Working in greyscale: understanding the role and position of social work in mental health services in England and Wales

Social work in England and Wales has played an integral role in mental health since the formalisation of mental health care. However, neither the scope of provision nor the role itself have been clearly conceptualised, leaving contemporary mental health social work nebulously defined and unclearly situated within mental health structures. Moves toward and away from integrated care have contributed to role erosion resulting in a profession unclear of its position. Policy-led role definitions have been unsuccessful in addressing this.

Social work roles are deemed quasi-professional and difficult to articulate, highly susceptible to the external gaze of other professionals and to organisational expectations, which can prompt role defensiveness. However, understanding of the interplay of these factors in mental health is limited. This research adopted a mixed-method approach to establish an overview of mental health social work provision and to explore how mental health social workers perceive their role, accounting for variation and similarity across the range of practice contexts. An initial survey of mental health social work providers generated a framework to inform a survey of 248 social workers, thirty of whom also completed an in-depth semi-structured interview, exploring their views on professional identity and practice context. Data was analysed statistically and using a Framework thematic approach.

Participants articulated their professional role as an interaction of tasks, values and knowledge which informed a distinctive approach to practice. The externally facing, task-based roles were seen to be sensitive to practice environments and influences, but values and knowledge-based roles were presented as consistent across settings. This indicates a need for definitions of mental health social work to be distinguished from the activities of practice if this workforce is to be understood and deployed effectively. Further research to elucidate the values and knowledge base being employed in these roles would be beneficial in this.