Social Work and Mental Health

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 14 September 2012



Gough, M. (2012), "Social Work and Mental Health", The Journal of Mental Health Training, Education and Practice, Vol. 7 No. 3, pp. 154-155.



Emerald Group Publishing Limited

Copyright © 2012, Emerald Group Publishing Limited

Karban's book provides a comprehensive framework for understanding mental health within a social work paradigm. With endorsements from David Pilgrim and Jerry Tew, I was expecting a strongly positioned social perspectives' evidence base to complement their work (Rogers and Pilgrim, 2000; Tew, 2011). However, Karban provides a balanced holistic overview of mental health with a particular emphasis on practice interventions and anti‐discriminatory awareness.

The book has an even weighting to it being split into three coherent parts. Part 1, Perspectives on Mental Health, sets out its stall with an opening chapter, “Voices from the front line: users and carers” which informs the reader about user politics, identity and the contested nature of mental health. Part 1 continues with “Theories, models and concepts; the policy framework and the legal framework”. The theories, models and concepts chapter expands some of the contested thinking around mental health in a dispassionate and objective manner. Karban writes in a non‐polemical way, despite an emphasis on the impact of inequality and discrimination throughout the book, she is very even handed when considering the different approaches. Karban draws on the work of Rogers and Pilgrim (2000) to provide some incisive commentary when critiquing the social model of mental distress. Karban hi‐lights a core paradox, namely that social causation and social constructionist perspectives of “mental illness” are not intellectually compatible. How can you have social causation combined with a paradigm that challenges the very existence of mental illness?

The policy and legal framework sections will be helpful to the student social worker especially in a book that has an emphasis on inequality. Mental health texts tend to focus exclusively on law or, exclusively on social inequality issues, often not both. The policy section has no commentary on Coalition government mental health policy. However, this is reasonable, given that Coalition policy beyond the No Health Without Mental Health (HM  Government, 2011) strategy is not very obvious. The Legal Framework section is almost exclusively England and Wales focused, which Karban acknowledges. There is a brief section outlining some of the UK wide provisions.

Part 2 is titled Mental Health, Inequalities and Diversity with two chapters. This pulls and develops on some of the discriminatory aspects that are referred to in the first part. Karban is not rigidly literal in her structure and it is fitting that in discussing racist discrimination in the mental health system, she discusses the strategic responses to the David “Rocky” Bennett death and subsequent inquiry, rather than in what may be a more “dry” context if located in the policy section.

Part 3 is richly practice focused with five chapters considering children, families, older people, working with people with depression, trauma and psychosis. The final chapter, “Interprofessional working in response to risk” is more system oriented. Each chapter has a depth and breadth of practice interventions. Throughout the book, Karban, has practice dilemmas which she then methodically works through rather than leaving the difficult questions hanging. On a rare occasion, I found the practice solutions a little incredible, such as a need for social worker to respond as community activists to bring about collective change. Karban, herself acknowledges how difficult such a reality may be in the current local government social work practice culture.

Karban has a thoughtful discussion about cognitive behavioural therapy and outlines its critiques. She manages to converge this with more familiar social work approaches such a solution‐focused and task‐centred work. There is a very humane section considering dementia beyond just an organic disorder. Karban challenges the convention of seeing dementia as just being an organic condition can miss the whole experience of dementia. She quietly champions the need to appreciate the power of stigma and loss and the need to appreciate these realities to effectively support someone with the condition.

Throughout the book, Karban hi‐lights flawed dichotomical thinking. Karban makes a case for people, their wellbeing, health, and power needing to be understood in more holistic ways. Karban challenges binary thinking by promoting the many factors that she argues help us to understand someone's mental health status. Though she makes a case for the role that inequality plays in people's lives, she hi‐lights the alternatives and her coverage is broad in offering a range of contemporary mental health understandings and intervention. The style of the book reflects a holistic philosophy throughout by offering a very comprehensive grounding in mental health social work which will be of value to the qualifying social worker and approved mental health professional alike.


HM Government (2011), No Health Without Mental Health: A Cross‐government Mental Health Outcomes Strategy for People of All Ages, Department of Health London.

Rogers, A. and Pilgrim, D. (2000), A Sociology of Mental Health and Illness, 3rd ed., Open University Press Maidenhead.

Tew, J. (2011), Social Perspectives to Mental Distress, Palgrave Macmillan Basingstoke.

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