Medical and psychiatric social work

Social Work (BSW) · Fields of practice · free study notes for exams, placements and interviews

In short

Medical and psychiatric social work is the application of social work knowledge, skills and values inside health care settings — hospitals, clinics, community health programmes, mental hospitals, de-addiction and rehabilitation centres — to address the social, emotional and economic factors that cause, worsen or follow illness. The medical social worker works on access, affordability, family support, compliance and after-care; the psychiatric social worker works on psychosocial assessment, family intervention, psychoeducation, rehabilitation and rights of persons with mental illness. It matters because in India out-of-pocket health spending, stigma, poverty and family burden decide outcomes as much as treatment does. It is examined as a core "fields of practice" paper in every BSW/MSW syllabus (UGC CBCS, TISS, Delhi University, NIMHANS pattern) and tested in interviews for AIIMS, PGIMER, tertiary hospitals, Ayushman Bharat/PM-JAY desks, District Mental Health Programme (DMHP) teams, palliative care units and NGOs. Psychiatric social work is also a regulated profession — the M.Phil in Psychiatric Social Work is recognised by the Rehabilitation Council of India (RCI) and the Mental Healthcare Act, 2017 defines a "mental health professional" to include a psychiatric social worker.

Explained

Origin, definition and conceptual base

Medical social work began with Richard Cabot at Massachusetts General Hospital (1905), who appointed Garnet Pelton and Ida Cannon as the first hospital social workers to supply the "social diagnosis" doctors lacked.
India: the first almoner/medical social work department was started at the J. J. Group of Hospitals, Bombay (1946), with the Dorabji Tata Graduate School of Social Work (now TISS, founded 1936) supplying trained personnel.
Psychiatric social work in India dates from the child guidance clinic work in Bombay (1937) and the All India Institute of Mental Health, Bangalore (1954) — now NIMHANS — which began the first formal psychiatric social work training; a Department of Psychiatric Social Work exists at NIMHANS, CIP Ranchi and IHBAS Delhi.
Definition (working): medical social work is professional help to patients and families in adjusting to illness, treatment and its social consequences; psychiatric social work is the same practice directed at mental illness, with emphasis on family, rehabilitation and community reintegration.
Conceptual anchors: biopsychosocial model (Engel) — illness has biological, psychological and social causes; person-in-environment; WHO definition of health as physical, mental and social well-being; social determinants of health (income, caste, gender, housing, occupation, literacy).
Models of disability/illness: medical model (locates the problem in the body) versus social model (locates it in barriers and attitudes) — the RPwD Act, 2016 and the Mental Healthcare Act, 2017 both lean to the rights/social model.

Roles and functions of the medical social worker

Psychosocial assessment / medico-social case work: history of the patient's social situation, family, income, occupation, housing, support system and the illness's impact; recorded in a medico-social case record that becomes part of the case file.
Resource mobilisation: linking patients to Ayushman Bharat PM-JAY (₹5 lakh per family per year, secondary and tertiary care, empanelled hospitals), state schemes (e.g. Rajiv Aarogyasri in Telangana/Andhra Pradesh, Mahatma Jyotirao Phule Jan Arogya Yojana in Maharashtra, Chief Minister's Comprehensive Health Insurance in Tamil Nadu), PM National Relief Fund, Health Minister's Cancer Patient Fund, Rashtriya Arogya Nidhi, CSR funds and hospital poor-patient funds. Scheme cover limits and names change by state — verify current rules before quoting to a client.
Counselling and emotional support: diagnosis shock, chronic illness adjustment, grief, bereavement, body-image change after mastectomy or amputation, infertility, HIV disclosure.
Compliance / adherence work: defaulter tracing and treatment adherence in TB (NTEP), HIV (ART centres), leprosy, dialysis and psychiatry.
Discharge planning and after-care: home readiness, referral to the nearest PHC/CHC, follow-up dates, home visit, linking to rehabilitation, certification and pension.
Liaison and advocacy: the bridge between patient, family, treating team, hospital administration, employer and community agencies; negotiating bed, investigation and concession.
Health education, camps and community outreach: immunisation, sanitation, nutrition, menstrual health, substance-abuse awareness, organ donation.
Administration, research and teaching: running the medical social service department, maintaining statistics, placement supervision of student trainees, hospital-based research.
Special-purpose roles: unclaimed/destitute and wandering patients, lost-and-found and restoration, child in need of care (link to Child Welfare Committee under the JJ Act, 2015), survivors of violence at One Stop Centres, medico-legal cases, organ transplant counselling under the Transplantation of Human Organs and Tissues Act, 1994 (as amended 2011 — the social worker often sits in or assists the Authorisation Committee process for donor-recipient relationship verification).

