A Halloween Mental Health Act Assessment

 

Dare you view the Masked AMHP’s latest YouTube video: A Halloween MHA Assessment?

It’s Halloween. You get a request to assess an elderly man living alone in a remote ancient cottage. What can go wrong?

How I became a social worker: #1 in a series

Back in the days when the Masked AMHP had long hair and a beard, and wore flared jeans...

I doubt that anyone has ever asked a child or even a teenager what they’d like to be when they grew up and the answer has been: “social worker”. A fireman. An engine driver. An astronaut. Maybe even a nurse. But never a social worker.

 Well, I’ve now been a social worker for over 44 years. This is how it happened.

 May be of interest to anyone curious about social work in the olden days (ie 1970's).

 (An edited version of this appeared in the Guardian on 30.09.2011.)

Assault and Battery – and Arrows

 

Vanessa was a woman in her late 20’s, who lived on a social housing estate with her two sons, aged 6 and 8. Vanessa had bipolar affective disorder. Over a two year period, I had had to assess her under the Mental Health Act on 8 separate occasions, invariably during a hypomanic episode.

I thought I knew Vanessa well. And that was my mistake.

Warning: Contains swearing. And arrows.

What does the Mental Health Act mean by “mental disorder”?

The legal definition of “mental disorder” for the purposes of the Mental Health Act has evolved over the years to reflect changes in society and the liberalisation of psychiatry.

The Mental Health Act 1959 was the first “modern” Act designed to deal with people with mental disorders. It replaced frankly archaic Acts such as the Lunacy Act 1890 and the Mental Deficiency Acts of 1913 and 1938. This was replaced in turn by the Mental Health Act 1983, which was further amended by the Mental Health Act 2007, which radically modified the definition of “mental disorder”.

This is an overview of those changes.

Is it a sin to section Jesus Christ?

 

It surprises me how many people I have assessed under the Mental Health Act over the years have delusions that they are Jesus Christ, a prophet from the bible, or even God. This is the story of one such person.

Anatomy of a Mental Health Act Assessment

Even though every formal assessment under the Mental Health Act 1983 is different, the actual procedure tends to follow a typical pattern.

Assessments have a similar structure, or series of steps, which have a logical sequence, and need to be followed if the assessment is to meet legal, ethical and professional standards.

The steps are as follows:

1 The Referral

2 Gathering Information

3 Organising the Assessment

4 The Interview

5 Reaching a Decision

6 Completing the application ( if one is to be made)

7 Arrangements for the Admission

8 The Admission

9 The Aftermath

In this video I illustrate these steps by referring to a real assessment I undertook: Robina, a woman in her early 80’s living alone, with steadily worsening dementia.

Section 117 Aftercare: A Brief Guide for Patients and Relatives

The Masked AMHP explains what section 117 of the Mental Health Act is all about, and what it means for sectioned patients and their relatives.

Section 117 of the Mental Health Act 1983 lays down a duty for the local authority and the NHS to provide services for people who have been detained under, and then discharged from, certain sections of the Mental Health Act.

I quite often get emails from relatives of people with mental illness asking questions relating to Section 117.

It often appears that the regulations and guidance relating to Section 117 are not being adhered to, or patients and relatives are not being kept in the loop when arrangements for aftercare are being made. I thought therefore that it might be helpful to lay out what the rights of patients and relatives are relating to Section 117