Think Ahead has raised concerns about cuts to mental health social work job numbers as it launched a campaign for the government to invest in thousands more roles.

The fast-track social work training provider said it had seen “trends of mental health social work roles disappearing in some NHS teams”, while some employers were pulling out of its programme on budgetary grounds because they could not commit to providing salaried jobs for trainees on qualification.

Under Think Ahead’s two-year programme to train people as adult mental health social workers, participants spend a qualifying year placed with an NHS or local authority employer, who then takes them on as a salaried employee in year two.

Cutbacks in mental health social work roles

The charity said that, of employers who partnered with it in 2024, 35% were unable to do this year for financial reasons, up from 20% of partners who pulled out last year for similar reasons. It said this was affecting NHS trusts more than councils.

“What we are experiencing in terms of the development of our programme is that where budgets are squeezed, non-clinical roles, like mental health social workers, seem to be first to take the hit – perhaps because they are seen as non-essential to mental health,” said Think Ahead chief executive Philippa Mariani.

Cutbacks to mental health social work numbers would mark a turnaround from the 20% growth in NHS mental health trusts seen from 2019-22, which left 3,576 whole-time equivalent (WTE) practitioners in post.

Despite the growth, this accounts for just 2% of England’s NHS mental health workforce, which numbered about 143,700 in 2023, according to think-tank the Nuffield Trust, with about twelve times as many mental health nurses (about 45,000) as social workers.

Also, the profession was not mentioned at all in the 2023 NHS workforce plan, prompting criticisms from Think Ahead and the British Association of Social Workers.

Call for 24,000 more practitioners

The plan is due to be refreshed this year and Think Ahead said it wanted to see a sevenfold rise in the number of NHS mental health social workers, to almost 28,000, over the next 10 years.

This is based on everyone with severe mental illness in England – of whom there were about 624,000 in 2024, according to an NHS estimate – having a social worker, and practitioners having a caseload of 20-25. The latter is based on a proposed limit for adults’ social workers set out in a 2022 report for Social Work Scotland.

Think Ahead said recruiting many more social workers would help tackle the social issues that were associated with mental ill-health, including those related to housing, poverty, employment, relationships and social connections.

Mariani said that, besides working in community mental health teams, social workers could be used more in inpatient settings, to support people’s recovery and discharge.

Think Ahead’s ambition would involve the recruitment of a net additional 2,400 social workers annually over the next decade, which the charity said would cost £130m in year one, including salary, oncosts and recruitment.

Social workers ‘a vital lifeline’ for tackling inequalities

Its Social Work Matters campaign was backed by charity the Centre for Mental Health, whose chief executive, Andy Bell, said social workers were “a vital lifeline” for tackling the inequalities faced by people with severe mental illness, including in relation to income, employment and life expectancy.

The NHS Confederation, which represents healthcare bodies, was also supportive, with its mental health director, Rebecca Gray, saying: “We welcome Think Ahead’s call to invest significantly more in mental health social workers in the NHS.

“They play a crucial role as part of multidisciplinary mental health teams – for example, in supporting patients who are leaving hospital, to finding suitable accommodation and working with parents who have mental health issues. This is so important as parental mental health is a significant risk factor for child mental health.”

Call for Casey Commission to address mental health social work

She said the Confederation hoped that Baroness Casey’s government-appointed commission on adult social care, due to start work shortly, “will present an opportunity to properly address the role and contribution of mental health social workers”.

In response to Think Ahead’s campaign, a Department of Health and Social Care spokesperson said: “Mental health social workers provide an invaluable service, and the workforce is critical to our reforms.

“We will publish a refreshed long-term workforce plan that ensures we have the right people, including mental health staff, in the right places, with the right skills to deliver the care patients need when they need it.”

Integrating local authority social workers within NHS mental health trusts can help reduce the number of “harmful” out-of-area hospital placements (OAPs), a report has found.

The Health Services Safety Investigations Body (HSSIB) said that placing social workers in mental health hospitals could help speed up safe discharge, thereby freeing up beds and enabling discharge.

However, the report said that, in recent years, councils had withdrawn social workers from integrated services hosted by NHS mental health trusts, despite such arrangements being seen as beneficial by practitioners.

