Institute of Psychiatry report by James Souttar

Standing out Positioning the Institute of Psychiatry as a centre of excellence for mental health social work Report and Recommendations

15 December 2008 Shirley Ayres Consulting Ltd 6 Sidney Road Beckenham Kent br3 4qa

Contents

Context What we set out to do

3 3

What we achieved Who we think your stakeholders are

3 5

Your ‘product’

Marketing challenges

A general lack of awareness But enormous potential

7 7

Action plan Awareness building

9 9

Generating interest Stimulating desire

10 10

Translating into action

Issues for the future

‘New Ways of Working’ Changes to the Mental Health Act

11 11

‘Every Child Matters’

Appendix 1: Competitor Analysis

Kingston University Tavistock Centre / University of East London

13 14

Bournemouth University

Appendix 2: Survey Analysis

Employers’ Survey Who the participants were

16 16

The survey Former Students’ Survey

17 21

Who the participants were The survey

21 21

Appendix 3: Focus Group Employment context

27 27

Motivation for enrolling on the programme Value for employers

27 28

Appendix 4: Telephone conversations Mental Health Trust / Local Authority Training Manager

29 29

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Context

What we set out to do We undertook to carry out a combination of web based surveys with employers and former students, a focus group with current students and telephone interviews with selected employers in order to be able to make recommendations for how the Institute positions its o¬er in mental health social work education and training. The questions we explored were: ‣ What is the market? ‣ How aware are employers of the MSc course? ‣ What do former students think? ‣ Who else o¬ers similar programmes? ‣ How e¬ective is the current marketing strategy and materials? ‣ What is the business case? What we achieved In summary, the answers we found to these questions were: What is the market? Employers recognise a need for advanced practitioners who are capable of making decisions that draw on the evidence base, who have the knowledge and confidence to work as part of a multidisciplinary team with mental health professionals, and who will be able to exercise the ‘responsible clinician’ role within their organisations. What is not well understood is how education at the ‘Advanced Award’ level can meet this need. Awareness of the AMHP, on the other hand, is high – and most of the training resources allocated in this area are focused in this direction. How aware are employers of the MSc course? Amongst employers in London and the South East, awareness of the Institute’s MSc in Mental Health Social Work with Children and Adults is patchy, to say the least. A few authorities are familiar with the programme, understand its value and recommend it as part of their training and development activities. For most employers, however, awareness is limited. What do former students think? Those former students who participated in our survey have, without exception, found the programme immensely valuable and enriching for their practice. They have also seen significant benefits for service users. However, there is a general sense of disappointment that their completion of the programme has been recognised by employers in tangible ways (promotion, salary, increased responsibility or use of their research capability). Those who have been able

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to use the programme to further their career development have done so by changing jobs rather than by promotion within their organisations. The picture painted by former and current students shows the immense value of the programme in delivering beneficial outcomes for practitioners, organisations and, above all, service users. However the lack of understanding and appreciation by management prevents the full realisation of those benefits. Employers need practical help to integrate the idea of the ‘advanced practitioner’ into their recruitment, retention and advancement strategies. They also need help to understand how advanced practitioners enable them to meet statutory requirements and deliver better services. Who else o¬ers similar programmes? One of the repeated messages from former and current students is that the Institute’s MSc programme is unique. Looking at competitive o¬erings from Kingston, the Tavistock Centre / University of East London and Bournemouth University, only Kingston presents their programme in comparative terms (and there is much that can be learned from their approach). Part of the problem here is that the structure of the educational framework gives a false sense of similarity between programmes. The fact that Kingston, UEL and Bournemouth have masters courses in mental health social work that are accredited at ‘Advanced Award’ level by the GSCC does not mean that they are by any means identical. And it will be important in the Institute’s marketing to bring out the di¬erences in its programme. How e¬ective is the current marketing strategy and materials? The Institute’s materials adequately represent the nature and content of the MSc course. They are held back, to a degree, by the somewhat pedestrian nature of the King’s College website and the limitations of its content management system, which presents content in a ‘flat’ and relatively unstructured way (comparison with Kingston shows how much more e¬ectively the message could be communicated in this medium). We have not, however, reviewed the Institute’s current materials because the findings of our research suggest that there is the need, and opportunity, to adopt a more closely targeted approach to communicating the Institute’s o¬er – and its value to students and employers. What is the business case? Currently the majority of students are, and have been, self-funding. Where students are supported by employers, the level of funding and support varies. Furthermore a percentage of students are agency sta¬, rather than permanent employees, and this would seem to be an increasing trend. In the current, worsening, economic climate this state of a¬airs must represent a threat. Prospective students may well decide not to pursue higher education, to take advantage of fully funded options instead, or to defer the course until they are in a more secure financial situation to undertake it. This trend is greatly exacerbated by the generally poor level of employer awareness, commitment or willingness to recognise and reward graduates appropriately.

