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 Table of Contents  
DEBATE/PERSPECTIVE/VIEWPOINT
Year : 2017  |  Volume : 33  |  Issue : 4  |  Page : 288-290

Psychiatric social workers in legal aid services in hospitals: Exploring roles in Indian context


Department of Psychiatric Social Work, NIMHANS, Bangalore, Karnataka, India

Date of Web Publication17-Nov-2017

Correspondence Address:
Ameer Hamza
Department of Psychiatric Social Work, NIMHANS, Bangalore
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9962.218592

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  Abstract 

Mental health and legal problems are interlinked in many ways. People facing legal issues may develop mental health problems, and people with mental illness and family also face legal issues. In India, Legal Services Authorities Act, 1987 gives provision for free legal aid services for the poor sections of society. Authors explain the roles of psychiatric social workers in legal aid services in hospitals. Social case work as a method of social work is suitable in legal aid services. Counseling, referrals, collateral contacts, advocacy and networking are major services from the social work perspective. Knowledge about laws and mental illness is essential for social workers to work in legal aid clinics (LACs).

Keywords: Legal aid, mental health, clinical social work, social case work, law


How to cite this article:
Thomas PT, Ragesh G, Hamza A. Psychiatric social workers in legal aid services in hospitals: Exploring roles in Indian context. Indian J Soc Psychiatry 2017;33:288-90

How to cite this URL:
Thomas PT, Ragesh G, Hamza A. Psychiatric social workers in legal aid services in hospitals: Exploring roles in Indian context. Indian J Soc Psychiatry [serial online] 2017 [cited 2017 Dec 12];33:288-90. Available from: http://www.indjsp.org/text.asp?2017/33/4/288/218592


  Introduction Top


Mental health and legal services have a reciprocal relationship. Mental ill health renders the sufferer and his family vulnerable to legal disputes. At the same time, prolonged and often bitter legal battles can be a precipitating factor for mental illness. Legal issues often become another factor in precipitating or maintaining the mental ill health in people with mental illness.

India is rightly acclaimed for achieving a flourishing constitutional order, presided over by an inventive and activist judiciary, aided by a proficient bar, supported by the state and cherished by the public. At the same time, the courts and tribunals, where ordinary Indians might go for remedy and protection, are beset with massive problems of delay, cost and ineffectiveness. Potential users avoid the courts, despite a long-standing reputation for litigiousness. The existing evidence suggests that Indians avail themselves of the courts at a low rate, and the rate appears to be falling.[1]

India has passed Legal Services Authorities Act in 1987 to prevent human rights violation and to protect and promote human rights of its citizens.[2] The National Legal Services Authority (NALSA) has been constituted under the Legal Services Authorities Act, 1987 to provide free legal services to the weaker sections of the society.[2] The Mental Health Act, 1987 also ensures the protection of human rights of people with mental illness and have provisions for the free legal aid.[3] At a tertiary referral center for psychiatry, neurology and neurosurgery in South India, a free Legal Aid Clinic (LAC) was launched in collaboration with the Karnataka State Legal Services Authority (KSLSA) on January 15, 2011 under the provision of the act. This LAC can be accessed by not only the patient and family seeking treatment in the institute, but also can be utilized by the general public.[4],[5] A panel of highly committed lawyers deputed by the KSLSA with the support of the district judge constitutes the legal team in the clinic. Along with them, psychiatric social work (PSW) consultants, staff and trainees, and a forensic psychiatrist on call form the multi-disciplinary team responsible for providing services in this clinic.[4]

In the legal aid services at the hospital, patients from the discipline of psychiatry, neurology and neurosurgery, and walk-in clients without any neuropsychiatric problem approach for help. The patients identified in the initial assessment requiring legal advice are also referred by the treating team members. It is observed that at times patients mention potential legal issues to their social worker/physician as they are developing, as opposed to waiting for a legal crisis to develop and approach a lawyer. In the last five years, which the clinic has been actively providing services, a total of 1337 clients have approached for various services. Patients availing health services at the hospital approached for free LAC for the following issues: family related issues (domestic violence, conjugal rights, and divorce and maintenance issues), legal advice on miscellaneous issues such as court procedure, jurisdiction, merits and limitation of their case, filing affidavit, information on various acts and laws, etc. Few needed assistance on property related disputes and job-related issues (leave, suspension, retirement and retirement benefit related issues); some were pertaining to medical certificates (injury certificate, disability certificate, insurance, compensation and disability benefit) and a few were in the context of the Mental Health Act 1987 (admission, discharge, escape and rights of the people with mental illness).[4]

Psychiatric social worker as an integral part of legal aid services

Social work, as a profession committed to enabling and empowering individuals to achieve optimum level of functioning at the individual, family and community realms, is a gaining momentum in India. PSW practice is the professional application of social work theory and methods to the treatment and prevention of psychosocial dysfunction, disability, or impairment, including emotional and mental disorders. PSW practice works with the goal of enhancement and maintenance of psychosocial functioning of individuals, families and small groups.[6] Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work. Underpinned by theories of social work, social sciences, humanities and indigenous knowledge, social work engages people and structures to address life challenges and enhance well-being.[7]

Social work professionals frequently find themselves working in psychiatric, medical and rehabilitative care settings. In recent years, social work has wide spread in all areas of human life, including mental health care, geriatric and palliative care, and legal aid services. In many countries, integrating social work into the medical-legal partnerships has been advocated.[8] The Legal Services Authority Act also mandates that judicial panels of Lok Adalats include one social worker.[1] The social worker in the mental health setting is in a unique position to understand the legal needs/problems of the patients/clients.[9] It is argued that the active engagement of the social worker in the interface of medical and legal issues greatly enhances the effectiveness of the services.[8]

In the LAC, the psychiatric social worker, at the contact, independently assesses the legal issues of the client in detail or assesses along with lawyer. Assessment proforma helps to assess the problems systematically. After the assessment of the problems, social worker may discuss it with a lawyer and if required also with the concerned health and mental health professionals (psychiatric social worker, psychiatrist, clinical psychologists, physicians from other specialties and other concerned professionals). The existing relationships and rapport of the psychiatric social workers or other professionals working with clients and the family have helped clients to avail legal aid services and to alleviate their legal and associated problems.

