Working in Partnership – Mental Health Services

Probation officers were sometimes faced with the need to write a social background report alongside the provision of a psychiatric report by a psychiatrist. My first experience of this has stayed vividly in my mind. Having met and made an initial assessment of the client I arranged to take the young man to the psychiatrist who was to do the psychiatric report. It is worth mentioning this, because it subsequently became clear that this practice was not always adopted. I claim no credit for it – I was simply doing what my manager advised was necessary. It immediately established me as a colleague with the psychiatrist who could share perceptions about the client – as opposed to a process where probation officer and psychiatrist never met but simply communicated by letter (or presumably e mail these days). The physical presentation of the psychiatrist was extraordinary. Before seeing the client, he invited me to discuss what I had learned about him so far and whilst talking to me, merged himself into a very messy ripe pear – I use the term ‘merge’ advisedly- it did not seem like eating! For all his eccentricity, this meeting established him in my mind as someone with a real interest in understanding the client and as someone who treated me not as an overgrown student (which I probably was) but as a professional colleague with my own territory of expertise.

Later experience with and observation of relationships with psychiatrists has underpinned the value of this early experience. So much can go wrong when the probation officer or social worker does not own where their expertise lies and therefore fail to approach psychiatric assessments with a critical eye. If this is only achieved by keeping the psychiatrist at a distance, opportunities for a constructive argument that can tease out the best management strategy for a case are missed.

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Working in Partnership – Schools 2

On the other hand, schools could lose sight of the strength of influence that they could bring to bear on troubled youngsters. What they often needed was not more criticism but reassurance and support. It was little use holding meetings about young people in trouble at some office miles away from the school, and summoning school staff to them. There seemed to be some logic for meetings to decide whether to prosecute or caution young people to be held at police stations where cases could be most efficiently processed, but in practice this would result either in the school being absent or being represented by one individual who would know nothing about each young person. We had much greater success when meetings were held in the schools, so that we presented ourselves as seeking to help the school with the young person, and could talk with the staff (released from the classroom for just a few minutes) who knew each young person . This also tended to result in a discussion in which the school teacher was as focussed on finding a solution as the other agencies and feeling less need to defend the school from unrealistic demands. Teachers could be creative about how to integrate responses to offending by the young person with the day to day contact they already had with youngster and family. They could also be a real help in judging when more formal court led responses to an offence were needed.

This also was in line with some evidence that positive outcomes for young people in schools were associated not with specialist intervention by a seconded social worker with the young person, but with the provision of that social work support to the school staff. (I can’t now find the reference for this but will look further!)

Putting schools at the centre of meetings rather than police or social work opened the door to a productive dynamic – away from a bunch of professional do gooders telling the school how to do its job, towards a more shared problem solving discussion where specialists could offer support to the school.

Working in Partnership – Schools 1

Work as a practitioner probation officer or social worker brought me into contact with a whole range of other organisations: schools, youth services, employment services, psychiatric services, occupational therapy services, physiotherapy, clergy, health visitors etc. Each have their own characteristic organisational cultures that need to be understood in order to work effectively in partnership (beyond the alliances that develop ‘naturally’ through personal compatibility of outlook.)

Schools were crucial when working with young offenders. There was a common refrain whenever you tried to seek some individual attention and flexibility for a youngster in trouble – ‘we’re not social workers’! It took some time for me to grow up enough to take this seriously and stop seeing it as evidence of a lack of compassion and understanding. And it needed to be taken seriously – schools operated under considerable pressures (not a modern invention!). Maintaining control of the pupils was a tough job and the inability to do so was threatening both to the career and the mental well being of young teachers. Parents would be putting pressure on the school to get rid of ‘trouble makers’ so that attention could be given to those who wanted an education.

