Teal speakerphone. Text: Podcast

Podcast: Penny East

24 September 2024

Thea is joined by Penny East, External Relations Director at Think Ahead which runs a training programme for mental health social workers. They talk about the role of social workers in providing mental health support and how that often tends to be overlooked, both in policy and in public awareness. They also discuss why we need to build a more diverse range of skills into the mental health workforce to properly meet people’s needs.

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Listen to the episode on Spotify or Apple PodcastsThe full transcript is available below.

Show notes

Alethea Joshi (AJ): Hello and welcome to Centre for Mental Health’s podcast. Centre for Mental Health challenges policies, systems and society so that everyone can have better mental health. I’m Thea Joshi, and each episode, I speak with our guests about mental health and social justice. And today, I sat down with Penny East. Penny is the External Relations Director at Think Ahead, which runs a training programme to train mental health social workers. And we talked about the role of social workers in providing mental health support and how that often tends to be overlooked, both in policy and in public awareness. We also discussed how building a mental health workforce to meet people’s needs doesn’t just require more of the same, but a workforce with a more diverse range of skills. Just a reminder that Centre for Mental Health is a charity, and so we rely on your support to drive change. You can donate to our work at the link in our show notes. Hope you enjoy this conversation.  So welcome, Penny. It’s great to have you here on the podcast.

Penny East (PE): Thank you so much. It’s great to be here.

AJ: And so you work for Think Ahead. So tell us a little bit about what Think Ahead do.

PE: Great, of course. So Think Ahead is a mental health organisation. We were founded 10 years ago by Norman Lamb and also our chair, Dame Carrol Black. And the idea came about by the fact that there was a real challenge within social work, in mental health teams, that was possibly not as well understood as it needed to be, not as integrated as it needed to be, and wasn’t part of the kind of public policy conversation. And so the charity was founded in order to resolve some of those issues. We run a yearly recruitment and training program where we find people that really want to make a difference to people’s lives, who really care deeply about mental health, and not, you know, medical by background, but therefore they want to become something like a social worker, which is an integral part of the mental health workforce. And we recruit and train around 160 people a year, and they’re from all sorts of different backgrounds.

I think that’s really important to get across, because, you know, it can sometimes be seen as a graduate scheme, and therefore everyone’s kind of 25 and that’s absolutely not true. There are some recent grads on our programme, but there are also people that have done other careers for 10, 20, 30 years, and there’s also lots of people that already work in the health and social care system as well who want to qualify as social workers. I mean, we’ve had everyone from art therapists to health care assistants to opera singers to bankers, you know. But I think there’s something really rich and brilliant about that, that all these people are coming together with shared values and a shared desire to make a difference, but they all have very different backgrounds and life experiences.  So we recruit them, and then we train them in partnership with Middlesex, and then they will go out and work in NHS and local authority teams within kind of five to six weeks of them being trained as student social workers and with a great deal of support around them, but yeah, they are absolutely out on the front line from day one. It is tough and it is challenging, but we really, really put in a lot of support to make sure that they are very much learning on the job.

They’ve got managed caseloads, and they’ve got a great deal of support, both in their setting and from us. So that’s the programme that we’ve been running. And I guess certainly over the last couple of years, we’ve really been wanting to do more on the wider workforce thing as well, certainly thinking about the fact that recruiting and finding and supporting 160 social workers is great, but really, there’s kind of systemic issues that we really want to get in to try and resolve. And we’ve built up quite a lot of workforce expertise over the years with working with NHS and local authorities, and we want to use that expertise to hopefully resolve some of those long standing workforce challenges. So that’s just a little bit of background about Think Ahead.

AJ: That’s super interesting. And I’m really glad to have you on because I just think it’s really easy when we think about mental health or mental health services, to jump to mental health nurses, psychiatrists, therapists, and we know that social work and more broadly, social care, are actually huge parts of that and the support that people receive. So can you walk us through what social workers do to support people with mental health problems?

PE: Sure, of course. And I think with social work generally, certainly, before I started working at Think Ahead, I used to work in domestic abuse, so different sector, but with a lot of similarities. I think there’s a real kind of public perception issue around social work, and people really thinking of social workers in that children and family setting only so around children and safeguarding, which obviously is a huge part of the role. And there’s thousands of thousands of social workers working in those settings, but there’s also thousands of social workers working in other settings, in adult mental health teams, working with older adults, forensics, maternity units, both in the NHS and in local authorities, and I just don’t think that there’s a kind of public awareness of that role and the kinds of things they do.

