Lock & Key

An introduction to mental health care for Social Work Degree and AMHP students 2020/21.

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About the Book


This book has been written to act as an introduction to the history of mental health care (and control) for Social Work Degree students and AMHP students. Looking at real-life case histories of patients who were detained at an asylum in Warwick, “Lock & Key” compares, contrasts and discusses the treatment those patients received with the treatments they might receive today, and looks at theory and mental health law in relation to their experiences.


About the Author


Progressing quickly from Dip SW to Practice Assessor (PQSW) and gaining a wide variety of social work practical experience and theoretical knowledge, my specialism is Mental Health including Psychiatry of Old Age (I became an Approved Social Worker {now AMHP} in 2005).  I have gained experience in hospital social work and physical and sensory disability and built up the service of Liaison for Psychiatry of Old Age from scratch. I also had the opportunity to cover the Liaison service for adults aged 18-65 years.

During my time in Liaison, I became aware of the lack of understanding of the needs of older people with dementia when admitted to a General Hospital, which sometimes led to a poor standard of care; and the lack of knowledge and general fear pertaining to assessing and treating people at risk of suicide. Following consultation with my line manager and discussion with the managers at the Hospital, a colleague and I delivered a training programme aimed at these areas.  Because of the time pressures staff were under (shift work etc), training sessions were short (sometimes to coincide with sandwiches at break times) and done in small groups.  We encouraged staff to discuss specific difficulties they were encountering on the wards, and discussed these with managers at a liaison meeting held regularly at the Hospital.  Understanding did improve, and so did the service and treatment of patients.

Having left the Liaison service, I trained as an ASW (now AMHP), and was responsible for a large caseload covering a wide rural area. At the same time I gained the formal qualification and experience of Practice Assessor. I retired in 2010.

Typical case history above..

Having worked as an ASW (Approved Social Worker) I came across much misunderstanding, stigma and prejudice about mental illness generally; and working as a Practice Assessor I found that degree students arriving on placement (third year) were fearful and lacking in knowledge.  How to combat this took time and work.  As learners, we bring to a new subject some of society’s prejudices and inaccuracies, and that takes time and experience to counteract.  This book is primarily aimed at those final placement students, who are shortly to graduate, and students on the AMHP course.  The qualities and skills needed for mental health social workers and AMHPs are quite specialised.  People need to be empathic, organised, up-to-date and knowledgeable about mental health law and be able to communicate with and relate to people who are in crisis.  I hope that this book reflects some of the skills and knowledge needed.  Added to this is the reality that the law changes, as do theories about mental health.  Just about every term or phrase now used relating to mental health is controversial.  There is no ‘safe’ ground.  I hope that I have reflected this fact too.  At the ends of chapters 2 – 5 I have referred readers to an interesting article and hope that I have stimulated more questions in people’s minds. 

Working on a mental health team, either as a student or as a practitioner, requires reflective practice.  This book is an attempt to look at real people who are experiencing mental illness and dispel some of the myths around it.  We will look at how mental illness affects people’s daily lives and how treatment has changed over time.  To this end, I have included up-to-date reports (from newspapers etc) written by people living with mental illness, so that the reader can draw comparisons between ‘then’ and ‘now’.  There is also some discussion around the Mental Health Act 1983 and its provisions, (applies to England and Wales); a brief history of how the asylums came into being and early mental health law; suicide and parasuicide; inequality and mental health and distress; the possible aetiology of some mental illnesses (depression, bi-polar disorder, post-partum psychosis) and some theories around mental illness/distress.

Typical case history above…

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A very big thank you to Warwick Record Office, Phil Tromans, Jane Burnand, Sue Ainsworth, Dot Owen, Jo Mutlow, Judy Roblin, John Gallagher, Caroline Gallagher and Ian Smith.  It’s difficult to convey adequately my gratitude to Hannah Davies, Polly Rowe, and most of all to Phil Rowe, without whose help and support, this would have been impossible.

M. Rowe.