Mental health practice guidance when considering referrals ... This presents challenges to the AMHP

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Transcript of Mental health practice guidance when considering referrals ... This presents challenges to the AMHP

  • Once printed, this is an uncontrolled document

    Version: 1 FOI Status: Public

    Derbyshire County Council Adult Social Care

    Derbyshire Approved Mental Health Professional Service Practice Guidance when Considering Referrals, and Planning and

    Undertaking Mental Health Act Assessments during the Covid-19 Pandemic

    Issued: April 2020 Review Due: June 2020

    Derbyshire County Council Adult Social Care

    Derbyshire Approved Mental Health Professional Service Practice Guidance when Considering Referrals, and

    Planning and Undertaking Mental Health Act Assessments during the Covid-19 Pandemic

    Name Job Title Date

    Jacqueline Ingerson Service Manager April 2020

    Approved by: Andrew Bartle

    Group Manager (Performance)

    April 2020

    Change History

    Version Date Name Reason

    V1 April 2020 J. Ingerson New Practice Guidance

    If you would like to make any comments, amendments or additions please email Phil Robson– Policies and Procedures, phil.robson@derbyshire.gov.uk

    mailto:phil.robson@derbyshire.gov.uk

  • Once printed, this is an uncontrolled document

    Version: 1 FOI Status: Public

    Derbyshire County Council Adult Social Care

    Derbyshire Approved Mental Health Professional Service Practice Guidance when Considering Referrals, and Planning and

    Undertaking Mental Health Act Assessments during the Covid-19 Pandemic

    Issued: April 2020 Review Due: June 2020

    Contents

    1. Context ................................................................................................................................ 1

    2. Definitions ........................................................................................................................... 1

    3. Referrals – General Guidance ............................................................................................ 2

    4. Referrals for a Mental Health Act (MHA) Assessment from Psychiatric Wards ................. 5

    5. Referrals from Police Stations ........................................................................................... 5

    6. Mental Health Act Assessments for Children and Young People ...................................... 5

    7. MHA Referrals for those with Learning Disabilities or Autistic Spectrum Disorder (ASD) . 6

    8. Expected Response from the AMHP team ........................................................................ 6

    9. Guidance for the AMHP planning the MHA Assessment ................................................... 7

    10. Guidance for the AMHP undertaking the MHA Assessment .............................................. 8

    11. Guidance for the AMHP following MHA Assessments ....................................................... 9

    12. Role of Other Agencies ...................................................................................................... 9

    Appendix A…………………………………………………………………………………………...11

    Appendix B Guiding Principles of the Mental Health Act 1983….……………………………...12

    Appendix C Relevant paragraphs from the Mental Health Act Code of Practice……………..13

  • Version: 1 FOI Status: Public

    Derbyshire County Council Adult Social Care

    Derbyshire Approved Mental Health Professional Service Practice Guidance when Considering Referrals, and Planning and

    Undertaking Mental Health Act Assessments during the Covid-19 Pandemic

    Issued: April 2020 Review Due: June 2020

    1

    1. Context

    1.1 The purpose of this guidance is to lay out what information is required in a Mental Health Act 1983 (MHA) referral to the Approved Mental Health Professional (AMHP) team, what response agencies can expect from the AMHP service, and the expectations that the AMHP service will have of other agencies. It also includes issues to consider during the planning and undertaking of MHA assessments.

    1.2 Section 13(2) MHA states that “… an AMHP shall interview the patient in a

    suitable manner and satisfy himself that detention in a hospital is in all the circumstances of the case the most appropriate way of providing the care and medical treatment of which the patient stands in need”. The AMHP service is currently undertaking MHA assessments at a time when public health measures have been implemented by the Government to contain the spread of the Covid-19 virus. This presents challenges to the AMHP service and the referral procedure has been reviewed and updated to take account of the change in working practices required during the Covid-19 pandemic.

    1.3 The Coronavirus Act 2020 (when enacted) does not amend the duties of the

    AMHP but it does require the AMHP service to interpret new terms such as ‘impractical’ and ‘unreasonable delay’. It is important that new ways of working are considered from point of referral through to conclusion of the MHA assessment in line with the Government guidance. The Explanatory Notes to the Coronavirus Act 2020 state that the purpose is to enable the right people from public bodies across the UK to take appropriate actions at the right times to manage the effects of the outbreak.

    1.4 This guidance will be reviewed regularly in order to ensure it remains reasonable and proportionate.

    1.5 For up to date guidance around personal protective equipment (PPE) or other

    issues please refer to the information in the Covid-19 folder on your desktop.

    2. Definitions

    2.1 An AMHP is a mental health professional qualified to perform certain roles and responsibilities required by the Mental Health Act 1983. One of the key roles is to co-ordinate assessments under the Mental Health Act, and to make an application for compulsory admission to hospital under Part 2 of the Mental Health Act, if they decide that this is the least restrictive option available.

    2.2 Throughout this guidance the term ’duty worker’ refers to the Central AMHP

    team duty worker.

  • Version: 1 FOI Status: Public

    Derbyshire County Council Adult Social Care

    Derbyshire Approved Mental Health Professional Service Practice Guidance when Considering Referrals, and Planning and

    Undertaking Mental Health Act Assessments during the Covid-19 Pandemic

    Issued: April 2020 Review Due: June 2020

    2

    2.3 Throughout this guidance an assessment with a view to compulsory admission under Part 2 of the Mental Health Act 1983 will be referred to as a MHA assessment and the Mental Health Act will be referred to as the MHA.

    3. Referrals – General Guidance 3.1 In line with the first principle of the MHA, potential referrers need to ensure

    that all least restrictive options to admission under the MHA have been considered before referring to the AMHP team.

    3.2 Potential referrers should consider whether the necessary support can be

    achieved by referral to the community mental health service, a review by social care for a change in the care package, or by referral to the Crisis team.

    3.3 If the person is already open to community mental health services, and the

    patient has not recently been seen, the doctor from the referring team should attempt to review the patient in person prior to referral. Depending on the circumstances, this might not be necessary if the doctor from the team is to be involved in the MHA assessment.

    3.4 If the person is not open to community mental health services, in most

    circumstances the GP should at least attempt to see the patient before a referral is made to the AMHP service.

    3.5 During normal working hours if a referrer is unsure whether a referral should

    be made, guidance and support should be sought from the duty worker (Tel: 01629 537904). Out of hours, the conversation should take place direct with the AMHP (via the Chesterfield Royal Hospital or Radbourne Unit, Royal Derby Hospital). In the event that there is a dispute, the situation should be escalated to the respective managers to resolve. It is important to remember that the AMHP only has to consider the request, they do not have to accept the referral. Referrals can come from many sources, typically:

     Derbyshire Healthcare NHS Foundation Trust – psychiatrists, bleep holders, Community Practice Nurses, Occupational Therapists, nurses working on wards, members of the Criminal Justice team, Liaison team, and Crisis team.

     mental health Prevention & Personalisation social workers

     primary care such as GP’s, including those working for Derbyshire Health United (DHU)

     police officers or forensic medical examiners

     children’s social workers

  • Version: 1 FOI Status: Public

    Derbyshire County Council Adult Social Care

    Derbyshire Approved Mental Health Professional Service Practice Guidance when Considering Referrals, and Planning and

    Undertaking Mental Health Act Assessments during the Covid-19 Pandemic

    Issued: April 2020 Review Due: June 2020

    3

     generic Prevention & Personalisation social workers

     East Midland Ambulance Service (EMAS) professionals

     prisons, including h