The HSSIB investigates patient safety concerns across the NHS in England. Its study of OAPs was part of a wider government-commissioned investigation into the safety of mental health inpatient setting, with previous reports covering the assessment of suicide risk and safety planning and the impact of workforce challenges on the delivery of safe and therapeutic care.

Missed target to eliminate inappropriate out-of-area placements

Under government guidance, an OAP occurs when a person is placed in an inpatient unit that does not usually admit people from their area and where they cannot be visited regularly by their care co-ordinator.

In 2016, the then government set a target of eliminating inappropriate OAPs – meaning those where the person was placed out of area because no acute mental health beds was available locally – by 2020-21.

However, this target was missed and, as of 31 March 2024, there were 900 out-of-area placements in England, of which 805 were inappropriate, based on data from 72% of relevant organisations.

NHS England told the HSSIB that increased complexity of need in the wake of the pandemic had had an impact on treatment times and lengths of stay in hospital that had not been planned for, leading to increased use of out-of-area placements.

Harm from being placed out of area

The HSSIB found that people and their families and carers were being harmed by OAPs, due to the increased anxiety of not knowing new staff and being separated from support networks.

The placements were also resulting in “significant anger, frustration and loss of trust in the mental health system”.

However, many NHS trusts told investigators they were “overwhelmed” by the number of people needing acute care and felt they did not have any option but to use OAPs, as this was better than the person remaining unwell in the community.

NHS England has put forward using community mental health, crisis and home treatment teams as key to tackling OAPs, by reducing people’s need for inpatient care.

But trusts said that there was “not always have the time, capacity or ability to make the changes needed” because of the pressure they were under.

Mental health system ‘cannot be looked at in isolation’

Practitioners told the HSSIB that the mental health system could not be looked at in isolation in consider OAPs.

“Many patients needed acute services because the lack of appropriate provision of community mental health care, social care support, drug and alcohol services, or delayed diagnosis of neurodevelopmental conditions, meant their needs had not been met to keep them safe in the community,” the report said.

The investigation found that “limited patient flow through mental health and other services”, meant it was difficult for trusts to discharge people from hospital, with the resulting lack of beds driving OAPs.

Local authority social workers told the HSSIB that high caseloads and “too many competing priorities” meant that they struggled to support the timely discharge of people from mental health wards, while the process was also slowed down by struggles getting support packages signed off by funding panels.

Loss of social workers from integrated teams

Practitioners told investigators that patients had benefited from council social workers being integrated into mental health trusts through partnership agreements drawn up under section 75 of the NHS Act 2006.

Social workers said this had given them greater visibility of patients in hospital and in the community and promoted collaborative working and improved understanding of cross-system pressures.

However, councils have pulled out of section 75 agreements in many areas over the past several years, reportedly due to operational pressures in other parts of the social work system, said the HSSIB.

This had had the unintended consequence of social workers who lacked mental health experience being assigned to support a patient.

Call to embed social workers in mental health hospitals

Based on its findings, the HSSIB said: “Health and social care organisations can improve patient safety by working together and embedding mental health social workers from the local authority in mental health acute hospitals.

“This can ensure that patients’ holistic health and social care needs are considered throughout their acute mental health admission and on into the community, and improve efficiency of working, patient flow and discharge and reduce the use of out-of-area placements.”

It recommended that the Department of Health and Social Care (DHSC) reviews current policies concerning mental health, social care and housing impacting on OAPs and “creates a proposal for the future accountability and integration of health and social care”, to help reduce and prevent out-of-area placements.

‘Close working relationships should be the norm’ – BASW

In response to the findings, British Association of Social Workers chief executive Ruth Allen, a former mental health social work director, said: “Section 75 arrangements have had challenges for the governance and quality of social care and social work when staff are seconded to Trusts.

“They have also foundered because of financial pressures.  But the principle of joint working on the ground and seamless, holistic support must not be lost in high level debates and disagreements about money and accountability.”

She added: “Joint teams and close working relationships should be the norm, and social workers must be available to support social needs and issues – in whatever way they are employed and managed.

“A focus on high quality delivery arrangements in well-functioning multidisciplinary teams – rather than on particular structures of multiagency governance and contracting – may break down barriers between professionals more effectively and ensure more truly integrated practice.”

