Reflections on a Mental Health Act assessment

June 19, 2020 | Written by Greg Slay

This is a guest blog by Greg Slay, approved mental health professional (AMHP).

One of the things that will stay with me from the period of Covid-19 lockdown is how resilient and enterprising Approved Mental Health Professionals (AMHPs) have been.

We have worked together with colleagues in specialist mental health services to support people through their own mental health crises – including arranging mental health hospital admissions as and when required – and we have thought up creative solutions to unexpected issues thrown in our direction.

Papers and plans in order

Last Sunday was no exception. I was on-call as an AMHP and was asked to complete a statutory application for a young man (in his late twenties) to be admitted to a mental health hospital in a neighbouring county, about 40 miles away.

I did not know the young man: he had been assessed under the Mental Health Act the previous day by one of my AMHP colleagues, and by two doctors. They concluded that he needed to be in a mental health hospital because the risks he would harm himself were high, and that he needed to be detained under the Mental Health Act because he was reluctant to go there.

I was given a town centre address, where I would be met by a community support worker from the local mental health crisis resolution and home treatment team and by a secure ambulance with three crew.

I collected the previously completed medical recommendations and wrote my statutory application, so that I would be ready.  I knew I would still need to check his situation for myself and be satisfied having interviewed him, however briefly, that an application needed to be made.

A patio and a patient wait

We assembled at the house at the agreed time and quickly established that he was not at home. The community support worker contacted the young man by phone. He told her that he was at an address six miles away, laying a patio in a back garden in return for some money.

We decided to visit him at the alternative address. As the only person who knew and could recognise the young man, the community support worker came with us. The ambulance crew took the view that they were on the job now so they should not be ‘stood down’. So, we all went in our different vehicles.

When we got there we had a slightly strained conversation in which the young man explained that he was ‘rather busy’ with the patio-building and could he ‘go to the mental health hospital another day’?

It soon however became clear to him, and to me, that the reasons for various people having had concerns for his health and safety were correct and that it would be in his interest to be in hospital.

To take off some of the immediate pressure about the inevitable, I suggested he show us the work he had been doing that morning. He agreed and we followed him around to the back garden. The ambulance was brought to the rear of the house as well.

A person-centred process

It was there that he decided that he would go to hospital after all. We agreed to wait until his friend had returned from the builders’ merchant with more building supplies, and some cash for the work the young man had completed that morning.

So, we made ourselves as comfortable as was possible on a warm day, in a small back garden, with no seats! In fact, we didn’t leave for another 40 minutes or so.

The young man had only the clothes he was wearing and he asked the community support worker to arrange for some clothes from his home to be brought to him in hospital. She agreed and he gave her the key.

His immediate priority was to get some cash from his friend so he would be set up for ‘smokes’ at the hospital. Once the cash arrived, he just stepped into the ambulance and off they went.

Going the extra mile

I was struck by the willingness of my colleagues from the local mental health crisis resolution and home treatment team and from the secure ambulance service provider to respond with absolute focus, strength and a real sense of purpose to help get the young man to hospital.

As he left the address in the ambulance, he thanked us all for our patience and support.

With the benefit of a few days’ reflection I can see that we had gone the extra mile (literally) to support this person and we had not bundled him into the ambulance as soon as possible just to get a job done.

Work under the Mental Health Act can be quite challenging and stressful at the best of times but we were able to work together and be really person-centred and person-focused.

We enabled this young man to achieve an outcome which, whilst it might not have been entirely of his own making, was one in which he had been able to take part and in which to have some ownership.

Tell us your social work story at telling us your name, job, contact details and social care number (just so we know you’re a social worker, we will keep it private).

Lockdown diary: ‘Visits were quite daunting’

June 16, 2020 | Written by Lara Campbell

This is a guest blog by Lara Campbell, a newly qualified social worker doing her Assessed and Supported Year in Employment at the London Borough of Wandsworth.

The initial days of working from home were great: a bit of fun, late nights, long lay-ins before running downstairs in my PJs and logging in just on time. This did not last long.

I realised that if I am going to make the best out of a bad situation – I needed to develop a routine.

I started waking up at 8am to do my morning workout at 8.10am. This is a 30-minute workout using YouTube or Instagram for inspiration. I am showered, dressed (not in PJs) and downstairs by 9am – sometimes 9.15am the latest!
I have a daily agenda which I find useful and overly ambitious. I thought I would have finished most of my assessments…but working from home is harder than I thought!

Team check-ins keep me going

My daily team check-ins really do keep me going. We ask questions, share ideas, experiences and update each other. It is nice to see other people other than my family members.

