The Role of the AMHP: A Fool’s Errand?

Caroline Norrie and Nicole Steils are researchers at the Social Care Workforce Research Unit (SCWRU), King’s College London. (618 words)

The identity of Approved Mental Health Professionals (AMHPs) was the subject of a joint SCWRU and Making Research Count seminar held on Thursday, 23 August 2018, at King’s College London (KCL) as part of the Contemporary Issues in Mental Health series.

Dr Caroline Leah

Dr Caroline Leah

The presenter, Dr Caroline Leah, Senior Lecturer at the Faculty of Health, Psychology and Social Care at Manchester Metropolitan University, discussed findings from her recently completed PhD about the role and identity of AMHPs, as well as enabling the audience, many being practising AMHPs, the chance to participate in lively discussions throughout the seminar.

An AMHP is a professional who is authorised to make certain legal decisions and applications under the Mental Health Act 1983; their powers include sectioning service users. This professional will usually be a social worker, who has undertaken additional training. In 2007, however, the law was amended to allow other mental health professionals to train for and to undertake this role. It is therefore now possible for psychiatric nurses, occupational therapists or psychologists to qualify as AMHPs, although this is still unusual. Continue reading

Research reveals reasons for low take-up of Approved Mental Health Professional role

Pay levels, poor awareness of the role, and a lack of associated career benefits all discourage health professionals from training and working as Approved Mental Health Professionals (AMHPs), according to new research by the NIHR Social Care Workforce Research Unit at King’s College London.

AMHP Final Report 2018Published today, Who wants to be an Approved Mental Health Professional?, finds that closer working between Mental Health Trusts and local authorities, higher remuneration and enhancing the reputation and profile of AMHP work would encourage more health professionals to take up such positions.

Greater engagement from the Royal Colleges of Nursing and Occupational Therapists, and the Nursing and Midwifery Council, may also make the AMHP role more attractive by helping to embed it in these health professionals’ career plans.

The research highlights how organisational barriers – such as difficulties in managing AMHPs across separate local authority and mental health trust teams – deter many health professionals from taking up the role.

The study consists of more than 50 interviews with individuals involved in AMHP services, as well as a survey of Local Authority AMHP Leads.

Unsurprisingly, health professionals interviewed for the research reported needing a high degree of motivation to become AMHPs, often having to overcome opposition from their managers. Some also feared being responsible for decisions to detain patients, which they thought would make it more difficult for them to establish and maintain therapeutic relationships. Continue reading

At the World Congress of Psychiatry, Berlin 2017

Gaia CetranoGaia Cetrano is a Research Associate at the Social Care Workforce Research Unit, King’s College London. (800 words)

From 8 to 11 October I joined the World Psychiatric Association XVII Congress in Berlin. This was my second WPA Congress; I also attended the previous one in Madrid in 2014. Berlin is a great city, which has developed at a tremendous pace in the last few decades. It perfectly represents how things can change, and thus offered the best context for a congress entitled ‘Psychiatry of the 21st Century’.

Remembering the Madrid Congress, I was expecting this to be a big event, but this one exceeded all my expectations. When I arrived at the venue, Messe Berlin, to join the opening ceremony on the first day, I suddenly felt overwhelmed, if not intimidated, by everything around me. The venue was enormous, there were stands, films, exhibitions, music, and hundreds and hundreds of disoriented-looking people around me (around 10,000 in fact). The programme, with its 900 sessions, was impressive but daunting. Continue reading

Who wants to be an Approved Mental Health Professional?

Stephen MartineauAs the Unit embarks on a new piece of Department of Health commissioned research examining the role of the Approved Mental Health Professional (AMHP), Stephen Martineau and colleagues report from the AMHP Leads Network conference, held in London last week (10 July), and map out some of the background to the study. (977 words)

AMHPs carry out a variety of tasks when it comes to the use of compulsion under the Mental Health Act 1983 (MHA). Chief among these is coordinating the assessment under the MHA of individuals whose mental disorder is such that it fulfils the statutory criteria; the application for a formal admission to a hospital must be ‘founded’ on medical recommendation, as the pink form for a detention under the MHA has it, but the AMHP takes the decision.[1]

Form A2 Section 2 appl by AMHP for admiss for assess-page-001

Form A2. Section 2 MHA: application by an approved mental health professional for admission for assessment (photo links to pdf)

Of course, this is only the very barest description of what is involved in the job: last week, someone who had been the subject of a MHA assessment by an AMHP wrote vividly of the experience in Community Care. Elsewhere, the Masked AMHP has asked, and answered, the question: What is an AMHP?

In making a MHA assessment of a person, AMHPs bring to bear a ‘social perspective’. And it is social workers—initially under the MHA, Approved Social Workers (ASWs)—who have been historically associated with the role. But in 2008 ASWs became AMHPs, and with the change in designation came a loosening of the ties to the social work profession: it was now also possible for certain kinds of nurses, occupational therapists and psychologists to take up the role. Continue reading

Mental Health Workers – We need your help for our research

Tasneem ClarkeTasneem Clarke, Research Officer at the Money and Mental Health Policy Institute, based at King’s College London, discusses the Institute’s latest research, which asks: what can mental health practitioners do to support people in financial difficulty? Please take this two minute quiz to register your interest and help her come up with pragmatic solutions to this difficult issue. (736 words)

Money and mental health – a toxic relationship

As practitioners in mental health services know, life can be messy. The people we work with are rarely only facing one issue; from relationship breakdown to past traumas, economic disadvantage or long-term physical and mental health problems – issues interweave and make each other worse. Continue reading

Mental Health Social Care 2016: Research findings informing policy and practice

Dr Joan RapaportJoan Rapaport reports from the annual event co-hosted by the Social Care Workforce Research Unit and Making Research Count. The day started with a presentation from a user-led study. (1,173 words)

‘The Girls Who Kicked the Hornet’s Nest’: Perspectives from a user-led study on service user experiences of mental health related violence and abuse in the context of adult safeguarding: Dr Sarah Carr, Associate Professor of Mental Health Research, Middlesex University and Alison Faulkner, Independent Survivor Researcher, Mental Health.

