Question:

history of mental ill health. Iman and Zara help each other in their daily lives.  However, Zara has started to be very anxious and confused. Staff at the college where Iman attends have noticed that Iman is sometimes very dirty and unkempt. The staff also think that he is looking thinner than he used to.  One day, Iman appears with a cut above his eye. When he is asked about this he says ‘I’ve been a naught boy’.  The College staff also discover that Iman is sometimes absent from College as he says that Zara locks him in his bedroom.

Critically discuss what interventions would be appropriate with Zara and Iman, ensuring you address relevant law and policy.  Include values and issues in relation to anti oppressive practice where this is appropriate.  Address all the questions in relation to each part of this case study.

Part A

• What issues does a social worker need to consider when working with Iman and with Zara?
• How does law and policy inform social work interventions with Zara and with Iman? Ensure you consider Zara’s role as a carer in your response.
• What approach should a social worker take in working with Zara and with Iman?

PART B

After a safeguarding enquiry, Iman moved away from his sister and now lives in a residential home.  Iman was assessed as lacking mental capacity to consent to the move but it was deemed to be in his best interest. Iman is unhappy in his new accommodation and wants to move back to live with his sister in the house he is familiar with.

• What issues need to be considered in working with Iman?
• How does the law inform any interventions with Iman?

Part C

 Zara’s mental health seemed to improve after Iman moved away, but it is now starting to deteriorate and Zara has been threatening neighbours and throwing rocks at trains as they passed by the end of her garden.  Neighbours have called the local authority as they are worried about Zara’s safety and the safety of others.

• What issues need to be considered in working with Zara?
• How does the law inform any interventions with Zara?

 Answer:

Part A

Question 1

Mental Health Act, 2007 deals with the laws pertaining to people suffering from mental disability about their care and treatment. It applies to individuals above or of the age of 16. Part 1 Chapter 1, Section 1(2) of the Act defines the term ‘mental disorder’. According to the section, mental disorder means any kind of disability or disorder of the mind. Again, Part 1 Chapter 1, Section 2 of the Act defines the term ‘learning disability (Dorn et al. 2013). According to the section, learning disability means a condition where a person has a partial or arrested development of his mind, which means there has been a significant arrest of his intelligence and social functioning. In this case, Iman and Zara are people suffering from learning disability and mental disability respectively (Huesch, Ostbye and Michener 2016). The Act lays down the provision, which is considered by the social workers in dealing with them. In dealing with these people, a social worker should give them the freedom of making their own decisions until and unless it it proved that, they suffer from impairment. Information provided to the people with disability in such a manner so that it becomes easy for them to understand the format and take a decision. If a situation arises where these people cannot take a decision, the social workers should take a decision, which must be in their best interest. The social workers often appoint trusted people for the people with impairment to take decisions for them in the future (Sommers et al. 2013).

Question 2

The Care Act, 2014 provides provisions as to the safeguarding of the carers and against neglect and harm towards the adult. A carer can any day witness neglect or abuse whether intentional or unintentional from the adult or a carer may also cause intentional or unintentional harm or neglect to the adult. Section 9 of the Care Act provides the provisions as to the assessment of an adult’s need for care and support (Blumenthal, Abrams and Nuzum 2015). The agencies that provide safeguard to the adults must act swiftly towards the neglect and harm reported by the adult. There must be sufficient support, advocacy, access to criminal justice, specialist expertise and all the the agencies must be committed enough to work together towards the well-being and safeguarding if the adult. The agencies cannot safeguard the adults alone. They do it with the help of local authorities, police, NHS and other organizations safeguarding against neglect and abuse. The local authorities take steps for safeguarding the adults as they get information about their neglect (Croft and Parish 2013). Applying this rule in case of Iman and Zara, where Zara is the carer and Iman is the adult, Iman is provided safeguards in accordance with the provisions of Section 9 of the Act. Iman was the adult taking care of Zara but Zara used to cause him harm and neglect whether it is intentional or unintentional. Therefore, Iman can be taken away from Zara because she ill treats Iman can causing harm and neglect to him.

