Miranda: Applying the First Principle -- the least restrictive option -- to a MHA assessment request

 

There are five overarching principles underpinning the Mental Health Act 1983. AMHPs and others acting within the MHA are bound to adhere to them in their practice.

The First Principle is:

Least restrictive option and maximising independence

“Where it is possible to treat a patient safely and lawfully without detaining them under the Act, the patient should not be detained. Wherever possible a patient’s independence should be encouraged and supported with a focus on promoting recovery wherever possible.”

This means that an AMHP should always explore alternatives to compulsory admission when conducting an assessment under the MHA. This can include finding alternatives to admission, such as involvement with Crisis Teams, support from carers, respite care, or informal admission.

This is an example of a response to a request for an assessment under the MHA where I tried to make the whole process as unthreatening and low key as possible.

Ricky No Wonder: The perils of persuading someone with bipolar affective disorder to go into hospital.

 The perils of persuading someone with bipolar affective disorder to go into hospital.

Ricky was an electrician. He also had bipolar affective disorder. The two things did not necessarily go well together.

Another assessment from the early years of the Mental Health Act 1983. 

You wouldn’t do it like that nowadays.

The First MHA Assessment under the 1959 MHA that I ever did

After getting the job of unqualified generic social worker in 1976 I worked for two years with a mixed caseload. This mainly consisted of elderly people, people with physical disabilities, some work with families, and one or two people with mental health problems and learning disabilities.

I was then seconded on full pay to a two year Certificate of Qualification in Social Work course and when I qualified I returned to work in my old office.

It’s 1981. I’ve only been a qualified social worker for less than a year. My boss calls me into his office and asks me to do an assessment under the 1959 Mental Health Act. But I’ve had no training...