‘It’s rather like writing a dark thriller’ were Sarah Carr’s opening comments regarding the research into service user experiences into and concepts of targeted violence and hostility, and prevention and protection. This small-scale exploratory study, led and entirely conducted by mental health service users, fills a gap in safeguarding research. It further provides an embedded knowledge exchange approach between service users, practitioners and agencies throughout the research process. Continue reading

Four studies in mental health social care

Dr Joan RapaportOn Thursday 8 October the Social Care Workforce Research Unit held its second annual Mental Health Social Care conference, in conjunction with Making Research Count. Joan Rapaport, Visiting Research Fellow at the Unit, was there. (2,275 words)

In her opening comments, Jo Moriarty, Deputy Director of the Social Care Workforce Research Unit, highlighted that the seminar was taking place as part of Mental Health Awareness week and that 10 October is World Mental Health Day. She observed that as well as mental health social workers, delegates from a wide range of organizations, in particular housing, were represented in the audience. This confirmed that adult mental health was not specific to one area of practice. Continue reading

Piloting the Sababu Intervention in the wake of Ebola

Meredith NewlinMeredith Newlin, Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s, reports from Sierra Leone. Her post incorporates photographs of the Sababu Training Programme in action last month. (1,386 words)

The Ebola outbreak, which reached Sierra Leone in May 2014, quickly became a global health crisis and caused significant psychosocial distress and a disintegration of communities across West Africa. The case numbers are now dropping and Sierra Leoneans talk about the ‘aftermath’ and a shift towards a recovery phase. However, amid a resource-limited system there is still an urgent call to address the psychosocial needs of individuals and families by enhancing the skills and capacity of the existing workforce. Continue reading

The challenges of mental health for social science and policy

Guntars Ermansons, student in the Department of Social Science, Health and Medicine, introduces a report on a workshop held earlier this summer. See the full report of the workshop. (309 words)

On 19 June 2014, a workshop on “The Challenges of Mental Health for Social Science and Policy” was held at King’s College London, Waterloo Campus. Supported by the King’s Interdisciplinary Social Science Doctoral Training Centre’s Science & Society initiative and organized by the Department of Social Science, Health and Medicine, in collaboration with the Institute of Psychiatry and Social Care Workforce Research Unit, the workshop hosted a number of distinguished speakers and experts on mental health and involved postgraduate and early career researchers. Continue reading

A Mixed-up World

Suzanne has been involved in the work of the Social Care Workforce Research Unit at King’s College London for many years, as a researcher and now as an ‘expert by experience’. She reflects on the integration of the medical versus social models of disability and the sense of dis(ease) which can follow the realisation that this has yet to materialise as a coherent practice.

Over two years ago I joined the ranks of those diagnosed with bipolar mixed affective disorder. I didn’t understand what it meant then in real terms and I am not sure I am much the wiser now. I had assumed it meant what the older term, manic-depressive, conveys quite cogently. I would have highs (which sounded like they might well be fun) and lows (which would not be!). I didn’t realise the significance of the word ‘mixed.’ I have highs and lows all at once and they can cycle very rapidly: sometimes over a few days, sometimes every few hours and—if it’s really bad—fluxing every few minutes. The character of the ups and downs are not what I expected either. The highs are not fun, just periods of great mental agitation when I obsess and worry about things. My head gets busier and busier. The lows are what you might expect—only worse. I feel depressed, sometimes become very tearful and often get overwhelmed by angst. In short: no peace at all.

There is a certain irony here. I had studied mental disorder and Bi-Polar prior to my illness, and worked with many people who had similar mental health problems. I realise now that I had little insight into their ‘lived experience’. I now know too well how hard it is to capture in words and images what such realities feel like. Normal language isn’t designed to accommodate these shady extremes of intensity.

What’s more nothing prepared me for the differences between the medical and social models as regards the ‘lived experience’. I expected that my treatment would be an integrated programme of medication and therapy, but that is not what the NHS offers. I have a committed psychiatrist who is determined to find me the right mix of medication, but it is an inexact science and takes time. I am very fortunate to receive counselling from Mind. The counsellor’s person-centred approach and my Community Health Team care co-ordinator’s style of reflective therapy gives me hope for the future.

So, exactly what have I experienced? I have lived the past two years on a cocktail of drugs some of which are potentially toxic and none of which has solved the problem or enabled me to regain equilibrium in my home or working life. I moved from being a sociable, glass half-full person to one for whom life is half-empty and being told by the doctors that my agitation was the high. I long to have the high that gives great elation—but that doesn’t come my way. Instead I have felt in limbo, argumentative with my family, not living life but existing in a swamp of sorrow or anxiety most of the time.

The medication path is fraught with difficulties. Are my symptoms an expression of the illness or side effects of the drugs? It is not easy to tell. My current medication is not stable at present as I am going through another titration. My psychiatrist sees a lot of me but I have a nagging instinct that if an integrated approach was truly followed I would be able to come off the drugs. Medication alone cannot be the solution or the answer to the symptoms. It provides a platform that should stabilise effects—but a lot else is needed. Is my lived experience the same as others out there?