Thursday, 29 November 2018

The Approved Mental Health Professional Workforce Briefing

I always like some tasty statistics, and what could be tastier than the briefing on the Approved Mental Health Professional Workforce in England, which has just been published.

A brief document, amounting to no more than 5 pages, it nevertheless contains some fascinating figures (at least to me) relating to numbers and demography of AMHPs.

As 92% of local authorities responded, it is a comprehensive description of the state of AMHPs in England. For a start, it can be said with a high degree of certainty, that there are 3,900 AMHPs in England.

Despite the Mental Health Act 2007 opening the AMHP role to nurses, occupational therapists and psychologists, as well as social workers, the overwhelming majority of AMHPs are still social workers. 95% are social workers, compared to only 4.5% who are nurses. The remaining 0.5% are occupational therapists. Oh, and there is actually one clinical psychologist.

A recent post on the Masked AMHP Facebook Group enquired how many AMHPs were full time. This document identifies that 23% of AMHPs work on a full time basis, while the remainder practice on a part time basis, in conjunction with their substantive post, whether that be as a social worker or mental health nurse. This second group would tend to be on a rota, perhaps on a weekly basis.

The report notes that “overall, AMHPs are more likely to be male, older and white than the whole social worker workforce”.

For example, while 10% of social workers as a whole are under 30, only 2% of AMHPs are under 30. This doesn’t surprise me. Most people do not make a decision while still in secondary education that they want to go into social work, but tend to make this decision later in life. A typical social worker would tend to be in their mid to late 20’s by the time they train. Then they would have to have at least 2-3 years post qualification experience before they’d even be eligible to train for the AMHP role.

The majority, 68%, are aged between 30 and 54. Which means that 30% of the current AMHP workforce are aged 55 or more. This is potentially worrying, as many of those (me included) are approaching retirement age, so it could mean that there will be a shortage of AMHPs in the future, unless there is a vigorous programme of encouraging social workers, nurses, and others, to train and practice as AMHPs.

There’s also a notable discrepancy in the gender of AMHPs. While 81% of social workers are female, only 71% of AMHPs are female. Perhaps female professionals are deterred from training as AMHPs by the perception of the riskiness of the role?

There is a curious discrepancy between the numbers of white AMHPs and those from a black or minority ethnic background. While 23% of social workers are non white, this falls to only 15% of AMHPs.

There are some interesting figures relating to the length of time professionals have practiced as AMHPs. This seems to indicate that, once qualified, AMHPs tend to remain in the role. 57% of AMHPs have been in the role for 10 years or more, and 19% of AMHPs have been practicing for 20 years or more.

This is where I modestly reveal that I have been a practicing, MWO, ASW and AMHP for a total of 37 years. I honestly don’t know where the time’s gone.

There are even figures about the pay of AMHPs compared to social workers as a whole. In England, AMHPs receive an uplift in pay of 9% compared to non AMHP social workers.
There are no national policies relating to the recompense of AMHPs for the highly skilled and often arduous work that they do. While most local authorities offer extra increments or honorariums for being on an AMHP rota, there are still some that don’t.

Lyn Romeo, the Chief Social Worker for Adults, concludes the report by saying: “Detention rates are increasing and AMHPs are dealing with challenging contexts as the prevalence of mental ill health episodes are increasing.”

She goes on to say:

We know that detention rates of people from Black and Minority Ethnic backgrounds are disproportionately high, so we need to think how we can ensure that the AMHP workforce reflects the population of people we are serving.

Since the Mental Health Act Review is specifically addressing this issue, among many others, and is imminently due to present its conclusions for reform to the Prime Minister, it is to be hoped that some at least of these discrepancies can be resolved.


  1. I'm a nurse who's wanted to train as an AMHP for the last five years. The problem is, many NHS trusts don't want to release their staff to train and then subsequently go on the AMHP rota, there also arguments from various unions that nurses (and indeed OT's) who do the course should be on a higher band, which NHS trusts will say they can't do.

    1. I think you're right, many Trusts do not recognise the benefits of having trained AMHPs working in their MH teams. Our local trust pays nurse AMHPs on Band 7, which is also an incentive for nurses to train.