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It is therefore absolutely essential that the Institute address employer awareness and issues, and seeks to enlist greater support for students. Former and prospective students can act as advocates in this process, but will need to be armed with a business case to take to their employers which shows the benefits to the organisation of their participation. We believe the Institute must establish this business case, make it to employers directly and equip prospective students to make it to their managers and learning and development departments. This report sets out our recommendations to the Institute for marketing its o¬er in the area of mental health social work to employers, prospective students and other stakeholders – an o¬er that includes the MSc in Mental Health Social Work with Children and Adults, the E-learning modules and the National CPD Conference for Mental Health Social Workers. Who we think your stakeholders are Employers Local Authorities Mental Health Trusts Criminal Justice Service Youth Justice Board Charities who employ social workers in providing therapeutic services CAFCASS Influencers Service Users and Carers Primary Care Trusts Sector Skills Councils GSCC, SCIE, CSCI etc. Our research focused specifically on employers, and within the employers group on Local Authorities and Mental Health Trusts. Most of those we communicated with worked within Local Authorities. However many had dual responsibilities within a Local Authority and Trust setting. And it is our perception that, in these cases, responsibility for training for mental health social workers is switching from Local Authorities to Mental Health Trusts. The implications of this are significant, since awareness of social work – and understanding of the social care model – is poor within Mental Health Trust training and development departments, and their emphasis is towards continuing professional development for nurses and clinicians. Indeed, on the basis of our research, it is not too much to say that the role of mental health social workers within a Trust setting is not clear, their value not well understood, and their functions in at least some cases indistinguishable from clinicians.

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Your ‘product’

On the basis of our research, we believe your product: ‣ is not the course ‣ is not the range of programmes and events you o¬er ‣ but is:

The advanced practitioner That is, the social work professional who is equipped with the expertise and knowledge to carry out the role of Consultant Social Worker as a result of successfully completing the MSc in Mental Health Social Work for Adults and Children. What we mean by the advanced practitioner here is a social worker with: ‣ ‣ ‣ ‣

greater competence and confidence leadership and decision making capacity evidence based practice reflective and reflexive skills

‘We define an advanced practitioner as someone “who has an explicit and articulated knowledge base that is theory-driven and research based and who can create new forms of social work knowledge that inform and shape policies and practice”.’ Martin Webber and Jack Nathan, Aiming Higher: Advanced Practitioners and the Future of Social Work, April 2007.

Our research identifies that there is (the perception of ) a policy vacuum with regards to the role and function of mental health social workers. As a respected, credible independent stakeholder in social care within the UK, we believe the Institute is in a position to exercise a leadership role – and advocacy for the idea of the advanced practitioner provides this opportunity. We believe you can ‘own’ this concept, on the basis of: ‣ ‣ ‣ ‣ ‣

your reputation and credentials your experience educating advanced practitioners your independent voice your engagement with employers your ‘future minded’ attitudes

Furthermore the concept of the advanced practitioner seems to respond exactly to employer needs (especially in the wake of the ‘Baby P’ inquiry) and evokes a resonance with employers in a way that the specific parts of your o¬er (the MSc course, the e-learning modules and the conference) do not. We believe that the concept of the advanced practitioner will enable you to get in front of the key policy influencers in employer organisations and be given a hearing – and that this represents the most productive use of your marketing e¬ort and resources. This point is developed in the form of a proposed Marketing Strategy in the following pages.

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Marketing challenges

A general lack of awareness Half the people who responded to our employers survey were not aware of the MSc course. Furthermore, the channels by which such information reaches individual social workers, particularly in Mental Health Trusts, were identified as a problem. The information is currently there for those who look for it, but interested parties need to already have a reasonable understanding of the Post Qualifying framework, and its vocabulary, before a search in – for instance, Google – can return relevant links. Even then, the Institute’s o¬er is not necessarily high up in the rankings (and only becomes so when the search terms are very specific). The fundamental marketing challenge, therefore, must be to increase awareness of the value of the advanced practitioner – and the ways in which the Institute can help organisations in developing sta¬ to this level – within the sector. But enormous potential The Institute’s database of previous Conference attendees reveals a fascinating picture. Stripped of academics and private individuals (identified by their email addresses), it can be seen to reveal the respective degree of awareness of the Institute’s o¬er in employer organisations by the number of delegates they sent. organisation

no. of attendees

Local Authorities Camden Hounslow Brent Southwark Hammersmith & Fulham Hillingdon Kensington & Chelsea Bromley Greenwich Lewisham Kingston Westminster Ealing Tower Hamlets Merton Wandsworth Richmond Hackney Croydon

12 10 9 8 7 4 4 4 4 4 4 3 3 2 2 2 1 1 1

Kent County Council Hampshire County Council

27 4

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Surrey County Council Medway Council East Sussex County Council

3 2 1

Mental Health Trusts South London and Maudsley South West London and St George’s East London Oxleas Camden and Islington West London Brent, Enfiend and Haringey Tavistock and Portman Sussex Partnership Hampshire Partnership West Hampshire East Kent

34 10 7 6 5 5 4 3 2 1 1 1

We suggest that the paradigm here is Kent County Council, which not only has an extraordinary degree of awareness of the Institute’s o¬er (witnessed by the sheer number of delegates) but also has contracted to send one person on the MSc course per year, and which provides a model to be aimed at in communicating with other organisations.