In its response to the report, the DHSC said: “Patient safety is paramount, and anyone receiving treatment in an inpatient mental health facility deserves safe, high-quality care, and to be treated with dignity and respect…This government will reform the Mental Health Act, to ensure that people with the most severe mental health conditions receive better, more personalised treatment that is appropriate, proportionate, and compassionate to their needs.”

“We walked out for 81 days and it made no difference. They aren’t listening to us. It’s as dangerous a service as it was when the dispute started.”

This is Sophie, a mental health social worker who took part in one of the biggest social work strikes in decades, at Barnet Council in London.

She – and colleagues – staged their first walkout on 26 September 2023 and their campaign culminated in a 12-week strike, from May to July 2024. In total, they were out for 81 days.

Dispute unresolved after 81-day strike

The causes of the dispute were working conditions, staffing levels and rates of turnover that the social workers and their union – Barnet UNISON – claimed were unsafe.

However, despite their action, the dispute – which concerns Barnet’s north and south mental health teams and its approved mental health professional (AMHP) service – is stuck and remains unresolved.

The council continues to reject the social workers’ core argument: that staffing levels in the teams are inadequate and practitioner turnover excessive, resulting in services that are unsafe for mental health service users.

Instead, the authority argues that the teams’ experience reflects a national issue with the recruitment and retention of social workers, in mental health and in adults’ services more generally.

Union’s call for 10% market supplement rejected

The authority also rejects Barnet UNISON’s proposed solution: a 10% market supplement on top of salary for staff in the three teams, arguing that the mental health practitioners’ pay compares well with that in other London boroughs.

Its counter-offer is a 5% supplement for a much larger number of practitioners – about 200 – in adults’ services, again on the grounds that the staffing issues faced by the mental health practitioners are not peculiar to their teams.

Barnet UNISON has pointed out, repeatedly, that the council’s proposal is more expensive than its own.

After strike action failed to break the impasse, the teams returned to work and further industrial action is not on the cards.

Half of staff have left, according to UNISON

However, the make-up of the teams has changed dramatically over that time.

Like many colleagues, Sophie is no longer in her post. According to Barnet UNISON, 50% of permanent staff in post across the three teams as of 1 January 2024 had left the council as of last month.

Photo: Yurii Kibalnik/Adobe Stock

This compares to a national turnover rate for social workers in English adults’ services of 14.5% in the year to September 2023.

Roots of the dispute

The roots of the dispute, according to UNISON, lie in the transfer of social care services that were previously integrated with health, under Barnet, Enfield and Haringey Mental Health NHS Trust. to the council, earlier in the decade.

Barnet is far from the only authority to have taken this step over recent years. Other previously integrated and NHS-managed services have broken up, with some councils arguing that core local authority duties under the Care Act were not being adequately met under these arrangements, because health service priorities took over.

However, for the practitioners we spoke to for this article, the result of the Barnet transformation has been bad for the quality of services received by people in distress.

Lack of access to records ‘incredibly dangerous’

For example, while working in the integrated service, the social workers used the same case management system as their NHS colleagues, enabling seamless sharing of information.

Now, they say, they have a separate system to NHS practitioners, meaning they lack access to people’s medical records when they are referred to the social work service.

Says Sophie: “The social workers, apart from AMHPs, don’t have access to those [NHS] records, which is incredibly dangerous. It’s their entire mental health record – their diagnosis, their section history, their ward notes. These are issues that we were raising three years ago – and these are still issues now.”

They say it is no coincidence that several of those to have left the authority in the past year have moved to integrated mental health services.

‘My job is managing referrals, not being a social worker’

Practitioners say that other problems were created by the way the mental health services were returned to council control.

Notably, the authority’s front door service did not take on responsibility for calls relating to mental health, meaning they there is no triage of initial referrals before they reach the north and south teams.

Picture posed by model (credit: Adobe Stock)

“My job’s changed from being a social worker to managing referrals,” says Kimberley, a lead practitioner who also left the service after speaking to Community Care for this article.

