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

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.