My first video call with one of my families was good fun. I managed to engage with the family for an hour – even though the children were not interested for more than five minutes.​​​​​​​

I give myself regular breaks and a proper lunch. I always have one too many snack breaks – definitely counteracting my morning workout. Maybe I’ll have to consider working further away from my kitchen? I go for an evening walk to wind down after work and split up my day. The days just seem to roll on now and some days I don’t actually know what day it is. This is my new normal.

Going on visits

By week three I had never been so happy to be on duty. Duty means ‘business as usual’ on the front line – going into the office and completing visits as normal. Having just my team in the office was great – I had my usual two screens (which I missed so much), a bank of desks to myself (maintaining social distancing) where I could spread out all of my things and no queues for the microwave. Oh, it was luxury!

Visits, on the other hand, were quite a daunting experience. The PPE provided made me feel somewhat protected, but I also felt really silly. I was anxious about putting myself or the family at risk – which made me feel on edge during the visits. ​​​​​​​​​​​​​​However, families were happy to see we were being cautious and protective. It is difficult to speak with the mask and to interact with children. Using the PPE was not ideal but best to keep safe.

Tell us your social work story at telling us your name, job, contact details and social care number (just so we know you’re a social worker, we will keep it private).

Not just heroes anymore

June 1, 2020 | Written by Peter Hay

Our Chair of Trustees, Peter Hay, blogs about the power of stories and why they matter so much right now.

As we have moved through the pandemic, the hero narrative has been strong.

We have rightly paid tribute to key-workers across all manner of roles who have supported us through the lockdown. From those working in the NHS, to the drivers of transport and supplies, workers in food production, teachers, those who kept our utilities working – even our broadband – and those who have delivered food, shopping and mail to our doors. Social workers, and especially  those working in the care sector, have been a huge part of this collective effort, and we remember those to who have contracted infection, been ill or lost their life.

Of course, there have been acts of courage and there are heroes. Yet if we built a library for just heroic tales  it  would be a small one that would miss so many stories . If we just collect heroic narratives, we downplay the profound isolation and loneliness that has been some people’s experience and skip over the deep rooted inequalities and racism that the disease has laid bare, particularly in the UK and the USA.

A heroic narrative can be used to divert our attention, which when combined with our natural desire to want to move on, can silence those voices from which we need to learn most. Human rights and social justice sit at the heart of social work and should be the warp and weft of our narrative.

What I have heard

Lockdown reminded me that one of the privileges of my ‘portfolio’ career is the range of people that I meet and the time we are able to spend together. I have heard stories of struggle – of social workers taking on issues that have been hitherto unknown. These are not people who see themselves as heroes, rather they see themselves as often limited mortals, desperately trying to assemble some response to the overwhelming odds facing people.

Their stories are powerful opportunities to learn and grow professionally in offering compassionate, kind social work. Some examples include:

  • The sorrow from a senior leader after she had admitted an elderly man with dementia to residential care. His previously innovative package of community support had included meals at the local pub. Dementia left him unable to process the changes that have taken place in his community and he was apprehended trying to break into the shuttered pub. He ‘just’ wanted his meal.
  • Amazing efforts made to communicate with children from videos, pictures and photos. One social worker set a child in care daily tasks with a video call each afternoon to see how this was going. When this became mutual, the social worker suddenly had to find out whether she could match the number of keepie-uppies!
  • Social workers giving evidence to courts via video link and patiently moving through their evidence to allow parents to fully participate.
  • Dealing with the fear that people have of seeing masks and the ways in which people have devised materials to support people with limited communication.
  • Team mangers going to extraordinary lengths to support social workers, to hold their teams together and to recognise the complexities of issues facing their social workers from adjusting to new work patterns, child care, health status or bereavement.

I have also heard from people with direct payments who appreciated the call from their social worker ‘just to chat’. I have heard and acknowledge the pain of those who feel left alone. There are also plenty of worries about what we will find as we move through the easing of restrictions – the pressures that have fallen upon carers, upon people’s mental health; an anxiety that people with dementia will not be able to adjust to new norms in communication or social distancing and a worry about the sustained strains upon families.

Your stories matterThese stories – and many others – matter . They tell of a reflective and thoughtful profession that is trying to find ways to practice in accordance with clear values at a time when many people are experiencing great stress and pressure combined with systemic injustice.

Each of us is holding a story. It might be heroic, it might be of struggle and uncertainty. It doesn’t always have a happy ending. It might be a story which speaks truth to power. The point is that the stories that each of us is holding matters now more than ever.

So, the Social Worker of the Year Awards wants to hear those stories. Our purpose is  the recognition of social work and in response  to COVID-19 that recognition needs to be broad and deep. It’s not going to be about ‘winners’ – this is not a time to separate people through judging  – but it is a time and opportunity for the voices of the profession to articulate its many stories. We look forward to hearing your story.

Tell us your social work story at telling us your name, job, contact details and social care number (just so we know you’re a social worker, we will keep it private).

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