AMHP decision not to assess

If an AMHP screens out a MHA request, can a psychiatrist request an other MHA from an other AMHP

Hi Tony, in general I’d say no, unless there is more information/ a change in circumstances/ something that you think hasn’t been taken account of.
However, I’d recommend you engage further, as for an explanation (if not already given) and talk through the threshold being set, and what would be happening if the threshold was made.

The legal expectation is that AMHPS ‘consider the case’ - if they’ve done so and given a reasoned explanation, looking for an AMHP more likely to agree with you wouldn’t really be within the spirit of the code or act.

Claire

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Of course, if the necessary medical recommendations have been made, the Nearest Relative could step forward to make the application.

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It would be interesting to hear how the AMHP/Local Authority have, “considered the case,” and justifies the decision to not assess. I have presumed the decision was to not asses rather than not make an application. There are a lot of reasons why an AMHP might decline to assess a person, not all of them justifiable or relating to the individual’s current situation or mental state. I have known assessments to be declined based on the fact that the community team have not seen the person for any number of days…

Hi Claire,Guy and Martin. Thankyou for your responses. I have not looked at this site untill today for varios reasons which i will bore you with.

However, all your answers are interesting. The situation was a 20 ish year old was in a local psychiatric ward on a volutery basis afterseeking help due to seeing and hearing various imaginary people that she was scared of.
P had used a number of illicit drugs up to the point of their admission on a regular basis over the previous six months.

On admission P got no assisstance with withdrawl. P was a know substance abuser and i dont believe P was truefull about the type or amount they used prio to hospital admission.
P’s behaviour became more erratic and prblomatic as P refused psychtrpic medication. The Amhp was told P was not harming or trying to leave. Amhp, who was an ex substance misuse worker informed ward staff that they would not assess as P had only been in hospital 3 days and could be withdrawing and that they,The Amhp would contact the ward the next day to follow up.
The ward contacted an other Amhp who carried out an MHA assessment detaining P on a sec 2. P was discharged 3 days later and not been admitted to ward since. Over six months ago. Does anyone know the paragragh number in Jones or the code of practice that refers to re assesments requested by medics. Thanks Guys, any pointers will be greatfully recieved . Tony

Interesting comments here from an inquiry:

"8.19The case was then passed without delay to the AMHP who decided on how to proceed; in this case by handing to the home treatment team. The investigation team could not find evidence within the clinical records the rationale for the AMHP passing the referral straight to the home treatment team. In particular, there is no articulation of the legal requirement to consider the patient’s case on behalf of the County Council within which it was reasonably believed that Mr K was residing and receiving GP services.

8.20 The Mental Health Act sets out in some detail what the AMHP should do if they think an application is necessary but is virtually silent on what should happen if they don’t think the patient should be detained. The Code of Practice is a guide for AMHPs that is not to be departed from save for good reason or faith. However, what is clear to us is that is that a form of an assessment must be undertaken, and therefore that the duty to consider the patient’s case on their behalf should be an assessment.

8.24 At face value, it would appear that the AMHP (AMHP1) did consider a viable alternative to achieve the proposed assessment or treatment, in that the case was handed over to the home treatment team. However, there is a lack of evidence that sets out how the AMHP considered this decision with knowledge of all the circumstances of the case (the context of the GP’s request), and in particular how the AMHP has used their knowledge of mental disorder to support the decisions made in relation to all of the circumstances of the case (the delusional nature of the illness being described by the GP). The GP’s request was clear in that he was asking for an assessment under the Mental Health Act

8.32 It is our view that:
• the legal duty to coordinate and/or complete a Mental Health Act assessment rests with the AMHP; and
• that consideration of the least restrictive alternative should form part of an actual assessment of the facts of the case and all of the circumstances of the case.

8.44 In summary, no assessment of Mr K was carried out by the AMHP on duty when the request was made by the GP. However, we are of the view that by passing the assessment to the Home Treatment Team, the AMHP retained vicarious responsibility for arranging and coordinating the assessment process. Therefore we are of the view that the relevant sections of the Code of Practice that refer to an assessment having been carried out are relevant."

Full report available here: https://www.england.nhs.uk/south/wp-content/uploads/sites/6/2022/02/final-report-2017-15440-v3.7.pdf

Hi Nick, You are a star. Thank you and sorry its taken a while to read and respond.

Tony