The extent of mental and physical ill-health of clients referred to social workers in a local authority department and a general attachment scheme

Psychiatric morbidity in the clients of social workers

Newly referred clients (N = 141) in two inner city Social Service department settings were interviewed using the Present State Examination and the Social Maladjustment Schedule and screened by social workers using the GHQ and the Case Review Form. 73% of cases were GHQ positive, using the 4/5 cut off on the GHQ-28. Receiver Operating Characteristic analysis showed that the GHQ cut-off point which maximised sensitivity and specificity in the present sample was 10/11. PSE/ID/CATEGO analysis identified 25% of the sample as "cases" (ID 6-8) and 28% as "threshold disorders" (ID 5). Using a straightforward "present/absent" assessment of "caseness" social workers misclassified more than a third of the PSE cases and correctly identified half of the non-cases. The results are discussed.

The health of clients referred to social workers in an intake team

Though numerous reports have strongly argued that there is a need for a closer collaboration between the health and social services, studies investigating the health of clients in contact with the personal social services have been few and limited. This study collected information regarding the physical and mental health of clients referred to social workers in the local authority intake team by means of questionnaires completed by the clients, and a selected sub-sample was also given an interview. Details were also taken regarding the social worker's assessment of health, reasons for referral and their intervention. The results indicated that the proportion of patients with physical or mental illness, or both, were very high and that social workers tended to under-report or under-estimate these illnesses. While there is some suggestion that the social workers were more likely to carry out more interviews with those clients who were ill, either physically or mentally, the contacts between social workers and medical personnel were very limited indeed.

The mental and physical health of clients referred to social workers in a local authority department and a general practice attachment scheme

Although numerous reports have strongly argued that there is a need for a closer collaboration between the health and social services, studies investigating the health of clients in contact with the personal social services have been few and limited. This study collected information regarding the physical and mental health of clients referred to social workers in a local authority intake team and to a general practice attachment scheme by means of questionnaires completed by the client and at interview. The results indicated that the proportions of patients with physical or mental illness were very high. However, while social workers in the attachment scheme had many contacts with members of the primary care team regarding these clients, contacts between intake social workers and medical personnel were very limited.

Psychiatric and social aspects of premenstrual complaint

A number of fundamental methodological problems exist in the area of premenstrual symptomatology and psychiatric ill-health. In the study described these have all been taken into account. The study has been so designed as to make expressly clear the definition of premenstrual complaint being employed and material gathered by means of a retrospective questionnaire is checked by means of an interview administered to a sub-sample and the use of a menstrual diary (Sampson & Jenner, 1977; Dalton, 1978). The use of an interview also permits a careful check to be made of the accuracy displayed by women asked to estimate their particular position in the menstrual cycle at the time of completion of the questionnaire. The use of the premenstrual interview, together with a standardized, semi-structured psychiatric interview specifically designed for the population under study, and a standardized, semi-structured social maladjustment schedule, permits a detailed assessment of the inter-relationship between premenstrual, psychiatric and social variables. Finally, the use of a general practice sample of women attending their general practitioners for many and varied reasons, together with a sample of women drawn from attenders at a specialized premenstrual tension treatment clinic, permits a comparison to be made between the symptom profiles of women in a general practice population who have not overtly identified themselves to the treatment agencies as premenstrual sufferers with a group of women who have so identified themselves. In this way, a more accurate estimate of the numbers of women in general practice samples who manifest a degree of premenstrual complaint equivalent to that shown by special treatment clinic attenders can be achieved.

The development of a self-report questionnaire to identify social problems--a pilot study

The construction of a short self-report questionnaire identifying social problems, difficulties and dissatisfactions is described. The questionnaire covers housing, occupation, finance, social and leisure activities, child—parent and marital relationships, relationships with relatives, friends, neighbours and workmates, and legal problems. Results of a preliminary testing in a general practice are provided and discussed, and plans for a more comprehensive assessment are outlined.