Features of psychiatric relevance at an experimental multi-disciplinary social casework centre in Edinburgh

Abstract

A brief description of an experimental multidisciplinary social casework centre in Edinburgh where a psychiatrist is part of the team is presented, as well as findings of psychiatric relevance about clients who used the Centre over a three-month period. The Centre, set up in anticipation of the Social Work Scotland (1968) Act, serves a defined geographical area of Edinburgh with a disproportionate share of the city's social and medico-psychological problems. One hundred and twenty eight new clients made contact with the centre over the three month period studied with self-referrals accounting for 39% of the cohort. Females, people aged 20–44 years, married or divorced people and people from social class 5 were significantly over-represented by comparison with the population from which the clients were drawn. Most clients ad had previous (and sometimes multiple) contacts with social work and other agencies, and 22% of the clients had made previous contacts with psychiatric hospitals. Slightly more than one third of the clients came from families without a parent or spouse, and the possible future consequences of this on their children are discussed. No significant association was found between recent change of accommodation and emotional or psychological problems among clients. Forty percent of the clients were found by the social workers to have psychological, marital or interpersonal problems. The psychiatrist, marriage guidance counsellors and mental health officers received 42% of the allocated cases, with the psychiatrist receiving the largest number of individual allocations. Clients mainly asked for material help even when psychological or emotional problems were found to be present by social workers. Clients allocated to the psychiatrist differed from those of other workers only with respect to social class distribution. The clients allocated to the psychiatrist are described and the role of the psychiatrist at the Centre discussed. The study underlines the widespread emotional disorder often associated with social problems and the need for psychiatric guidance to social workers. The findings from the Centre will be of interest to a variety of workers as it is the first multi-disciplinary social casework centre, where a psychiatrist is part of the team that includes social workers from statutory departments and voluntary organisations.