of social work. Changes in social work practice and legislation have often been a response to high profile cases. In the area of children and families social work, a public inquiry in response to a high profile child death has been a recurring feature of the policy landscape for the past 70 years (Warner, 2015). In the area of mental health, a series of inquiries into institutional abuse played a key role in highlighting the abusive nature of the asylum regime. This is not just a recent phenomenon. One of the most famous psychiatric institutions in the UK – the York Retreat, established in 1796 – was a response to a scandal. In 1790, Hannah Mills, a local Quaker, died as the result of appalling neglect in the local lunatic asylum. William Tuke and other members of the Quaker community raised funds to establish the Retreat (Cummins, 2017). More recently the Ely Inquiry (Howe, 1969) into the abuse of patients at a large psychiatric unit outside Cardiff was prompted by allegations from a whistle blower. The allegations were originally made in a letter to the News of the World. The Inquiry was chaired by Geoffrey Howe, later Chancellor of the Exchequer, during the Thatcher administrations. The Ely report presented a picture of wider neglect – an institution that was representative of the wider isolation, geographical, psychological and professional of mental health services of the period. One part-time and two full-time doctors were responsible for the care of more than 660 patients. There were difficulties in recruiting staff to an institution whose buildings were over 100 years old.
There is something of a shift in focus in the mental health inquiries from the late 1980s onwards. There were inquiries that focused on institutional issues – for example, the Ashworth Inquiry headed by Louis Blom-Cooper (Department of Health, 1992) and the Fallon Inquiry (Fallon et al, 1999) into Lawrence Ward, the personality disorder unit at Ashworth. However, the majority of these inquiries and certainly the most high profile – the Ritchie Inquiry into the care and treatment of Christopher Clunis (Ritchie et al, 1994) – focused on cases of homicide committed by individuals either with a history of mental illness or recent contact with mental health services. The ‘Spokes Inquiry’ (DHSS, 1988) was established following the murder of Isabel Schwarz (1955–84), a psychiatric social worker based at Bexley Hospital. Schwarz was stabbed to death by Sharon Campbell, who was 20 years old. Campbell had previously been a patient at Bexley and had been discharged against her will. She had previously attacked Schwarz and made other threats against her. Schwarz was attacked when she was working at the hospital late one evening. The Inquiry highlighted a number of issues that became recurring themes of later cases – poor communication, lack of coordination between services and the failure to take a holistic view of the assessment of risk. Butler and Drakeford (2005) suggest that Schwarz’s position as a social worker and the contradictory status that it has meant that this awful case did not become a scandal. The Inquiry recommended there should be a register of the most vulnerable mentally ill patients living in the community and they should be appointed keyworkers to have a coordinating role in their care (DHSS, 1988). The Spokes Inquiry led to the Griffiths Report (1988), the forerunner of the NHS and Community Care Act (1990).
Moral panics
Social work and social workers are often caught up in the moral panics of the day (Butler and Drakeford, 2005). On one level, this given the nature of social work and its liminal position between individuals, families, communities and the wider state, this is not surprising. There was a moral panic about the perceived failings of community care in the late 1980s and 1990s. Community care, in this context, was specifically used as a shorthand for mental health services – other areas of provision were not subject to such scrutiny or detailed media coverage. Cohen’s (1972) notion of a moral panic provides a theoretical lens through which the responses to inquiries into homicides, committed by those with current or some previous contact with mental health services, can be explored. Policing the Crisis (Hall et al, 2013) is a classic study of the way that moral panics reflect wider social and political disquiet. Its discussion of the way that racialised narratives have a key role in many moral panics is important in the mental health field. Hall et al (2013) seek to explore how and why particular themes, including crime and other deviant acts, produce such a reaction. They argue that social and moral issues are much more likely to be the source of these panics. There are certain areas, for example youth culture, drugs or lone parents, where there are recurring panics. The response to this panic includes not only societal control mechanisms, such as the courts, but also the media becoming an important mediating agency between the state and the formation of public opinion.
There have been a series of moral panics following the deaths of children. Jones (2014) shows the role that the media played in demonising social workers in the aftermath of the death of ‘Baby P’. Warner (2015) highlights that politicians had a key, often inflammatory, role in the developing media coverage. David Cameron and Ed Balls both wrote emotive newspaper columns about the case. In these columns, both politicians made links between their own experiences as fathers and their disgust at the treatment inflicted on ‘Baby P’. Of course, one does not have to be a parent to be repulsed by neglect and abuse of a child. Cameron and Balls were doing this to side with ‘ordinary’ members of the public as opposed to ‘out of touch’ social workers who, in this narrative, had allowed these events to occur.
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