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Action plan

Our recommendations for promoting the Institute’s o¬er (MSc course, e-learning modules and the annual Conference) fall into the classic marketing stages of awareness, interest, desire and action. Awareness building The o¬er needs to be represented by a better web presence: one that promotes the idea of the advanced practitioner as well as providing information about the components of the o¬er and how they support this idea. The web presence should consist of material on the King’s College website, plus additional linked resources. These could include research and positioning papers about the ‘advanced practitioner’, resources for students and employers (such as an ‘employer’s guide’) and, if at all possible, a virtual community forum focused on the subject. We believe that the Institute should consider a separate website, with its own domain (advancedpractitioner.org and advancedpractitioner.org.uk are currently available), where a case can be set out and these additional resources housed. We believe the Institute should also contemplate the production of a printed ‘Employer’s Guide’, setting out in marketing language a summary of the benefits of this approach for employer organisations, providing a template for integrating the MSc modules into workforce development, o¬ering case studies of organisations (such as Kent County Council and SLAM) who have taken this approach, including frequently asked questions and answers, and showing how the IoP o¬er e¬ectively delivers to this agenda. This could be provided to the key contacts identified in each of the designated target organisations, all conference attendees and other selected stakeholders. We believe the Institute should attempt to get as much press coverage for the idea of the advanced practitioner as possible, in particular cultivating contacts at The Guardian and Community Care. The opportunity to present this idea at sector wide events (conferences, seminars etc.) should also be explored. The 2009 Conference might also be themed around the idea of the advanced practitioner and the employment issues that arise from it. We also believe the Institute should aim to convert five London Local Authorities and five Trusts into ‘Kents’ over the next twelve months. On the basis of our figures, these should be: Camden, Hounslow, Brent, Southwark and Hammersmith & Fulham Local Authorities and South London and Maudsley, South West London and St George’s, East London, Oxleas and Camden and Islington Mental Health Trusts. If each one of these agreed to send one person to the MSc course per year, this would almost fill the current course capacity. Furthermore, if the remaining Local Authorities and Trusts on our list (i.e. where there is at least one contact who has some familiarity with the Institute’s o¬ering in this area) can be built up towards a level of awareness and participation equivalent to, say, Camden or South West London and St George’s – which should be achievable – there will be scope to bring on further ‘Kents’ for the future.

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Based on these figures, there should be more than su~cient potential for future student recruitment from the London and South East region over the next five years for the Institute not to have to engage in nationwide awareness building or marketing e¬orts. Despite this, it seems likely that focused marketing e¬ort within the region will almost certainly yield greater awareness, by word of mouth, across the UK. Generating interest We recommend that there should be one-to-one meetings with key contacts with a view to making a presentation of the ‘advanced practitioner’ (and the way in which the Institute can help organisations realise the value of this) to key policy makers within the organisation. The outcome of these meetings should also be the development of a channel of communication, through the key contact (or others that are suggested), through which information about the MSc course, the elearning modules and the Conference can be made available to mental health social workers in the organisation. We also recommend that the Institute carry out a survey of recruitment agencies specialising in placing social workers to determine their CPD support for agency workers and establish a channel of communication. Stimulating desire To create an appetite for the MSc Course, and the e-learning modules, we believe the Institute should take a radical step: to make the e-learning modules freely available over the web (in a form that does not involve any personal pedagogical input – such as assessment). The only requirement for participation would be a standard web registration, adding the applicant to a marketing database. We also think that this unassessed version of the e-learning modules should be promoted to employers for inclusion into their learning and development strategy. The idea behind this is to encourage individuals and organisations to become familiar with the course with minimal commitment – with a view to stimulating participants to sign up for the ‘full’ version of the e-learning modules or, indeed, the MSc course. Translating into action For organisations that are willing to make an ongoing commitment to the course, we think the Institute should be able to provide an element of consultancy and mentoring, to help the organisation through the processes of integrating the programmes into its sta¬ development framework, and finding ways of appropriately recognising and rewarding the role of advanced practitioner.

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Issues for the future

We identified three policy drivers that will have a significant bearing on the roles and responsibilities of mental health social workers in the coming decade. ‘New Ways of Working’ “New Ways of Working (NWW) is about changing the practice of the current workforce; developing extended roles beyond the scope of current professional practice and bringing in new people to the workforce in new roles, at assistant and practitioner levels. There is no single model for NWW; it is simply about making the best use of the skills in the workforce to meet need in a cost e¬ective way. “‘Social work brings something distinctive to mental health. Articulating it is more di~cult. It is a constellation of values, commitment to social justice and partnership with users and carers. Social workers practised social inclusion before the term had been invented. Above all in mental health, it challenges the traditional medical model which does not fully acknowledge the patient or client as best informed about their needs.’ “The challenge for social work identified in New Ways of Working: ‣ to maintain and nurture the social work identity to help with recruitment; ‣ to promote the leadership expectations of social workers; ‣ to encourage the expectation among both sta¬ and employers that research will ‣ form an integral part of future employment arrangements for social workers; ‣ For employers to put in place a career pathway or progression not only to ‣ help raise the profile of the social worker profession, but also to help with ‣ retention; and ‣ to actively embrace new opportunities.” Changes to the Mental Health Act A briefing paper for the Association of Directors of Adult Social Services states: “The CSIP National Workforce Programme and the Mental Health Act Implementation team are working closely together to assist and support service providers in their preparations to become Mental Health Act ready in 2008. The changes to the 1983 Act principally introduce two significant workforce flexibilities: 1. The introduction of the Approved Mental Health Professional. In principle, this allows non social work mental health professionals to enter into the role having undergone the thorough training and approval mechanisms in place currently for ASW's, which will be modified to meet the requirements of the AMHP role. In principle, there should be little change to the role, with the Government firmly committed to AMHPs continuing in the tradition of ASW's in terms of values and practice, aiming for the least restrictive approach to the use of compulsion

