When I started writing this blog, it was intended to consist purely of reminiscences of my present and past practice as an Approved Mental Health Professional (and previously Approved Social Worker). Cases were frequently chosen to illustrate the dilemmas and problems with which AMHP’s have to deal. I imagined that the readership (if any) would consist mainly of other AMHP’s or aspiring AMHP’s, and hoped it might be of interest to them.
From the feedback I have received from readers’ comments (which I really appreciate), I am building up a picture of the readership of this blog. As well as other mental health professionals, I am aware that there are also people who have been on the receiving end of the Mental Health Act, as well as others with a wide range of mental illnesses and disorders. This is making me aware that my accounts of assessments under the Mental Health Act might give to those readers an unduly alarming and possibly distorted picture of the consequences of having a mental disorder.
Readers need to be aware that my work as an AMHP is only a comparatively small part of my overall work as a social worker in a community mental health team, and by definition it only deals with crisis situations where people are acutely mentally disordered and may need compulsory detention for their safety and/or the safety of others. I have not written about anyone who has not been subject to an assessment under the MHA.
The people I see in my day to day work have a wide range of mental health problems, including depression, bipolar affective disorder, schizophrenia, personality disorders, anxiety, obsessive compulsive disorder, post traumatic stress disorder, and the long term psychological effects of childhood abuse. The vast majority of them will never find themselves needing to be assessed under the MHA or admitted to a psychiatric ward. Believe it or not, as a team we try to keep people out of hospital. What’s more, the vast majority of the people I see will improve, reach mental equilibrium and stability and be able to manage their disorder, or even recover completely, and will in time move on and cease to require support from mental health services.
I hope that service users and people who might have been detained themselves who read this blog will find it interesting and informative to see the process of assessment from the other side. I hope that they may recognise that AMHP’s are only ever trying to do what is in the interests of the patient and their carers, and that they must comply with the law and adhere to the highest standards. The fact that the AMHP, who makes the actual application for detention, is not a medical professional, is designed as a safeguard against undue medicalisation of the process of assessment in those acute circumstances.
I am aware that some of my accounts appear to have sad or unfortunate endings. I am, of course, only writing about the most severe and difficult situations I have come across in my career.
However, since this is my blog, I can write what I want, so I may also include some accounts of people I have worked with who did not need to be assessed or detained under the MHA, and whose stories have unequivocally happy endings. There are plenty of them.
Thank you all for reading.