). If a person is putting their own or others lives at risk, then they are violating Article 2 of The Human Rights Act 1998 and so detention cannot be seen as a violation of Article 3. Although, at this stage I do not feel D will need detention to hospital, this legislation is something that I need knowledge on for my work with all mental health service users.

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Although my remit is mental health, D has recently given birth to a baby. Therefore, The Children (N.I) Order 1998, is going to be a necessary piece of legislation to know. This Order states that “the welfare of the child is paramount” () no matter what else if happening within the family home. It would be my responsibility to ensure that any information I may be told relating to risk to the child would be reported to the appropriate agencies immediately. At this stage I already know that childcare are involved with D and her baby. It would be ...

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