I am a volunteer supporting families of adults with mental health conditions. For many years before retiring I was an ASW. I have been told that our local authority are saying to clinicians that before they will come out and join assessments under the MHA section 13 requires them to hold preliminary meetings to decide if such a response is necessary. They are very short staffed and this seems to me like an attempt to protect their resources by adding an unnecessary step in to the process. Has anyone else come across S13 being used in this way? Is it legitimate?
A MHA assessment is not mentioned as such in the legislation. Section 13 places a duty on the relevant local authority to arrange for an AMHP to take the patient’s case into consideration. This does not mean the AMHP must immediately set up a full bells-and-whistles MHA assessment. There has been increasing discussion within the AMHP profession during the last year or two about the importance of careful consideration and exploration of alternatives before going to the MHAA process. It is a fact that in the current state of the NHS and mental health services that it is far from unknown for a referral to be made to the AMHP service before alternatives have been explored.
So no, increased discussion at the point of referral is not a way of protecting their resources, it is an attempt to maximise the role of the AMHP as exploring the least restrictive alternative, rather than the routine executor of detention.
Those of us who are very long in the tooth may recall a local authority circular from 1986 (LAC(86)15 to be exact). It states (in relation to ASWs rather than AMHPs of course):
“Approved social workers should have a wider role than reacting to requests for admission to hospital, making the necessary arrangements and ensuring compliance with the law…Their role is to prevent the necessity for compulsory admission to hospital as well as to make application where they decide this is appropriate”.
This is an attempt to return to this role - make applications where appropriate, but to fully explore less restrictive alternatives, as the current Code of Practice requires.
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Thanks Steve. I understand what you’re saying. It’s a long time since I acted as an ASW and I guess I had slipped into the assumption that it was at the formal MHA assessment that the ASW would make sure all alternatives to compulsory admission had been fully explored
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I have always seen an MHAA (and potential Application) as the final option/consideration.
I was an ASW/AMHP for about 20 years and it is my opinion that the “last chance” event was about resources (lack of) rather than treatment options/interventions.
It is reassuring to hear @SteveC say, “There has been increasing discussion within the AMHP profession during the last year or two about the importance of careful consideration and exploration of alternatives before going to the MHAA process.”
Very often, MHAAs are desperate calls for help (from professionals) to sort out a situation that community services are unable to contain. The result is likely to be that an individual will be deprived of their liberty.