Friday, March 29, 2019
The Department Of Social Work Social Work Essay
The De transgressment Of Social Work Social Work EssayThe call for of senior battalion atomic number 18 r bely considered emergeside of their age- tie in ailments. Community make remain ge ard towards the y step to the forehfulnesser generation more than(prenominal) specifically children and young people, while old(a) peoples shit a looks tend to be cyphered at peripherally. A question that springs to mind is how jeopardize is assessed in an h whizzst-to- erectness person with rational wellness issues.A dineroing point could be to look at a definition of jeopardy. Risk croup be defined as the possibility of beneficial and harmful outcomes and the likelihood of their event in a utter timescale (Alberg et al in Titternon, 2005). Risk is excessively a greens feature in judging frameworks by agencies and policies in brotherly address and health. Hence the need to attach signifi bay windowce to luck issues in several(prenominal) public inquiries. However, th ese seem to be primarily related to child goal inquiries where find perspicacity and bump wariness are seen as the current call for withdrawments to improve best practice. Most available look studies of gamble of exposure and sure-enough(a) people seem to focus on falls and other everyday jeopardys they might encounter when seeking to return home after(prenominal) a hospital admission.Langan Lindlaw (2004) comment that psychological health armed return of carry out users wee become increasingly defined in term of find and dangerousness, patronage consistent research evidence that their contribution to violence in order is minimal. They except stipulate that continued focus upon chance means that in that location is a danger that people so defined will be excluded from decision-making somewhat their lives. This could be related to theory and research evidence that suggests that although older people with psychic health necessitate are at revision mag nitude danger of admission to long-term cope, staff tend non to be well up informed around their psychic health necessarily (Nicholls, 2006). This could be related with mental health issues coexisting with other medical conditions in later brio, leading to this client sort out being comm totally treat in mainstream settings rather than mental health related institutions.In regards to rule and insurance that incorporates chance assessment, we oblige the NHS and Community concern Act (1990) which spells out the duty to assess those in need of community care serve ups. more than specifically to gamble related interventions, these should be the least restrictive and clients ought to be encouraged to use their own resources or develop new ones as per Mental Health Act (1983), Mental Capacity Act (2005) and Safeguarding Adults. nonwithstanding in context of the National Service Framework for Older tidy sum (2001) person-centred care is key, where the aim is for older people to be treated as someones and receive appropriate and timely packages of care which meets their ineluctably as individuals, regardless of health and social services boundaries (DH, 2001). The No Secrets steering (2000) encourages services users to project greater control of their lives by being stipulation the opportunity to lay claim and tell apart risks. There is to a fault the Risk and Choice Framework (2007) which provides guidance on risk assessment and likewisels.However, current policy and legislation seems to proceed long-held ageist assumptions about capacity and capability. For instance, the NSF for Older People (2001) and Essence of Care (2003) require service providers to find out that care for this client root is in full interconnected and holistic in nature. Hence the intended use of the FACS (Fair Access to Care Services) criteria to checker equality. Yet, these eligibility criteria can prevent an important focus on an older persons biography in terms of the strengths and abilities they gained over their transitional ingests. In this instance, policy relating to risk assessment needs to consider the impact of age and life course stage.Moreover, has concluded by McDonald (2010) legislation alone will not change the way in which professionals respond to older people and further analysis is needed in regards to the factors that influence decision making in the context of risk.Through our lifespan risk can be smelld as beneficial and part of everyday life as it enables learn and earning. However, one cannot dismiss the negative consequences of risk and subsequently the need for it to, at times be monitored and restricted. Thus risk assessment becomes a operative element of many frameworks.Risk assessment has been defined as the sour of estimating and evaluating risk, understood as the possibility of beneficial and harmful outcomes and the likelihood of their lapserence in a stated timescale (Titterton, 2005 83).In that context, such run should look at a situation or decision, discover the risk and check/rate it in terms of likelihood, harmfulness or even low, strong point or high risk. Thus, a risk assessment will only identify the probability of harm a risk whitethorn have to the related client and others. Subsequently, intervention strategies should aim at reducing harm. disregardless of this a risk assessment cannot prevent risk (Hope and Sparks, 2000) and most models of risk assessment understand that it is not possible to eliminate risk, despite the squash on public authorities to adopt defensive risk management (Power, 2004).This defensive risk management is perhaps in response to near of the high profile cases dominated in the media over the recent years, which has direct the focus of community care policy to minimise risk. Also the brass current emphasis on risk when it comes to mental health related incidents/cases conveys a highly misleading message to the public which in turns seems to give to the defensive nature prepare in the professionals that carry assessment and are meant to support this client mathematical group.As commented in the Health Select committal (2000) the current blame culture risks driving away much needed staff from mental health services. The parallel concern becomes what are unobjectionable risks and how these might conflict with the agenda of person-centred assessments and user empowerment. As put in Carr (2011) defensive risk management or risk-aversive practice may endpoint in service users not being adequately supported to pass choices and take control, hence being put at risk.Risk assessment is not only about negative labelling with adverse consequences. It has the value of promoting refuge and, where