Settings, specialities and methods

Settings: general and teaching hospitals (AIIMS, PGIMER, CMC Vellore, JIPMER), speciality units (oncology, nephrology/dialysis, cardiology, burns, NICU, obstetrics), rehabilitation centres, mental hospitals, de-addiction centres, palliative care and hospice, school/community health, employee health and ESIC hospitals, PHC/CHC and urban health posts, NGOs and corporate CSR health projects.
Speciality practice:
- Oncology social work: diagnosis disclosure, treatment cost, travel and stay, child cancer, palliative and end-of-life care, bereavement.
- HIV/AIDS: confidentiality, disclosure to partner, stigma, ART adherence, children affected by AIDS; governed by the HIV and AIDS (Prevention and Control) Act, 2017 — bars discrimination and requires informed consent for testing.
- Palliative care: pain, dignity, advance planning, family care-giver support — Kerala's community-based palliative care (Neighbourhood Network in Palliative Care) is the global example.
- Maternal and child health: anaemia, institutional delivery, JSY/JSSK entitlements, adolescent health (RKSK).
- TB: nutrition support under Ni-kshay Poshan Yojana (DBT for the treatment period; the monthly amount was revised upward — check the current circular before quoting), contact tracing, workplace stigma.
Methods used: social case work (the dominant method here), group work (patient and care-giver support groups, ward groups, de-addiction groups), community organisation (camps, village health committees), social welfare administration, social action and advocacy, research.
Core skills: interviewing, active listening, empathy, observation, home visit, record-writing, crisis intervention, referral, networking, documentation, team work in a multidisciplinary team.

Psychiatric social work: assessment and intervention

Multidisciplinary team: psychiatrist (diagnosis, medication), clinical psychologist (psychometry, psychotherapy), psychiatric social worker (psychosocial assessment, family and community work), psychiatric nurse, occupational therapist.
Psychosocial assessment content: presenting problem, personal and developmental history, family history and genogram, premorbid personality, socio-economic and occupational history, social support, stressful life events, substance use, treatment history, disability and functioning, insight, risk (suicide/harm), family burden and expressed emotion.
Tools commonly taught: genogram and eco-map; Family Burden Interview Schedule (Pai and Kapur); General Health Questionnaire (GHQ-12); PHQ-9 and GAD-7 screeners; IDEAS (Indian Disability Evaluation and Assessment Scale) for mental-illness disability certification; WHODAS 2.0; Socio-Economic Status scales (Kuppuswamy, modified); AUDIT and CAGE for alcohol; Mini Mental State Examination for cognition.
Interventions:
- Psychoeducation — explaining illness, course, medication and relapse signs to patient and family; the single most evidence-backed family intervention in Indian schizophrenia care.
- Family intervention — reducing high expressed emotion (criticism, hostility, emotional over-involvement), problem-solving, communication training, care-giver burden reduction.
- Crisis intervention — short, focused, time-limited work at the point of breakdown (Caplan/Roberts models): ensure safety, ventilate, restore coping, mobilise support, follow up.
- Counselling and brief therapies — supportive, cognitive-behavioural techniques, motivational interviewing (especially addiction), relaxation, activity scheduling.
- Psychiatric rehabilitation — daily-living skills, social skills training, vocational training, sheltered and supported employment, half-way homes, day care centres, self-help groups.
- Case management and after-care — follow-up, defaulter retrieval, drug compliance, linking to disability pension and certification.
- Suicide prevention — risk assessment, means restriction, safety planning, Tele-MANAS (national tele mental health helpline, number 14416), follow-up contact.
- De-addiction — detoxification support, relapse prevention, family work, aftercare; centres funded by the Ministry of Social Justice and Empowerment under NAPDDR, and IRCAs.
Community mental health: District Mental Health Programme (DMHP) under the National Mental Health Programme (NMHP, launched 1982; DMHP from 1996, based on the Bellary model) — each DMHP team includes a psychiatric social worker; functions include OPD, outreach, school and workplace mental health, suicide prevention and life-skills education.

