Approved Mental Health Professionals (AMHPs) carry out assessments under the Mental Health Act (MHA) for people who are:
- experiencing a rapid and serious deterioration in their mental health
- experiencing a gradual decline over a longer period which has reached a critical point
- at significant risk of harm to themselves or others as a result of their current mental health needs
Detention under the MHA is often known as being ‘sectioned’ or ’sectioning’ in reference to the application of sections of the MHA relevant to this process.
Referrals are made to the AMHP Service by relevant professionals or through a nearest relative (this does not mean next of kin, for example a spouse, parent, or child). Read the definition of what a nearest relative is on the Rethink website.
The AMHP service responds to referrals 24 hours a day, 365 days a year.
If you or someone else is in need of urgent care
If you, a friend or relative is in need of urgent medical assistance (for example, an ambulance) please call 999.
If it is less urgent, you dial 111, or contact your local NHS Crisis Team:
If you or the person is not registered with a doctor, you can find your nearest GP surgery on the NHS website.
Other types of support
Involvement of the AMHP Service and assessment under the MHA should only be considered once other less restrictive options have been explored - this includes:
- help from their GP
- NHS Community Mental Health Team or Crisis Team: Lancashire and South Cumbria NHS Foundation Trust and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
- Cumberland Council - we may have a duty to provide services to meet eligible social care needs
Other organisations that can provide support:
- Rethink Mental Illness - find information about different mental illnesses, living with mental illness, your rights and benefits and information and resources to help carers of people living with a mental illness
- Mental Health Crisis Breathing Space - provides additional protections for people currently receiving mental health crisis treatment
The role of the AMHP
Approved Mental Health Professional (AMHPs) may be:
- social workers
- nurses
- occupational therapists
- psychologists
All these professionals have gained an additional qualification and have been approved by the Council which allows them to undertake the AMHP role. Most of Cumberland's AMHPs are social workers, though some are nurses and occupational therapists.
AMHPs arrange and conduct assessments under the Mental Health Act (1983) (MHA) in Cumberland, as well as outside of that area in particular situations. AHMPs role during the assessment is to consider:
- the person’s fundamental human rights and whether there are even grounds to intervene in the person’s life
- social impact, rather than a medical opinion
- criteria set out in the Mental Health and Mental Capacity Acts, any relevant case law, and the various Codes of Practice, to make sure that any interventions undertaken are lawful and proportionate, and necessary
Often, the purpose of the assessment is to consider whether it is necessary for the person to be in hospital under a section of the MHA (detained). A person will only be detained if their care and treatment can no longer be provided safely in the community, and they are unwilling (or unable) to agree to go into hospital (or stay in hospital) voluntarily.
Before the assessment
The duty AMHP will:
- consider the request to make sure that an MHA assessment is appropriate
- check if whether other ways of helping the person with their mental health have been tried first, which might prevent the need to use the MHA (for example, involving a crisis team or arranging for a review of the person's social care needs)
In almost all circumstances, NHS Crisis Services will be contacted to first conduct an assessment to determine if they could provide an alternative to statutory MHA intervention.
If an MHA assessment is appropriate, an AMHP will be asked to arrange the assessment.
Requests are prioritised based on a risk assessment and the needs of the person or others.
During the assessment
AMHPs usually undertake MHA assessments alongside authorised doctors through an interview with the person. An MHA assessment may take place in a wide range of places, including at the home address, in a hospital (if the person is already an inpatient), in an A and E department or other places.
An important part of the AMHP role is to make sure all alternatives to detaining someone in hospital have been considered. To help them decide whether an application to detain someone should be made, the AMHP will consult with professionals involved in the person's care as well as speaking to the person, family members and carers to seek their views. Where safe and viable alternatives are found, the AMHP may conclude that an MHA assessment interview requiring doctors is not necessary or proportionate.
As part of the process, the AMHP will attempt to speak to the person's nearest relative. There are some instances where a person's nearest relative can object to the AMHP making an application to detain the person in hospital, so their views are extremely important.
During the assessment the AMHP will do their best to make sure that the person being assessed is fully informed about what is happening. The AMHP will also try to make sure that the person is able to participate as fully as they can in the assessment and that their views and wishes are listened to. The AMHP will try to accommodate family members or carers to be present if the person being assessed wants them to be – although this will not always be possible.
The AMHP and doctors will ask the person some questions to help them understand what the person is going through and how best to help them. The AMHP and doctors will also be trying to establish whether the person is suffering from a mental disorder and whether any risks mean that hospital admission is necessary.
After the assessment
The AMHP will explain the outcome of the assessment to the person being assessed. If a decision is made to use the powers of the MHA, the AMHP will try to make sure that the person understands the reasons for this decision and what this means. The AMHP will talk to the person about their legal rights under the MHA.
The AMHP will also inform the nearest relative of the outcome of the assessment, the reasons for the decision and the nearest relative's rights under the MHA
Where hospital admission is necessary, contact will be made with the NHS Mental Health Trust's bed management team to request that an inpatient bed be identified. The bed management team will inform the AMHP of the hospital where the bed has been identified.
Once a bed is confirmed the AMHP can complete their application to detain the person to that hospital. The AMHP will make arrangements for the admission and for the most appropriate transport to the hospital.
Throughout this process the AMHP will consider any risks to the person or to others and will make sure the person is treated with dignity and respect.