Ask the AMHP

Ask the Masked AMHP for the answers to your thorny MHA related problems. He might know the answer. Or not.

The Masked AMHP always tries to assist people, whether professionals or patients, who ask for assistance or advice. However, I cannot guarantee that my advice is definitive.

This month: transitional arrangements for s.117 aftercare when the MHA 1983 came into force, and procedures for AMHP reapproval after a lapse in practice.

A social worker asks an unusual but pertinent question about s.117 aftercare.

If a person was admitted to a psychiatric hospital for treatment in 1980 can they claim s.117 Aftercare, or did Aftercare only start with the 1983 Act?

The Masked AMHP replies:

S.117 aftercare did not exist before the Mental Health Act 1983. However, there were transitional arrangements for patients who were detained under the MHA 1959 at the moment that the MHA 1983 came into force, which was the 30^th September 1983. I remember this date vividly, as I was a Mental Welfare Officer under the MHA 1959, and suddenly became an Approved Social worker (ASW) on that date. I did my first MHA assessment under the MHA 1983 within the first two weeks, which happened to be a detention under s.4.

Anyway, the transitional arrangements stated that any patient detained under s.26 MHA 1959 at that moment would be deemed to be detained under s.3 MHA 1983, and would therefore be entitled to s.117 aftercare on discharge from hospital. S.26 was the equivalent of s.3, being for treatment. However, a patient who had been under s.26 but who had been discharged from this section prior to 30^th September 1983 would not be eligible.

Several people whose AMHP approval has lapsed have asked about the requirements for being reapproved.

The Masked AMHP replies:

The answer to this question lies at least partially in The Mental Health (Approved Mental Health Professionals) (Approval) (England) Regulations 2008 (there are separate regulations for Welsh AMHPs). These regulations state which professionals are eligible to train to be AMHPs (social workers, mental health nurses, occupational therapists or clinical psychologists), and what competences need to be evidenced in order to be approved.

Regulation 3(1) states:

An LSSA may only approve a person to act as an AMHP if it is satisfied that the person has appropriate competence in dealing with persons who are suffering from mental disorder.  

The notes add that before a person can be approved to act as an AMHP if he has not been approved before, that person must have completed an approved course of training within the last five years.

The regulations are, however, silent when it comes to the question of reapproving an AMHP following a period of not practicing. What is required appears to be down to individual local authorities.

In Cambridgeshire, for example, there needs to be evidence of the following:

• A recommendation from their line manager / supervising AMHP that they are acclimatised to local services and ready to be approved.
• Evidence of successful completion of a recognised AMHP course with requisite evidence of attendance at post qualifying AMHP training up to the period of lapse.
• A recommendation / reference statement from the last authority in which they were appointed to act as an AMHP.
• To have led at least one assessment with a competency statement provided by the supervising AMHP, with regard to AMHP competences as set out by HCPC.
• Evidence of at least one specific AMHP supervision session with a suitable qualified professional, following the shadow / lead assessments undertaken.

If the lapse had been for more than a year, the AMHP might be required to complete part or all of an AMHP qualifying course.

Torbay & South Devon’s guidance is much less specific. They state that the re-approval procedure will identify appropriate training/practice needs that are required before re-approval can take place. This would involve the presentation of a portfolio, and a formal meeting to look at learning and practice needs.

Norfolk’s procedure for AMHPs who have had a lapse in practice of more than a year requires an individual support plan. This could include:

• a period of both observing and being observed on MHA assessments, supported by their AMHP supervisor and other experienced AMHP as appropriate
• MHA legal refresher training
• attending AMHP team meetings
• taking part in any other relevant training, such as safeguarding or risk management
• undertaking regular AMHP supervision.

Solihull make decisions concerning reapproval on a case by case basis which would include factors such as when the AMHP was last approved, their current skills and knowledge, familiarity with local services and so on. In the event of a long gap since last period of practice, there may be a need for completion of part or all of an accredited AMHP course.

So it appears that there are as many answers to this question as there are local authorities. However, the willingness of a local authority to facilitate the reapproval of an AMHP whose approval has lapsed would ultimately depend on the urgency to fill any shortfall in AMHP availability.

And while the national demand for AMHPs to undertake MHA assessments continues at the current record rate, it would be surprising if any local authority were to make the reapproval process too onerous.