View report page

83
normally have seen a social worker, but it was felt by the family
doctor that there were unexplored emotional factors for which the
patient needed help. Some patients showed problems in the management
of their young children, others were at a crisis point in
their life, e.g. separation from husband. The social worker endeavoured
to identify certain specific areas of difficulty either in
the patient herself or relating to her family, where it might be
possible after a few interviews to alleviate the situation. Three
school girls were referred, two with serious problems of growing
up and getting on with people, and these were seen for regular
sessions. The social worker also acted as a liaison with many
other social work agencies, co-ordinating, referring on, or putting
families in touch with appropriate agencies.
The work was particularly rewarding because relatively little
help seemed to produce satisfactory results. It seems that in the
setting of the surgery patients can be helped with their emotional
problems long before they have reached a chronic or severe state.
This is the purpose of preventive mental health work.
Since October, another psychiatric social worker has been
linked to a group practice of general practitioners in the Putney
area. The social worker spends one afternoon a week in the
surgery seeing suitably selected patients for either short or long
periods, varying with the needs of the patient.
During the three months that this scheme has been in operation,
the doctors have referred eleven of their patients to the social
worker. Referrals have been carefully made so that the patient
does not feel that he is being rejected by the doctor, but rather that
this is an additional service thought by the doctor to be helpful to
the patient. Of these eleven patients, two failed to turn up or
answer the doctor's letter, and one woman cancelled an appointment
with no reason given after having been seen twice by the
social worker. After an exploratory interview, two patients were
referred for community care to the Mental Health Section and
one family, with extremely complicated problems needing very
careful handling, was taken on to the social worker's own caseload
within the department. Two adolescents and one elderly lady
have received social worker support over a long period whilst the
remainder of the referrals have been seen for a limited period
only, knowing that they could make further appointments to see
the social worker if they wished to do so. In three cases, other
members of the family were seen at the request of the patient.
The doctors have tried to refer cases not likely to receive help
from a social work agency under normal circumstances. Examples
of the type of referrals are cases in which the doctor feels that
emotional factors are the prime cause of the patient's continual
attendance at the surgery, even though the patient may not be
aware of this; situations where the doctor feels that the social
worker may be able to offer support, or perhaps investigate the