To get in-depth understanding of the case, social worker may make collateral contacts to different sources such as other legal aid clinics, hospitals, health and mental health professionals, lawyers, legal services authority, police, work place of client, family, non-government organizations (NGOs), government organizations (GOs), etc. Additionally, in some cases, she or he may go for home or agency visits of the client. Often advocacy and social action roles may be taken to reach an effective solution. Networking with various agencies may also be required. Based on the problems, the client may be given advice, legal counseling, legal actions and referrals to appropriate legal agencies by the advocate and the social worker.

Clients presenting for legal aid services may at times require specific mental health services, when they have difficulty in coping with legal and associated issues. Such clients may require psychiatric evaluation and psychosocial interventions at individual or family level. Additionally, there are chances to receive people with mental illness as clients in the LAC. Therefore, the psychiatric social worker, using the method of social case work, uses his clinical diagnostic skill to understand the mental health status of the clients, which will help the lawyer to take appropriate decision on legal matters. This will help psychiatric social worker to refer the client to avail mental health services.

In case of family disputes or domestic violence or child protection related cases, the psychiatric social worker may have to provide/arrange protection services to women, elders and children. Advocacy with various people or agencies may be required. In some cases, marital and family dispute cases may be solved by counseling or family therapy. Psychiatric social worker may provide brief (single) interventions that may motivate the clients to seek non-legal measure to solve their problems. Hence, the psychiatric social worker can refer the clients to appropriate agencies for psychosocial interventions.

The psychiatric social worker can also play an important role in sensitization of public regarding the availability of free legal aid services, especially for the people with mental illness and their caregivers.

The person-in-environment tenet of social work practice, which forms the basis of assessment and interventions in social work, when viewed in the context of social work's system's approach, helps the social worker to see the client who is embedded within the multiple layers of social contexts beyond the presenting 'problem'. With their unique skills, social workers augment the legal aid services by doing a total assessment of the client and barriers and by widening the breadth of knowledge and solutions available to both, clients and lawyers. Using this approach, social workers can bring in an enhanced understanding of factors contributing to the legal problem, including the mental illness and associated sociocultural factors. This understanding can pave the way for a more effective and potentially permanent solution to the problem.[10],[11],[12] The social worker relies upon the primary and secondary methods of social work to contribute to the services. Thus, social case work services, including assessment and interventions from the above-mentioned theoretical framework, aid the process.


  Conclusion Top


Legal issues affect well-being. Legal aid services in hospitals are useful to address legal and associated problems. Psychiatric social workers can play a major role in these clinics. Counseling, collateral contacts, referrals, advocacy and networking are major areas of interventions from social workers. Knowledge about laws and mental illness is essential for social workers to work in LACs. Social workers with clinical diagnostic and therapeutic skills can perform better in these clinics. In India, we need more training and research in this field from the PSW perspective.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Galanter M, Krishnan JK. Bread for the Poor: Access to Justice and the Rights of the Needy in India. Hastings Law Journal 2004;55:789.  Back to cited text no. 1
    
2.
GOI. Legal Service Authorities Act; 1987 [14/06/2016]. Available from: http://nalsa.gov.in/actrules.html. [Last accessed on 2016 June 14].  Back to cited text no. 2
    
3.
Sarkar J. A new mental health act for India: Aan ethics based approach. Indian Journal of Psychiatry 2004;46:104.  Back to cited text no. 3
[PUBMED]    
4.
Math SB, Kumar NC, Harish T. Legal aid in hospitals: Aan innovative approach. The Indian journal of J Medical Research 2013;137:440.  Back to cited text no. 4
[PUBMED]    
5.
NIMHANS. Legal aid clinic 2016 [01/07/2016]. Available from: http://www.nimhans.ac.in/patient-care/legal-aid-clinic [Last accessed on 2016 July 01].  Back to cited text no. 5
    
6.
NASW. NASW Standards for the Practice of Clinical Social Work 1989 [01/07/2016]. Available from: http://www.socialworkers.org/practice/standards/clinical_sw.asp [Last accessed on 2016 Jul 01].  Back to cited text no. 6
    
7.
IFSWGlobal Definition of Social Work 2014 [25/06/2016]. Available from: http://ifsw.org/get-involved/global-definition-of-social-work/. [Last accessed on 2016 June 25].  Back to cited text no. 7
    
8.
Colvin JD, Nelson B, Cronin K. Integrating social workers into medical-legal partnerships: Comprehensive problem solving for patients. Social work 2012;sws012.  Back to cited text no. 8
    
9.
Bernstein BE. Lawyer and social worker as collaborators in the medical setting. Health and Social Work. 1977;2:147-55.  Back to cited text no. 9
[PUBMED]    
10.
Karls JM, O'Keefe ME. Person-in-environment. Social workers' desk reference. New York, NY: Oxford University; 2008;371.  Back to cited text no. 10
    
11.
Lazarus RS, Launier R. Stress-related transactions between person and environment. Perspectives in Iinteractional Psychology. New York, NY: Springer; 1978;287-327.  Back to cited text no. 11
    
12.
Weiss-Gal I. The person-in-environment approach: Professional ideology and practice of social workers in Israel. Social Work 2008;53:65-75.  Back to cited text no. 12
    




 

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