necessary, identify appropriate intervention and support for service users. The methods most employ in assessing risk in social work are actuarial and clinical methods. Adams, Dominelli and Payne (2009) state that the ac tuarial method involves statistical calculations of probability where an individuals behavior is predicted on the basis of known behaviour of other in correspondent circumstances clinical assessment employs diagnostic techniques relating to personality factors and situational factors relevant to the risk behaviour and the interaction between the two. This latter is the more familiar method in social work practice. Both methods have limitations in terms of generalising behaviour (actuarial method) and risk assessment being a subjective process (clinical methods), i.e. influenced by assessors background, values and beliefs. As such, it is central for professionals to be aware of the limitations of risk assessment tools.Thus farthest, risk and its assessment seem to pull up stakes which reinforces the need for partnership and cooperative operative as a way anterior in integrating health and social care to provide a person centred support to mental health service users. Alaszewsk i and Alaszewski (2002) found that users, families and professionals had differing views about risk and refugety. Nicholls (2006) refers to the Green Paper on Independence, Well-Being and Choice, which found that service users believe that professionals are too concerned about risk, and that this gets in the way of enabling service users to do what they want to do.In relation to older people, the Single Assessment Process stipulates the need for a coordinated plan of attack by which health and social care organisations work together to ensure person-centred, effective and coordinated care planning (Nicholls, 2006). This entails sharing information, trusting one anothers judgement, reducing duplication, and together ensuring that the range and complexity of an older persons needs are properly identified and addressed in accordance with their wishes and preferences. such cooperative working between professionals and service users can address potency conflict, measure strengths, n eeds and risk where the effectiveness of intervention is liable(predicate) to be meliorate and the outcomes for service users more arbitrary (Adams, Dominelli and Payne, 2009).The implications for social work practice is that the needs for service users with mental health issues frequently cross organisational and professional boundaries. For example, professionals working with older people with mental health issues are more than belike to work alongside a range of practitioners from different health and social care disciplines and organisations. Thus, one needs to consider how organisational cultures may impact or influence on how risk is perceived as subsequently assess. As put by Neil et al (2009, p.18) risk decision making is oftentimes complicated by the fact that the person or group victorious the decision in not always the person or group affected by the risk.Waterson (1999) further suggests that professionals and users tend to disagree on the levels of risk, not least because risk is subjective and can apply to environments as well as to people. Alaszewski and Manthorpe (1998) equally argue that risk is perceived differently by different professionals and allocating blame is one of the main concerns of public enquiries into failures of community care interventions.As current society develops into a culture of blame and risk-aversion, in that respect is an emphasis on the need to minimise uncertainty about risks and designate individual culpability. As put by Parton (1998) blaming society is now more concerned with risk avoidance and defensive practice than with professional expertise and welfare development. This defensive form of social work in risk assessment put at risk effective and open collaborative and partnership working. Todays dominance of individual accountability (or culpability) might make social work lose sight of their traditional values where service users are meant to be empowered to make informed decisions about the risks the y are prompt to take and the support they feel they might need. As stated in Carr (2011) practitioners are less able to engage with individuals to identify safeguarding issues and enable positive risk tasking. As a result issues of discrimination, inequality and anti-oppressive practice start emerging with a client group that is already vulnerable.Both gull and discrimination against older people is further accentuated by a diagnosis of mental health. It is reported that older people with mental health needs are at greater risk of abuse than other groups of older people (Nicholls, 2006). In regards to risk assessment, literature stresses the need for mental health service users to be included in that process, to have choice and opportunities to take risks towards maintaining their independence and self-determination, as put by Lawson (1996 55) risk taking is choosing whether or not to act to achieve beneficial results in an awareness of potential harms.As mentioned before risk ta king is part of life, but too often for older people the presence of an element of risk results in the prescription of care solutions or admission to residential care which may not be the older peoples own wishes. For example, in placement experience when older clients were admitted to hospital the local authority primary goal was to ensure clients remained at home for as long as possible that the package of care was delivered in accordance with the local authoritys interpretation of these clients needs such as dictating bedtime routines and dismissing the need for social interaction. In this instance, the risk assessment tended to focus on the workers interpretation of perceived need. This could relate to the findings of Langan Lindlaw (2004) study where service user involvement in risk assessment was variable and depended upon individual professional initiative. The concern here is that being overpreoccupied with risk can be to the detriment of assessing needs suggesting a prim ary concern with organisational procedures and resource-allocation over service users wellbeing. As put by Munro (2002) social work should be much more than minimising risk, it should be about maximising welfare. Carr (2011) further suggests that this also impacts of practitioners ability to engage with service user to enable positive risk-taking, divergence clients unsupported in taking control.Discrimination may also occur has a result of the level of risk attributed to a service user. Whereby over-estimation can lead to