© British Association of Social Workers
The Psychiatric ‘Caseness’ of Clients Referred to an Urban Social Services Department
Peter Huxley is Senior Lecturer in Psychiatric Social Work in the Department of Psychiatry at Manchester University and Director of the Mental Health Social Work Research Unit. He is the author of Social Work Practice in Mental Health (Gower, 1985) and Mental Illness in the Community (with David Goldberg; Tavistock, 1980).
Jacqueline Korer is a Research Associate in the Mental Health Social Work Research and Staff Development Unit in the Department of Psychiatry, Manchester University. She has published several papers describing her previous research.
Sheila Tolley is a Research Officer for the Housing Department, Manchester City Council. She is also a part-time MA student (Applied Social Research) at Manchester University.
Correspondence should be sent to Dr. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Manchester University, Stopford Building, Oxford Road, Manchester M13 9PT.
Summary
Of 158 clients referred to two area offices and six general practice attached social workers, 141 weré interviewed using standardized social and psychiatric research interviews. The General Health Questionnaire (GHQ) was completed by 138 clients. Their social worker completed the Case Review Form. Scores of 5 or more on the PSE Index of Definition (for the client) were used to indicate psychiatric caseness. Using ID scores of 5 or more, 53% of the sample were identified as ‘cases’. The GHQ (cut-off 4/5) identified 73% of the clients as cases; and the GHQ (cut-off 10/11) identified 51% cases.
Morbidity was significantly greater in the general practice setting. Social workers' judgement (about the presence or absence of mental illness/emotional disorder) was not significantly better than chance in the identification of specific disorders, but was significant in relation to the whole sample.
The results are discussed and further studies are being conducted using more sophisticated judgements of ’caseness’, and extending the enquiry beyond an inner city population.