Legal, ethical and institutional framework in India

Mental Healthcare Act, 2017 (in force 29 May 2018; replaced the Mental Health Act, 1987): rights-based. Key features a student must know — right to access mental healthcare, right to community living, protection from cruel treatment, advance directive, nominated representative, decriminalisation of attempted suicide (Section 115 presumes severe stress and bars prosecution), restrictions on ECT (prohibited for minors without permission and without anaesthesia and muscle relaxants), Mental Health Review Boards, State and Central Mental Health Authorities, registration of mental health establishments, and inclusion of psychiatric social worker in the definition of mental health professional (with prescribed qualification/experience).
Rights of Persons with Disabilities Act, 2016: 21 specified disabilities including mental illness, intellectual disability, autism spectrum disorder, specific learning disabilities; 4% reservation in government jobs for benchmark disability (with 1% for the category covering mental illness and multiple disabilities), 5% in higher education, UDID card, certification, accessibility and non-discrimination.
Rehabilitation Council of India Act, 1992: regulates rehabilitation professionals and courses; M.Phil in Psychiatric Social Work is an RCI-recognised qualification with a CRR registration number — practising rehabilitation work without registration is an offence under the Act.
National Mental Health Policy, 2014; National Suicide Prevention Strategy, 2022; National Tele Mental Health Programme (Tele-MANAS, 2022).
Other Acts routinely used: Narcotic Drugs and Psychotropic Substances Act, 1985; Juvenile Justice (Care and Protection of Children) Act, 2015; Protection of Children from Sexual Offences Act, 2012; Protection of Women from Domestic Violence Act, 2005; Medical Termination of Pregnancy Act, 1971 (amended 2021 — limit extended to 24 weeks for specified categories); PCPNDT Act, 1994; Clinical Establishments Act, 2010; Consumer Protection Act, 2019 (medical services); Transplantation of Human Organs and Tissues Act, 1994.
Ethics: confidentiality and its limits (danger to self or others, court order, statutory reporting of child abuse under POCSO), informed consent, self-determination, non-judgemental attitude, controlled emotional involvement, individualisation, professional boundaries (no dual relationship, no accepting gifts/money), documentation integrity, cultural sensitivity. The NAPSWI (National Association of Professional Social Workers in India) code of ethics is the reference text; India still has no statutory social work licensing council for general social work — only RCI covers rehabilitation/psychiatric practice.

Process of practice — step by step

Referral / intake: from doctor, ward, OPD, helpline, walk-in or outreach; record the reason for referral.
Engagement and rapport: privacy, introduction, purpose, confidentiality statement, consent.
Psychosocial study: interview patient and family, home visit if needed, collateral information, standardised tools.
Social diagnosis / psychosocial formulation: predisposing, precipitating, perpetuating and protective factors; strengths and needs.
Goal setting and intervention plan with the patient (and the multidisciplinary team), written and time-bound.
Intervention: counselling, psychoeducation, family work, resource linkage, advocacy, group work.
Monitoring and recording: progress notes, team meeting/case conference presentation.
Evaluation: against goals, using functioning, burden, adherence and satisfaction measures.
Termination and after-care: summarise gains, plan follow-up, hand over to community resource, close the record.

Advantages, limitations and comparisons

Advantages: improves adherence and reduces readmission; reduces length of stay through planned discharge; converts entitlements into actual money for the poor; reduces family burden and relapse through psychoeducation; gives the clinical team social data it cannot collect; strengthens patients' rights compliance in hospitals.
Limitations: very few sanctioned posts (most district hospitals have none); low worker-to-patient ratio; subordinate status to clinicians in team hierarchy; no national licensing for general social work; poor pay in NGOs; heavy documentation and scheme paperwork; burnout and vicarious trauma; stigma limiting family cooperation; urban concentration of mental health services (India's psychiatrist availability is far below the WHO-suggested norm — around 0.75 per 100,000 against about 3 recommended, per NMHS 2015-16 era estimates; figures vary by source and year).
Medical versus psychiatric social work: same methods, different emphasis — medical work is shorter, more resource- and crisis-oriented, often one or two contacts; psychiatric work is longer, family-centred, rehabilitation-oriented, with relapse and disability management across years.