Referrals ‘taking more than 16 weeks at one point’

“And we’re so far behind on it, because we’re not resourced to deal with it. There’s a policy where you have to deal with a referral within five days. We were over 16 weeks at one point.

“And some people email us because they think the person is going to take their own life and they don’t realise they need to contact the crisis service. Sixteen weeks is way too late for people.”

As well as being dangerous for individuals, she says this is costly, resulting in people ending up in hospital where this could have been avoided with an earlier response that would have enabled practitioners to signpost them to NHS crisis services.

According to Barnet UNISON, the council agreed, in 2022, that mental health referrals would move to the social care front door once staff in that service had been trained. However, two years on, this has not happened.

Waiting times of up to 17 months

Once the team do respond to referrals, those eligible for a service are added to a waiting list, the length of which has been a core issue in the dispute.

The social workers say that, as of August this year, people were waiting a maximum of 17 months to be seen by a practitioner.

Photo: fotolia/tiko

“This is much too long for people with mental ill-health, and they are really deteriorating without our support,” says Kimberley.

They also claim that, once the person is seen and assessed, there is pressure to close cases quickly by putting in a care package.

Says Sophie: “Recently, an email went out that  if we’re keeping cases open for longer than a month, we need to look at that. But in mental health, it can take a month to track your service user down.

“We are working with people who have suffered real trauma, who are among the most marginalised people in the country. They deserve more than a month.”

‘People need a social worker, not a care package’

Kimberley adds that what people often need is direct work from a social worker, not a care package.

“For most of our service users, we are the resource,” she adds. “We are best placed to work with them and help them take those small steps to build their independence so they don’t need a care package in future.”

For the social workers, working under these practice conditions has generated burnout and high levels of stress.

‘The overwhelm is incredibly high’

“People are working late to try and keep people safe and contain things because they are going in immediately where there’s a fire,” says Kimberley. “The overwhelm that people feel is incredibly high.”

Those who have left, she says, have reported a positive impact on their health.

“Workers who have left talked about how their physical health has improved since leaving, how with the state they were in, their body wasn’t able to heal.”

As well as an exodus of permanent staff, the teams have also faced high levels of agency worker turnover, which has not been good for mental health service users, the practitioners say.

Agency staff leaving ‘still has a massive impact’

Katie, another social worker who left the council after speaking to Community Care, recalls being given a high-risk safeguarding case, involving serious self-neglect, that had been previously held by two agency staff, when she was newly qualified.

“There will be loads of examples like that across the team,” she says. “Agency staff leaving still has a massive impact on the team.”

The practitioners add that, as in Katie’s experience, newly qualified and early career social workers have been loaded with significant responsibilities due to the loss of experienced colleagues.

Pressure on newly qualified social workers

One newly qualified social worker recalls: “I was recently given a case given to me to do with the Court of Protection. No one has experience or training in the Court of Protection. So whom do I rely on?”

These experiences were the catalyst for the practitioners’ campaign of strike action.

UNISON vice president Julia Mwaluke on the picket line with Barnet UNISON members (credit: Barnet UNISON)

But, despite 81 days on the picket line, they say they returned to an unchanged situation.

“Coming back after strike, the management don’t acknowledge it, we raise problems and they just don’t go anywhere,” says another social worker.

“My concern is, how can I practise safely as a social worker? I really can’t do a proper job. It’s just so frustrating.”

‘The strike was about making things better’

“There were a lot of things we liked about the service,” says Katie. [The strike] was about making things better so we could stay, and make it a safe service, not just for the service users but for ourselves as employees.”

She adds: “I’m not leaving because of the strike, I’m leaving because, through the strike, it’s become very apparent that nothing is going to get any better, as they don’t seem to value our opinion or our feedback.”

Throughout the industrial action, the practitioners have been supported by Barnet UNISON branch secretary John Burgess, himself a former mental health social worker.

‘It’s unsafe and we will continue to be public about that’

“You can’t continue strike action when you’ve lost most of the workforce,” he says. “The council is saying, ‘if you agree to 5% the dispute’s over’, but we rejected that months ago.

“Those who are left…I’ve no doubt that some of them are making plans to leave unless things change…It’s an unsafe workplace and we will continue to be public about that.”

Community Care put the concerns voiced by the social workers in this article to Barnet Council.

