I ‘section’ people under the MHA

[Narwhalelife]

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 😊

Oh I really love AMAs, they're so interesting but find it hard to follow when the OP only tags the person they're responding to, it means I have to scroll up and down to see the question again.

Please can I put in a request for you to quote the person you're responding to rather than just tag 🙈 it would be really helpful, thank you for taking the time to answer questions

@Takingthepmaybe s.2 is for compulsory admission for assessment and treatment of a mental disorder and lasts up to 28 days.

s.3 is for treatment of a mental disorder and lasts up to 6 months - this can be renewed several times if needed.

dependant on the person and their situation will depend on how long they are subject to these conditions but the work to get the person better should start straight away. If risk reduces that’s a positive thing but is not always the deciding factor in how long a person remains on these sections.

it’s very difficult and a lot of cases sit with you for a long time - it’s never a good day when we are involved. I have dogs and swim with them in the sea 😊 (and gin)

Another question- do you bormally approve an application? I’m not suggesting you rubber stamp and am sure
thst you do a robust evaluation - I’m just interested to know how often people might be brought to be sectioned who aren’t and - in those cases - what sort of reasons there might be that they are put forward for sectioning but aren’t?

Thank you for answering.

Please can I ask one more question😬

How old was the youngest person you've had to section?

Gah so many questions I want to ask!

@KL2222 confidentiality is still down to the NHS & social care policy so you may not get far if she has withdrawn consent but no harm in asking when you are there.

her husband is entitled to be included in meetings about her care and if he hasn’t been I would be asking when the next consultant review meeting or CPA meeting is and if he and the family are invited.

@SafeguardingSocialWorker i don’t like the term sectioned but agree it’s what people know it as so it is a widely used term. I prefer detained as it’s the legal terminology - none of it is great language but there isn’t another way of differentiating between formal or informal admission.

Re: beds. Never. I will make it clear that if I need a bed, I need a bed and il wait days If I need to escalating every opportunity.

@EmmatheStageRat 😊I am so pleased your brother has recovered in this way and I’m sorry to hear about your dad. Thank you for your comment.

@Narwhalelife not done it yet and been qualified since 1993! The patient can normally be persuaded to see a doctor.

Im too lazy to do my AMHP training 😉

Why do the police arrest people who are known EUPD sufferers over sectioning them? Just wondering as this happened to a friend of mine and the police don't seem bothered about taking her mental health into account but want her to end up with a conviction. Are they just being lazy with paperwork?

@Emelene yup! Know exactly what an AMHP does! the best (and richest 😉) s.12 docs are the ones that really listen to the handover (even better if they have read about the case before), ask decent questions in the interview (although not legally required it’s good form), write good quality med recs, legible (although some are typed now), mention diagnosis or your impression, nature, degree, why community options are not feasible , don’t be in a rush to leave (I’m speaking now to the ‘lunch break’ docs) don’t tell the patient you are going to detain them without consulting your AMHP! and practice writing a med rec leaning on a car or an AMHP’s back in the rain/snow/42 degree heat, always wear flat shoes (especially community assessments), But I am sure you will be fine ☺️

@QuizzicalLady can’t say tbh, the police make some VERY bizzare decisions when it comes to mental health patients sometimes 😔

@Spidey66 ☺️☺️

Do you ever find out what happens to a person after you've detained? Like ultimately whether they improved?

Are professionals put off from referring a patient for sectioning? I never understood how my DB avoided it considering the very dangerous behaviour he exhibited to the crisis team over a long period of time. It was a hellish time for family to keep him safe and it felt like the trigger point for him to be treated as an inpatient was non-existent.

What improvements do you think are needed to mental health care in this country?

I'm a MHP in Ireland and am curious about differing grounds for involuntary admission as its called here. Is EUPD or any other PD for that matter grounds for detaining in and of themselves? Do you work in a specific area or is it a case of wherever there is a bed free whether it be 20 or 200km away? What's the process for getting the person to the hospital? Is it always police or are there specific teams to assist admission?

