Introduction
This essay critically examines the impact of legislation and social work intervention methods, including collaborative practice, on addressing needs and challenging societal barriers in two cases from a hypothetical caseload. As a social work student, I draw on key legislative frameworks such as the Care Act 2014, the Mental Health Act 1983 (MHA), and the Mental Capacity Act 2005 (MCA), alongside social work knowledge and research. The analysis focuses on decision-making processes, the role of multi-disciplinary team (MDT) working, and the complexities of hospital discharge and community support. The first case involves an older adult with complex care needs requiring hospital discharge planning, while the second concerns a young adult with mental health challenges in a community setting. By exploring these cases, this essay highlights how legislation and intervention strategies can both support and challenge the societal barriers faced by service users, such as funding constraints and stigma, while acknowledging the limitations of current practice.
Case 1: Complex Hospital Discharge and the Care Act 2014
The first case involves an 82-year-old individual, referred to as Mr. A, who experienced a prolonged hospital stay due to a hip fracture and subsequent complications. Under the Care Act 2014, local authorities have a statutory duty to assess and meet eligible care needs, promoting wellbeing and independence (Care Act 2014). In Mr. A’s case, the assessment identified a need for a comprehensive care package, including home adaptations and daily support to prevent hospital readmission. However, societal barriers, particularly funding constraints, significantly impacted the intervention. Research highlights that local authority budgets for adult social care have been reduced by approximately 6% in real terms between 2010 and 2020, despite rising demand (Institute for Fiscal Studies, 2021). This created delays in securing appropriate support for Mr. A, illustrating how systemic underfunding can undermine legislative intent.
Decision-making in this context was guided by the Care Act’s emphasis on person-centred care, yet complex hospital discharge processes revealed limitations. Collaborative practice with hospital staff, occupational therapists, and community services within an MDT framework was essential in coordinating a safe discharge plan. Nevertheless, discharge delays—often termed ‘bed-blocking’—reflect broader systemic issues, with NHS data indicating that over 50% of delayed transfers of care are attributable to social care funding or capacity shortages (NHS England, 2022). While MDT working facilitated communication, the lack of immediate resources meant that Mr. A faced unnecessary prolonged hospitalisation, arguably compounding his vulnerability. This case demonstrates that, while legislation provides a framework for meeting needs, societal barriers such as funding shortfalls can hinder effective intervention.
Case 2: Mental Health Support in the Community under MHA and MCA
The second case concerns a 24-year-old individual, referred to as Ms. B, who has a diagnosis of bipolar disorder and resides in the community. Under the Mental Health Act 1983, Ms. B was previously detained for treatment due to acute episodes, but currently receives support through a community mental health team. Decision-making in her case often intersects with the Mental Capacity Act 2005, which presumes capacity unless proven otherwise and mandates that all practicable steps be taken to support decision-making (MCA 2005). My role involved assessing her capacity to make decisions about her treatment plan, including medication adherence, while balancing her autonomy with safeguarding concerns during periods of crisis.
Societal barriers, notably stigma surrounding mental health, posed significant challenges. Statistics from Mind (2021) indicate that 1 in 5 people with mental health issues report experiencing discrimination in accessing services or employment, which aligns with Ms. B’s experiences of social isolation and reluctance to engage with support. Collaborative practice proved vital here, as working alongside mental health nurses, psychiatrists, and voluntary sector organisations helped tailor interventions to her needs. For instance, linking Ms. B with a peer support group facilitated a sense of belonging, challenging the societal exclusion she faced. However, resource limitations within community mental health services—often stretched thin due to high caseloads—meant that consistent support was not always available, echoing research by the King’s Fund (2020) on workforce shortages in mental health care.
This case highlights the complexity of community-based interventions. While the MHA and MCA provide legal frameworks to protect rights and ensure care, their application is often constrained by societal attitudes and systemic issues. Collaborative practice offers potential to address some barriers, but its effectiveness is limited without adequate resourcing, raising questions about how social work can fully challenge structural inequalities.
Critical Reflections on Legislation and Collaborative Practice
Both cases underscore the dual role of legislation as a tool for empowerment and a source of limitation when unsupported by resources. The Care Act 2014, for instance, prioritises wellbeing, yet funding deficits in Mr. A’s case delayed the realisation of this principle. Similarly, while the MHA and MCA safeguard rights for individuals like Ms. B, their practical application is hindered by societal stigma and overstretched services. This reflects a broader critique in social work research: legislative frameworks alone cannot dismantle systemic barriers without corresponding investment and cultural change (Rogowski, 2020).
Collaborative practice, a cornerstone of social work intervention, offers a partial solution by fostering integrated care. MDT working in both cases enabled more holistic assessments and interventions, aligning with evidence that interdisciplinary collaboration improves outcomes in complex cases (Reeves et al., 2017). However, its success depends on shared resources and mutual understanding among professionals, which can be disrupted by organisational silos or funding disparities. Indeed, while collaboration helped address some immediate needs, it did not fully overcome the structural barriers of underfunding or stigma, suggesting a need for broader policy reform.
Conclusion
This essay has critically analysed the impact of legislation and social work interventions on two distinct cases, highlighting their role in meeting needs and challenging societal barriers. In Mr. A’s case, the Care Act 2014 provided a framework for person-centred care, yet funding shortages delayed effective hospital discharge, demonstrating systemic limitations. Similarly, for Ms. B, the MHA and MCA supported rights-based decision-making in a community context, but stigma and resource constraints undermined outcomes. Collaborative practice through MDT working emerged as a valuable method to navigate complexities, though its efficacy was curtailed by structural issues. These cases reflect broader challenges within social work, where legislative intent often clashes with practical realities. Moving forward, addressing societal barriers requires not only robust legal frameworks but also sustained investment in social care and public awareness campaigns to combat stigma. As a social work student, engaging with these complexities reinforces the importance of advocacy and systemic change alongside direct practice, ensuring that interventions truly meet need.
References
- Institute for Fiscal Studies. (2021) Adult Social Care Funding and Reform. IFS.
- King’s Fund. (2020) Mental Health Services: Workforce and Funding Challenges. King’s Fund.
- Mind. (2021) Mental Health Facts and Statistics. Mind.
- NHS England. (2022) Delayed Transfers of Care: Monthly Situation Reports. NHS England.
- Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017) Interprofessional Collaboration to Improve Professional Practice and Healthcare Outcomes. Cochrane Database of Systematic Reviews, (6).
- Rogowski, S. (2020) Social Work: The Rise and Fall of a Profession? Policy Press.
