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We catch up with Sanctuary Training AMHP Refresher course tutor, Les Konzon, who talks about the challenges AMHPs face in keeping up-to-date with the law. 

Recalling his memories of when he first entered the profession, Les says:

On 2nd November 1974 I detained someone under the Mental Health Act for the very first time. I had only been a social worker for one month, so I asked a colleague what to do and received the reply that it was “easy; all you do is fill in this form”. Since then I have found something that has driven my professional life; championing the rights of people who are confronted by the power of professionals and the law.  I’ve done this throughout my own practice, managing the performance of others and helping other professionals understand the full complexity of what “sectioning” someone means; and “easy” it is not!

A lot has changed since then with new legislation, codes of practice, amendments to the Mental Health Act (MHA), a plethora of case law, and eventually, the formal recognition that interpreting the law correctly and keeping up-to-date with legal developments has to be central to being a competent Approved Mental Health Professional (AMHP).  And, yes.  I’ve changed too!

I have told the prospective adult social workers and AMHPs during this time that detaining someone is relatively straightforward.  After all, two doctors have already said that this is what should happen!  Where the approved professional really earns their spurs though, is not in making the application; but in having to stand alone and be counted.

How do you explain to a doctor that you are not criticising their professional integrity when you disagree over ‘sectioning’ someone? How has the Enfield judgment affected the Bristol judgment in the AMHP’s decision-making?  And, then to name just one of many issues, there is the little matter of no bed being available when the service user needs to be detained! 

Whilst I reflect upon what’s changed, a brief look at the statistics reminds me that the number of Mental Health Act (MHA) assessments has grown beyond expectations. In the last recorded year, there were 50,408 detentions under the act which represents a 4% (1,777) increase from the previous reporting period and about a 40% increase on 1982-83. Of those people who spent time in hospital, 45.6% were subject to the MHA at some point in the year. Males aged 18 to 35 were most likely (56.1%) to be subject to the act, whist women form the majority of in-patients. Amongst statutory NHS providers, the data shows an 8.7% increase in the number of in-patients being subject to the Mental Health Act during the year. 

This statistical data gives a window to examine the outcomes of AMHP practice. After all, they are the gatekeeper for so many things; their decision is critical to our system of lawfully depriving people of their liberty working correctly. Therefore, they deserve the best support to their practice that is available.

To book onto the next AMHP Refresher course on 10-12 October 2016 in London, visit our Sanctuary Training booking page.

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