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...

Violet

During my years practising first as a Mental Welfare Officer, then as an Approved Social Worker and then as an AMHP, I’ve been in a few tight spots (being chased round a bungalow by an old man with dementia brandishing a shotgun being one that springs to mind). However, I have only rarely been actually physically assaulted.

I like to think that’s because I know how to keep myself safe and de-escalate potentially violent situations, but perhaps luck also has something to do with it. When I look at the situations in which I was assaulted, generally I can recognise that I’ve made mistakes of judgment (although sometimes they are completely unpredictable).

The Masked AMHP tells the sorry tale of when he was ambushed by a little old lady in his latest YouTube channel video. A warning to always be vigilant during MHA assessments.

June: An Assessment Under the Mental Health Act 1959

As the British Association of Social Workers has been celebrating its 50 years of existence, there has been a lot of discussion about whether or not social work was better back then. (By the way, I joined BASW as a student member in 1978.)

Over the years I’ve been writing this blog, I’ve written several posts about my experience of social work in the early years of my career (which started as an “Assistant House Parent” in a children’s home in 1975).

This post is a description of an assessment under the Mental Health Act 1959 Act that I witnessed in 1976, when I got my first job as an actual social worker.

A comparison with the way in which assessments by AMHPs under the MHA 1983 are conducted today shows the huge changes in philosophy and practice that have taken place over the intervening years.

"You'll have a cup of tea..."

Another story from my long career as a social worker, ASW & AMHP. In which the Masked AMHP is held hostage during a MHA assessment.

Death & Fire Bunnies

The latest video from the Masked AMHP's YouTube Channel. This is about helping an old lady who had just lost her husband, and at the same time avoiding the sledgehammer of a MHA assessment.

You can see it here.