Best Practice in Emergency Mental Health Social Work: On Using Good Judgement

My shift on the emergency social work duty desk began at 10.00, one Saturday morning, with a typically terse instruction from the social work team manager: ‘There’s a mentally ill woman on the seventh floor of Olympic House threatening to throw herself and her baby off the balcony. Go and sort it out’. The implicit faith in my abilities was flattering, but the potential implications of the situation were almost numbing. In this chapter I will use this case example as the basis for examining some of the key issues and dilemmas in performing critical best practice (CBP) in mental health social work. Particular consideration is given to the core ethical dilemmas and tensions that arise from having the intention to work as a critical practitioner in empowering ways which promote service user’s choice and self-determination, while being a statutory social worker operating within mental health legislation with the duties and obligations to protect vulnerable people that this brings. What in this context does it mean to use good judgement? In exploring ways to use good judgement and work with the tensions between care and control I will suggest that the discursive use of language (Potter & Wethereil, 1987) is important in all aspects of social work, and particularly in achieving CBP in ‘emergency’ mental health work.