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and being able to act in an independent position able to challenge the views of other mental health professionals. The AMHP role will extend the duties and responsibilities of ASWs once the amendments are introduced. It is anticipated that, subject to transitional training arrangements, all current ASWs will become AMHPs and non social work professionals will enter the role gradually over time, subject to service needs and skill mix requirements. 2. The introduction of the Approved Clinician (including Responsible Clinicians). This role replaces the existing RMO role established with the 1983 Act. This workforce change is highly significant, o¬ering the flexibility to Mental Health Trusts to consider options for lead clinicians of service users subject to powers of compulsion, to be appointed from non medical professionals. These include psychologists, social workers, nurses and occupational therapists. Issues around professional background will be taken on the needs of service users, treatments being admixture or o¬ered to patients, and workforce issues within localities. Responsible Clinicians will have to demonstrate a set of competences laid down in Regulations, and be formally trained, approved and re-approved. All existing RMO’s, once receiving further training will be approved for three years from the date of the Implementation of the amended Act in 2008. ‘Every Child Matters’ From the ‘Every Child Matters’ website: “Every Child Matters: Change for Children is a new approach to the well-being of children and young people from birth to age 19. “The Government's aim is for every child, whatever their background or their circumstances, to have the support they need to: ‣ Be healthy ‣ Stay safe ‣ Enjoy and achieve ‣ Make a positive contribution ‣ Achieve economic well-being “This means that the organisations involved with providing services to children – from hospitals and schools, to police and voluntary groups – will be teaming up in new ways, sharing information and working together, to protect children and young people from harm and help them achieve what they want in life. Children and young people will have far more say about issues that a¬ect them as individuals and collectively.” “Over the next few years, every local authority will be working with its partners, through children's trusts, to find out what works best for children and young people in its area and act on it. They will need to involve children and young people in this process, and when inspectors assess how local areas are doing, they will listen especially to the views of children and young people themselves.”

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Appendix 1: Competitor Analysis

We identified three other universities as o¬ering a comparable programme at Advanced level: Kingston University, The Tavistock Centre/University of East London and Bournemouth University. We also understand that City University is currently seeking accreditation for their programme. Middlesex University, whilst it doesn’t o¬er a programme at Advanced Award level, should be considered a competitor due to the strength of its School of Health and Social Sciences, its close links with employers and focus on work based learning. We looked at marketing messages for the programmes from each of the three principal competitors as these were projected on their websites (being the most accessible form of communication, and one identified by students as a primary information source). Our focus was on the extent to which these institutions anticipated employer needs and employment issues, as well as the degree to which their materials understood and ‘sold’ the advanced practitioner, the value of research literacy and capability, and the importance of evidence based practice. Kingston University

Kingston’s programme details sit three relatively intuitive ‘clicks’ beneath the University’s home page (home > postgraduate study > social work > professional mental health studies). This is an excellent website: it has a simple, straightforward information architecture, it is well designed, clearly signposted and well written. The course text covers o¬ all of the main keywords that inquirers may be searching on: ‘Post-Qualifying’ ‘Higher Specialist’ and ‘Advanced level’, for example.

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In particular the paragraph: “The focus at Higher Specialist level is on the knowledge and skills needed to make complex judgements and discharge high levels of responsibility for the co-ordination of social support and the management of risk. The focus at Advanced level is on the knowledge and skills required for professional leadership and improvement of services.” This shows that Kingston clearly understands the employer perspective and goes some steps towards the ‘advanced practitioner’ perspective. The way that ancillary information (e.g. ‘who teaches the course’, ‘related courses’ and ‘facilities’) and calls to action (e.g. ‘apply for this course’) are pulled out alongside the course description is also excellent. Kingston clearly sets the standard for promoting an Advanced Award programme – and this also shows in their Google rankings. Tavistock Centre / University of East London

Is not quite so impressive or intuitive. Do searchers know the di¬erence between the Tavistock Centre and the Tavistock Institute? Or that this programme is o¬ered by the former, which is now dressed in NHS corporate style as a Trust, rather than the latter which looks at first glance much more like a research institution?

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Interested parties must go to either the University of East London or the Tavistock and Portman NHS Mental Health Trust websites. On the UEL site it is reached in five rather convoluted clicks (home > programmes > postgraduate > S > Social Work: Integrative Programme MA/Higher Specialist and Advanced Awards: view summary) and on the Tavistock and Portman site in three (home > training > By course code > M26). From this, it can be seen that ‘findability’ is an issue. In contrast to Kingston’s excellent website, both of these sites are about as dismal as academic websites can get – poorly written, poorly designed low energy a¬airs that do nothing to inspire confidence or stimulate interest. Bournemouth University

Bournemouth is something of a star amongst the ‘new’, post 1992 universities, having established a considerable reputation in a relatively short time. In the social care sector, it is well known for its Post Qualifying programmes, and its Advanced level courses attempt to build on that success. The programme is reached in a not totally straightforward and overly lengthy manner from the university home page (home > academic schools > school of health and social care > postgraduate / post qualification courses > postgraduate courses > professional development mental health practice part-time). And whilst the design gives the impression of a clear, well organised site, the actual information is poorly written, confusing and thin. For instance, having reached the course description it is by no means clear –until the second paragraph – that the course is concerned with social work. And this is the only reference to social work or social workers (otherwise it talks about a generalised ‘practitioner’). Few would understand from this description that it is a requirement that the applicant be a qualified social worker.