‘Our pay compares well with other boroughs’

In response, a spokesperson for the authority said: “Barnet UNISON has requested a significant recruitment and retention payment for qualified social workers in the three teams.

“While we appreciate how hard our mental health social workers work, analysis shows that our pay compares well to other outer London boroughs.

“We are not aware of any London borough paying a market supplement for recruitment and retention just to mental health social work teams, nor of a greater recruitment and retention challenge in those teams compared to our wider adult social care service.

“Levels of permanent staffing in the striking teams are around 80%.

Council ‘remains open to discussions’

“We are continuing to work with unions and staff in the service to address the concerns that have been raised. We met UNISON earlier in the summer, where both UNISON and the council agreed on several next steps and also agreed to meet again.

“We remain open to continuing discussions.”

A former Association of Directors of Adult Social Services (ADASS) president has been appointed chief social worker for adults.

Sarah McClinton will succeed Lyn Romeo in January 2025, a year after the longstanding chief left the Department of Health and Social Care (DHSC) position.

McClinton, who was ADASS president from 2022-23, will work alongside Robert Lewis, who has been appointed mental health social work lead in the department, a role he has already started.

As chief social worker, McClinton’s role will be to advise ministers on adult social work policy and provide leadership to adults’ practitioners across England.

Long search for Romeo’s replacement

McClinton’s appointment follows a long search for a replacement for Romeo, who was chief social worker for adults from 2013-24.

The DHSC’s initial attempt to recruit a new chief, in late 2023, failed, after which it readvertised the position at a higher salary: £120,000-£130,000 per year, up from £100,000.

This was more in line with the pay of chief social worker for children and families, Isabelle Trowler, whom the Department for Education lists as being on a salary of between £145,000 and £149,999.

Latest recruit from senior council role

Like Romeo, Trowler, and Mark Harvey and Fran Leddra, who held the chief social worker for adults’ role on secondment from 2019-21, McClinton has been recruited from a senior local authority role.

Since 2019, she has been deputy chief executive and director of health and adult services at Greenwich council, her third director’s role since 2010, prior to which she was an assistant director for about eight years.

Before entering senior management, she worked as a specialist HIV social worker, and she has maintained her social work registration during her time in leadership.

While McClinton’s career has largely been in local government, she has previously worked in the civil service, as director of mental health, disability and dementia in the then Department of Health, from 2014-16.

She said: “I am delighted to be appointed to this important role towards the beginning of a new government and look forward to working closely with colleagues both inside and outside the department.”

New mental health social work lead

Lewis, like his predecessors as mental health social work lead, Jason Brandon and Mark Trewin, has been seconded into the role from a local authority management post, in his case, AMHP service manager at Devon council.

He also stepped down recently from being co-chair at the Approved Mental Health Professional (AMHP) Leads Network after two years in that role.

The DHSC said his new responsibilities included supporting improvement in mental health social work in councils, the NHS and other sectors, and fostering the sustainability of the AMHP workforce.

The workforce is 35% short of what is required to provide a 24-hour service, according to a survey of AMHP leads earlier this year.

In a post on LinkedIn announcing his appointment, Lewis said: “Having the opportunity to help shape and influence mental health social work, social care, and approved mental health professional policy and practice at such a high level is unique and something I could never take for granted.

“I really do not feel like it is my job, it belongs to all of us and I hope I can represent colleagues in the way that they need and deserve.”

Sara Galvin’s tenacity in supporting and advocating for vulnerable people is admirable.

It is an ethos she has put into practice in running Coventry and Warwickshire Partnership NHS Trust’s (CWPT) mental health homeless pathway service, helping anyone who is homeless or at risk of eviction due to mental illness to access accommodation and therapy.

In 2021, she took on managing the service single-handedly and, last year, her work was recognised with a silver award at the Social Worker of the Year Awards, in the mental health social worker category.

Speaking to Community Care, Galvin talked about her triumphs and struggles leading the pathway, working in the sector as an autistic practitioner and what needs to be done to make the workplace more supportive for neurodivergent people.

What led you to pursue a career in social work?

