Introduction
This essay seeks to explore the role and responsibilities of the Approved Mental Health Practitioner (AMHP) in the context of a case study involving Tunji, a 34-year-old man with a diagnosis of schizophrenia displaying concerning behaviours. It will be argued that the AMHP plays a critical role in assessing Tunji under the Mental Health Act 1983 (MHA 1983), ensuring that legal, ethical, and professional standards are upheld. The analysis will apply relevant legislation, including the MHA 1983, the Mental Capacity Act 2005 (MCA 2005), and statutory guidance, while considering the intersection of child and adult legislation where relevant. Furthermore, professional values, such as those outlined by Social Work England, will be integrated to strengthen the discussion. The essay will focus on analysis rather than description, drawing on published literature and official sources from gov.uk to support the arguments presented.
Legal Framework and the Role of the Approved Mental Health Practitioner
It is often argued that the MHA 1983 provides the primary legal framework for the detention and treatment of individuals with mental disorders in England and Wales. Under section 13 of the Mental Health Act 1983 (MHA 1983), the AMHP is tasked with a pivotal role in coordinating and conducting assessments to determine whether an individual should be detained for treatment or assessment due to their mental health condition posing a risk to themselves or others. In Tunji’s case, where he exhibits distressing behaviours such as hallucinations, refusal of medication, and suicidal ideation, the AMHP must assess whether the criteria for detention under s2 MHA 1983 (assessment) or s3 MHA 1983 (treatment) are met. These sections stipulate that detention is justified only if the individual’s mental disorder warrants hospital treatment and if it is necessary for their health, safety, or the protection of others (Department of Health, 2015).
It should be noted that the AMHP must also adhere to the guiding principles of the MHA 1983 Code of Practice, which emphasise the importance of least restrictive options, respect for individual rights, and effective communication (Department of Health, 2015). Given Tunji’s current outreach support from the adult discharge team, the AMHP must consider whether community-based interventions could address his needs before resorting to detention. This reflects a commitment to balancing legal obligations with ethical considerations, as supported by professional standards outlined by Social Work England, which prioritise dignity and respect in decision-making (Social Work England, 2020).
Application of Child and Adult Legislation in the Case Scenario
While Tunji’s situation primarily falls under adult mental health legislation, it is the case that child protection concerns may arise due to his cohabitation with his sister, Fumilau (Fumi), particularly if there are undisclosed dependents in the household. The Children Act 1989 (CA 1989) and the Children Act 2004 (CA 2004) establish a duty for local authorities to safeguard and promote the welfare of children. If children are present, the AMHP must liaise with children’s services to ensure that Tunji’s mental health crisis does not pose a risk to their wellbeing, as highlighted in the statutory guidance under the CA 1989 (Department for Education, 2018). Although the case study does not mention children explicitly, the unpredictability of Tunji’s behaviour—such as running and shouting in shared spaces—could necessitate an inter-agency assessment to rule out potential harm.
Additionally, the Care Act 2014 imposes a duty on local authorities to promote individual wellbeing and provide support for adults with care needs. In Tunji’s context, the AMHP must consider whether his refusal of medication and deteriorating mental state indicate a need for enhanced support under this legislation. This intersection of adult and child legislation underscores the complexity of social work practice, where holistic assessments are required to address overlapping vulnerabilities (Braye and Preston-Shoot, 2016).
Principles of the Mental Health Act 1983 and Professional Values
It will be recognised that the MHA 1983 is underpinned by principles that prioritise patient autonomy and the least restrictive approach. The AMHP must evaluate Tunji’s capacity to make decisions regarding his treatment under the MCA 2005, which assumes capacity unless proven otherwise (section 1 MCA 2005). If Tunji is found to lack capacity due to his mental state—evidenced by his belief that the TV is talking to him and his statement about seeing no future in living—the AMHP must act in his best interests while ensuring that any intervention is proportionate (Department of Health, 2009).
Moreover, professional values play a critical role in this process. Social Work England’s standards require practitioners to uphold human rights, challenge discrimination, and work collaboratively with individuals and families (Social Work England, 2020). The AMHP must therefore engage with Fumi to understand the full context of Tunji’s behaviour and explore whether informal support could mitigate the need for compulsory intervention. Indeed, involving family members aligns with the MHA 1983 Code of Practice, which advocates for collaboration and transparency (Department of Health, 2015).
Critical Analysis of Statutory Guidance and Its Application
It cannot be denied that statutory guidance, such as the MHA 1983 Code of Practice, provides a framework for the AMHP to navigate complex cases like Tunji’s. The guidance stipulates that assessments must be conducted promptly and involve at least two medical recommendations alongside the AMHP’s evaluation (Department of Health, 2015). In the scenario described, where the police and AMHP have already been involved due to Tunji’s disruptive behaviour in the stairwell, a swift assessment is crucial to prevent further escalation. The guidance also highlights the importance of cultural sensitivity, which is pertinent given Tunji’s unique beliefs about possession. The AMHP must ensure that these are not misattributed solely to mental disorder without due consideration of cultural factors (Braye and Preston-Shoot, 2016).
However, it should be pointed out that the application of such guidance is not without limitations. The pressure to act quickly in crisis situations may constrain the AMHP’s ability to fully explore less restrictive alternatives, a concern echoed in academic literature on mental health law implementation (Fistein et al., 2009). This tension underscores the need for robust training and inter-professional collaboration to ensure that decisions are both legally sound and ethically defensible.
Conclusion
In summary, the role of the AMHP under the MHA 1983 is multifaceted, requiring a careful balance of legal obligations, ethical considerations, and professional values. In Tunji’s case, the AMHP must assess the necessity of detention under s2 or s3 MHA 1983 while adhering to the principles of least restriction and individual rights as outlined in the Code of Practice. The potential intersection of adult and child legislation, such as the CA 1989 and Care Act 2014, further complicates the assessment process, necessitating a holistic approach. Furthermore, professional standards from Social Work England reinforce the importance of dignity and collaboration in decision-making. The implications of this analysis suggest that while the legal framework provides a robust structure for managing mental health crises, its practical application requires critical awareness of contextual factors and potential limitations. Ultimately, the AMHP’s role is not merely procedural but deeply embedded in the pursuit of justice and wellbeing for vulnerable individuals.
References
- Braye, S. and Preston-Shoot, M. (2016) Practising Social Work Law. 4th edn. Palgrave Macmillan.
- Department for Education (2018) Working Together to Safeguard Children: A Guide to Inter-Agency Working to Safeguard and Promote the Welfare of Children. HM Government.
- Department of Health (2009) Mental Capacity Act 2005: Code of Practice. The Stationery Office.
- Department of Health (2015) Mental Health Act 1983: Code of Practice. The Stationery Office.
- Fistein, E. C., Holland, A. J., Clare, I. C. H. and Gunn, M. J. (2009) ‘A comparison of mental health legislation from diverse Commonwealth jurisdictions’, International Journal of Law and Psychiatry, 32(3), pp. 147-155.
- Social Work England (2020) Professional Standards. Social Work England.
- Statutes: Mental Health Act 1983. Available at: https://www.legislation.gov.uk/ukpga/1983/20/contents [Accessed 10 October 2023].
- Statutes: Mental Capacity Act 2005. Available at: https://www.legislation.gov.uk/ukpga/2005/9/contents [Accessed 10 October 2023].
- Statutes: Children Act 1989. Available at: https://www.legislation.gov.uk/ukpga/1989/41/contents [Accessed 10 October 2023].
- Statutes: Care Act 2014. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents [Accessed 10 October 2023].
