1. A View of the Role of the Counsellor and the Social Worker on the City South West Multi-Disciplinary Team. City South West Sector Profile The population of City South West is 23,591. Activity figures show that 28% of all admissions and 25% of outpatients in the South Lee Catchment area are generated by this sector. There are 19 Electoral Districts. 13 of those have maximum scores out of a possible 16 in the SAHRU Deprivation Index (Irish Index of Deprivation). This scale takes into account the following 5 indicators, unemployment, low social class, no car, type of housing tenure and overcrowding. (Kelly & Teljeur, 2004) The area is also part of the RAPID Programme (Revitalising Areas by Planning, Investment and Development). Key Findings on Mental Health and Well Being It is known that deprivation affects mental health. The Health Research Board statistics (2004) show a correlation between lower socio- economic groups and higher admission rates to hospital. The Slan Report (2009) found that people with higher incomes, higher education and in paid employment report higher levels of positive mental health. It also found that reported levels of depression are higher among urban residents, medical card- holders, lower income groups, divorced/separated people and unemployed people. A similar pattern emerges for generalised anxiety disorder. This is more prevalent among women in lower social class groups, urban residents, medical card holders, divorced/separated people and those with lower levels of education and income. The Importance of Mental Health Services for this area These findings highlight the importance of making available, accessible, community based services. These are especially important for those in more socially disadvantaged and low income positions. These services would ideally offer a range of medical, psychological and social therapies relevant to the needs of service users. Counselling Service/City South West This service began as a pilot scheme in 2004 with the aim of providing a high quality, professional counselling service to meet the emotional and mental health needs of the clients attending it... Functions of the Service Clients are helped through counselling to explore their difficulties within a caring, professional and confidential environment. The sessions enable them to access the coping and managing skills needed to determine what course of action would best help them resolve their personal issues. Clients are helped to find their own solutions and to gain insight into repeating patterns of behaviour that may be preventing them from leading fulfilling and satisfying lives. Audit Review of 216 Clients 2004 – Present Day Types of Problems Depression – 47% Anxiety – 20% Bereavement – 12% Family & Interpersonal Relationship Problems - 7% Others – (includes Adjustment Problems, PTSD, Abuse) 14% Review Findings Age Profile < age 20~2% 20 – 29 ~ 22% 30 – 39 ~ 26% 40 – 49 ~ 23% 50 – 59 ~ 15% 60 - 69 ~11% 70 - 79 ~ 1% Service Boundaries This service offers 14 sessions of counselling per week to clients who live in the City South West Area. It operates within the Specialist Mental Health Service and is reserved for more complex mental health problems. Referrals come from the Mental Health Team following an assessment by them at the Out Patients Clinic. Mental Health Social Work Social Work aims to address the social factors that are connected to mental illness, working in partnership with the individual and their family. In their assessment of peoples needs, social workers place emphasis on the strengths and natural coping abilities of service users and their families. They act to empower service users to access the services and resources they require, to recover and maintain good mental health, and achieve a good quality of life in terms of their relationship, income, occupation and accommodation. Services Offered By Social Work Social Work Assessments: Mobilising Resources, Networking and Professional Advocacy: For example addressing Complex Social Welfare and Housing Issues. Supporting vulnerable parents: supportive counselling for vulnerable parents and accessing extra resources for families. Family Interventions and group work: Support to families including education on Schizophrenia, Bi-polar Affective Disorder, Depression and Anxiety. Working with individuals and families on the identification of early warning signs and relapse prevention. WRAP Supporting Vulnerable Adults: Working with victims of domestic abuse of a physical, emotional or financial nature. It entails supportive counselling, linking people with appropriate statutory and voluntary services and the use of legislative framework and judicial system where necessary. Who should be prioritised for referral to social work? Individuals with enduring mental health problems. Individuals who are isolated, with limited or no social supports. Vulnerable parents with young children, especially single parents. Individuals who are known victims of abuse or where there is a suspicion of abuse. The homeless Families who are struggling to cope and who require support and education. Wellness Recovery Action Plan (WRAP Group) Social Work facilitated a recovery group in Tearmann Phadraig for 12 weekly sessions from October 2008 to January 2009. The group was based on the principles of mental health recovery and wellness recovery action plan (WRAP) programme developed by Mary Ellen Copeland. The group looked at promoting wellness and recovery through sharing practical ideas of how to cope with the symptoms and vulnerabilities of their illness. The group commenced with seven service users from the City South West Catchment Area. The group members were all female and had a common experience of mental health difficulties and social isolation. The group members benefited from completing their own wellness recovery action plan by coming up with ideas through through group discussion and activities. Prepared by Mary Murray (Counsellor) and Catherine O’ Shea (Social Worker) members of the City South West Multi-Disciplinary Team as part of South Lee Mental Health Services.