I wanted to work in the social sector after my bachelor’s degree, but life took a different turn for me. I married at 21 and, at 23, became a stay-at-home mother at to my two children, until they went to primary school.

In 2011, shortly before getting divorced, I became a support worker at People in Action, a charity for people with a learning disability, I helped service users meet their personal care needs and achieve independence as much as possible by assisting them with laundry, preparing meals and taking prescribed medicines.

However, I wanted to do more impactful work.

I pursued a master’s degree in social work at Warwick University from 2012-14 and was fortunate, as the university funded half of the degree.

During my time as a social worker in the child protection service at Warwickshire County Council, I became drawn to aspects of mental health, when I had to work with parents with mental health complications or teenagers with similar issues.

It was a few years later, in 2019, that I made the big move to join the mental health team in the Coventry and Warwickshire Partnership NHS Trust.

It was a major decision, but the right move for me.

Can you tell me a bit about the homelessness pathway?

Photo provided by Sara Galvin

At the pathway, we accept referrals directly from homeless people, charity organisations, the council, community mental health teams, access hubs and other housing providers.

We support anyone who is homeless or at risk of eviction because of serious mental illness.

Once we get involved, our goal is to sort out accommodation and link people to the correct mental health service. We have helped people who have been sleeping rough get housing assessments and then get access to temporary accommodation.

Our clients were invisible until the pathway came into being. They are often ignored by society and do not have anyone, including family, to advocate for them.

What are the challenges you have faced while running the pathway?

A huge challenge has been managing the workload by myself when the pathway was launched, as I was the only post in the service at the time. I started the role in December 2021, and in July 2022, a support worker joined the team.

I manage multiple tasks in the pathway. For example, mental health teams email me asking about someone who has been moved around and whose location is not known.

I have links with the council, so am able to find out information about the person, but it takes time to contact the right people and sift through the information.

Staff from hostel accommodations may also contact me about someone needing a mental health assessment, but they may not know how to go about it because the clients are difficult to communicate with or sometimes hard to reach.

Because people who are homeless are difficult to reach and may take time to trust our services, I have to think of out-of-the-box measures to support people in distress.

What are some of the out-of-the-box measures you have taken?

I do not like saying no to problems or giving up.

When a challenge comes up, I need to find out more about it and figure out a solution.

I work very closely with our approved mental health professional hub to support homeless people.

As it is unrealistic to expect our clients to come to us, I am willing to go wherever they are. I have gone to ditches and the top of a hill to see if there are people there in need of mental health assessments and housing.

It is never easy, but I like the challenge, it makes my job interesting and keeps me on my toes.

How has the service benefited the people you work with?

There are a few stories that reflect how the service has helped people.

One is Wayne’s story. In September 2023, he was evicted from his house by his father and stayed on the streets for a few days. He then found temporary accommodation in a hostel at the Salvation Army.

On one of my visits there, I met Wayne downstairs, and he was very distressed and in a state of panic. He thought I was a staff member and started talking to me.

I helped him get admission into CWPT’s Caludon Centre, where he received treatment for psychosis for two months. He was eventually discharged and went back to the Salvation Army where they gave him a room to stay.

I was involved with Wayne throughout. I used to have conversations with him, when he was at Cauldon, about his treatment and stayed in touch with his psychiatrists to monitor his progress.

Another case was of a lady who was floridly psychotic and regularly begging in town. I helped her get admission to a mental health centre and now I am working towards getting her into supported accommodation.

What was your experience of working in social work with undiagnosed autism?

It was not a great experience, especially in children’s services.

I always hold onto things that I feel are right and fight for people who need support. Many people considered me as argumentative and strong willed as a result.

I used to have meltdowns because I was overstimulated and misunderstood.

So, working when I was undiagnosed was quite hard because there nothing for me to explain why I acted and felt the way I did.

How did the diagnosis change your experience in the workplace?

I can now mention it at work and people will be more understanding. This has lifted a bit of the pressure on me to wear a mask and always explain myself, which I did when I was undiagnosed.

It has helped build connections with clients who are neurodivergent. I do not always self-disclose, but where appropriate, it helps build rapport and enables us to understand each other better.

Raising a child with autism has also helped me be more compassionate and empathetic as a social worker.

