Think Ahead raises concerns about mental health social work job cuts in call for thousands more roles

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.”