By Kirsten Bingham, Dr Jill Hemmington, Dominic Marley and Nick Perry
This is the first in a series of regular pieces in Community Care from the co-chairs of the AMHP Leads Network. Through these columns, we aim to reach out to approved mental health professionals (AMHPs) across England and Wales: to report back, but also to seek advice and new connections.
The AMHP Leads Network has been in existence for 20 years, but AMHP leads are not formally constituted posts; nor are they effectively mandated through statutory guidance as are local authority principal social workers. The network is a voluntary community of interest, and we are in the process of refreshing the way it operates.
Platforming AMHP expertise
We want to build beyond the original aim of the grouping: to take it from being for AMHP leads, to being for AMHP leaders. We may even change its name.
We know that whilst AMHP expertise is respected (if not valued) locally, it can often be overlooked at a national level, and we seek platforms to share it more effectively.
We are determined to ensure that there is a regional structure in place for all AMHPs: a structure within which to escalate concerns about practice in every part of England and Wales, with pathways through which this AMHP intelligence can be brought together and used to inform policy and decision making.
We are acutely aware that the AMHP role is a complex, risky and emotionally draining one, and we want to do all that we can to support wellbeing and workforce planning.
We also see it as vital that AMHPs from minoritised communities have adequate support, protection and representation – and that these colleagues are empowered to take leadership roles.
Sharing knowledge and concerns
AMHPs sharing knowledge and concerns is vital for the work that we do and the areas we seek to serve.
Recently, we were told about workforce planning difficulties in the Midlands: where the front door for a new super-hospital had crossed a local authority boundary and the AMHP service responsible was struggling to cope with demand, as well as inadequate provision of health-based places of safety.
The East of England AMHP Forum has shared observations and challenges in relation to differing and changing approaches to arranging Mental Health Act 1983 work from custody, including an increasing trend of using section 136 across the region.
Conversely, we have heard about issues in London and along the South Coast, where the Right Care, Right Person policy has led police officers to begin justifying restraining people via mental capacity assessments rather than section 136.
We are hearing from colleagues in the North West that doctors’ medical recommendations are being rescinded by trust internal processes when bed availability has collapsed.
We continue to hear reports from our regional representatives about what is likely to be hundreds of people being de facto detained in emergency departments every week. This involves days and sometimes weeks of waiting for compulsory admission under the Mental Health Act, with even longer waits if medical recommendations expire, which is also happening.
Influencing Mental Health Act reform
And we hope you will have seen our recent statement, clarifying that the amended Mental Health Act will not include a new category of “authorised person” able to carry out detentions under sections 135 and 136, alongside the police. There will be a consultation on these powers which may inform the drafting of the new code of practice. More to follow on this.
These are just some of the AMHP experiences that we are hearing about through our regional reps; and we want to hear from you too.
You can contact us at: amhpleads.network@researchinpractice.org.uk
We can’t AMHP-lify the issues if we aren’t in close contact with the AMHPs. So that must be the priority. As part of that, let us know your thoughts about priorities for column #2.
The ALN co-chairs are Kirsten Bingham, Dr Jill Hemmington, Dominic Marley and Nick Perry