So social workers in mental health teams are really about building relationships with clients, with service users, really being an advocate for that person and helping them navigate both the system, which isn’t always particularly therapeutic, sometimes in terms of the bureaucracy and the difficulty of navigating it all and the different layers and the different agencies involved in someone’s care. So a social worker can be real advocate in helping people navigate some quite complex system issues when they’re feeling quite vulnerable themselves. And also around some of these like practical issues, whether it’s housing, relationships, their personal finance, whether they’re accessing all the benefits that they’re entitled to, things like travel, people that might be socially isolated because they’re not comfortable or confident on public transport, or they’re living in an area with really poor public transport and a social worker can help navigate some of that so they can feel part of a community, whether it’s through volunteering or anything else. 

So I would say they’re a real advocate for the client. It’s all about relationship based practice and adapting their care depending on what that person needs. An older adult, somebody who might be in their 80s or 90s, who’s still living at home who might be very socially isolated, is going to need a very different care, to say, a woman who’s recently had a baby and is struggling with her mental health. So social workers really need to be able to adapt their care depending on the person they’re supporting. But I do think it is one of those professions that just doesn’t have the public awareness that it needs and deserves. And actually, through our research, we see we’ve heard from social workers the kind of demoralising impact of some of that lack of public awareness and some of it being quite negative misconceptions about the work of social workers. I mean, not to name any names, we did have one “Westminster type” person who once said to me, you know, no one emails me saying, ‘Why aren’t you recruiting more social workers?’ They would email saying, why aren’t you recruiting more nurses, more teachers, more police. But no one is asking, why aren’t there more social workers? And that’s not because there shouldn’t be more social workers, and they’re doing this incredibly, fundamentally important job with a whole range of different people. It’s just because of that public perception issue that people just aren’t quite sure of what they do, or if they do, think they might have some negative misconceptions about their roles as well, particularly around children.

So yeah, it’s something that’s really important to Think Ahead, to kind of raise the profile of the work and also challenge some of those misconceptions and make sure that social workers feel prioritised, both in terms of practice and in policy and in that kind of public perception piece and all those three things work in tandem, really.

AJ: Yeah, that’s really helpful. And I think we’ll get on to talk more about the workforce and where social workers fit into that, because I think it’s really pertinent what that “Westminster type” said to you, because it’s the sense of what we need. And I think there’s a growing awareness that we’ve talked about before on the podcast about, you know, people realize that mental health is really important, that there isn’t enough support there. You know, we had the Darzi review out just yesterday when we were recording this. We were literally yesterday talking about kind of major problems with the NHS and in terms of mental health services, and that’s where people’s minds go. Speaking personally, from my own perception, there’s less understanding of kind of where social workers come into that and the crucial role that they play. That’s really helpful to kind of get a bit more of a sense of that. In terms of where they will work with other clinicians, with other support services, where do we see that playing out? Is that, like in multidisciplinary teams, is it in other areas?

PE: Yeah, so it depends on the setting that they’re working in. But yeah, certainly within an NHS setting they work in that multidisciplinary team. So they might be working with psychiatrists, they might be working with mental health nurses. It really depends on the setting that they’re working in, but they absolutely work in that kind of integrated way. And it’s really important that in those teams, social workers have the capacity and the support to bring their own set of expertise around relationship based practice, their legal knowledge in terms of the legal frameworks, of someone’s rights, and also their knowledge of kind of the whole system, as I say, whether it be around housing, finance, etc. And I think it’s key in those teams that social workers have the support within it to be able to speak. And we do hear this a lot. And you know, unfortunately, with our trainees, when they go into work, they have a way that they’ve been trained to work – relationship based practice, building up that relationship, building up that trust with their client.

And unfortunately, a lot of them aren’t able to work in the way that they want to be able to work because of the pressures, because of high vacancy rates, high case loads. It means that quite often it feels like, instead, it’s going from crisis to crisis, and that the kind of reliance on the medical approach comes in when ultimately you’re really trying to keep people safe, and that’s really the only thing that you can do. That long-term relationship based work, where you’re really trying to build up someone’s sense of hope, aspiration, feeling like they can see where their future may be, that that is undermined and curtailed by, obviously, the workforce pressures, and they’re not able to work. So that’s the other thing on our programme, is that we’re very keen we kind of provide them with a practice specialist and a consultant social worker throughout the two years of the programme to really support our trainees, because it’s a real you know, from classroom to frontline, it’s a big old move, from what the theory says to reality.

