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Purpose
The purpose of this paper is to argue that the work of the American feminist political and legal philosopher, Martha Fineman can be the basis for a shift away from the proceduralism and managerialism that has come to dominate social work practice.


Design/methodology/approach
This paper's work is based on the application of Fineman's work to social welfare settings.


Findings
Fineman's work calls for a radical rethinking of our notions of autonomy and vulnerability.


Originality/value
This paper applies Fineman's work to this field.

This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the UK from 2010 onwards. In response to the fiscal crisis following the bail out of the banks in 2008, it was argued that significant reductions in public spending were required. The background to these policies is examined before a consideration of their impact on mental health services. These policies had a disproportionate impact on people living in poverty. People with health problems including mental problems are overrepresented in this group. At the same time, welfare and community services are under increasing financial pressures having to respond to increased demand within a context of reduced budgets. There is increasing recognition of the role that social factors and adverse childhood experiences have in the development and trajectory of mental health problems. Mental health social workers, alongside other professionals, seek to explain mental distress by the use of some variant of a biopsychosocial model. The extent of mental health problems as a one of their measures of the impact of inequality. More unequal societies create greater levels of distress. There is a social gradient in the extent of mental health problems—the impact of severe mental illness means that many individuals are unable to work or, if they can return to work, they find it difficult to gain employment because of discrimination. The paper concludes that austerity and associated policies have combined to increase the overall burden of mental distress and marginalisation within the UK.

PurposeThe purpose of the paper is to report the findings of a small scale indicative research project. The project explores the assessment of detained persons in police custody by Forensic Physicians (FP).Design/methodology/approachA range of information was collected in every case where custody staff had identified a mental health concern and requested an FP assessment. As well as information about demographic factors, this would include questions regarding any links that the individuals had with community‐based mental health services. As well as this information, anonymous custody records and force adverse incident records for the month were examined.FindingsIn the month of the project, 59 FP assessments were requested. Only six members of this group had any contact with community‐based mental health services: two with a social worker, two with a CPN and two with a psychiatrist. Of this group, three had not been in contact with mental health services for over a month.Research limitations/implicationsThe size of the cohort and variety of arrangements for providing nursing and social care support in custody settings may limit the generalisation of the findings.Practical implicationsThis study highlights that there is a group of individuals whose mental health causes concern to the police in a custody environment. In this study, the overwhelming majority of the group have no contact with mental health services. The research supports the recommendations of the Bradley Review for wider health care provision in custody settings.Originality/valueThe paper highlights that fully effective community mental health services need to consider police custody settings as a key point for intervention.

One effect of the policy of deinstitutionalisation has been to increase police contact with people, who are experiencing the effects of acute mental illness. Policy documents such as Home Office circular 66/90 recognise that adults with mental health problems are especially vulnerable within the criminal justice system. The overall aim of policy is that vulnerable adults should be diverted to mental health services at the earliest opportunity unless the offence is so serious that this would not be in the public interest. However, there is little concrete evidence of the success of this policy. The result is that police officers have an increasing role to play in working with individuals experiencing acute mental health problems. In this process, custody officers have a key role to play as decision‐makers as to whether the protections that PACE (1984) offers to vulnerable adults should apply. This article is based on a small‐scale indicative research study, which examined how officers make these decisions and the training that they receive relating to mental health issues.