Within this assignment I will be discoursing, through a lens of hazard, work I carried out with Charles during our contact whilst on arrangement. In order to supply background to the instance I will get down by sketching my bureau scene and my ain duties. I will so supply a brief description of Charles and explicate the context of my bureaus engagement in his instance. I will so explicate the relevant legal model and policies act uponing his instance. I will sketch differing theoretical accounts of appraisal used to measure him and show my apprehension of hazard theoretical accounts and theory which relate to societal work. I will besides take to show my application of the theories and theoretical accounts in this scenario. I will foreground the hazards and possible hazards I was turn toing in Charles ‘ instance and critically analyse and measure the accomplishments used during the intercession and their effectivity. I will besides reflect on how my ain individuality impacted upon the work that was carried out, foregrounding quandaries stemming from my ain values and moralss and how these were overcome or addressed. As antecedently indicated I will get down by sketching the bureau involved and my ain duties.
The bureau is in statutory mental wellness and is a average security infirmary where persons have been detained under assorted subdivisions of the Mental Health Act 1983 ( DOH: 1983 ) . Persons with a forensic history may besides hold been detained at the installation after having a infirmary order via the condemnable justness system. The installation besides houses wrongdoers who have developed, or have displayed open symptoms of mental unwellness, such as paranoid schizophrenic disorder, whilst functioning a tutelary sentence and have been transferred to the installation for appraisal or to get down intervention. As such, due to the length of detainment a figure of patients require societal work aid.
My duties, when covering straight with Charles as an inmate, were to help with a assortment of societal work issues. These ranged from lodging affairs, benefit entitlement, obtaining information through interviews for approaching Tribunal and Border Agency Hearings and to see and program for aftercare agreements upon discharge. I besides worked as portion of a wider squad within the installation where my input could be used to measure Charles mental presentation and associated hazards. This on-going appraisal could be used to inform squad believing when sing future attention planning and any possible hazards posed and demonstrates a focal point on the installations drive to “ Regularly proctor, re-assess, and manage hazard to persons, households, carers, groups and communities ” in line with the National Occupational Standards for Social Work ( GSCC, 2002: 4.12.3 ) .
The function was progressively of import when Charles applied for a Tribunal Hearing with the purpose of being discharged from the installation back into the community. A referral to a community mental wellness squad was to be arranged and suited adjustment and appropriate degrees of support sourced. It would besides be of import to intercede with bureaus supplying eventual aftercare on an on-going footing so that hazards could go on to be managed and the installation was able to stay actively involved in Charles attention in the community. Before the hazards involved in Charles instance can be explored in greater item I will foremost supply some background to Charles ‘ instance and the ground for the installations engagement.
Charles is a white male in his early mid-thirtiess who has been resident in the UK for over 5 old ages, holding settled here from another state. Charles suffered from a mental unwellness and was charged with aggravated burglary and attempted slaying after assailing a member of the public and trying to coerce entry to the victim ‘s belongings. Whilst in detention expecting sentence at that place was concern for his mental province which led to the engagement of the bureau and his transportation to the installation for appraisal and intervention. Charles has since been diagnosed and treated for paranoid schizophrenic disorder and responded good to medicine, doing a good recovery. Bradley ( 2009 ) provinces in the instance of mental unwellness:
“ the anti-social behavior is straight related to or driven by facets of mental upset. In this instance, effectual intervention of the mental upset would be probably to cut down the hazard of farther anti-social behavior ” ( Bradley, 2009: p17 ) .
As such the bureau supports his conditional discharge into the community sing his unwellness to be under control and Charles to be low hazard to the public – hazard to the public being a cardinal facet in White Documents such as Modernising Mental Health Services ( DOH:1998 ) used to inform authorities mental wellness policies such as Journey to Recovery ( DOH:2001 ) . The instance for conditional discharge is complex due to the nature of the offense and Charles ‘ current in-migration position as The Ministry of Justice and the Borders Agency are presently taking stairss to behave Charles. Due to this all clinical and societal work planning has to be hazard focused in order to confirm and supply grounds for a successful entreaty to stay in the UK.