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Appendix 2: Survey Analysis

Employers’ Survey We sent out invitations to participate in the survey to 71 individuals who were the designated PQ leads for their organisations (every local authority and mental health trust in London and some in Kent, Surrey, Sussex and Hampshire.) finding the appropriate contacts proved to be di~cult: in the event we hired a researcher to attempt to track them down. Skills for Care no longer make the list of London PQ leads publicly available and there are no other published sources. In the event we were able to find most of the leads on Adult Services but it proved far more di~cult to do so for Childrens’ Services. Mental health trusts have a di¬erent structure for these functions and we eventually identified that the person in each trust with the equivalent responsibility is the social care lead (a role that usually sits beneath the borough directors). Of the 71 invitations sent, 4 bounced (i.e. the email addresses were no longer recognised despite the information having been recently collected). Twelve people participated in the survey – representing an 18% response rate (20% is the average for surveys of this kind). One response came too late to be included here. Who the participants were Their job titles Deputy Director of Education and Training 1 Senior Training O~cer 1 Workforce Development Manager 1 Training and Workforce Development Manager 1 Mental Health and MCA Training Manager and AMHP Lead 1 Learning and Development O~cer 1 Learning and Development Manager – Adults and Mental Health 1 Acting Team Manager 1 Mental Health Practice Development Manager 1 Practice Learning Coordinator and PQ Lead for Adults Services 1 Not specified 1 Their organisations Local Authorities 8 Mental Health Trusts 1 Joint responsibility: Local Authority and Mental Health Trust 2 The fact that every single participant in the survey had a di¬erent job title (and some had more than one relevant title), as well as the di¬erent levels of seniority in the roles given, indicates the di¬erences between organisations. All but one of the participants was the designated PQ lead for their organisation. Two participants identified a dual responsibility to both a Local Authority and a Mental Health Trust, but it is our sense that this is actually more common (and that this may apply to some of the other participants who specified only one organisation).

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The survey The first two questions asked the participants’ names, organisations, contact details and job titles (Question 4 is also omitted). Since it was made clear that participation would be treated confidentially, no personal details are given. Question 3 Which service user group/s are you responsible for? Answer Options adults children and families both

Response % Response Count 60.0% 6 20.0% 2 20.0% 2 answered question 10 skipped question 1

Question 5 How important is mental health training for social workers in your organisation? Response PerAnswer options cent Response Count not a priority 0.0% 0 it can be useful 0.0% 0 we o¬er basic training 9.1% 1 it’s important 18.2% 2 it’s absolutely essential 72.7% 8 answered question 11 skipped question 0

Question 6 How aware are you of the mental health training provision on o¬er? Answer options I’ve not investigated it I know a little I’m reasonably aware I try to keep up with it I’m thoroughly familiar with it

Response % Response Count 0.0% 0 10.0% 1 10.0% 1 40.0% 4 40.0% 4 answered question 10 skipped question 1

Question 7 How familiar are you with the MSc in Mental Health Social Work with Children & Adults from the Institute of Psychiatry (part of King’s College London, University of London)? Answer Options I don’t know anything about it I’m vaguely familiar with it I’ve heard about it I’m reasonably familiar with it I know all about it

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Response % Response Count 30.0% 3 10.0% 1 30.0% 3 20.0% 2 10.0% 1 answered question 10 skipped question 1

Question 8 To what extent is your organization already engaged in training social workers in advanced mental health practice issues? Answer Options It’s not A little training takes place We are beginning to address this It’s been identified as a priority We’re doing it already

Response % Response Count 11.1% 1 11.1% 1 11.1% 1 11.1% 1 55.6% 5 answered question 9 skipped question 2

Question 9 Does your organization have a career grade for advanced social work practitioners/consultant social workers? These posts enable experienced practitioners to to engage in direct work with service users and provide professional leadership within the organization. Answer Options Response % Response Count Yes 50.0% 4 No 25.0% 2 We are exploring this development 25.0% 2 answered question 8 skipped question 3

Question 10 Do you have a framework for career progression that includes the Post Qualifying awards in Social Work? Answer options No, we don’t We’re working towards it Yes, we do

Response % Response Count 25.0% 2 12.5% 1 62.5% 5 answered question 8 skipped question 3

Question 11 Are Social Workers supported by your organisation to undertake Post Qualifying education and training?

Answer Options At specialist level At higher specialist level At advanced award level Are they given financial support? Are they given time off work?

Where it has been Where it is a identified in their departmental supervision and Response No priority appraisal Always Count 0 2 4 3 9 1 2 3 2 8 1 1 4 1 7 0 1 3 4 8 0 0 2 6 8 answered question 9 skipped question 2

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Question 12 Do you have a policy of buying places on post qualifying programmes each year? Answer options No No, but we plan to in the future Yes

Response % Response Count 12.5% 1 37.5% 3 50.0% 4 If yes, at what level? 5 answered question 8 skipped question 3

Question 13 Is your organisation working with other universities or training providers in the area of mental health training? Answer Options Response % Response Count No 0.0% 0 Yes 75.0% 6 at specialist level 0.0% 0 at higher specialist level 25.0% 2 at advanced award level 0.0% 0 With whom? (Middlesex, Brunel, LSBU, Canterbury Christchurch) 8 answered question 8 skipped question 3

Question 14 How important are these issues as priorities for your organisation?

Answer Options training social workers in mental health issues training unqualified social care sta¬ in mental health issues flexible short course training delivery of training via e-learning blended learning opportunities continuous sta¬ development post qualifying training to retain sta¬ recruitment of sta¬ with a post qualifying award the use of evidence based practice familiarity of sta¬ with research methods

something very not a we’re impor- imporpriority aiming for tant tant

Rating Average

Response Count

3.777778

3.444444

1 2 1 0 0

1 1 1 0 1

4 4 4 3 2

3 1 2 6 6

3 2.5 2.875 3.666667 3.555556

9 8 8 9 9

3.25

3.777778

2.888889

answered question skipped question

9 2

Question 15 Is e-learning a part of your organisation's learning and development strategy? Answer options Yes No

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Response % Response Count 77.8% 7 22.2% 2 answered question 9

Question 16 Are you aware that the Institute of Psychiatry o¬ers an e-learning module which develops skills in research methods and critical appraisal for social workers and allied professionals? This course is the e-learning version of a module of the MSc in Mental Health Social Work with Children & Adults. Students can progress to the full Masters degree and Advanced Award upon successful completion of this course. Answer options Yes No

Response % Response Count 33.3% 3 66.7% 6 answered question 9 skipped question 2

Question 17 Would you be interested in receiving further information about the e-learning modules? Response PerAnswer Options cent Response Count Yes 66.7% 6 No 33.3% 3 answered question 9 skipped question 2

Question 18 Other activities Answer options Are you aware that the Institute of Psychiatry organises the National Continuing Professional Development Conference for mental health social workers? This event brings together social care professionals, health practitioners, academics and researchers to share the latest developments in mental health social work research and practice. Would you be interested in receiving further information about the 2009 Conference?