AJ: Translating theory to practice.

PE: Yeah, there can be real disparity between those two. So people need a great deal of support to help navigate that.

AJ: Okay, so it’s really helpful to have a little bit more understanding of how social workers work in different contexts. And you mentioned that they support people with a massive range of needs and in lots of different settings and ways. So have you got an example of where you might see a social worker at work supporting someone with their mental health?

PE: Certainly, yeah. I mean, I’ve spoken about the kind of very different teams, whether it’s in an NHS setting, whether it’s in local authorities and then different teams within that working with different demographics. So, for example, one of our trainees, Harry, who was working in Durham initially, he was working in an older adults team, and he was visiting older adults in their 80s and 90s, who are still living at home. Some of them may be suffering with dementia. Some of them may be socially isolated. Some of them may be struggling with the kind of physical side of things, in terms of their homes. And really, Harry’s role, as I say, is around that kind of building relationships. I mean, he’s a brilliant person to talk to. He cares so much about his clients, about the people that he goes to visit. He talks to them. He talks to them about their stories from the past. He offers an ear, while also providing that kind of practical support as well, checking in on things like their heating, their home, whether they’ve been out that week, all that. So it’s that kind of safety and support while also building that relationship. But then we’ve got other people.

We’ve got a social work trainee who works in maternal mental health, so working with women, pregnant women, and women after they’ve given birth. And again, that would be a different type of client base. But again, you’re looking at things like, obviously, mental health conditions that may have come on through pregnancy. But you’re also looking at things like social isolation, domestic abuse as well. You know, if that mum has safe, secure relationships, looking at her housing. So it’s really about navigating the different person and the different setting. But what it always comes down to is relationship based practice and trust. And I think you know not to hammer home the kind of challenges and the importance of the workforce issues, but one of the things that we see in terms of kind of poor retention rates, poor recruitment rates for social workers is this high turnover of social workers. And of course, that absolutely makes the job of social work so hard, because you’re building up relationships with people when they’re possibly at their most vulnerable, as I say, whether it’s they’ve just had a baby, they’re older, they’re really struggling with their mental wellbeing, that relationship takes such a long time to invest in, to build that trust.

But then, if you’ve got high turnover of staff, or you’re relying on agency workers, then that relationship is so hard to build, and then the client feels like they’re starting again and again and again. So it’s finding the resources and the investment necessary to make social workers feel supported in their jobs so that they can see a clear career trajectory. So they’ve got this social and wellbeing support. They’re being paid enough, they’re being given opportunities to train in different areas. That’s fundamental to keeping them within the role and keeping them within the sector.

AJ: And therefore providing good social work and good support, right?

PE: Yeah, absolutely. And with retention, often you see it kind of looking at it through a financial lens. You know, you’ve had somebody you’ve invested in in terms of training and all the rest of it, and then they leave, and then you’re just, it’s kind of like a sieve. You’re just constantly recruiting, recruiting, recruiting, to try and fill the vacancy rates filled by people leaving. But it’s also, as I say, the impact on the ability of the mental health outcomes as well, that if you’ve got that high turnover, it’s much harder for a social worker to work in an effective way. Certainly within social work, you see a huge number leaving in those first few years post qualification, because the role is so demanding and difficult. And I think the role is always going to be demanding and difficult. You know, if you’re a social worker working in adult mental health teams you have gone into that knowing it’s challenging. But we should be doing everything we can to give them the support necessary to be able to do that job. And I think, yeah, sometimes we just hope for the best that people will be able to survive and often they just can’t balance it with their lives, with their personal lives, with their need to kind of look after their own mental health and wellbeing. And that’s absolutely fair enough.

