By Abul Hussain
So what exactly does an AMHP do? At its core, I am here to protect rights and keep people safe under the Mental Health Act 1983, as amended by the Mental Health Act 2007.In practice, the role is about finding the gentlest way forward when someone is in crisis. I weigh risks, think about what someone can manage, and, most importantly, listen to what they want.
This job is pure teamwork. Clinical colleagues bring medical expertise. Ambulance and police support safety. Interpreters bridge language barriers. Housing teams, volunteers and faith groups widen support networks. Relationships matter. Trust improves outcomes. We agree roles and share simple timelines. Information sharing is lawful and proportionate.
The aim is help that is safe and lawful.
Independence matters. My decisions are based on the law and on evidence. I ask about culture and faith. What matters to you matters to me. Things do not go as planned at times. When that happens, I own it, apologise and learn.
When a referral comes in
A crisis referral comes in. History is reviewed. Legal status and risks are checked. I make calls to the person, where possible, and to family friends who know what is happening.Next comes the assessment and the practicalities. We agree where to meet. I think about access needs. I confirm who is attending and plan transport. A backup plan is set.
When we meet, I introduce myself and explain why I am there. Rights are set out in plain language. I listen to concerns. I map out existing support.
Adapting your practice
When someone is frightened or mistrustful, I see that as a signal to adapt. I slow down. I offer a different setting. I bring in a trusted person or an advocate. I use clear rights information. These steps often enable engagement and allow us to plan care together.Someone is in severe distress and has not slept for days. Their behaviour is unsafe. Family members are frightened. If the assessment shows high risk with no safe alternative that day, admission can be the least restrictive option that keeps them safe. No one wants it, but sometimes it is needed.
Alternatives to admission
It does not always go that way. Another person may accept home treatment with daily support from the crisis team. We agree a crisis plan. A peer worker is involved. We set review points. With safeguards in place, they stay at home with family close by.Then there are complex situations. Someone who is terrified of hospitals does not feel safe to engage at first. I leave information and arrange a return visit. A trusted relative joins us the next day. This enables engagement. We agree a home support plan that avoids admission.
These examples show how the same principles guide different paths to safety.
The ethical dilemmas
Decisions affect liberty, dignity and family life. The hardest moments come when wishes appear to conflict with safety. Families may disagree about what should happen.I have stood in corridors at two in the morning wondering if someone who wants to go home is safe to do so. I have made decisions when someone lacks capacity to make relevant decisions and the family want something that does not feel right.
The least restrictive option is not always the safest option. I live with that tension."There is a balance between autonomy and protection from serious harm. When someone says they want to die, do I honour refusal or step in because thinking is clouded? When a parent is struggling and there are children in the home, whose rights should take the lead?
These are not academic questions. They are early morning calls where there is no perfect answer. Supervision and peer reflection keep my practice open to scrutiny. In the end, I make the call and live with it.
Building resilience
This job tests every emotional boundary. You see people at their worst moments. You make decisions that families may dislike. Some cases stay with you. Without resilience, the work will break you.Resilience starts with accepting that I cannot save everyone. I do my best with the information I have. I follow the law. I use my training. Often it is enough. Some days it is not, and that is not always on me.
I debrief after tough cases, speak to trusted colleagues, take annual leave and switch off. I keep hobbies outside mental health, exercise, and eat well. After difficult shifts I take time to recover.
I also debrief when an assessment lands well, so I can repeat the helpful parts.
'Even on hard days, someone was heard and kept safe'
The work needs emotional intelligence and good boundaries. I care deeply, but I cannot carry everyone’s pain home. Learning that boundary took time and near burnout.What keeps me going is knowing that even on hard days, someone was heard and kept safe. That matters when everything else feels impossible.
Demand fluctuates. Bed availability varies. Transport can be delayed at busy times. I manage fatigue with rest breaks, supplies, checklists, and by asking for support as risk grows.
The work spans services. Police, ambulance teams, clinicians, interpreters and carers all contribute. We make mistakes at times and use debriefs to repair relationships. Small improvements matter. Clearer handovers. Better use of community resources. Earlier involvement of advocates.
Rights, safety and dignity
AMHP work comes down to careful listening and clear decisions. Rights come first. Safety is not negotiable. Dignity stays central. Services get busy and plans change. Through it all, conversations continue and planning adapts.People deserve steady professionals who explain the process and hold hope. I take pride in this work while staying humble about its limits. The search for better ways never stops. Care can be kind and lawful at the same time. That builds trust.
Abul Hussain has been an AMHP for over 20 years and currently works across two inner London boroughs. He has a specialist interest in addiction, mental health law, and transcultural mental health. He is writing in a personal capacity and examples given in the article are composites, with details changed to protect privacy.