Charles had been found non guilty of the charges by pleading insanity as per subdivision 5 of the Criminal Procedure ( Insanity ) Act 1964. Therefore he was considered by the tribunal
“ aˆ¦unfit to plead, but to hold done the act or made the skip of which they are accused, the tribunal may do an order under this subdivision ” ( Jones, 2008: p216 ) .
The tribunal made Charles capable to Mental Health Act 1983 ( DOH:1983 ) sections 37 “ powers of tribunals to order infirmary admittance and care ” and 41, “ power of higher tribunals to curtail discharge from infirmary ” ( Jones, 2009: p2 ) . To critically analyze this class of action, the condemnable justness system, by holding Charles was exhibiting symptoms of a mental unwellness and condemning suitably and puting him in the installation, can be said to hold already begun to turn to immediate and future hazards posed. The tribunals segmenting prevented Charles from presenting a hazard to other inmates and to himself, whilst guarding against the hazard of isolation an undiagnosed and untreated unwellness may hold subjected him to in detention.
Upon appraisal by the Responsible Clinician, Charles was diagnosed with paranoid schizophrenic disorder. Charles was non considered to hold capacity to decline intervention under subdivision 58 of the Mental Capacity Act 2005 ( DOH: 2005 ) , and began a class of medicine to alleviate the symptoms and cut down his immediate hazard. Further to this, in a state of affairs where a sectional in-patient garbages medication the installation has the power to enforce intervention without consent, nevertheless, MacLaughlin ( 2001 ) states “ Under current statute law nonvoluntary intervention can merely be given when person is an in-patient ” . This means that in order to cut down and understate the hazard posed by an single agony from mental unwellness, they must be an in-patient to have nonvoluntary intervention or actively consent to intervention in the community.
To this terminal the clinical squad were merely prepared to back up a conditional discharge whereby intervention could be continued in the community in line with the Mental Health ( Patient in the Community ) Act 1995 which states certain mental patients are “ to be obligatorily monitored in the community after discharge ” ( cited in Tovey, 2007: p145 ) . Further to this Doel states “ The protection of one person, whether kid or grownup, may imply a limitation of their rights to act as they choose or it may curtail others ” ( 2005: p200 ) .
Following the determination to back up a conditional discharge I conducted a figure of interviews within the remit of my societal work function to garner grounds for a Social Work Report the extroverted Tribunal Hearing. These face to confront interviews, utilizing a narrative attack to data aggregation ( Maclean, 2008: p109 ) , were conducted to set up how Charles saw his hereafter in the community, but besides had the double intent of foregrounding any possible hazards to enable consideration to inform how these could be managed. By taking his positions into history this demonstrates how I worked in partnership with Charles. Tovey ( 2007 ) provinces:
“ There is now, more than of all time before, a professional and governmental realization that societal workers need to work with clients in an empowering and inclusive manner ” ( 2007: p160 ) ,
Therefore treatments were inclusive and empowered Charles to inform me of his adjustment and location penchants, and besides how he saw his future chances in relation to instruction or employment. In his reappraisal into mental wellness and the condemnable justness system Bradley ( 2009 ) included findings of a 2007 study by HM Inspectorate of Prisons which found that:
“ Poor conformity by patients with resettlement and intervention governments resulted in possible re-offending. In some instances, no engagement by patients in their relocation planning, intensifying conformity issues and entree to allow services increased hazard to practicians and the wider community ” ( HMIP: 2007 ) .
By working in partnership and in a individual centred mode with Charles it could be said that future hazards were already being addressed.
To critically analyze my attack and to get down to associate our contact to put on the line appraisal theoretical accounts and theories, my initial attack demonstrates I was following a clinical attack to appraisal and concentrating on possible hazards and menaces to Charles mental wellness, and non the actuarial hazard he himself posed.