AJ: Yeah, I totally agree. And we really will get into the workforce question, because I feel like that’s hovering around us, but I think that that’s something that we’ve been thinking about a lot in our work, thinking about the mental health workforce and social work as part of that, is we just feel like across the board, we’re seeing people who are really struggling. It’s trying to support people with their own mental health needs and equally struggling as well personally. And then actually, do they have the support available to them to keep them well and keep them in their role. And, you know, we have to think about these things as a whole, because, as you say, we can’t just keep filling the sieve with new people and people then burning out and heading off. So lots to think about there. I guess I wanted to think a little bit about, and I think we sort of, again, talked around this, but I wanted to talk about, you know, we know that the social determinants of mental health, things like poverty and discrimination, have a major impact on our mental health. They drive inequities in mental health. And so I guess I’m thinking about the role that social work and social workers play in tackling those mental health inequalities.

PE: Yeah, absolutely. And I think, you know, Centre for Mental Health has done amazing work around this, you know, regular briefings on the impact of poverty and its relationship with with mental health outcomes, and, of course, things like housing, personal finance. Also, you know, I’ve mentioned domestic abuse as well, like, that’s another huge one that I just think in terms of the scale and the impact of domestic abuse on people’s mental wellbeing, and people’s ability to become well and access the help that they need. So it’s absolutely huge. And I don’t think there can be anyone or any organisation that can doubt how impactful those social issues are. And I think we all want, well, I say we all want, hopefully, many people want, you know, more social housing to support people, more information, access to benefits that mean people can live with dignity and be able to see hope for themselves in the future, and not just struggle day from day. And those are all long standing social issues, right? Like these are taking decades to get to a point where people feel like they’ve got a home and a community, and they feel safe and secure, and it doesn’t cause anxiety. But I think the social work part of that is that there’s a kind of workforce solution to some of that. It’s not the only part of the solution. Of course, it’s not, but having non clinical roles who understand the importance of those different social issues and also can provide practical support.

Can help people fill out the forms, can talk to them about where they might need to talk to a housing officer about getting a more suitable home who can navigate them and refer them to domestic abuse services, for example, or addiction services, having someone with that kind of holistic lens who understands all these different social issues and can provide practical solutions. It’s not that social workers can be highly knowledgeable about every social issue that could affect somebody, but having the practical know how of what doors need to be opened, what agencies need to be talked to in order to solve some of those issues, and also to be able to spot where there is risk, you know, understanding domestic abuse, understanding mental health, understanding addiction, what that looks like, what that looks like in someone’s behavior. And I think particularly, you know, when someone’s trying to access mental health support, things like managing appointments, for example, you know, it’s that kind of thing where appointments might come through from the NHS in letter form, you know, with one appointment, one appointment option only, at 10 past 9, somewhere 20 miles from your house. If somebody is struggling with their mental health, struggling with anxiety, that is a very hard thing to navigate, to work out how they’re going to get to that appointment, to be able to keep to that appointment. And so it’s that kind of thing where a social worker can really help somebody navigate a system that isn’t necessarily working in a way that understands the profound impact of mental ill health on someone’s ability and resources to navigate that kind of thing. So it’s really a practical role in helping some of those social issues. But as I say, I don’t think anyone’s in doubt of the importance of those social issues.

And I think campaigning for better housing, campaigning for suitable, appropriate benefits and financial support for people that need it is absolutely fundamental. But there’s that workforce solution as well, which is really prioritising social workers in workforce plans. And you mentioned the Darzi report just a second ago, and you know social workers weren’t mentioned there. Whenever I see a new report coming out about NHS, mental health, anything, my first thing is just do a Ctrl +F to find whether social work is mentioned. To be fair, that report is very upfront that it’s limited in scope, but it did talk about the importance of the social issues around people’s mental health, but then didn’t necessarily then go on to talk about the importance of non clinical roles. It then went on to talk about mental health nursing and various other things. So it’s that’s slight disconnect between the fact that everyone knows that it’s wider than health and wider than mental health in terms of supporting someone. But then the non clinical roles are often overlooked. And I think that’s both in policy and unfortunately, some frontline services as well. So how we kind of prioritise social work is key to that.

