Hi all, a request has come in for a MHA assessment for a 9 year old child with the AMHP service being contacted at the last minute, and being given some quite conflicting information - currently on a children’s ward in a general hospital with either 2 or 4 to 1 staffing, apparently under 5,2, mother saying he cannot come home partly because of risk to even younger children, doctor completed med rec without discussing with anyone else etc.
Question - has any other area ever used the MHA for someone this young - I know the whole “zone of parental control”/ Gillick competence etc is an ever evolving area, but my feeling is that a 9 year old should not generally need MHA assessment, and if they do then it is a far from simple matter for a duty AMHP to undertake under pressure of time.
Morning,
A very sad read.
A child can be detained under the MHA if there is a mental disorder and the MHA applies.
Of course it has to be that the child is refusing to remain on the ward and has a mental disorder. If there are domestic issues, then it would fall under social care.
CAMHS tier 4 clinicians must be involved for anyone under 18, and for someone of this age it’s even more crucial. There have been some significant disputes regarding the role of the CAMHS NHSEI clinicians as gatekeepers to beds and their relationship to AMHPs and the MHA assessment process, but with a situation such as this, there is no doubt that their involvement is crucial.
You no doubt understand this but the decision to admit this child needs to be inextricably linked to the decision to treat them when they are admitted. You’ve mentioned the risk of returning home but you’d have to be absolutely sure what the point of putting the child through this would be.
How have you got on? I’m sorry I didn’t have the capacity to think about this this morning. My youngest MHA assessment was for someone who was 12 years old and it was exceptionally challenging. Sorry not to have been able to hep earlier.
Sorry to come into this so late on.
Possibly you have already proceeded & actions in place.
Of course without much information of presentation and mainly risks that are “demanding “ a MHA one can only say so much.
In my opinion, Social care- children and families need to be involved and ascertain if any needs arising from this child can be addressed via their route and expertise. Involving parent/s is vital.
If an assessment must go ahead a psychiatrist from CAMHS and a joint MHA assessment is crucial so you all 3 (AMHP & 2 doctors) can think it through and agree whats the plan is. Making an application should be avoided as much as possible, the distress is extremely high unless ofcourse its the only option.
Thanks all for the comments - we managed to agree that admission to a tier 4 bed would not be appropriate, especially as his presentation in a busy hospital ward is hardly likely to be a true picture of how he is in more familiar settings. If CAMHS had been pushing for admission I’d like to think parental responsibility would be more appropriate than a MHA admission for a 9 year old, but at one point he was no four to one, which would exceed the “normal” parental control over a nine year old.