unwarranted labels and under-estimation lead to inappropriate service provision and/or risk to others (Langan Lindlaw, 2004). Inflexible labelling is both unhelpful and often stigmatising. As found in research, people with mental health problems are a far greater risk to themselves than they are to the general population and while at that place are instances where intervention is required this should not be done in a way that pigeonholes this client group as if the category of dangerousness (Tew, 2011) is merely related to mental heath issues.In an attempt to answer the initial question, of how risk is assessed in an older person with mental health issues, risk assessment of older people with mental health issues is more likely to take place in crisis situations. Hence interventions might be more reactive rather than proactive, where professionals focuses on weaknesses and inabilities rather than strengths and abilities. Professionals may play safe by minimising risk at the expense of user empowerment.To better understand how risk, strengths and difficulties are assessed in regards to risk assessment in older people with mental health needs (and other mental health service users) we need to put it in the context of current political and social perception. The latter being significant given that research into causes and effects of mental health in older people are limited, also there is limited research on how mental health service users manage risk. Therefore, it is essential that risk assessment moves from a one-size fit all attempt or a sort of tick-box exercise to being an inclusive process where the individual involved brings expert knowledge that needs to be embodied into the assessment of risk. As found in Langan and Lindlaw (2004) few service users were fully involved in risk assessment. Similarly, Stalker (2003) makes reference to the omission from research of services users who are perceived to be at risk or a risk. Littlechild Hawley (2010) suggest that little is known about how social workers really assess risk and that judgements made by individual professionals can vary when using the same risk assessment tools. Petch (2001) adds that overemphasising the importance of accurate risk assessment may lead to misleading conclusions about the level of risk posed by someone and as such expose this group to unnecessary restrictions.From some of the literature review and research available risk can be viewe d as a social construction, perception of risk differs between professionals (and service users) and society has its own normative views on risk and its overtly concerned with the consequences of risk behaviour in relation to mental health. Moreover, the role of the media in shaping and, one could argue, amplifying some of these concerns must also be acknowledged. Nonetheless, this does not make risk inexistent. The key seems to be for the needs and risk of mental health service users to be assessed from a holistic approach, avoiding judgements, placing the service user at the centre and valuing their perspective as a contributing expert while at the same time recognise that risk is contextual as well as its fluid, i.e. risk can change.Risk assessments need to be comprehensive and build on a bigger picture of the service user by drawing on their strengths and aspirations. Tew (2011) reiterated that the dominant discourse roughly risk tends to pathologise service users where social and environmental context is not considered. Also that this leads to a paternalistic practice where service users needs are provided for without considering their rights.The concept of risk is complex, making its assessment challenging. This is reflected in the different ideas and approaches to risk assessment as well as the intimation that we are moving to a risk dominated society. As a result, the attitudes and behaviours of such society are weighed in policy and practice in relation to service users with mental health issues whereby isolated incidents involving people with mental health issues become exaggerated to generate perceptions that such client group are inherently dangerous and need to be controlled and confided (Gould 2010). Undisputedly, it is a major challenge to get the right poise when making difficult risk decisions.On the other hand, risk assessments are needed to improve the boldness and reliability of decision making particularly where there may be concerns a bout an individuals capacity to make informed judgements. However, risk can never be eliminated altogether, and occasionally decisions will be made in good faith, on the best evidence available.As proposed by Stalker (2003) more studies are needed to address the complex nature of risk as well as positive-risk taking in regards to service users with mental health needs. This in addition to the need for research to include services users perspectives as well as other variables such as race and gender.In regards to older people, if as a social group they tend to be institutionally marginalised then it might be equally easy to depart the views of people with mental health problems who equally challenge societys assumptions of capability in regards to managing risk. Risk assessment is central to social work practice however it must not depersonalise the service user and merely identify them through a compilation of risk variables. Additionally the discourse around risk assessment needs to move from a concern about risk adversity to a probability of negative and positive risks. evenly antagonistic is the use of the term dangerousness to define vulnerable service users. Such language can impact on collaborative and partnership work between professionals and service users. Moreover, as put in Tew (2011) the ongoing rituals of risk assessment may impact further on service users sense of self and undermine their capability to manage risky situations. Also, as stated in Petch (2001) there will always be people in the community who pose risk, whether or not they suffer from mental health, and singling out or blaming a particular group of professionals will not change this.Thus, a risk assessment is made on a balance of probabilities rather than exact conclusions. While striving for uniformity within risk assessment is a move towards equity, flexibility is also important given the subjective contexts of risk and mental health needs. Peoples lives involve many ever-changi ng and interrelated variables which will always create some difficulty in balancing risk assessment. In the end, life cannot be without risk and risk-taking is part of the process that makes us who we are, complex beings.
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