The diagnosis made me want to raise awareness about it in the workplace. I feel I need to talk about my experiences so that others going through the same do not feel alone.

Now I can see that my autistic traits make me wholeheartedly fight for homeless people and ensure they are supported and not invisible.

What do you think could be done to make the workplace more supportive for neurodivergent people?

There needs to be better management, that’s key.

It’s not rocket science, but more needs to be done about treating people equitably and respecting that we all work in different ways.

Simply because I work in a way that is different from most people does not mean that is wrong. Understanding that takes time, but it is important to empathise with differences.

I am a new manager myself. That’s been a massive challenge to me. We work very well together, but my co-worker does not work in the same way as I do.

Being a manager has shown me that neurodivergent people can work in an amazing way. It needs to be embraced more in the workspace and our work styles should be understood and accepted.

But since social work is stressful, managers often forget to take time out for neurodivergent people to understand where they come from.

I hope we can create a more inclusive space for neurodivergent staff [in the pathway] and honour our differences.

Our interview with Ruth Allen is part of a series of profiles of key figures who have shaped social work over the past five decades, to mark Community Care’s 50th anniversary. Previous interviewees include Eileen Munro, Herbert Laming, and June Thoburn.

Ruth Allen has spent the past eight years as chief executive of the British Association of Social Workers (BASW), providing leadership and representation to members from all parts of the profession.

But before that, her focus was squarely on mental health social work.

Having practised in mental health settings after qualifying in the 1990s, she went on to become director of social work in two NHS Trusts.

Then, in 2012, she became chair of the mental health faculty at The College of Social Work, the body set up to provide leadership for the profession, which closed in 2015 after the government withdrew funding and it was unable to sustain itself.

Most recently, she was elected president of the International Federation of Social Workers Europe, the regional division of the profession’s global body.

Speaking to Community Care, Allen reflected on the evolution of mental health practice within social work, the lack of shared knowledge across services and BASW’s impact under her leadership.

BASW chief executive Ruth Allen (credit: BASW)

How has mental health social work evolved over recent years?

I think there is an acceptance that if you’re working in social work, you need to have an understanding of mental health, whether you’re working with children, adults or older adults.

There’s been quite a resurgence over the past 20 years in the importance of qualifying and ongoing training in mental health and a recognition of what social work brings to mental health services in integrated settings and teams.

But there’s still quite a long way to go to develop the knowledge and basic skills needed to work well with mental distress disorders.

What would you describe as those basic skills?

The first thing is that all social workers should be confident addressing mental health topics, whether that’s with adults, parents or even children. Obviously, when talking with children, you probably need some additional training to do that, but you need to first have confidence to raise the issue.

I know people who trained around the same time as me who didn’t know how to have conversations about mental health and wellbeing.

Then it’s the skill to listen and recognise that, if there’s an authentic and trusting relationship with those you support, it’s easier to talk freely.

In the process of becoming a registered professional, sometimes you take on a mantle of professionalism. This often includes putting distance between you and the people you’re working with, in the name of objectivity and using evidence. I don’t think I was too badly affected by that but I know some people are – they become stiff in their professionalism.

But it’s the relationship you build that is the crucible of where change happens and people start addressing their issues. You have to have a lot of skill, resilience and knowledge, but also the ability to build relationships.

You were chair of The College of Social Work’s mental health faculty. What is its legacy?

Although the College didn’t last, I think the work that came out of its faculties – children’s, adults’ and mental health – had a subsequent life.

At the mental health faculty, we were able to do a range of things to bring a spotlight on mental health. I really was very pleased because it was needed.

We worked on a document called The role of the social worker in adult mental health services, which defined what it was to be a mental health practitioner and ended up being quite influential. I am now working with colleagues to review and revise this.

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This was at a time when we were still trying to help the integrated NHS and local authority mental health services adapt to the Care Act 2014. There was still a sense of, ‘What is it that social workers do?’.

So we created the document to help with that. It was well-informed and well-evidenced.

We launched it in Parliament, and it was supported by Lyn Romeo [then chief social worker for adults] and the then care minister, Norman Lamb. It bridged the gap between political leadership, senior social work leadership and social workers on the ground.