Key points

Medical social work - professional help with the social, emotional and economic consequences of physical illness in a health setting.
Psychiatric social work - psychosocial assessment, family intervention and rehabilitation in mental health settings; a regulated field via RCI.
Richard Cabot, 1905, Massachusetts General Hospital - origin of hospital social work; J. J. Hospital, Bombay, 1946 - first in India; NIMHANS (AIIMH, 1954) - first psychiatric social work training in India.
Biopsychosocial model - illness results from biological, psychological and social factors together; the professional basis for the role.
Medico-social case record - the written psychosocial study, diagnosis, plan and progress notes kept in the patient's file.
Social diagnosis - formulation of predisposing, precipitating, perpetuating and protective factors, not a medical label.
Mental Healthcare Act, 2017 - advance directive, nominated representative, Mental Health Review Boards, decriminalised attempted suicide, ECT restrictions, psychiatric social worker recognised as a mental health professional.
RPwD Act, 2016 - 21 disabilities, 4% job reservation for benchmark disability, 5% in higher education, UDID card.
IDEAS - Indian scale used to quantify mental-illness disability for certification.
Family Burden Interview Schedule (Pai and Kapur) - standard Indian tool for objective and subjective care-giver burden.
Expressed emotion - criticism, hostility and emotional over-involvement in the family; high EE predicts relapse, and reducing it is a core intervention.
Psychoeducation - structured teaching of illness, treatment and relapse signs to patient and family; strongest evidence base in Indian practice.
Crisis intervention - brief, time-limited, here-and-now work to restore pre-crisis functioning; not long-term therapy.
DMHP - district-level delivery arm of the National Mental Health Programme, with a psychiatric social worker in the team; modelled on Bellary.
Tele-MANAS (14416) - national tele mental health helpline for counselling and referral.
Ayushman Bharat PM-JAY - ₹5 lakh per family per year for secondary and tertiary care; the medical social worker's main financing tool, alongside state schemes and relief funds.
Discharge planning - arranging home care, follow-up, referral and entitlements before discharge; reduces readmission.
Confidentiality has limits - risk to life, statutory reporting (POCSO, JJ Act) and court orders override it; always say so at the start.

Formulas and examples

Standardised screener score = Σ (item scores); interpret against published cut-offs. PHQ-9: 9 items × 0-3 → 0-27; 0-4 minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. GAD-7: 7 items × 0-3 → 0-21; cut-off ≥10 for probable anxiety disorder.
Disability percentage (mental illness, IDEAS) = sum of 4 item scores (self-care, interpersonal activities, communication/understanding, work) each 0-4, plus a score for duration of illness → converted to a percentage by the prescribed IDEAS conversion table (Global disability score of 0-20 maps to a % band). Use the official table; do not interpolate.
Out-of-pocket expenditure (OOPE) = Total treatment cost − (insurance/scheme payment + charity/relief fund + employer reimbursement)
Catastrophic health expenditure = OOPE as % of household consumption expenditure; the commonly used threshold is OOPE > 10% of total household expenditure (or >40% of non-food expenditure).
Care-giver burden index = Σ objective burden items + Σ subjective burden rating (Family Burden Interview Schedule: items rated 0 = no burden, 1 = moderate, 2 = severe)
Treatment adherence (%) = (doses actually taken ÷ doses prescribed) × 100; ≥ 80% is the usual adherence cut-off
Default/dropout rate (%) = (patients who stopped attending ÷ patients registered) × 100
Caseload per worker = total active cases ÷ number of social workers (units: cases per worker)

Example 1 — Catastrophic expenditure and scheme linkage. A daily-wage family in Nagpur spends ₹2,40,000 on the father's cardiac surgery. Annual household consumption expenditure is ₹1,80,000. PM-JAY covers ₹1,70,000 of the package; a hospital poor-patient fund gives ₹20,000.

OOPE = 2,40,000 − (1,70,000 + 20,000) = ₹50,000.
OOPE as % of annual household expenditure = 50,000 ÷ 1,80,000 × 100 = 27.8% → far above the 10% threshold, so this is catastrophic expenditure even after insurance.
Before scheme linkage it would have been 2,40,000 ÷ 1,80,000 = 133% of annual expenditure.
Social work action: apply to the Chief Minister's Relief Fund / Rashtriya Arogya Nidhi for the balance, negotiate generic drugs and a Jan Aushadhi prescription, arrange travel concession, and plan income support since the earner will be off work.

Example 2 — PHQ-9 scoring and response. A 42-year-old woman on dialysis scores: little interest 2, down/hopeless 3, sleep 3, tired 3, appetite 2, feeling bad about self 2, concentration 1, psychomotor 1, thoughts of self-harm 1.

Total = 2+3+3+3+2+2+1+1+1 = 18 → moderately severe depression.
Item 9 is positive (score 1) → mandatory suicide risk assessment the same sitting: ask about ideation, plan, means, intent, past attempt; remove means; make a written safety plan; involve a nominated family member with consent.
Action: refer to psychiatry the same day, begin supportive counselling, psychoeducate on depression in chronic kidney disease, and screen for dialysis non-adherence as a self-harm route.