AJ: Yeah, I totally agree with all of that. And I think it’s really useful to hear about the role of social workers, as you say, as kind of system navigators, more than that, but it is just also just helping someone having that scope over the whole system and how it all works together, because, as you said at the very beginning, it is a complex system, particularly if you are already struggling with your mental health or other social issues around this. And it’s encouraging to hear that there are people who are helping people navigate all of this with an oversight over different domains they need support in. And as you say, kind of underpinned by that relationship building. It made me think actually, of some work we did earlier in the year with our Equally Well campaign, which is around people with severe mental illness, but we were also just talking about how they get physical health checks. But the facts around that are similar in that it’s, you know, how do people navigate getting to appointments? How do they navigate being in a medical space where they may or may not feel comfortable? How do they do it if it’s a really early appointment in the morning? It’s all of those kind of social things around someone getting the support that they need, which are also really critical. And we also did a piece of work, I think it was last year, on different social interventions. So looking at the way that things like employment support, housing support can can really help people. And I think we’re clear at the Centre that, you know, we bang on about it all the time, that someone’s mental health is affected by many different determinants and circumstances. And so to see everything through a very clinical lens, or through a kind of siloed approach, of like, we’re going to help you with this diagnosis and nothing else fall short of what people really need a lot of the time and isn’t the way to see lasting wellness and recovery and health.

PE: I couldn’t agree with that more. And I think that point you say there about not being comfortable in a medical setting. So that is one that makes me think of one example when I was talking to a woman for some of the research that we were doing for one of the Department of Health consultations. And she had been accessing mental health support, she had mental ill health, and she was in an inpatient setting, and she had a social worker as well. And she describes the fact that she was in bed in hospital and that the clinician, the doctor, was coming in every day to talk about her medication and talk about her needs, and she was lying in bed, and she described him as kind of looming over her and and, you know, there’s no criticism, not criticising individual clinicians at all, but, you know, he’s, I’m sure, giving her really sound advice, but the kind of dynamics of that, the power dynamics, perhaps he’s not thinking about the fact that she’s been very vulnerable, she is lying down as a woman, and he is coming in and kind of speaking over her. And she talked to her social worker about this and how uncomfortable it made her feel. And then the next day, the social worker got some chairs out and put them in a circle and insisted the doctor sit down, and that she sit down, and that they were on a level talking eye to eye. And it’s just having someone think about, yeah, when someone is struggling that being in a medical setting, the power dynamics around that and helping them navigate that, and being a being an advocate for them. So hearing someone say this makes me feel uncomfortable, and then going and doing something about it. So yeah, I think that’s really true. I think medical settings, unfortunately, don’t feel necessarily therapeutic in nature at all. Of course they are where some people need to be for their own safety and for their own recovery, but anything that we can do to make those places feel like places of equality and inclusion rather than things being done to them, I think social workers have a role to play in that as well.

AJ: Yeah, exactly. And then, as you say, considering the housing that someone might go back to or might struggle to go back to, considering the benefits that they may or may not be able to access, considering all of these different elements of life that make up our lives and make our lives rich and good and worth living, not all of that happens within a kind of clinical setting. And, you know, I’m definitely preaching to the choir here, but it’s encouraging to hear it. Just interrupting our conversation briefly with a quick plea. Centre for Mental Health is an independent charity, so if you appreciate this podcast, you can support our work, either by following and rating this podcast or by donating at www.centreformentalhealth.org.uk/donate. We really appreciate it. Right, back to the show.  So last year, we had the NHS long term workforce plan, and that set big ambitions in terms of how many people would be trained up within services. And we hosted a roundtable this year with Mind and the NHS Confed bringing together organisations, including Think Ahead, to explore how we can transform this workforce, and not necessarily just in terms of, like, more numbers, more people, but in terms of maybe a different makeup, in terms of roles. And obviously, of course, Labour’s manifesto this year also committed to expand the mental health workforce. So I’m interested just to think about how you see social work fitting into that kind of ambitious expansion.