@BoomVan sometimes, we have people come back to us and we often see people on the wards, i have had family members call me to tell me about their person. But not always and it’s a hard part of the job sometimes we it would be lovely to follow everyone up, but data protection rules mean we can’t access notes etc after we are finished with our bit and we respect that.

sometimes people try too hard for too long to exhaust the community options. Sometimes professionals really think they can treat the person, other times they weigh up the challenges in admitting someone as it’s not always the best place for people. Also there are resource issues that can sway professionals (not AMHP’s usually as we are legal/ needs led more then others).

We need more psychiatric beds, more community services that can actually serve people and their needs.

Just wanted to say thank you for what you do. My DH was sectioned in 2017 out of the blue with psychosis (eventually schizoaffective disorder) and twice sectioned in 2018 , with a few 'voluntary ' admissions along the way too for med complaince/adjustments. We had the loveliest people at my house at 2am putting a section in while our 2 year old was asleep upstairs and honestly I didn't know what to do, but they were so so kind to me and made sure he was in the right place so quickly. He's made amazing progress, is working in a high level job, had counselling, does his mindfulness regularly and we went on to have another child too, and I always credit the lovely people who initially sectioned and then listened to me later on when I knew there was a sudden relapse. Up and down days still but we are in such a better and more stable place purely because of that initial help in getting a section and diagnosis.

@Goneback2school good to hear from you!

yes we can and do detain for PD on its own.

we have a bed stock in my county (about 60 mile radius) but specialist beds can be 100’s miles away.

Physically getting someone in to hospital? The AMHP does this we stay until the end, we usually use non emergency ambulance or a private ambulance with specially trained security and mental health nurses. sometimes families can take their person. Police will not convey to hospital in my area.

The courts can also section people, with 2 doctors recommendations (37/41 or 47/49 or 48/49).

What are your thoughts on the AMHP role being widened to other professionals rather than just social workers? I know this is old news these days but it still feels like it is taking a while to filter through.

@FlowerTink ☺️ So pleased your husband is doing well now! And thank you, we try our best and are used to working in any conditions or situations and we really listen to family as we need them to tell us exactly how it is so we can best help their person. Thank you for your comment 💕

@Narwhalelife are you aware of what the mental health wards are like? Do you believe they are conducive to recovery? I felt this was the only possible reason why he was kept out of hospital, because that would be so much worse than potentially harming himself or someone else and making other family members ill with the stress of keeping him safe.

Fascinating threat. Thank you so much for the incredible work you do and for taking the time for an AMA.

My brother is schizophrenic and has recently been discharged from a psychiatric hospital. He’s been unwell for over 20 years and recently had a significant decline - psychosis, paranoia, living in squalor and not being able to manage his money. We had to write to his MP to get him medical attention as no one else would act. He subsequently spent 3 weeks on a psychiatric ward, had his medication changed and is now back in the community. Problem is that I think he’s even more paranoid than he was before. He believes his stalker has planted cameras and microphones in the smoke alarms over his block of flats. He’s claiming to be listening in on his neighbours’ being recorded. Is this level or paranoia enough for to be “sectioned?. What else can we do to get him help? He can be very convincingly “‘normal” when he has to be.

@Mandatorymongoose yep although the forensic sections are a whole other ball game lol

Personally I think it suits social work best, but we have one nurse and one OT AMHP in my team and they are brilliant. Never met a psychologist AMHP 😬

a lot of the issues in my Area (and most surrounding) is that health teams don’t want to pay for their staff to do the training or release them for the training and then rota commitment!

@BoomVan yes I go to the wards a lot.

It depends on his diagnosis and what they felt he needed. They definitely are places for people to get better but not always. They are usually quite bare, sometimes mixed, sometimes single sex, group work is big, then med rounds etc.

I’m sorry your family were left to manage him without appropriate support.

What an interesting thread and thank you so much for all you do to help people x

@Ontheboard thank you.

Almost impossible for me to answer because we take a lot of information into account including history, but he shouldn’t have to wait to get seriously unwell before hospital can be considered. Whoever is his nearest relative (they should have been identified before and inform) they do have the right to request a mental health act assessment, to do this just Google your local AMHP service or contact the crisis team and they will have the number.

We are trained to ‘see through’ even the most plausible people if we have the history and I have hours with people to see if their presentation change.

i watched about 4 episode of PMQ’s with a gentleman once before he finally revealed exactly what his family had been telling services.