Mental health social work and the use of supervision registers for patients at risk.

Abstract

The widespread media coverage of lapses in community care for people with severe mental illness was instrumental in 1994 to the setting up of supervision registers of patients at risk as part of the Department of Health's Ten Point Plan (Health Service Guidelines (94)5). This study emerged from a recognition among social workers and the Association of Directors of Social Services that the development of such registers had broad implications for the future of mental health social work practice within the framework of the Care Programme Approach. The focus of the study was the impact of the supervision registers on social work practice. A questionnaire was completed by 137 social workers about clients on their caseload, who were also on the supervision registers. The sample of 235 clients was drawn from 27 different local authorities. This paper describes the nature and circumstances of those being placed on supervision registers under the three separate categories: risk of serious violence, suicide and severe self-neglect. Social workers' opinions were explored regarding the usefulness and effectiveness of the registers, together with their experience of inter-disciplinary relationships in the supervision registers' process.