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I ‘section’ people under the MHA

172 replies

Narwhalelife · 13/07/2022 22:26

I am an Approved Mental Health Professional (AMHP). It is only AMHP’s that can section people.
Little is known about us and our role but lots of people know what ‘sectioned’ means - Ask me anything 😊

OP posts:
AlphaAlpha · 13/07/2022 22:29

The police can invoke a s136.

Narwhalelife · 13/07/2022 22:30

@AlphaAlpha yes police can arrest under a.136, lasts 24 hours

OP posts:
babysteps22 · 13/07/2022 22:31

I'm a gp and I've sectioned people (s2) admitted not for bloody ages as I can see 20 people in the time it takes so usually leave it to the s12 dr

Narwhalelife · 13/07/2022 22:35

@babysteps22 as a GP you won’t have ‘sectioned’ anyone - you will have made a recommendation for admission under s.2

OP posts:
Riggsisadino · 13/07/2022 22:36

An amhp is the only person to be able to put people on 'proper' (there is a better word from it I promise and the OP will of course along and tell you !!) like a s2 or s3. 5:2 and 136 can be placed these are used to take people to places of safety (or remain) these trigger a mental health act assement where you see an amhp (and 2 docs) to possibly so on a further section ie 2.

ElephantGrey101 · 13/07/2022 22:37

What is your professional background? How big a part of your job is sectioning people?

babysteps22 · 13/07/2022 22:37

Narwhalelife · 13/07/2022 22:35

@babysteps22 as a GP you won’t have ‘sectioned’ anyone - you will have made a recommendation for admission under s.2

That's right, section 2.

Narwhalelife · 13/07/2022 22:37

@Riggsisadino pretty much - an AMHP is the only person who can detain a person under the mental health act, are you in mental health?

OP posts:
KL2222 · 13/07/2022 22:39

@Narwhalelife my sister was sectioned yesterday and has been moved to a private hospital 200 miles from her home. I am going to see her, I hope, tomorrow. What advice would you give about talking to someone suffering psychosis?

GordonBennetttt · 13/07/2022 22:39

Ooh interesting thread!

There are probably many reasons, but could you list a few which would make you think somebody needed to be sectioned?

Riggsisadino · 13/07/2022 22:39

That may not have been explained right and the OP will be along as they are the expert! I am currently on a section 3 possibly awaiting a long term placement.

I do have a question though how do you feel
About detaining people with eupd ? I have had some lovely understanding amhps. But suing these last few months (where at one point I was discharged but didn't last well in community) I came across two amhps who no matter what wouldn't section people with an eupd diagnoses. Luckily the police stepped in and escalated it and probably saved my life. But just wondered what your opinion was ? (Sorry that was long !)

Riggsisadino · 13/07/2022 22:40

And before I was sectioned with this crisis I was very stable for a number of years and I did work with my local mental helath trust mainly with camhs patients specifically camhs 136.

Spidey66 · 13/07/2022 22:41

An RMN without further AMHP training can invoke a 5(4) , although for only 4 hours until a doctor/AMHP arrives.

Narwhalelife · 13/07/2022 22:41

@ElephantGrey101 Im a social worker by trade, then it’s a post grad diploma for the AMHP training, then an internal ‘warranting’ process with the local authority, mandatory top up training every year, and then a 5 yearly ‘re warranting’ portfolio and panel for reapproval. 😬

its my full time job so every day - we work 12 hour shifts.

i am also a Best Interest Assessor but that’s a whole other post

OP posts:
Narwhalelife · 13/07/2022 22:43

@KL2222 sorry to hear your sister has been moved so far away. Don’t try to correct her too much, people in a deep state of psychosis have an altered reality, so as much as you say something isn’t true is as bewildering and confusing as someone saying something you know to be true doesn’t exist. But mostly just spend time talking about whatever and ask what’s going on on the ward, encourage her to engage in groups if this is possible

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Narwhalelife · 13/07/2022 22:45

@GordonBennetttt the mental health act has a strict legal criteria, but in essence. They have to be suffering or suspected to be suffering from a mental illness or disorder that’s risks their health, safety or the protection of other people.

In addition to this, hospital admission has to be a proportionate response. If you can treat safely in any other way this absolutely should be tried first

OP posts:
babysteps22 · 13/07/2022 22:47

How many sections do you do on a shift? And do you make the final decision on your own?

Also, are the next of kin rules as restrictive and annoying as they were 15 years ago?

Takingthepmaybe · 13/07/2022 22:50

Is sectioning a short term intervention just to stop immediate harm? Is there a connection where it then leads to meaningful long term support or does it tend to be a stop gap?

and on a personal level how do you manage your own mental health spending so much time with people suffering so terribly?

KL2222 · 13/07/2022 22:51

@Narwhalelife thank you for your reply. Can I ask a question and medical consent? My sister has not given anyone in her family medical consent so we don't know anything about her treatment etc. She's on a section 2 and was thankfully entered into the system by police. Her husband is her nearest relative but this doesn't seem to mean that much?

Narwhalelife · 13/07/2022 22:52

@Riggsisadino firstly I wish you well in your recovery and I hope that the new treatment hospital is a million miles away (and they always seem to be!)

Oooo that is very complex (which I am sure you have heard a million times) but I actually wrote my dissertation for my masters on this subject.

In short, we know that EUPD gets better with age. We don’t see the degree of this diagnosis in people over about 55 (really - there will be people occasionally) so detention can literally preserve life and get people to the point they can recover. However, there is an idea that admission for people with EUPD can make matters worse by the triggering environment and quick discharge.

OP posts:
SafeguardingSocialWorker · 13/07/2022 22:52

What is your preferred way of describing what you do when you are doing it to someone?

I notice you often put sectioned in quotation marks. I try and avoid using it where possible but I'm not keen on 'detained under the mental health act' either and most people at least understand what sectioned means.

How often does bed availability influence your decision?

Narwhalelife · 13/07/2022 22:52

@Spidey66 yup, although I rarely see that in my area, it’s usually straight to s.5(2) 😬

OP posts:
EmmatheStageRat · 13/07/2022 22:53

Thank you so much for the important job that you do. My brother had a catastrophic mental health breakdown following the death of our father a year ago. He was sectioned under 2 and 3 (I think) and spent virtually six months on various psychiatric wards. He tried to kill himself on railway tracks. He has made a remarkable recovery. He is a high functioning professional and has managed to resume his previous career and lifestyle. It’s almost like it never happened (apart from what I think is my resulting PTSD). The AMPH I met was exceedingly kind.

Narwhalelife · 13/07/2022 22:55

@babysteps221- 2 mental health act assessments is normal per 12 hours. Not all result in detention. I think anymore and the AMHP doesn’t have time to consider (we are lucky in my team we are given the time to do good work).

yes AMHP’s make the final decision independently.

and yes!! The nearest relative rules are set in stone and haven’t changed since the Victorian days 😬

OP posts:
Emelene · 13/07/2022 22:57

Any words of advice for a psychiatry trainee doctor who is hoping to do Section 12 training soon? 😊 I’m sure you’ve worked with lots of doctors!

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