More funding needed for mental health research

While Homer Simpson may have said “people can come up with statistics to prove anything”, there are some occasions when bald numbers do tell their own story. Mental health funding is one of those.

For instance, according to a review by the Medical Research Council, mental health is estimated to cost £77 billion each year in England alone. It accounts for 15% of all disability due to disease and affects 16.7 million people in the UK at any one time. Yet only about 5% – £74 million – of medical research budgets are dedicated to it per year.

Professor Til Wykes from the Institute of Psychiatry at King’s College London hit the nail on the head in a recent BBC piece, saying that mental health research is “incredibly underfunded”

This seems especially so, given that mental health problems affect more people at any one time than cancer or heart disease – both of which receive more funding.

Given the statistics, it is hard to argue with Prof Wykes. Whether this relative lack of funding is down to stigma or the fact that mental health is not a “sexy” illness is debatable, but at least there are moves to challenge the situation.

For example, in its review, the MRC has outlined the priorities for the research community for the next 5-10 years:

• Focus on the prevention of mental disorders based on better understanding of causes, risk levels and new approaches to early preventive measures
• Accelerate research and development to provide new, more effective treatments for mental illness, and implement them more rapidly
• Expand the capacity for research in this area in the UK.

The MRC will work with funding agencies such as the Economic and Social Research Council, the National Institute of Health Research and the Health Departments of the devolved administrations on approaches to take forward these recommendations, but whether more funding will be forthcoming is debatable.

The logic for more funding is hard to argue against – basically, more research would lead to better and more effective ways of preventing and treating mental illness, thus reducing the burden to the country and saving money – but the financial state of the country may dictate what happens.

With the Department of Health looking for savings, research budgets look set to be slashed for many areas of healthcare – although not dementia – so any large increases may be out of the question, although an increase in real terms may be feasible. Whether that is enough is another matter – it may be another case of innovative work having to be done with fewer resources, which could hold back the pace of development – to everyone’s detriment.

SCRs: to publish or not to publish?

In the fallout from the Edlington case – where 2 brothers subjected 2 other children to a sustained attack – aspects of social services have again come under the public microscope. This time, it is serious case reviews (SCRs).

The Conservatives, and others, have called for the full Edlington case SCR to be published, rather than just the summary. Labour has rejected these calls.

As reported by the BBC last week, Conservative leader David Cameron believes fully-published SCRs would lead to a greater understanding of what went wrong and result in quicker action to prevent such events happening again in the future.

In the report, he said: “There is a sense at the moment that it is a sort of establishment stitch-up where all the people who have taken part in this issue are not named, they are not having to take proper responsibility, the public isn’t able to see what has gone wrong and the pressure isn’t there to put it right.”

It seems to me that Cameron is indicating that SCRs should be about ‘naming and shaming’ – to use a tabloid buzzphrase – and damning those who were at fault for the case going wrong. The assumption being that the SCR is there to do that and that there is always someone to point the finger at.

There is a common misconception that SCRs are there to apportion blame. They aren’t. They are – or should be – about learning from mistakes so they don’t happen again in the future. They apply to local conditions and social work practice – out of this context they lose some of their relevance. This should be explained better by the sector.

Secondly, cases are anonymised for a reason; there are child protection factors to be considered, as well as protecting the social care professionals involved. If they were public, would the media pass up the chance to splash the details? The Baby Peter case, for one, indicates otherwise.

Social workers do take proper responsibility; if there is proved to be negligent practice, for instance, they are disciplined. But again, that is not the job of the SCR.

I would argue also that there is pressure to “put things right”, not only from the public, but from within the sector. Ofsted makes regular inspections and there was the recent Social Work Task Force report, but surely all social workers want to ensure that practice is as good as practically possible?

SCRs are not perfect by any means – critics say they often focus on protocol rather than frontline practice – but to open them up fully could create more problems than it solves.

How Social Work Task Force report can tackle image of social work

Scanning the newspapers to gauge the reaction to yesterday’s final report from the Social Work Task Force, it is the comments from some of the public that caught my eye.

Most of the national newspapers I’ve seen have covered the report in a straight way – outlining the major reforms, along with comments from ministers. The BBC has also done roughly the same.

The Daily Mail has tried to put more of a spin on it, highlighting the recommendation for reforming the pay structure – Social workers to be given pay RISES in wake of Baby P scandal – rather than the recommendations to drive up standards. Interestingly, the article’s original headline contained the word ‘outrage’ but dropped it soon after, presumably due to the general lack of outrage.

But as usual, the comments at the bottom of the article include anti-social worker vitriol along the lines of ‘sack them all’ (among many others). Ignoring the ludicrousness of those sorts of statements, it nevertheless shows how much still needs to be done to improve the image of social workers in the public eye.

These sorts of comments appear at the bottom of many articles on social work – regardless of the newspaper – and highlight the deep-rooted prejudice that exists among some of the general public.

Tackling these perceptions will be incredibly difficult. The Task Force recommendations should help if they are driven through. It calls for a programme of public understanding, with greater openness and enhancing awareness of what social workers do and the contribution good social work makes to society.

This is key; I think a lot of anti-social worker feeling is down to misconceptions about what they do and the fact that it is only when it goes wrong that it is reported in the media – social workers seem to be painted as either child snatchers or uncaring box-tickers that ignore obvious abuse.

More campaigns along the lines of the one to improve recruitment seen earlier this year – and which created a huge spike in interest – are needed, as is a sustained feeding of ‘good news’ stories into the media.

Also, if the other recommendations do end up raising standards, the resulting better outcomes – and fewer poor outcomes, more significantly – will help to change the perception of social workers over time. Likewise, the number of damning newspaper articles would decrease.

Achieving this will take a sustained campaign over many years, but it needs to be done. Teachers’ status has been rehabilitated following similar campaigns in the past decade, and there is no reason that it can’t be done for social workers.

Children’s social work in balanced TV show shocker

At last, a terrestrial TV programme about children’s social work that provided an accurate portrayal of the day-to-day work of those on the frontline.

Last night’s Panorama programme (http://news.bbc.co.uk/panorama/hi/) on child protection social workers in Coventry was a welcome snapshot of social work teams; overworked, dealing with complex cases where the truth is hard to find and – crucially – dedicated to protecting children.

Social workers have been on the receiving end of some astonishing vitriol from some members of the public – who I’ll wager have no idea of what really goes on in a child protection team – in the months following Baby P, and this should have given the critics food for thought.

While there is a long way to go to improve the perception of social workers among the public – the overwhelming tide of social work news is still negative – this was a good start.