Captación de lo real y orientación de la libertad

Almost as crucial as the lack of mental health services was social workers' own inability to provide care givers with adequate support. Social workers described themselves as having a central role in supporting caregivers although they were aware ofthe deficiencies in their support.

The nature of social work support

Caregivers were clearly valued by social workers who participated in this survey.

"Caregivers are the most important linkfor children and young persons with mental health disorders. We don 't have enough of these caregivers. Most are taken for granted. Statutory agencies are not good at supporting caregivers ",

The comments provided insight into how social workers constructed effective social work support to caregivers. Social workers described their support as constituting a range of matters including formal advice, passing on knowledge and expertise and providing access to resources such as respite care. For some respondents, social work support included listening, respecting caregiver opinions and relieving caregivers of self-blame.

Being available and accessible was understood as an important part of offering support, this

was described as being involved, available and able to call on caregivers. "Ongoing social

input) tends to be needed". Providing practical support was emphasised by a number of other

social workers: "practical support re minders, respite, babysitting are most important

because it doesn't matter how much a caregiver understands or cares if they are exhausted they will not cop€.. " Others mentioned: ''Appropriate resources, toys, books, computers in the house ".

Some social workers included in their comments, a concept of teamwork whereby social workers and care givers worked together to achieve casework goals. Teamwork, when discussed by respondents, included communication over planning, involving caregivers in treatment programmes, and joint decision making. Respondents emphasised the value of

integrating caregiver experience and opinion in casework planning: "Health and other

service professionals listening carefully to caregivers and placing importance on what they say they are experiencing ".

Problems in information sharing were viewed as confounding the provision of support to caregivers. Discontinuity exists at a number of points in the system, for example, between mental health and social work and between social workers and care givers. Social workers highlighted how important it _{was for caregivers to have access to detailed information about} mental health problems. Obtaining this information is perceived as difficult because social workers did not see themselves as possessing sufficient knowledge to assist caregivers in this way. Some social workers expressed frustration that access to information was blocked by mental health services, making it difficult for them to pass this on to caregivers.

Most importantly, social workers in this study linked their own capacity to support

care givers to the manner in which they were being supported themselves. "Support must be

more than lip service!-support needs to be seen to be happening both physically and emotionally -This of course is extremely draining on the social worker who also needs

support ". Social workers l inked the failure of mental health to support them, to their

acknowledged failure to support caregivers. Social workers particularly emphasised their

lack of expertise. "In my opinion social workers lack knowledge and are not adequately

trained in mental health. This therefore hinders their ability to support, inform and advise caregivers ".

The organisational constraints

Organisational constraints, in particular fiscal pressure, compromised social workers' abi lity to support care givers. While special funding programmes existed, social workers described difficulty accessing these and needing skills to be successful in obtaining funding. Social

workers recognised that higher levels of remuneration to caregivers were j ustified in many

cases due to: "damage done by clients to caregivers ' home, vehicles" and the need for

"remuneration which reflects the difficulties in caregiving If. In other circumstances, such as

when a young person was too unwell to go to school, caregivers required extra fmancial support. However, social workers indicated that fmancial constraints impacted on their capacity to respond with higher remuneration packages. In addition, it was difficult to resource adequate support arrangements because of the problems in payment mechanisms.

Wider organisational problems also impacted on the ability of social workers to support

caregivers: "The office organisational structure needs to be taken into consideration i.e.

offices that are under resourced, vacancies, new inexperienced workers, sick leave hinders any social workers availability to provide required support ". Many respondents regarded

social work caseloads as too high to a.llow adequate time to respond to caregivers. Others stressed the extra requirements in managing casework for children with mental health problems, such as interagency work. There appears to be little recognition within the system of these extra demands.

Social work support - someone else's job

A group of responcients indicated that it was no longer feasible for the main role of social

work support. to caregivers for this group of children and young people, to be carried out hy the child's social worker because of the intensity of the task and the limit.ations on social workers time.

" We need more time fo spend with them than with other caregivers as their role is often 24

hours and challenging without the let up of healing. Don '[ think a social worker can do that - need to have someone who has just that support, practical role, almost like a minder for caregiver!! "

Some social workers saw the new caregiver liaison social workers as able to fulfil this role. Others expressed doubts however, that the number of newly appointed caregiver liaison social workers would be sufficient to support caregivers in the way that was needed.