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MENTAL HEALTH OFFICER SERVICES: STRUCTURES AND SUPPORTS
ANNEX 1: MHO FOCUS GROUP FORMAT
Focus Group Vignette
Duncan is a young man aged 20, living at home with his mother and younger brother and sister. His mother has had concerns about her son's behaviour over the last two years. He has attended the first year of a university course, but has returned home and become increasingly withdrawn and socially isolated. Duncan is suspicious of his mother's attempts to seek medical help and has been physically threatening towards her. He was referred to a consultant psychiatrist by his GP last year, and she has made a diagnosis of schizophrenia. Over the last 2 months Duncan's aggression towards family members has become more pronounced. He will not accept help from his GP and has rejected both prescribed medication and the offer of an admission to the local psychiatric hospital.
Questions then follow on in a similar time sequence to a possible admission process
- If GP / Consultant/other professional looking for MHO advice in relation to Duncan how would they access it? Are you often asked for advice?
- If GP / Consultant/other professional requesting assessment by MHO how would they access MHO for s.24 or s.18? Different in daytime or out of hours? System effective?
- Would this be different if Duncan was in hospital (s.24/ s.26/ s.18)? Different in daytime or out of hours? System effective?
- If a Social Circumstance Report was required for Duncan how would this be allocated? Would there be constraints on its completion?
- Would these arrangements be different if Duncan was an older person/ had contact with criminal justice services/ had children / was already a social work service user?
- If Duncan lived in your area what do you think his experience of continuity of the MHO service in relation to his care (e.g. one MHO seeing through process? Several MHOs? Links between OOH and daytime services?)? Quality of communication between the different parts of the service that might be involved? Procedures?
- Where would you go for advice in relation to Duncan (manager, mentor, other MHOs, specialist worker, other professionals)? How accessible/ knowledgeable are your sources of advice?
- If you were asked to make e.g. a s.18 application for Duncan how would you access legal advice? Would you be represented at a s.18 hearing? How? Access to and quality of legal advice, information and support? Procedures for accessing legal support?
- What contact would you expect to have with the Sheriff Court? Quality of communication with court and its staff? Procedures governing these?
- How would you access other individuals who might be involved in Duncan's care e.g. CPNs, OTs, support workers, housing, police? Are there procedures for doing this?
- How would information about your involvement with Duncan be collected by your service?
- If there was a disagreement between yourself and other professionals about the use of the MH(S)A for Duncan e.g. consultant, GP how might this be resolved? Are there formal mechanisms to do this?
- How would your work with Duncan be supervised? Who would do this? Frequency and quality of supervision?
- Who would you be accountable to in relation to your work with Duncan and his family?
- How would your work with Duncan be affected by where you work in Social Work Services (e.g. CMHT/ criminal justice/hospital/children and families)?
- If Duncan and his family lived in a remote location in your area, would this affect the way in which the MHO service is provided?*
- What kinds of workload management issues might arise in relation to taking on the role of MHO in this case? How do you balance our MHO work with other responsibilities? Do these responsibilities sometimes conflict?
- How do you ensure that you are sufficiently up to date with changes in practice (legislation, policy, developments in treatment) to provide a good service to Duncan and his family? (Sufficient opportunities to practice/ opportunities to update through training/ discussion groups/ written information/informal meetings?)
- Are there other ways in which you think your practice competence could be supported?
Thinking back to the start of this scenario, what if, instead, Duncan had a learning disability, so that you were required to work with the AWIA? Now you are being asked to advise on and possibly apply for a guardianship under the Act………….
- How well prepared do you feel to carry out MHO functions under the AWIA? (Training received, access to advice, information, procedures)?
- Would the issues already raised about MHO structures and supports in relation to MH(S)A be any different in this new scenario?
* Remote and rural group only
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