Mental Health Act (1983)

   T O N Y   D E A N E

Like many others I sort of fell into social work by happy design and accident.

I was born and raised in the North of Ireland, at the height of the Troubles and in an environment within which I was encouraged to ask the what, why and where questions, and to question authority in its various guises. It was an interesting place to learn about issues of social justice and oppression and inequity and stuff … not all the learning was good, by the way.

Thanks mostly to my mum, I was lucky enough to attend a school that tried very hard to inspire and add value to the young men it got. As a youth I had hoped to go to university to read History and Politics (at a proper ‘red brick’ one). However, as a youth I was much distracted by what life had to offer and my ‘A‘ Level grades suggested a different path.

I knew then that I didn’t want to work in a bank or be suit and tie type of guy, but I wasn’t actually sure what I wanted to be or do. My first work experience was two weeks at a local alcohol rehabilitation unit, where I basically made tea and played football with the men undergoing treatment. However, I also got to hear people’s life stories and the whole experience left an indelible mark on me. People’s family histories very often reflect so much about how society and social norms change over time.

So in 1988, towards the end of a certain Prime Minister’s reign and after the miners’ strike and by happy accident I ended up in a northern English (steel) city at a Polytechnic doing a Social Science Degree. I then did post-gradaute training to qualify in social work (ever the student, avoiding responsibility and filling my mind with all sorts of things – and my belly with beer).

By then, in a different English city, I knew that I wanted to be a Mental Health Social Worker and, having gained the experience required, there I was, in my chosen profession.

If you were going to be a Mental Health Social worker it was an Approved Social Worker (ASW) you aspired to be. These ASWs knew their stuff and they were capable and knowledgeable, and the bosses mostly left them to it. So, after more schooling, I was an ASW and I am now an Approved Mental Health Professional (AMHP).

Being an AMHP is at times an almost impossible task and we are almost invisible, stuck in a twilight zone between Local Authorities and the National Health Service. Most people have no idea what an AMHP is or does.

Being an AMHP is always interesting and often challenging. It is sometimes very difficult, upsetting and distressing, and sometimes just ridiculous and sometimes just very funny.

It is also a privilege to be an AMHP, as the role gets you invited into other people’s lives, often when they are at their lowest ebb. It’s a role in which others are all too keen to tell you what you need to do; however, more often than not, the people instructing or indeed obstructing have never actually read the Mental Health Act (MHA) or Code of Practice (CoP).

I chose the Mental Health Act (1983) and the Guidance because …

… taken together with the Jones MHA Manual, the Code of Practice and the ‘Pink Forms’, these are all the tools of our trade and it is by knowing these and using them skilfully that the AMHP can ensure that a person’s rights are protected and that they (and sometimes others) are kept safe. The MHA allows the state to remove a person’s liberty, but only through a prescribed process and only if it is thought necessary.

A Mental Health Act Assessment (MHAA) is many things, but it is also a legal process and it is the AMHP that is tasked with coordinating that process. AMHPs have many duties and responsibilities, and the lawful power to remove a person’s liberty, if that person meet the criteria for detention. However, the starting point and the Guiding Principles of the MHA mean we should be starting the journey somewhere else. I have become concerned that psychiatry has become overly reliant on the MHA and coercion; AMHPs can make a difference in this regard.

AMHPs are not perfect and we get it wrong. It is not an exact science. However an AMHP that understands the law and the Code of Practice and an AMHP that can apply that knowledge in the real world is capable of doing a very difficult task well, and of ensuring that people are treated with dignity and afforded the rights that the rest of us take for granted.

AMHPs come in all different shapes and sizes, and from very diverse backgrounds and creeds. We are all different and I like that we are an eclectic mix of individuals. We are not what people assume and it is our job to ensure that the law is complied with.

So my objects allow me to do difficult job as well as I can. They are to be used every day and not left to gather dust on a shelf.