Question 3

The social worker should always consider that the person with disability is treated with care and attention. The decisions the workers they take on their behalf must be towards the utmost importance for their benefit. Social workers are people working towards enhancing and maintain the quality of life of the people with disabilities (Saper 2015). They provide support to the disabled people, their family, the community through their work. Their work includes counseling, planning, program design, management and even development of policy advocacy and research. They focus on improving the life of individual, family carer, adult and community needs and strengths and work together to provide people the life they want. They take a holistic approach that includes systematic and individual factors. Their work revolves around families, adults, children, career, groups and communities (Rogers and Pilgrim 2014). The various approaches taken by them includes:

1. Assessment which includes;

• Risk assessment such as abuse and family violence
• Functioning, capacity and development assessment
• Strength based psychosocial assessment.

1. Capacity building which includes:

• Working with mainstream services to increase awareness
• Enhancing the capacity of the families or individuals to steer health and welfare system and get information
• Educating and engaging with local communities, organizations to deal with the people with disability in a better way.

1. Case management and service coordination

• Assessing resources
• Coordinating supports
• Service brokerage

1. Planning
2. Advocacy
3. Mediation and conflict

The social workers even expertise in certain psychosocial aspects. They are;

• Mental health which includes carer issues
• Impact of disability
• Abuse, neglect and violence
• Inappropriate accommodation and homelessness
• Resolving traumatic crisis and experiences

Socio-legal issues and ethical decision making, like advanced health directives, enduring power of attorneys, end-of-life decision-making, and withdrawal of life support systems (Gough 2016).

Part B

Question 1

Iman is an adult suffering from learning disability. When he shifted to a different house from her sister he was suspected of having mental disability. But later he did not want to stay alone so he wanted to shift back to her sister. Iman said he would be happy to be with his sister that’s why wanted to go back. In taking the decision the local authorities must consider his criteria and take an decision in his best interest.  The issues that should be considered is that the social workers should take the decision in the best interest of the Iman. If Iman is not happy and the he is capable enough to take the decision by himself to go back to his sister the social workers should take steps towards it. According to the law every person has the right to take their own decisions. The local authorities must take decisions in the best interest of the adults even if he feels that he capable of taking a decision. The local authorities carry out supported decisions where the person lacks capability (Golightley 2014).

Question 2

The Care Act provides various provisions as to protection of adults with disability. Section 9-13 of the Care Act 2014 lays down the rules as to assessment of adults.  Section 11 of the Act lays down the rules as to Refusal of Assessment. Under this section if an adult refuses to carry out assessments the local authorities will be comply with it and not carry out assessment subject to certain exceptions. If the local authorities feel that the adult has incapacity to carry out the decision and that carrying out assessment would be fir the best of interest of the adult he will carry out the assessment in the best of his interest. The local authorities will also carry out assessment in situations where he feels that the adult is experiencing or is at risk of abuse and neglect. Under section 12 of the Act the local authorities in dealing with the assessment must consult with persons who have expertise in the matter (Johns 2014). The assessment carried by the authorities must be done in a specified proper and appropriate manner for the best interest of the adult. This Section also provisions as to assessment towards carer. The Section also lays down that the local authorities are to give written record of his assessment to the adult to whom the assessment relates to and also to the person who the adult wants the authority to give the copy of the written report too. The same provisions are also laid down for the carers. A reference to an assessment is also provided by the local authority. Section 13 of the Act lays down provisions as to eligibility criteria. Where the local authorities take the decisions it must take into considerations the eligibility criteria’s. Where one of the criteria’s are fulfilled the authorities are to take the decision for the adults in the best of his interest.

The Judge declined R (SG) v London Borough of Haringey the decision because the decision was taken before the commencement of the Care Act and after coming under the purview of the Act they are to be provided eligibility. The claimant was a asylum seeker and not provided accommodation on the basis of the social care functions (Pilgrim 2014).