Example 3 — Family burden and after-care plan. A 26-year-old man with schizophrenia, 4 years' illness, 3 admissions. Family Burden Interview Schedule: financial burden 2, disruption of routine activities 2, disruption of family leisure 2, disruption of family interaction 1, effect on physical health of others 1, effect on mental health of others 2 → objective burden total = 10 of 12 (severe). Mother reports subjective burden as "severe".

Adherence check: prescribed 60 doses in 2 months, 33 taken → 33 ÷ 60 × 100 = 55%, well below the 80% cut-off → non-adherence is the likely relapse driver.
Plan: psychoeducation (4 sessions), consider long-acting injectable with the psychiatrist, reduce expressed emotion through communication training, enrol mother in a care-giver support group, apply for disability certification via IDEAS and the UDID card, link to a day-care/vocational unit, monthly follow-up with a defaulter-tracing call.

Example 4 — Caseload and departmental planning. A district hospital medical social service unit has 2 social workers; in a month it handles 640 new OPD referrals and carries 180 active cases.

Caseload = 180 ÷ 2 = 90 active cases per worker; new referrals = 640 ÷ 2 = 320 per worker per month.
On 24 working days, that is 320 ÷ 24 ≈ 13.3 new cases per worker per day; at 20 minutes each that is ≈ 4 hours 27 minutes of interviewing alone, leaving little time for home visits, groups or records.
Evidence-based ask: sanction a third post, or triage — screen all, take full psychosocial study only for flagged categories (destitute, catastrophic cost, suicide risk, medico-legal, non-adherent).

Example 5 — TB defaulter retrieval. A TB unit registered 250 patients in a quarter; 30 stopped attending.

Default rate = 30 ÷ 250 × 100 = 12%.
The social worker traces 30, contacts 24; reasons: migration 9, side-effects 7, stigma at work 4, alcohol use 3, cost of travel 1.
After intervention 21 restart → retrieval = 21 ÷ 30 × 100 = 70%, bringing effective default down to 9 ÷ 250 = 3.6%.
Each reason needs a different response: transfer-out to the destination unit, side-effect management with the medical officer, workplace advocacy and confidentiality, de-addiction referral, and Ni-kshay Poshan Yojana plus travel support.

Aspect	Medical social work	Psychiatric social work
Primary setting	General hospital, speciality unit, PHC/CHC	Mental hospital, psychiatry OPD, DMHP, de-addiction, rehab centre
Dominant concern	Access, cost, adjustment to illness, discharge	Family intervention, relapse, disability, reintegration
Typical duration	Short — days to weeks	Long — months to years, episodic
Key tools	Socio-economic scale, scheme eligibility, medico-social record	Genogram, FBIS, IDEAS, PHQ-9/GAD-7, psychoeducation modules
Key law	PM-JAY rules, Clinical Establishments Act, THOTA, HIV Act 2017	Mental Healthcare Act 2017, RPwD Act 2016, RCI Act 1992, NDPS Act
Regulation of the worker	No statutory licence; MSW qualification	M.Phil PSW with RCI (CRR) registration for rehabilitation practice

Where it is used

Government tertiary hospitals and institutes: medical social service officer / psychiatric social worker posts at AIIMS, PGIMER Chandigarh, JIPMER, NIMHANS, CIP Ranchi, IHBAS Delhi, state medical colleges and ESIC hospitals.
Private and trust hospitals: Tata Memorial Hospital (oncology and the Cancer Patient Aid Association), Apollo, Fortis, Christian Medical College Vellore, Aravind Eye Hospitals — patient-welfare, insurance/TPA counselling and CSR-funded treatment desks.
National programmes and public health: DMHP teams, NTEP (TB) and HIV/ART and Targeted Intervention projects under NACO, NTCP, RBSK and RKSK school and adolescent health, National Programme for Health Care of the Elderly, Tele-MANAS centres.
De-addiction and rehabilitation: Integrated Rehabilitation Centres for Addicts (IRCAs) under the Ministry of Social Justice and Empowerment's NAPDDR, half-way homes, day-care centres, sheltered workshops, old-age and dementia care.
NGOs and community organisations: The Banyan (Chennai), SCARF, Sangath, Basic Needs India, Vandrevala Foundation, AASRA and iCALL (TISS) helplines, palliative care networks in Kerala, Child Welfare Committee and One Stop Centre placements.
Corporate and allied roles: employee assistance programmes (EAP) and workplace counselling, insurance/TPA medical coordination, school counsellor and special-education support roles, CSR health project managers, and research posts in ICMR/NIMHANS-funded community mental health studies.