“ In a context of forensic psychiatric pattern and the condemnable justness system, involvement in the issues of dangerousness focal points on hazard appraisal – in the sense of injury to the populace ” Fernando et Al ( 1998: p75 ) ,
a position which echoes authorities policy in relation to mental wellness. Therefore, in order to measure future hazard posed by Charles the usage of specific psychological appraisal tools to foretell force such as the Historical, Clinical and Risk Management Scales ( HCR-20 ) and Health of the Nation Outcome Scales ( HoNOS ) could be researched in order to be cognizant of anticipations of future hazard and reoffending, instead than following a one dimensional attack to assessment ( cited in Gray, 2008: p384-7 ) . I recognised that in order to efficaciously measure hazard, both clinical and actuarial demand to be taken into consideration in order to derive a better penetration and more holistic attack to put on the line appraisal ( cited in Maclean, 2008: p130-2 ) .
I had addressed hazards to my ain safety when meeting with Charles by following the installations risk direction and the bar and direction of force policies. Interviews were conducted within a secure puting on a ward and should any state of affairs nowadays a menace to my personal safety I had a personal dismay which would alarm nursing staff. Further to this, subdivision 4.53 the Mental Health Act 1983 Code of Practice lineations that although patients should be seen on a one to one footing, if the worker feels it is a menace to their ain personal safety they can bespeak another professional to be present ( Cited in Jones, 2009: p30 ) . This demonstrates that I understood the nature of hazard to myself and its direction ; hence the same attack would necessitate to be employed when sing Charles ‘ hereafter in the community amongst the populace.
Stevenson and Parsloe see there to be three different types of hazard “ physical, societal and emotional ” ( cited in Doel, 2005: p199 ) , by following this attack and taking a more holistic attack to put on the line appraisal this increases the figure of possible hazards to see in Charles instance. Whilst the list is non thorough I considered these to be cardinal hazards in Charles instance: hazard to self, hazard to others, hazard of exposure and societal isolation, hazard to victim and hazard of backsliding. By sing these and measuring the related hazards I could see risk direction schemes to undertake the related issues. For illustration, as Charles is non a UK national and has a immensely decreased support web he is at hazard of societal isolation. By measuring this as a hazard programs can be considered to battle this issue and to help his colony into the community. An purpose of the authorities policy National Service Framework for Mental Health is to
“ aˆ¦ensure wellness and societal services promote mental wellness and cut down the favoritism and societal exclusion associated with mental wellness jobs ” ( DOH:1999 ) .
These issues could hold been addressed by actively sourcing, and working in partnership with bureaus that could help Charles colony into the community, and to help Charles in prosecuting in educational or recreational activities. For illustration, when carry oning an interview Charles shared that he is a Jehovah Witness. This is one avenue that could be explored to enable him to pattern his faith, engage with others of the same belief system and organize appropriate relationships with equals. Engagement in the community of his pick could besides instil a sense of belonging to the country he may be placed in.
To accomplish this, there were a assortment of accomplishments employed to transport out the interviews, hazard appraisal and informations aggregation. For the intent of showing these accomplishments I have chosen to reflect on hearing and entering accomplishments. Recording and listening accomplishments were paramount in order to accurately document the interviews. The information collected had to be used for more than one intent – after each meeting it was a clinical policy that the consequences of any contact was documented on the in-house computing machine system. This allowed other professionals accessing Charles notes to be cognizant of the ground for the interview, the results and of any future action to be taken. It besides provided an chance to measure Charles mental province at that minute and to flag any concerns, for illustration if he was exhibiting any irrational beliefs. In order to set up this careful consideration had to be given to what was being said. This had to be done from a professional position and to reflect events accurately, forbearing from including personal sentiment or doing premises.
