The psychiatric social worker in the community.

As you probably know, in January, i@, the Provisional National Council for Mental Health were asked by the Board of Control to provide a Social After-Care Service for men and women discharged from Service Psychiatric Hospitals. For the purposes of this work an experienced psychiatric social worker, known as Regional After-Care Officer, was appointed to each of the Civil Defence Regions to undertake and organize this service. The psychiatric social workers visited the Psychiatric Service Hospitals in their areas, obtaining a full history and recommendations from the psychiatrist referring the case, and interviewing each patient to discuss his needs and plans. These reports were then sent to the Regional After-Care Officer in the patient's home area and formed the basis of our work. Soon cases began pouring in, not only from Service Hospitals but from other agencies interested in the resettlement of the psychiatrically disabled Ex Service man, such as Disablement Resettlement Officers, Ministry of Pensions doctors, Red Cross workers and so on. By the end of 1946 some io,ooo cases had been dealt with under this scheme. Throughout we have been faced with an acute shortage of trained per sonnel and in most regions it was only possible to have the services of one or two full-time psychiatric social workers, so that most of the Regional After Care Officer's assistants were trained social workers without the Mental Health Certificate. These general case workers receive a great deal of tuition and supervision from the psychiatric social worker. This dilution is raising great controversy, but it must be stated that some of the social workers have done remarkably patient casework of a high standard and that the scheme would have broken down without their help. As I will show later, emphasis on the general casework side is much greater than in orthodox clinic or hospital psychiatric social work, so that there is a place for the general case worker, under the guidance of a psychiatric social worker, in such a community service. It is the first time that a community service on a national basis has been provided for a selected group of psychiatrically disabled persons and it ha@ offered the psychiatric social worker enormous scope in applying her skifi in the wider social field. After three years of hectic activity, I felt the need to assess the value of this new service and its possibilities for the future, and began a study of successes and failures in our work.