Yes

Response Count

answered question skipped question

9 2

Question 19 Do you have any other thoughts and comments about mental health training for social workers? Responses “For my organisation it is important to think about joint work with mental health social workers and other mental health professionals working with parents. Our focus is on the children.” Senior Training O~cer, Local Authority Safeguarding Children Board c

“This survey does not reflect the complex funding arrangements associated with service integration. There are three levels Local authority employees funded by Social Care, Local Authority seconded sta¬ funded by Social Care and Trust employees who are social workers. I am responsible for the third group not 1 & 2. Sta¬ in the third group are fully entitled to funding and support from NHS London contractual arrangements.” Deputy Directory of Education and Training, Mental Health Trust c

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Former Students’ Survey We invited 42 former students (who had completed the MSc course between 2001 and 2008) to take part in the survey, using the Institute’s database. Ten of these invitations bounced. Of the remaining 32 students, 13 participated (representing a very significant response rate of 40%). Who the participants were Their job titles Learning and Development O~cer and Professional Development O~cer 1 Service Manager 2 Practice Manager 1 Acting Team Manager 1 Practice Supervisor 3 Senior Social Work Practitioner 4 Not specified 1 Their organisations Local Authorities 11 Mental Health Trusts 1 Other 1 The survey The first two questions asked the participants’ names, organisations, contact details and job titles. However, since it was made clear that participation would be treated in confidence we haven’t given any personal details here. Question 4 Which service user group/s are you responsible for? Answer options adults children and families both

Response % 75.0% 25.0% 0.0%

Response Count 9 3 0

answered question skipped question

12 1

Question 5 How did you find out about the programme originally? Answer Options From a colleague From a learning/development manager From the Internet Received the programme brochure At a conference/seminar/workshop From the Skills for Care PQ Directory From the GSCC (General Social Care Council) From a former student Other (from the press)

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Response % 27.3% 36.4% 9.1% 9.1% 9.1% 0.0% 0.0% 9.1%

Response Count 3 4 1 1 1 0 0 1 1 answered question 11 skipped question 2

Question 6 What motivated you to apply for the programme? Answers “Professional Development” “the challenge, recognition of existing skills and knowledge” “Personal achievement” “The Institute of Psychiatry had a very good reputation, two of my colleagues had completed the course in the past and it o¬ered me AASW as well as the Masters degree” “Personal development/Institue's reputation” “opportunity to study mental health social work further – needed further education to do job, enjoy academic challenge” “I wanted to undertake a course at post-grad level. I also wanted the opportunity to explore and analyse my own practice and consider the possibility of moving into an academic post once finished.” “To enhance my learning and experience research” “Wanted to do research” “Advanced Award in one go” “Challenge” “AASW incorporated into MSc – highly regarded institute”

Question 7 How important is mental health training for social workers in your organisation? Answer options not a priority it can be useful we o¬er basic training it’s important it’s absolutely essential

Response % 0.0% 0.0% 8.3%

Response Count 0 0 1

25.0% 66.7% answered question skipped question

3 8 12 1

Question 8 Did you receive financial support from your employer? Answer options No Yes Some

Response % 20.0% 80.0%

Response Count 2 8 5 answered question 10 skipped question 3

Question 9 Did your employer grant you study leave? Answer options No Yes Some

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Response % 0.0% 100.0%

Response Count 0 10 5 answered question 10 skipped question 3

Question 10 Did your employer pay your travel costs? Answer options No Yes

Response % Response Count 50.0% 6 50.0% 6 answered question 12 skipped question 1

Question 11 Does your employer have a framework for career progression that includes Post Qualifying awards in Social Work? Answer Options No, they don’t They’re working towards it Yes, they do

Response % Response Count 8.3% 1 16.7% 2 75.0% 9 answered question 12 skipped question 1

Question 12 What have been the major benefits for you of undertaking the programme? Answers “Personal development/career development now I manage practice.” “Thinking about individual work with clients (process).” “More research literate, more knowledge, more confidence, more respect from other professionals, have been asked to present my research many times, set up training, and fed into purchasing.” “The ability to take time out to concentrate on practice issues.” “Although I am still in the same post there have been definite benefits, these include;having a much greater knowledge of the evidence base of the work that I do and being able to access further research material quickly:” “1. knowledge and reflection re mental health social work 2. opened door to teaching opportunities.” “Consolidation of learning/sense of achievement.” “The psychodynamic psychotherapeutic input in year 1 was the jewel in the crown for me provided by Jack Nathan and I wish I could access support from him now. Also Martin Webber's incredible support for me in the research thesis process right up until the end. I have critical appraisal skills that I did not have before. finally the fantastic confidence I now have in myself to have obtained a Masters degree from KCL/IOP – I consider this prestigious.” “Confidence in my abilities.” “Raised my self esteem.” “Case consultation, understanding and using research studies, the research study that I completed, mental health in children and adolescents, Family therapy skills, CBT skills.”

