Reflections on a Mental Health Act assessment

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.

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