Working in Partnership – Voluntary Organisations 3

This work also taught me about the financial structures, disciplines and governance in organisations. In the statutory sector at that time, a practitioner and a first line manager needed to understand precious little about the way in which services were funded and financially managed. You could not work in the voluntary sector in such innocence however. All too often, in a voluntary organisation, it was up to the staff to generate the income that paid their own salaries. This experience proved valuable as statutory organisations very soon began to grapple with the consequences of cash limited budgets and ‘cost centre’ management structures. Whereas for many, this requirement to engage with the financial realities of an organisation was a troublesome diversion from the true client centred purpose of the organisation, I felt differently. Just as in the case of the young man in therapy whose therapist took no interest in how he raised the money to pay for the sessions, only to find that the young man was stealing it, I did not think that the work of helping people could be done in some kind of therapeutic bubble, and this was equally true for organisations. There is no such think as unconditional help, free from all constraints – love is always offered within the boundaries of a concrete reality, and has to be negotiated in the context of that reality. True love is ‘good enough’ love not some fantasy of perfection.

Working in Partnership – Voluntary Organisations 2

By and large, some thirty five years ago, voluntary organisations sprang from an urge to improve the world rather than from a desire to establish a successful and profitable organisation; the desire to be successful was of course there, but secondary – to change the world was the primary goal. The first step for such local groups would often be to attract sufficient funding to pay for a worker who could take responsibility for delivering the organisation’s objectives. Such a worker would have to be able to deal with the internal demands of running an organisation – finance, data, administration, property – as well as the ability to provide an appropriate public service. The more the worker became the public face of the organisation, the more existed the potential for tension to grow between them and the managing committee of volunteers. Workers would easily become frustrated with their committees who would rapidly understand less about the business than the worker, and could often unconsciously sigh with relief that they had a worker to look after the day to day realities of the organisation, allowing them to take a back seat / become remote.

This meant that as an outsider to the organisation, you were sometimes working with someone who felt alone and unsupported, and sometimes with a worker who behaved as if their management committee didn’t exist (as indeed sometimes it did not!), becoming maverick or arrogant at worst, or creative but vulnerable at best. At FWA, where part of our role was the development of a lively and healthy voluntary sector in the new city, our energies were frequently devoted to building the strength of the management committees and supporting a constructive relationship between committee and their worker.

Working in Partnership – Voluntary Organisations 1

The world has moved on somewhat since my days as a practitioner since by and large in those days, voluntary sector organisations were adding to the work of statutory organisations, rather than replacing them or being contracted to deliver their objectives. They had a greater freedom to operate in the ways they thought fit but they were vulnerable to feeling ignored or used by statutory organisations. It was always striking to me for example, that when faced with an alcoholic, a probation officer’s immediate assumption would often be that the individual should be referred to a voluntary sector alcohol project for treatment. This would not be affected by the thought that the probation officer had received two years’ professional training including training in addiction problems, whilst the alcohol project was staffed by well meaning volunteers or perhaps an untrained lead worker.

Mind you, I am using the term ‘voluntary organisations’ loosely here. In my time in Milton Keynes, there was a very obvious divide between larger often national voluntary organisations – such as NSPCC or the FWA for whom I had been working – and the locally managed groups that depended on local management committees and often no more than a couple of staff.

Working in Partnership – Child Care Services 2

It was common to see people taking ‘tribal’ positions in which other agencies were the object of criticism and negative feelings, but such positions were excuses to stay safely in the particular cultural world of one’s own agency – finding potential for positive partnership was needed. This need was dramatised at points of transition from one agency to another. Sadly, genuine partnership at these stages of life were all too rare. When a young offender reached the age of adult responsibility when probation would take over their management from Social Services, it was all too easy for conflict between agencies to occur, or for the client to be passed over with minimal communication. Genuinely shared work in making the transition from one agency to the other was unusual.

Problems such as this were of course by no means confined to the relationship between probation and child care services. Similar patterns of disfunctional work could be found both in work with other partners, such as mental health services, schools, prisons, benefits agencies etc., and in work within the probation service between different teams. Failures of communication are so endemic to child death enquiries, and so resistant to change over many years of such enquiries, that the issue demands more detailed attention. Unpicking some of the organisational dynamics, as I am attempting in this section, is part of the story but I will return to this subject in a less agency specific way