Question 13 What have been the major benefits for your employer of you undertaking the programme? Answers “Improved leadership skills.” “I do not feel that my employer recognises any benefit.” “I am more research minded which benefits those I supervise.” “I am a more confident practitioner and have added research methods to my list of skills as well as a deeper understanding of Psychodynamic psychotherapy.”

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“Greater confidence in supervision/managing complex casework.” “1. more skilled worker 2. sta¬ retention 3. use skills in current post supporting others with academic work especially with raised level of amhp course. Also helps with selection of appropriate candidates.” “A more wider context of experience in respect of supervising students/social workers.” “Research and knowledge fed into my work with clients, and informed policy.” “Clarity of thought and evidence base.” “Improved and wider areas of knowledge.” “Highly knowledgeable and skilled sta¬ member who is managing others – a very valuable piece of research that has taken place in the borough re. lac mental health needs and access to services”

Question 14 How do you feel the programme is impacting on your own practice? Answers “Much more reflective practice/more knowledge in the area of mental health.” “In the ways I engage with clients.” “Better developed and clearer about decision making.” “More knowledge, more aware of evidence based practice, more aware of issues relating to my research topic, which inform my practice.” “It has given me confidence in considering holistic issues for service users.” “No longer practicing social worker; but helps with training issues as above; support, selection.” “Greater understanding of psychiatry.” “Psychodynamic approaches are more integrated into the way I work.” “Relating practice to theory more.” “I now o¬er training to colleagues, volunteers and sta¬ in my service area.” “Improved leadership and supervisory skills.”

Question 15 How do you feel the programme is impacting on other team members who you supervise/support? Answers “They have benefitted in helping them to analyse cases using psychoanalytical interpretations.” “It has improved the level of mental health knowledge and raised awareness within the team, which has encouraged individual members to undertake other training programmes.” “I have more knowledge.” “I have a much better understanding of research in terms of critical appraisal and this helps me discern so-called evidence based practice/care.” “Not sure.” “Has helped raise academic standards in preparation for amhp course. Some will curse me as I have turned them down, IoP MSc has helped me identify that they would struggle with amhp course.” “I o¬er consultations to students/colleagues who are currently undertaking assignments/research for di¬erent internal qualifications.” “Knock on e¬ects.” “Greater depth of knowledge base.” “As above – I supervise sta¬ and therefore am responsible for their knowledge/practice in this area.”

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Question 16 Have the results of your dissertation been publicised through: Answer options Writing for a professional publication? Presenting at an internal seminar? Presenting at an external seminar/conference? Other

Response % Response Count 10.0% 1 60.0% 6 10.0% 1 20.0% 2 answered question 10 skipped question 3

Question 17 Do you think that there has been any direct impact on service users as a result of you undertaking the programme? Answer options No Yes

Response %

Response Count

0.0% 100.0%

0 12

answered question skipped question

12 1

If yes, could you give us details? “Practice at the sdq’s which will be enforced soon and also findings formed part of working group re. how to address the mental health needs of lac in the borough.” “Research evidence indicated areas where it needed to be put into practice: specifically ensuring patients understand the ramifications of their legal status (Section).” “Making the right decisions for children.” “Better practice – myself and others.” “More awareness for professionals in respect of identifying suicidal behaviours in adolescents.” “I have altered my style and focus of intervention with a number of service users following the opportunities for reflection on practice o¬ered in the 1st year.” “I believe the course helped me think more analytically and critically. I think this has supported me in providing better care, although it is impossible to identify exact instances: too many factors are involved. I also think it has helped me support others in thinking more analytically and critically, challenging the status quo. I believe they will o¬er a better service to service users as a result.” “Di~cult to quantify but a sense that I have a better understanding of options available to individuals and can therefore o¬er better advice. Same applies I guess, to clients of those I supervise.” “Much enhanced skills and understanding of psychodynamic psychotherapy.” “I feel I am more competent and confident.” “My service – a service for young people aged between 12–25 – has been mainstreamed and highly acclaimed via ofsted and dh inspections, and by Young Minds. There are now 2 centres on either side of the borough which o¬er a range of services to young people, and the service is seen as the major transition service for 18+.” “I have used the cbt skills in my direct work and clients have commented positively about this.”

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Question 18 Have there been any changes in your career since undertaking the programme? Answer Options Promotion Changed jobs within the organisation Moved to another organisation Other (please specify)

Response % Response Count 45.5% 5 9.0% 1 0.0% 0 45.45% 5 answered question 6 skipped question 7 “Unfortunately not really – except higher expectations and greater workload with no extra pay.” “No, I have stayed where I am but intend to apply for a more senior position within the organisation very soon” “None.” “Promotion to management level.” “No.”

Question 19 What message would you like to give employers about the value of the programme? Answers “It has been a very invaluable experience that has not only benefitted me but my team and organisation as whole.” “Good mental health is the key to better social functioning and a sta¬ group that can recognise and intervene early with mental ill health issues can positively change outcomes for many children, young people and their families. We have a duty to do this, as recent events have proven.” “People who complete the program are going to be more competent and valuable assets.” “It is extremely valuable for mental health social workers and is worth supporting both financially and with time o¬ for study” “It’s worth the investment in terms of employee job satisfaction and direct benefit to service users. Possibly even leads to greater e~ciency because of increased understanding of psychiatry, it’s complexity and scope and potential.” “It has I think been very valuable for me and for the organisation, for the reasons above. However, it may in some senses be superceded by the new amhp course which in our area will o¬er the opportunity to build it to an ma. However, the amhp/ma will not o¬er the same reflective structured approach and space with alternative ways of considering mental health issues that was provided by the IoP MSc. Baby P shows us that the refiective space is vital, and the mistakes with Baby P are the kind of mistakes that could have been made in Adult Mental Health.” “It is extremely valuable in enhancing your own practice and being available to assist team members with their learning.” “Please encourage social workers to enlist, support them, and encourage them to disseminate what they have learnt. If possible pay their fees. Insist on them ring fencing their study leave.” “Valuable for developing workers professionalism.” “This programme will increase the confidence of sta¬ by giving them a rich knowledge base.” “This course is far more valuable in what you will get back through your sta¬ member/for your service than the relatively low level of financial and time support that you will need to o¬er – At a time where social work practice needs to become even more professional than it currently is. This course enables good practitioners to become leaders and this is the only way in my opinion that we will address issues re. poor social work practice and service delivery.”