Part 3

Question 1

The issue that is to be considered in dealing with Zara is that she is a carer and is suffering from mental illness. After Iman left her mental health started improving at the beginning but later it started detoriating. She started throwing stones at the neighbors and trains, which made her neighbors, make complain to the local authorities. The issue here is that Zara suffers from mental incapacity. She can’t take a decision properly so the local authorities must intervene into the matter and take a decision in the best interest of Zara. The local authorities must consider the fact that she suffers from mental ill health (Frazier 2016).

Question 2

The carer previously did not have any legal right as to get support even when there were local authorities could give them support at their own discretion. The carer can receive assessment under the Care Act 2014. Section 9-13 provides the rules as to the assessment of carer. The ocal authorities while taking in consideration of the condition of Zara must take a decision, which is in best of interest of Zara. The authorities must look into the situation and then decide whether the carer needs support or not.  Under the Act the local authorities must intervene in to the matter between the carer and adult and provide them support irrespective of the fact that they are in need of it. the local authorities will consider what the carer needs in their day to day life. Issues such as whether a carer is in need of the assessment, wants to work or study, or wants to carry on the assessment more socially are to be considered and then a decision is reached by the local authorities at the best of their interest. Where an individual lacks capacity the local authorities must consider the situation, make them involved in the decision as far as possible, and take a decision in the best of their interest. Section 12 of the Act determines that the local authorities must consult the people with expertise in the particular area and take a decision. Section 13 says that a written record is also provided to the carer of the decision taken and provides the eligibility criteria (Payne 2014).

In a case study of Luke Davey, 39, who is quadriplegic and has cerebral palsy brought a judicial review against the decision of the Oxfordshire Council for not abiding by the rules laid down under the Act. The Council breached the statutory duty of well-being under the Act and the duty wherein the Council did not meet the eligible needs set out in Section 18 of the Act. It was first legal decision that was taken in the High Court in the year 2015. The Council was given an order to bear all the expenses of the current package of Davey until the case runs (Kadushin and Harkness 2014).

References:

Blumenthal, D., Abrams, M. and Nuzum, R., 2015. The affordable care act at 5 years. New England Journal of Medicine, 372(25), pp.2451-2458.

Croft, B. and Parish, S.L., 2013. Care integration in the Patient Protection and Affordable Care Act: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 40(4), pp.258-263.

Dorn, S., Isaacs, J., Minton, S., Huber, E., Johnson, P., Buettgens, M., Wheaton, L., Act, A.C., Landey, A. and Wulff, C., 2013. Overlapping Eligibility and Enrollment: Human Services and Health Programs Under the Affordable Care Act. Washington, DC: Prepared by the Urban Institute for the Office of the Assistant Secretary for Planning and Evaluation [ASPE], Department of Health and Human Services [HHS].

Frazier, L.A., 2016. More than the Affordable Care Act: Topics and Themes in Health Policy Research. Policy Studies Journal, 44(S1), pp.S70-S97.

Golightley, M., 2014. Social work and mental health. Learning Matters.

Gough, M., 2016. Mental Health and Mental Capacity Law for Social Workers: An Introduction, Simon Godefroy. British Journal of Social Work, p.bcw034.

Huesch, M., Ostbye, T. and Michener, J.L., 2016. The Affordable Care Act, State Policies and Demand for Primary Care Physicians. CESR-Schaeffer Working Paper, (2016-010).

Johns, R., 2014. Using the law in social work. Learning Matters.

Kadushin, A. and Harkness, D., 2014. Supervision in social work. Columbia University Press.

Payne, M., 2014. Modern social work theory. Palgrave Macmillan.

Pilgrim, D., 2014. Key concepts in mental health. Sage.

Rogers, A. and Pilgrim, D., 2014. A sociology of mental health and illness. McGraw-Hill Education (UK).

Saper, C.B., 2015. The Affordable Care Act… or Is It?. Annals of neurology, 78(2), pp.155-157.

Sommers, B.D., Buchmueller, T., Decker, S.L., Carey, C. and Kronick, R., 2013. The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health affairs, 32(1), pp.165-174.