Interview questions

Q: What exactly does a medical social worker add that a doctor or nurse cannot? A: The social diagnosis — the family, income, housing, occupational and stigma factors behind the illness — plus the resource linkage, counselling and discharge planning that turn a clinical prescription into something the patient can actually follow.
Q: Name the main rights the Mental Healthcare Act, 2017 gives a person with mental illness. A: Right to access affordable mental healthcare, community living, dignity and protection from cruel or degrading treatment, confidentiality, legal aid, an advance directive and a nominated representative, with Mental Health Review Boards to enforce them.
Q: How did the 2017 Act change the position on attempted suicide? A: It presumes a person who attempts suicide is under severe stress and bars prosecution under the Indian Penal Code provision (now reflected in the Bharatiya Nyaya Sanhita framework), placing a duty on the government to provide care and rehabilitation instead of punishment.
Q: What is an advance directive and who can override it? A: A written statement of how a person wishes to be, or not to be, treated for mental illness made while they have capacity; it can be reviewed, altered or cancelled by the Mental Health Review Board on application.
Q: What is expressed emotion and why do you care about it? A: Criticism, hostility and emotional over-involvement by family members; high expressed emotion predicts relapse in schizophrenia, so family psychoeducation and communication training are aimed at reducing it.
Q: A patient's relative asks you for the patient's HIV status. What do you do? A: Refuse without the patient's informed consent — the HIV and AIDS (Prevention and Control) Act, 2017 protects confidentiality — and instead work with the patient on supported disclosure to the person who needs to know.
Q: How do you handle a destitute, unidentified patient admitted after an accident? A: Record a detailed medico-social history, inform hospital administration and police, attempt restoration through missing-person channels and media/helplines, arrange free treatment under the hospital's poor-patient fund or state scheme, and plan placement in a shelter or home if no family is traced.
Q: What is crisis intervention and how is it different from counselling? A: It is short, focused, present-centred work during acute breakdown aimed at restoring the pre-crisis level of functioning; counselling can be longer, exploratory and developmental.
Q: Which qualification lets you practise as a psychiatric social worker in a mental health establishment? A: An MSW with the prescribed psychiatric social work experience, or the RCI-recognised M.Phil in Psychiatric Social Work with a CRR registration number — the Mental Healthcare Act, 2017 and the RCI Act, 1992 together set the standard.
Q: How would you assess suicide risk in ten minutes? A: Ask directly about ideation, plan, means, timing and intent; check past attempts, substance use, hopelessness and recent loss; assess protective factors and supervision; then restrict means, make a written safety plan, involve a nominated person with consent and arrange same-day psychiatric review.
Q: Your assessment of a family's need differs from the treating doctor's discharge decision. What do you do? A: Present the psychosocial evidence in writing at the case conference, propose a workable alternative such as short-stay extension or day care with a home visit, and record both the recommendation and the final team decision — the clinical decision is the team's, but the record must show the social risk was raised.
Q: What is IDEAS used for? A: Scoring disability due to mental illness across self-care, interpersonal activities, communication and work plus duration, to arrive at the percentage used for a disability certificate and UDID card under the RPwD Act, 2016.

Common mistakes

Treating the social worker as a "scheme form filler" and writing the psychosocial study only as a financial eligibility note, with no social diagnosis or plan.
Quoting the repealed Mental Health Act, 1987 or its "licensed psychiatrist/reception order" language in answers instead of the Mental Healthcare Act, 2017 — and still saying attempted suicide is a crime.
Confusing the roles: giving the social worker's answer as psychometric testing or diagnosis (that is the clinical psychologist's and psychiatrist's work).
Promising scheme money, bed or a disability percentage before verifying eligibility and the current circular — amounts and lists change by state and year.
Breaching confidentiality casually — discussing a case at the nursing station, naming a patient in a report, or disclosing HIV or psychiatric status to employers and relatives without consent; equally, promising absolute confidentiality when risk to life and statutory reporting override it.
Working with the patient alone and ignoring the family and the home — in Indian practice the family is both the main care-giver and often part of the problem, so the home visit and burden assessment are not optional.
Writing exam answers as lists of virtues with no Indian specifics — no Act, no scheme name, no tool, no institution; and in placement interviews, being unable to state a single standardised tool or a step-by-step intervention plan.