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Appendix 3: Focus Group

On the 10th December 2008 we carried out a 45 minute focus group with nine current students (from both the first and second years) on the Institute’s MSc programme. The principal concern of the focus group was to find out how the course a¬ected students experience in the workplace: to what extent their employers had been willing to support them, how it was influencing their practice and what benefits their enhanced knowledge and skills had for their organisations. Employment context five students were self funding, one student was supported with study leave but with no funding and four received di¬erent levels of funding. The students’ employers were: ‣ Lambeth Child Protection (originally with Amicus) – funded ‣ Hertfordshire County Council Adoption Service – self funding ‣ Capita slam asw – self funding ‣ Reed Hackney camht – self funding ‣ Kent adults – funded ‣ Cambridgeshire camht – funded and fares paid ‣ Lambeth Adults Mental Health Trust – self funding ‣ Newham NHS Hospital (Stroke Unit) – Study Leave but no financial support ‣ NSPCC (Therapeutic Services) – half funding Motivation for enrolling on the programme “The course is an exemplar of joined up thinking.” “Need for more child protection managers to undertake the course.” “Cases are becoming more complex and I feel more confident about identifying the cases it is appreciate for me to work with and those that should be referred on to more specialist resources.” “Confident about making assessments and able to refer to other.” “Learning about evidence base – what does research tell us about what works?” “Limited career progression even with advanced award.” “Course has lived up to expectations – it is unique – links with both adults and children’s mental health in a multi-disciplinary environment.” “Negotiated to undertake advanced award as an incentive to become a permanent sta¬ member.” “No career pathways with my current employer but will enable me to apply for senior jobs.”

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“The programme has helped consolidate my knowledge and instilled a new level of knowledge which enables me to relate theory to practice, feel more confident in myself and my assessments and instil confidence in other social workers in the team. This is very important when working in a multi-professional environment.” “There is a problem at the moment with a great emphasis on management and meeting targets and less emphasis on improving professional practice. Should there be a requirement for managers to have a solid professional base before being promoted?” “Much more confident about making professional decisions and challenging decision made by colleagues from other professions.” “Has enabled me to make the links between research and practice.” “Complements and adds to both basic social work training and the ASW/PQ Award.” “Agencies – some will support sta¬ – di¬erent conditions depending upon how long you have worked with them – Reed/Amicus/Capita mentioned. Would it be useful to undertake a survey amongst agencies establishing the CPD support they provide?” Value for employers The value of research capability “More enlightened employers will support students and understand the benefits. There does not seem to be an understanding that the students are a really useful management resource and could be undertaking work- based research for their employers as part of the course.” “One key to engaging managers – what research question would you like answered in your department?” “Undertaking the programme will provide research orientated, reflective practitioners able to use research to underpin their professional values and have equal status with professional colleagues.” The value of reflective practitioners “Practice informed by an evidence base.” “Able to make the connections between children and adults mental health.”

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Appendix 4: Telephone conversations

Six of the employers who completed the survey questionnaire indicated that they would be willing to be interviewed over the telephone to explore some of these issues in greater detail. However, despite repeated attempts, it proved possible to speak to only one. Nonetheless this conversation made up for the lack of availability of other respondents by highlighting a number of issues of crucial importance to the project. Mental Health Trust / Local Authority Training Manager “I’m not aware of the course – and yes, it’s of great interest to us. We wouldn’t think of the Institute of Psychiatry as a place to look for something like this. Currently we have an agreement with Middlesex University for our mental health training and development.” [Higher Specialist level: amhp] “Most mental health social workers (in the Local Authority) are seconded to the Trust. They are cut o¬ from the usual social care channels of information – I’m one of only two people in the Trust who has access to the Local Authority network.” “The channels for learning and development information within the Trust are good, but the information is for nurses and clinicians – not for social workers. This is a cultural thing.” “Most Mental Health Trusts will have a Social Care Lead. We’re lucky to have a Social Inclusion Director who sits just below the Borough Directors. He convenes a quarterly meeting with them, where the Trusts social care policy is discussed. He also convenes meetings for social care sta¬ from across the Trust. Where he knows about something, he sends emails to them – but it’s a bit ad hoc.” “The problem comes from the fact that the GSCC – and the local SSD’s – seem to be muddled about what they want social workers to do. The GSCC told us we all had to do PQ; now they seem to be backpeddaling on it.” “Other professional groups get clear pathways for career advancement. But what do we want social workers to do? Social workers are the group who can get qualified and then do little else for the rest of their career.” “The ASWs are a very skilled bunch – it’s a pity that hasn’t been taken further.” “The lack of a professional framework has a big e¬ect – some social workers are motivated to take their professional development further but others rightly wonder ‘what’s in it for me?’ And in most cases, there isn’t anything in it for them.” “We do have senior practitioner roles, but they are not well developed. We particularly need more consultative roles for social workers.”

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