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Social Work - Adult Services
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Lecture notes SWK3004 (full semester) Social work in Adult services
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SWK3004 05OCT2020Mental health policy & SWK practice in NI
History of mental health services in the UK
3 Main phases
● Pre 1845 - no formal system of care
● 1845-1961 Lunatics Act & County Asylum Act -
institutional care was dominant
● 1961 - present Development of community care
○ 1950s/60s -
○ 1960s/70s - at this time there was a lot of
pressure on public spending
○ 1980s - Political shift to New Right, mixed
economy of care and an increase of private care
homes
○ 1990s - Community care, evidence based
practice, recovery approach
○ 2010s - has been impacted by a number of
legal developments and economic factors
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,SWK3004 05OCT2020
Institutionalism
● Recognised in the 1950s - people who spend
long times in institutional care can develop problems
such as becoming withdrawn, lacking motivation,
and even not wanting to leave the institutional
environment
● See Wing & Brown (1961, 1970)
History of mental services in NI
● People first - development of community care in
NI during the 1990
○ Needs led services
● Current policy set by Dept of Health
○ The medical model remains strong NI
Mental health policy & the Troubles (3 phases)
1. At the start of the conflict there was major concerns
ab0ut impacts on mental health
2.Research then suggested that the Troubles would
not have a major impact
○ Quotes on slide from (Lyons, 1971, 1972)
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, SWK3004 05OCT2020
○ See also (Cairns & Wilson 1984) (Curran
1988)
3.After the Good Friday agreement there was
acceptance that the Troubles had caused trauma,
and that these issues had to be addressed (e.g. high
suicide rates compared to the rest of UK & Ireland
○ There were several reports published which
highlighted the scale of the problem in NI (e.g.
‘Living with the trauma of the Troubles’ (1998)
○ See also Ferry et al (2008) estimated the
number of people in NI suffering from trauma or
stress disorders associated with the conflict
○ Leavey et al (2009) mental health problems
30 % higher than rest of UK
○ Ni Study of health & stress
The Bamford Review of Mental Health & learning
disability
● Commissioned by DHSSPS in 2002, to provide
an in depth review
● The main themes of the review included
a. Community care should be a priority
b.The need to mainstream services
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