There were a figure of challenges to entering information. The interviews I conducted were for the most portion semi-structured. By critically analyzing this attack I can see that this sometimes made it hard to enter everything that was discussed accurately. By taking notes I felt this distracted my ability to listen efficaciously to Charles responses. I found that after the interview was ended I would so hold to pass clip make fulling in any spaces whilst it was still fresh in my head. Should I be approached by another patient I was working with to discourse their instance when go forthing the unit, this could impact my ability to reflect on the interview accurately. The dangers of this being that something of import may be missed. Therefore a scheme was adopted where I would stay in the interview room undisturbed after the meeting to finish my notes whilst the interview was still fresh in my head.
Similarly, in line with Smale and Tuson ‘s ( 1993 ) Questioning Model, as the purpose was sometimes to garner specific information for a study this led to the meeting fulfilling my ain docket and became a barrier to turn toing wider issues Charles may hold had ( cited in Maclean, 2008: p113 ) . By reflecting on this I could see that, despite a thrust to work in partnership with Charles, I was sometimes actively commanding interviews to fulfill clinical docket, whereby the consequences could be used to perchance curtail Charles in the hereafter. Despite a thrust to “ Balance the rights and duties of the persons, households, carers, groups and communities with associated hazard ” ( GSCC, 2002: 4.12.2 ) , it was clear that Charles ‘ rights were secondary to put on the line, and that the legal and policy model in this country of mental wellness were efficaciously in control. I reflected that this caused me a grade of personal struggle, which I had to accept, as although I understood the badness of the offense, my emotional response as a private person was to experience sympathy as such a high degree of microscopic invasion which would go on indefinitely in the community for many old ages. I could n’t alter this – I simply had to run within the model of the intercession.
My individuality and values and moralss were continually challenged during the clip I worked with Charles. Initially, due to the nature of the installation and the offenses that had been committed by the wrongdoers detained at that place, I was missing in assurance and fixated on the offense that he had committed and worried for my ain safety. My simplistic position of offense and penalty was challenged and it was merely through exposure that I began to develop a deeper apprehension and to see past the offense and to the individual. It became clear that I had preconceived thoughts about what to anticipate and had made opinions about people. It was merely by hearing personal narratives and the alone fortunes that I began to to the full prosecute in the work I was set abouting and to actively back up the persons, instead than merely put to death a societal work map. The quandary being that my ain professional rawness, and my ain personal positions on how to pull off hazards, could go forth me unfastened to use by seasoned wrongdoers and my deficiency of cognition of relevant jurisprudence and policy addition danger of non offering the right counsel and offer hope where there was none. These obstructions were overcome by deriving direct experience on arrangement and from detecting other professionals put to deathing their functions.
To associate this to Kolb ‘s ( 1984 ) Experiential Learning Theory, the experiences informed my apprehension and enabled me to develop an appropriate manner of brooding societal work pattern ( Maclean, 200: p88-9 ) . This has increased my assurance in my ability to use myself to other societal work service user groups efficaciously and cemented the demand for continued contemplation and on traveling personal analysis. This demonstrates how the intercession and designation of hazard became more effectual over clip as my working relationship with Charles developed.
As the instance is still on-going the hazard direction has non yet been to the full executed, necessitating Charles to be in the community before these can be put into action. My engagement has, nevertheless, ensured that issues of hazard have been identified and the clinical squad are cognizant of possible stairss that can be taken to understate these on Charles eventual discharge. Therefore, due to my rawness at the start of the intercession I do non experience that could hold done much otherwise, but due to this experience feel that I can now near similar state of affairss in a more direct and proactive manner now I have increased cognition and a better apprehension of the issues of hazard that need to be addressed. Similarly, I have a more in-depth apprehension of what services I am able to offer as an employee.
In decision, I have outlined Charles ‘ instance, the bureaus engagement and the work I carried out, I have explained some of the relevant legal and policy determining the instance and how this is used to turn to issues of hazard. I have provided illustrations of hazard appraisal and direction and my application of these, foregrounding the issues of hazard as I saw them. I have reflected on my ain accomplishments used during the intercession and how these could be improved. I have reflected on the results of the intercession up to its current phase and the ethical and personal individuality issues at drama during the intercession and how these were overcome.