Fabio: Well,
here we are on a fine day, not a cloud in the sky. The Masked AMHP’s sitting at
his desk in the AMHP Office, chewing at the bit to take a referral. It’s a
quiet day so far, isn’t it, Adrian,
but who knows what could be just around the corner?
Adrian: That’s right, Fabio, but look! Just
as he’s settling back to read the paper –
Fabio: It
looks like the Guardian to me, Adrian –
Adrian: I believe you’re correct there,
Fabio – but The Masked AMHP’s mobile’s now
ringing, he’s picking it up – and he’s taking notes!
Fabio: Just
look at the skill there! He’s asking pertinent questions at the same time as
he’s madly scribbling on his notepad! What a consummate professional!
Adrian: And just look at the ease with which
he writes down all the salient details! From here it looks like it’s a referral
from the Home Treatment Team. It’s for a woman in her 40’s called Dolores, with
a long history of schizophrenia, who’s been refusing her depot injection. Home
Treatment have been trying to persuade her to take oral medication –
Fabio: Looks
like Quetiapine to me –
Adrian: I do believe you’re correct there,
Fabio. Hard to tell, The Masked AMHP’s handwriting leaves something to be
desired!
Fabio: No-one’s
perfect, not even The Masked AMHP!
Adrian: Never
a truer word, Fabio, never a truer word. Anyway, she’s refusing that too, and
becoming increasingly psychotic!
Fabio: Looks
like The Masked AMHP’s going to have to go out on this one, Adrian!
Adrian: You’re right there, Fabio! And just
look at that! A quick browse through his contact list and he’s got two Sec.12
doctors on board! What a mover!
Fabio: That
was a bit of luck there.
Adrian: Luck’s got nothing to do with it!
The Masked AMHP knows all the Sec.12 doctors who’re wanting to build swimming
pools or saving up for a BMW 7 Series.
Fabio: And
they’ll never turn down a chance for a quick 170 quid.
Adrian: You’re not wrong there, Fabio.
Fabio: That’s
all well and good, but what about a bed? He’s ringing the bed managers, but he
doesn’t look like a happy bunny!
Adrian: He’s muttering something about the
nearest bed being in Harrogate!
Fabio: Phew!
That’s 300 miles away! He won’t get the local ambulance service to transport a
patient there!
Adrian: He’ll have to get a private
ambulance for that little job.
Fabio: The
Masked AMHP’s Trust must have deep pockets, Adrian.
Adrian: Either that, or they’ve got no
common sense.
Fabio: A
bit close to the knuckle there, Adrian.
Adrian: But seriously, doesn’t this put paid
to any Mental Health Act action today? There’s no point in going out to assess
if there’s no bed, surely?
Fabio: Au
contraire, Adrian.
The Masked AMHP’s legally bound to make an assessment. And don’t call me
Shirley.
* * *
Adrian: Well here we are outside the
patient’s house. Nice little suburb, by the look of it – but look at that!
There’s a broken window, and the TV’s out on the front lawn! Doesn’t look good
to me, Fabio!
Fabio: But
ever the professional, The Masked AMHP’s calmly sitting it out, waiting for the
doctors to arrive.
Adrian: Perhaps we can turn to our guest
expert in the studio for an opinion. Tell me, Richard, what do you think he’ll
go for here? Section 2 or Section 3?
Richard Jones: (For
it is he) Of course, we mustn’t jump the gun. An AMHP will always have to
consider the least restrictive option before resorting to a formal application
under the Mental Health Act. But as a rule of thumb – Section 2 if you don’t
know the patient, or there’s been a significant change in presentation
requiring a fresh assessment, and Section 3 if the patient is known and the
appropriate treatment has been decided. But I’d probably tend to favour a
Section 2 if the patient’s in the community, especially in these circumstances.
Of course, the new Draft Code –
Adrian: Thanks for that Richard – but look
at what’s going on! The doctors have arrived, they’ve all had a bit of a
chinwag in The Masked AMHP’s car, and now they’re going to the front door!
Fabio: What
are the odds on The Masked AMHP getting through the door, do you suppose, Adrian?
Adrian: Well, judging from past performance,
he can be a nifty little mover in a tight spot.
Fabio: There’s
Dolores, she’s opened the door – and The Masked AMHP is engaging her in
conversation!
Adrian: And look at that – foot in the door,
stepping forward – and they’re in!
Fabio: Amazing
bit of footwork from old Masky there.
Adrian: Now they’re in, he’s telling her the
purpose of the visit.
Fabio: Ever
the professional. Oh and look! She’s asked him for his ID and he’s showing her
his card!
Adrian: Is that a yellow card, Fabio?
Fabio: No,
it’s just a trick of the light.
Adrian: Well, Dolores is cooperating with
the assessment so far, she’s even telling them about the voices she’s been
hearing telling her not to take her medication!
Fabio: It’s
going smoothly so far, but it could still be an early bath for The Masked AMHP.
Adrian: Well I didn’t expect that! She’s
saying she’ll agree to an informal admission! Isn’t that offside?
Fabio: Don’t
get me started, Adrian!
Adrian: Well they’ve concluded the
assessment – now it’s decision time. What do you think Richard – Section 2,
Section 3, or – Oh, and they’ve gone with the informal admission.
Fabio: Bit
risky that, don’t you think? What if she changes her mind?
Adrian: I think old Masky’s weighed it all
up, and he’s gone for the less restrictive option.
Fabio: But
couldn’t he have gone with Home Treatment?
Adrian: You’re forgetting – they’ve already
tried Home Treatment and it didn’t work. So that only leaves informal
admission, or detention under the Act.
Fabio: Masky’s
on the phone to the bed managers – and he’s smiling! It can only mean one thing! They’ve
used a leave bed and got her into a local hospital.
Adrian: That’s cause for celebration, all
right!
Fabio: Well,
they think it’s all over – it is now!