PE: Yes, certainly, and it’s something that we hopefully, you know, we’ve been quite vocal about that that expansion of 8,500 additional mental health roles, that we want to see non clinical roles being part of that, whether they’re qualified social workers or whether they’re other community based roles. That is, they cannot all be clinicians. I know that, obviously there’s real pressure on Labour to cut those waiting lists, to cut those waiting list times, and a lot of that will be people waiting for some sort of therapeutic intervention, but in terms of that kind of long-term planning, of hopefully having fewer people need to join waiting lists in the first place, having a workforce that look at those social issues, so that when someone starts to feel unwell or starts to feel anxious or starts to feel unable to manage life, that there is a practitioner role in there that can look at all that stuff, as you say, that makes us whole, that makes us people, what our home looks like, what our relationships look like, what our jobs and communities look like. There’s having roles that understand that having early work with people when they’re feeling unwell or feeling in some sort of distress. So absolutely in terms of the Labour manifesto around the 8,500. And then also just going back to retention as well. Though, of course, you know, 8,500 it sounds good, doesn’t it? And 6,500 teachers, but actually, they’re not huge numbers, and actually, you know, it’s not necessarily the harder bit, but the bit that possibly is kind of more of a long standing challenge is also around retention and people with experience. Because when we talk to service managers or we talk to people in the NHS, quite often, what we find is actually they’ve got people coming in who are inexperienced, who are eager to learn, but it’s that kind of people who have been in the job 5-10 years, who are leaving. And that real experience, that real understanding of how to navigate the system, understanding risk, understanding someone’s mental health needs, that that experience being lost through poor retention rates because they’re not getting the support they need is equally important to the recruitment drive as well. So we really always want to balance that kind of pressure to recruit more practitioners with also retaining the brilliant ones that we already have.

AJ: Yeah, and I think something we felt when we did this roundtable and discussing that kind of makeup of the workforce is that we need not just like more of the same, because, as you say, there are lots of people waiting for therapeutic interventions. And I, you know, I and we feel strongly that everyone should be able to get that when they need it, but equally, as you say, if we’re taking an approach of all of these different circumstances can affect our mental health, then we need to be looking at all of that as well. And that’s what we always bang on about at the Centre, you know, in terms of things like poverty and housing and racism. Because if we’re not addressing and tackling those things, then we’re just funneling people towards a certain clinical intervention which isn’t necessarily addressing the wider circumstances of their lives. And actually we did in our Mentally Healther Nation report, which Think Ahead obviously was one of the supporters for. And in that, we mentioned that the World Health Organization says that social determinants account for 55% of our health outcomes. And so I think it’s just taking that into context of going, okay, we really have to look at people as whole people, and not just as certain clinical outcomes.

PE: And I think those social determinants, like, it’s not just about them being obstacles to people on their road to recovery when they’re not resolved, actually worsening people’s outcomes. So you know, one example, a d ear friend of mine, actually from a few years ago. Unfortunately, we lost him to suicide, and he was in an inpatient unit in and out for a year or 18 months or so, and they really struggled to find him secure housing for when he left. And it wasn’t just the anxiety that there was nowhere for him to go. It was the emotional part of that he used to say to me, I feel like a burden. I feel like I’m a burden. So I think it’s not just that kind of when you’ve got somebody who’s vulnerable and struggling with feelings of hopelessness that not having enough to eat, not having enough money in the bank, not having secure housing it’s not just like this is very difficult and stressful. It’s deeper than that.

It really speaks and when you’re already struggling with some of those kind of profound issues about your feeling of where your place is in the world, I just think, and it’s not just about having enough provision, obviously that’s really important. It’s also having a workforce that understand some of that. So the way that they respond to people, it’s not that we can just magic up all these brilliant kind of housing solutions that will get built tomorrow that mean that they are places for people to leave hospital that have the kind of wraparound care that they might need. It’s about having a workforce that understand how stressful and difficult it is for people and how emotional it is when there isn’t somewhere for them to go. And that can be in really small signs, but just having that empathy, and I think that’s mindset, but it’s also having the time. I think it’s just an actual thing that if you’ve got a workforce with high vacancy rates and high caseloads, there just isn’t the time to respond, necessarily, with the required amount of empathy or patience that you might need. And it’s not the practitioner’s fault. It’s certainly not the service user’s fault. But the results can be really, really profoundly negative, if someone feels like they are a hassle or a burden because somebody can’t help them get what they need.

Yeah, and as you say, kind of acknowledging that these things affect our actual sense of self and self worth. And you know, all of these things. We published a piece on the cost-of-living crisis the other week. And very much that idea of it did cause extreme stress to people who were already struggling with their mental health, but also, as you say, just not being able to picture a future that is hopeful or worth living. So yeah, these are, like, profound things, aren’t they? I don’t want to do a disservice by saying it’s just about the practical elements. It’s really about kind of, I guess, instilling hope and a life, as you say, a life worth living. And I guess that must also be really hard, though, for social workers, as you say, if they are operating in such limited and high pressure, high caseload situations, it must be really hard sometimes to feel like they can do the job that they are meant to do and that they want to do. They can do the best job when they are operating in a really resource limited situation.

