AMHP Procedure
Amendment
In October 2024, an amendment was made to Section 2, Introduction to the AMHP Service.
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).
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:
- An AMHP Manager (and deputy manager) based in Kirklee’s AMHP Hub; and
- A team of AMHP’s within the AMHP Hub;
- The AMHP service is made up of a ‘Hub and spoke’ model with community AMHP working across all ASC teams.
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.
The following steps should, wherever possible all be taken before contacting the AMHP service:
- Identify possible causes (this may include social, emotional and physical causes);
- Explore other solutions including less restrictive solutions; and
- Consult with a medic involved with the person’s care.
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 mental health professional.
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 you should contact Kirklee’s AMHP Hub to discuss a referral with the Triage AMHP.
If you are unsure you should always consult with the Triage AMHP before requesting an assessment.
The following information must be provided to the Triage AMHP;
- The current circumstances and reason the MHA 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.
What contingency plans are in place/will be put into place. 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 Triage AMHP will determine whether an AMHP needs to be allocated to consider the MHA assessment based on the information that you provide.
If the Triage AMHP determines that it is not appropriate at this time to allocate to an AMHP, they will provide you with advice about alternative solutions that should be explored which you can act upon in a timely way. If these do not prove effective further contact with the AMHP Hub can be made.
If the Triage AMHP 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 Triage AMHP must be made as soon as possible.
When appointed by the AMHP Manager to decide whether a Mental Health Act assessment is the most appropriate and proportionate course of action all AMHP's must:
- Apply the 5 guiding principles of the Mental Health Act;
- Have full regard to the Mental Health Act Code of Practice.
|
Principle |
Definition in Code |
|---|---|
|
Least restrictive option and ensuring independence |
Where it is possible to treat a patient safely and lawfully without detaining them under the Act, the patient should not be detained. Wherever possible a patient's independence should be encouraged and supported with a focus on promoting recovery whenever possible. |
|
Empowerment and involvement |
Patients should be fully involved in decisions about care, support and treatment. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. |
|
Respect and dignity |
Patients, their families and carers should be treated with respect and dignity and listened to by professionals. |
|
Purpose and effectiveness |
Decisions about care and treatment should be appropriate to the patient, with clear therapeutic aims, promote recovery and should be performed to current national guidelines and/or current, available best practice guidelines. |
|
Efficiency and equity |
Providers, commissioners and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. All relevant services should work together to facilitate timely, safe and supportive discharge from detention. |
See the Mental Health Act Code of Practice.
If there is a possibility that the person with mental health needs may lack capacity to make decisions relevant to their mental health care and treatment the AMHP must have full regard for the principles of the Mental Capacity Act.
See the Mental Capacity Act 2005 Resource and Practice Toolkit, which explains the principles of the Act and how to implement them.
If a decision is made not to detain a person under the Mental Health Act the impact of any other action taken upon the person's liberty must be considered, and appropriate authorisation sought where any deprivation of liberty is likely to be unlawful.
See: Recognising and Responding to Deprivations of Liberty, which explains how to recognise a deprivation of liberty and the action that should be taken.
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
- Decisions to be documented within worksteps/workflows where possible; 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 AMHP should arrange any other mental health services that are needed (for example a Psychiatry consultation or intervention by a CPN or other mental health worker); and
- 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;
- Document their rationale and any alternative plans or recommended actions discussed with the referrer;
- Alert the allocated social worker or team; and
- Arrange any other mental health services that are needed (for example a Psychiatry consultation or intervention by a another team or service).
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 23, 2024
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