AMHP Procedure
This procedure should be used by:
- Practitioners and managers working in Adult Care and Support teams and services; and
- Approved Mental Health Professionals (AMHP'S).
It should be noted that escalation to a Mental Health Act Assessment will ordinarily be commenced through the service users current SWYFT team. If the service user is not currently open to a team, referral should be made through SWYFT via the Single Point of Access.
Advice can always be sought through the MHA/MCA Team.
The Approved Mental Health Professional service (AMHP service) responds to requests for Mental Health Act assessments to be carried out. They:
- Decide whether or not to carry out an assessment; and
- If so, make all necessary arrangements for the assessment to be carried out.
The service consists of:
- A Team Manager; and
- An AMHP Manager;
- An AMHP Rota Coordinator;
- 3 x dedicated AMHP/BIAs;
- A team of virtual AMHPs, based in several locations across the district.
The AMHP service works on a rota basis and social work practitioners not on duty fulfil a range of social work functions under the Care Act in whichever team they are ordinarily based.
A person may need to have a Mental Health Act assessment when:
- There is an acute and critical deterioration in their mental health; or
- There is a gradual decline over time that has reached a critical point; and
- The person or those people around them are at significant risk of harm as a result of their current mental health.
The following are just some of the things that could indicate a person's mental health has deteriorated:
- Increases in challenging behaviour towards others;
- Increases in actual, or threats of self harm;
- High risk self neglect, for example refusing food or drink;
- A point of carer breakdown is reached or imminent.
Many people suffer from Mental Ill Health but only a tiny fraction of those people would ever need intervention via the MHA. There are other steps to take before intervention is required for example; review of medication, referral to SWYFT, working with the crisis team etc…
Advice can be sought from either the MHA/MCA team or SWYFT via Single Point of Access.
The following steps should, wherever possible all be taken before contacting the AMHP service:
- Identify possible causes;
- Explore other solutions; and
- Consult the Consultant Psychiatrist.
See the Mental Health Act Code of Practice.
The table below sets out some of the factors that can lead to changes in a person's mental health. It is important that you rule these out, and take any appropriate alternative action before contacting the AMHP service.
|
Step to Consider |
Example |
Advice |
|---|---|---|
|
Could there be a medical reason? |
An infection (e.g. a UTI), an injury, an illness |
If there is, or may be a medical reason the urgent advice and support of the person's GP should be sought. |
|
Have there been changes in mental health medication? |
New medication, increases or decreases in dose |
If there may be issues with medication, the urgent advice and support of the person's Consultant Psychiatrist or CPN should be sought. |
|
Have there been changes in circumstances? |
A new home, living with different people, relationship issues, bereavement, diagnosis of a serious health condition (e.g. Cancer). |
Other support, such as Psychology services may be more appropriate to support the person to manage the change in circumstances. |
The AMHP service should only be contacted when it is clear that there is no alternative, less restrictive solution.
These could include:
- Support from a Home Treatment or Emergency Response Team;
- Additional respite for a carer;
- Changes to a care and support service;
- The provision of urgent care and support services;
- Reablement e.g. to support a person to learn a new medication regime.
Attempts should always be made to establish whether the person has a Consultant Psychiatrist.
If the person has a Psychiatrist you should make every effort to contact them in order to:
- Provide information to them about the situation;
- Agree whether they will respond; and
- Take their advice about the need to contact the AMHP service.
If the person's Psychiatrist is not available attempts should be made to speak with a Community Psychiatric Nurse (CPN).
If the Psychiatrist confirms that they will respond and arrange to visit the person, the outcome of their visit should be established before contacting the AMHP service.
If it is decided that accessing the AMHP service is the most appropriate and proportionate course of action escalation to a Mental Health Act Assessment will ordinarily be commenced through the service users current SWYFT team. If the service user is not currently open to a team, referral should be made through SWYFT via the Single Point of Access.
Advice can always be sought through the MHA/MCA Team. Which can be reached at 01924 303105.
If you are unsure you should always consult with the AMHP Manager before requesting an assessment.
Wherever possible contact should be made in the morning, as this will allow any AMHP that is appointed to gather information effectively from other practitioners, and consult with those involved in the person's normal care or treatment.
The following information must be provided to the AMHP Manager;
- The reason that a Mental Health Act assessment may be needed;
- What possible causes have been explored and ruled out;
- What other solutions have been explored and why they are not appropriate;
- Whether you have contacted the person's Consultant Psychiatrist, and the advice given;
- What the actual or likely risks are to the person, and to others.
Risks should be evidence based, taking into account what has actually happened, or is likely to happen using existing information about previous incidences of mental health deterioration.
The AMHP Manager will determine whether an AMHP needs to be appointed based on the information that you provide.
If the AMHP Manager declines to appoint an AMHP they will provide you with advice about alternative solutions that should be explored, which you should act upon in a timely way. If these do not prove effective further contact with the AMHP Manager can be made.
If the AMHP Manager appoints an AMHP to consider the need for a Mental Health Act assessment you may be contacted by the AMHP to:
- Provide further information; or
- To support in the assessment process (where there is a clear benefit).
You should co-operate with any requests made by the AMHP whenever it is possible for you to do so.
A clear record of the outcome of any contact with the AMHP Manager must be made as soon as possible.
If the AMHP has arranged and carried out a Mental Health Act assessment they should:
- Complete an AMHP report, in line with local recording requirements; and
- Write a summary case observation; and
- Alert the allocated social worker or team.
If the person has been admitted to hospital under the Mental Health Act arrangements should be made by the allocated or duty social worker to cancel or suspend any care and support services that were in place.
If the person was not admitted to hospital the allocated or duty social worker should arrange to carry out any care and support functions required (for example, reassessment, urgent care and support, review).
If the AMHP decided that a Mental Health Act assessment was not appropriate or proportionate they should;
- Write a summary case observation setting out a clear rational for their decision;
- Alert the allocated social worker or team; and
- Seek to make other arrangements that may be necessary for the service user’s ongoing care.
The allocated or duty social worker should arrange to carry out any care and support functions required (for example, reassessment, urgent care and support, review).
Last Updated: October 11, 2022
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