Psychiatric social work in primary care: A pilot scheme in one inner-city practice

Abstract

Psychiatric social workers (PSWs) in a mainstream psychiatric hospital offered a service to a small number of clients referred by two local GPs, for 12 months. Although the service was initially stylised as ‘counselling’, a wider approach seemed likely to be needed for an inner-city clientele whose needs often exceed the usual remit of psychology, counselling, psychotherapy or community nursing. As well as giving PS W students a novel training opportunity, the scheme aimed to establish which aspects of PSW practice GPs valued most, and what balance of practical versus interpersonal intervention was most helpful to clients. GPs valued the comprehensiveness of the PSWs' assessments, particularly of mental state, personal history, and problem formulation. Clients and GPs also valued the broad based nature of the interventions, which combined direct therapeutic work (support, advice, counselling, problem solving) with practical help (for finances, housing, social outlets, occupation, education). Shared burden of care and open collaboration between GPs and PSWs were also features of the service. Two substantial, general practice-based PSW services have subsequently been funded. This innovation might act as a template for similar developments, nationally.

Key Words:

• Psychiatric social work
• inner-city general practice
• assessment
• systemic approach