It also ended up being the basis for other guidance, like Social work for better mental health, a government strategy to improve mental health social work and raise its profile within the sector.

How integrated is mental health social work across settings?

NHS organisations are now recruiting more social workers directly into the NHS because they recognise that they bring a holistic approach.

There’s a recognition that there is a spectrum of skills that social workers bring which is distinctive. This includes an understanding of social context and the structural and systemic problems people face.

But I would like to see more mental health expertise being shared across the sector.

Social work around adults with mental health disorders has grown in recognition, knowledge and skills. They’ve had some more investment. Yet mental health knowledge hasn’t been integrated very well into wider practice. For instance, there are big differences between how adults, young people, children and the elderly are approached when it concerns mental health. The models are so different.

In a way, the role of social work in children and adolescent mental health services has actually declined and could benefit from more skill development.

That is partly because of one of the other significant problems that we have now – the division between adults’ and children’s services, which is right at government department and local level in England.

Why is the division between adults’ and children’s services such an issue?

Westminster government introduced separate directors for adults’ and children’s services in the 2000s and divided child and family and adult social work at government department level.

My experience on the ground is that professionals and the different specialists will do whatever they can to try and create relationships and close the gap.

But social work services are so pressed now, you’ve got different legislation when working with adults and children.

With the best will in the world, very busy social workers can’t go around making all the connections. At points of transition, particularly between children and adults services, there are huge differences in practices and the resources available.

What was your vision for BASW when you joined?

My vision was for BASW to be a strong independent voice for social work and to consolidate and improve the services that we provided to members.

I also wanted to do some myth-busting about what BASW was and wasn’t. We’re not a trade union, we are a professional body. We are interested not only in supporting practitioners, but in developing social work and influencing change on things like inequality. We set our new mission after I joined.

I spent a few years sorting out internal and external issues and modernising our communications and press work, particularly regarding our professional development offer. So we constantly go back to our members and non-members and ask, ‘What do you want from us?’. That is still ongoing.

What are some obstacles you’ve faced as chief executive?

I think one of the obstacles is the issue of funding and investment in social work at the moment. I think we do a good job helping people stay in social work because we are a place that people can go to for coaching, as well as formal advice and solidarity and a sense of belonging.

But it is very tough out there. The pressure of workload and resources that people are under is an obstacle – to best practice and to people making choices in their own best interests.

We would like to see more co-operation across the board to find coherent solutions for social work and social care. But sometimes it feels like we’re all pulling in different directions.

The public and political support and press coverage of social work has also improved broadly over the years. But there needs to be more consistent noticing of what social workers do – a fair portrayal, telling the good stories as well as the bad ones.

That’s why we’ve created the BASW Social Work Journalism Awards.

What are your proudest achievements at BASW?

Our campaigns have been really important, especially the collaborative work on working conditions and social work experiences, with the Social Workers Union and Professor Jermaine Ravalier (now of Buckinghamshire New University).

While we didn’t change the Illegal Migration Act 2023 [the government legislation designed to deny asylum to anyone deemed to have entered the UK illegally], we’ve been a strong force in that area.

Our efforts on migration, the retention of the Human Rights Act and the “homes not hospitals” deinstitutionalization work [regarding people with learning disabilities and autistic people] in England has been powerful. There are many campaign activities to be proud of.

Our strength as a campaigning voice also relies on our internal strength. During Covid-19, we moved our entire operation online within a week and became a strong presence for social work. We gathered social workers’ perspectives and provided additional support services quickly.

It helped us reach so many people because we were a visible and human presence during a really terrible time for many people.

That’s probably helped with getting core participant status now in the Covid inquiry. We are the main social work voice in the inquiry as an organisation.

What would you like to see change in social work?

I would like to see social work more united, having a collective, strong voice and more influence on our politicians and decision makers, beyond the public.

It’s also important as a profession that we can communicate with different parts of the sector and learn from each other.

There needs to be a credible, long-term investment programme in social work and social services in England to restore the confidence of practitioners.

I think social workers are absolutely remarkable with what they’re continuing to achieve, but we are falling behind other nations. That needs to be turned around for the sake of everybody.

I’d just like to see social workers become more influential so that we can use our values and our knowledge in policy everywhere.