Approved mental health professional

The role of Approved Social Worker, or ASW, has now been replaced by that of Approved Mental Health Professional, or AMHP, in England and Wales.

The 2007 amendment of the Mental Health Act 1983 abolished the professional role of the Approved Social Worker and created that of the Approved Mental Health Professional . This role is broadly similar to the role of the Approved Social Worker but is distinguished in no longer being the exclusive preserve of social workers. It can be undertaken by other professionals including community psychiatric nurses, occupational therapists and psychologists.

Professional role

Approved Mental Health Professionals (AMHPs) are trained to implement coercive elements of the Mental Health Act 1983, as amended by the Mental Health Act 2007, in conjunction with medical practitioners. They have received specific training relating to the application the Mental Health Act, usually lasting one year, and perform a pivotal role in assessing and deciding whether there are grounds to detain mentally disordered people, who meet the statutory criteria, without their consent.

Assessment and detention under the Act is colloquially known as being 'sectioned', or 'sectioning', in reference to the application of sections of the Mental Health Act relevant to this process.

Mental Health Act assessments

AMHPs are responsible for organising and co-ordinating, as well as contributing to Mental Health Act assessments. To be detained under the Mental Health Act (1983), individuals need to be assessed as suffering from a recognised mental disorder of a nature or degree which warrants detention in hospital on the grounds of health or risk to themselves or others. The AMHP's role includes arranging for assessments of the person concerned by two independent medical practitioners, at least one of whom is specially qualified in mental health, and interviewing the individual themselves. Efforts should be made to seek alternatives to detention, such as arranging appropriate support in the community, in line with the principle of care in the least restrictive environment . AMHP's are expected to take account of factors such as gender, culture, race, age, sexuality and disability in their assessments. Efforts should be made to overcome any communication barriers, such as to do with language or deafness, and interpreters may be requested.

The nearest relative

An important factor in assessments is the role of the nearest relative. This differs from simply next of kin and is determined according to a specific hierarchy outlined in the Mental Health Act (1983). If the individual is to be assessed under Section 2 (assessment) of the Act, the AMHP is expected to make reasonable efforts to contact the nearest relative, ask their opinion and to inform of their right to request discharge of the person concerned. If the individual is to be assessed under Section 3 (treatment) of the Act, the AMHP must ask the nearest relative if they object to the individual being detained and if they do then the detention cannot go ahead. The rules around the nearest relative are quite complex. There are occasions when the nearest relative need not be contacted or may be displaced. .

Detention in hospital

If the both medical practitioners agree that the person needs to be detained under the Mental Health Act then the AMHP is able to make the final decision as whether to proceed with the application. For Section 2 and Section 3, assessments by medical practitioners need to take place with no more than 5 days clear days between each other (in effect, within 7 days). AMHPs then have up to 14 days from the time of the second medical assessment to make a decision. If proceeding with the application, AMHPs are then responsible for organising the detained individual's conveyance to hospital, which is usually done by ambulance but, where there is risk to others, may be done by police. They are expected to hand over information verbally and in writing to nursing staff, checking and submitting Mental Health Act administrative papers for them to be processed by the relevant Mental Health Act Manager.

Community Treatment Orders

The revised Mental Health Act makes provision for Community Treatment Orders (CTOs). CTOs can be arranged for patients detained under Section 3 (treatment) of the Act, allowing them to return to a place of residence in the community, depending on particular specified conditions, such as to the taking of medication or participating in therapies. If conditions are breached, patients can be formally recalled to hospital for a period of up to 72 hours, during which a decision should be made as to whether their CTO should be revoked. If the CTO is revoked, patients return to being at the beginning of a Section 3 and are automatically referred for a mental health review tribunal. AMHPs work with the Responsible Clinician and others in the process of assessment and decision making in setting up CTO's and in making decisions on revocation.

Further reading

The Mental Health Act Code of Practice is the best guide to the roles and responsibilities of each professional involved in Mental Health Act assessments. Though not statute law it functions as guidance which professionals are expected to follow or give good reason and rationale for not doing so.

Richard Jones's Mental Health Act Manual (11th edition) has long been a standard reference for Approved Social Workers and now AMHPs. It details statute law and guidance with detailed notes and reference to case law.

The Nearest Relative Handbook by David Hewitt details the complicated legal issues around the definition of, powers, declaration and displacement of the nearest relative and has been updated to include the new amended Mental Health Act 2007.

External links

• Wiki Mental Health - Comprehensive information on mental health law in England and Wales, including full text of the Mental Health Act (1983), as amended by the Mental Health Act (2007), and case law.