PE: Yeah, absolutely. And how do you give social workers and other practitioners the support they need to navigate that? And of course, there are numerous, numerous examples of services that are doing it brilliantly. I mean, I go back to Harry, who I talked about earlier, who was working with older residents, and he talks really powerfully about the great amount of support that he receives from his manager, about real strong team morale, about the fact that they all know that they’re in it together, that they’re there, and that’s brilliant. Of course, you get pockets. I mean, not just pockets. You get several, many, many examples of teams that have got real strong bonds. It can’t be some kind of postcode lottery. And other teams for whatever reason, higher caseloads, less resource, systemic issues mean that teams aren’t able to operate in that way. And for all the wonderful stories that we hear from people like Harry, we also hear stories from people that say, haven’t seen my supervisor in months. I don’t even know who my supervisor is. Or people that on the practical side of things, and I think this, again, came through a little bit in the NHS report that came out this week, about the kind of infrastructure support for people as well. I remember doing a bit of research with social workers. I think it was 10% of social workers said that they didn’t have a functioning laptop. Or, you know, people that said the internet doesn’t work, they’re given iPads that aren’t connected to the rest of the system, that they’re filling out the same form five times in five different ways. It’s not the most emotive side of things to talk about, but when you’re doing such a tough job, and you don’t have the infrastructure, you don’t have the tools, that mean you can get through the amount of work that you need to easily. That’s what we were coming back to earlier, wasn’t it? We were saying, we know it’s a tough job, but there are some things that they don’t need to be tough. A working laptop like, that’s just something surely we can resolve.

AJ: And also that really, really practical things that impede giving the best care that we can and impede people’s experience at the service as well. And obviously, that report was also talking about the conditions that a lot of mental health facilities are in, physically, in terms of just needing so much updating or refurbishment. You know, these are all part of giving people, as you say, a very like, a more therapeutic experience as well. So they are important, even if they seem very practical.  So I feel like we’ve covered a lot, and we’ve been frank about the real challenges facing social work and social workers, but also the massive and vital role that they play in supporting people with their mental health. And I guess sort of thinking more aspirationally about the future, I’m just interested to know, what would you like to see for mental health social work in the next 2 ,5, 10 years, as Labour rolls out their plans about the workforce, as we hope to see some investment to rebuild mental health services and NHS services. What is it you’d like to see? Big question, sorry.

PE: No, not at all. I mean, I think coming back to that public awareness piece, because those three elements, like public awareness, policy and practice, they’re all so interlinked, right? Without public awareness of the role and a public understanding of the fact that social workers are working in this way, are working in mental health teams, it’s much harder to get good policy and good commissioning practice, because pressure on governments comes from the public. People saying you need to treat police officers better. You need to make sure that junior doctors are paid a decent wage. All of which, of course, I agree with. There is no public pressure really, around social work. Of course, there’s campaigns around things like making sure they get paid a decent bursary to train, making sure they get decent salary and conditions. Of course, these campaigns exist, and there are brilliant organisations doing those, but they don’t have the cut through of some of the other frontline practitioner roles that we see. And so I’d really love to see Labour lean into the importance of social work, whether it’s through a national awareness campaign, whether it’s just including them in their workforce targets and their policy documents, you know, seeing them have more prominence in an NHS and mental health setting, especially, I think that will really start to unlock better policy that supports social workers, more pressure on making sure they get decent training budgets and decent support packages. And then that will obviously come through in terms of better integration on a practical practice level as well. But yeah, until we really societally understand the vital role that social workers play in supporting some of the most vulnerable and unwell people who are really trying to navigate a system that doesn’t necessarily feel like it’s set up to help a lot of the time, until there’s a greater public awareness a lot of those other things, in terms of commissioning and policy, are much harder to win and secure and see progress on. So that’s what I’d love to see for the next five years, that real lift and public awareness of what a brilliant job that they’re doing.

AJ: Amazing. Well, I think that’s a great note to end on, and I join you in sharing that ambition and that hope for people who are doing an amazing job and are a vital part of this workforce. So, Penny, thank you for coming to speak to us today. And yeah, thank you. Wish you all the best.

PE: Thanks so much.

AJ: Thanks for listening. You can join the fight against mental health inequalities by donating at www.centreformentalhealth.org.uk/donate or find the link in the notes. See you next time.

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