PARAMEDIC SERIES: What Is An AMHP?

This is one of the PARAMEDIC SERIES of blogs.  To see all of the others, refer to the index:

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An Approved Mental Health Professional is a person who is warranted, or authorised, to make certain legal decisions and applications under the Mental Health Act 1983.  Usually, this person will be a social worker who has undertaken additional training to become warranted but in 2007 the law was amended to allow other mental health professionals to undertake this role.  So it is now possible to see psychiatric nurses, occupational therapists or psychologists becoming AMHPs.  The majority are social workers.

Police officers and paramedics will encounter AMHPs in two common enough situations, as well as very occasionally in some rare situations:

• Place of Safety assessments – Decisions around people who have been removed to place of safety by the police under section 135 or 136 of the MHA will be coordinated by an AMHP and will involve a Doctor.  These assessments may then subsequently involve the second kind of situation:
• Mental Health Act assessments – decisions about whether a person will be offered inpatient hospital care, either on a voluntary or statutory basis, will be coordinated by an AMHP and will involved one or two doctors depending on the kind of MHA assessment was organised.  Usually it will be two doctors for consideration of admission under section 2 or section 3.

WARRANTS UNDER THE MENTAL HEALTH ACT 1983

Certain things that can happen under the MHA may require the need force entry to a building and this is only possible with a warrant from a Magistrate.  There are two warrants in particular worth knowing about and AMHPs are often the people to apply for them -

• Section 135(1) – this is a warrant to force entry to a premises and / or remove a person from a private place to a place of safety for assessment, potentially for their initial detention under the MHA.  Only an AMHP can apply for this warrant and it can only be executed by the police whilst accompanied by an AMHP and a DR.
• Section 135(2) – this is a warrant to force entry to a premises it take or re-take a person in custody who is already liable to be detained under the MHA or is missing from hospital.  An AMHP or a police officer can apply for this warrant and whilst the police could execute the warrant alone, it is suggested best practice for the police to be accompanied by a mental health professional.

DETENTION AND CONVEYANCE

If as a result of a Mental Health Act assessment an AMHP decides to apply for the detention of a patient in hospital, that person becomes in the legal detention of the AMHP, by virtue of s137 MHA.  The AMHP is subsequently authorised by s6(1) MHA to”detain and convey” the person to the named hospital for admission, using reasonable force if necessary.

The AMHP can ask other professionals to detain and convey on their behalf, assuming the right to use force and this request is often made of the police, who will in turn often ask for an ambulance to be the vehicle used to convey.  Paramedics are sometimes asked to assume this authority and you should check with your own Trust as to how to handle those requests.  It is certainly lawful to do so, but whether local policy allows it, varies from trust to trust.

OTHER FUNCTIONS OF AN AMHP

• AWOL patients – where a patient is absent without leave from hospital, an AMHP is authorised along with police constables and others to retake the patient into custody and return them to the hospital from which they are missing.  I’ve never known it happen, but it’s on the statute books and it would be legal.

• s42 Warrants – Where a patient has been detained in hospital after a criminal trial, subject to a restricted hospital order they can be discharged into a form of community care.  If the Ministry of Justice thinks it necessary, the person can be recalled to hospital by the issuing of a warrant.  AMHPs can be encountered whilst waving warrants asking for police / paramedic support to retake and repatriate a person specified in such a warrant.

• Guardianship – when decisions are being taken about the detention of some people under the MHA or the discharge of patients from hospital, one opportunity is for a person to be made subject of Guardianship, which means that they live with a nominated position who assumes certain responsibilities with regard to that persons care.  AMHPs co-ordinate applications for guardianship and transfers between hospitals / guardians.

FURTHER READING

Don’t forget three methods of using this blog to find out more:

• There is a full index of almost 300 posts on all manner of topics.
• There is a series of “Quick Guides” originally intended for police officers, but some will be of interest to paramedics.
• There is a “search” facility in the top right hand corner: by entering any keywords on policing / mental health will bring up the relevant posts, including entering sections of the MHA like “s136″.

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The Mental Health Cop blog won

- the Mind 2012 Digital Media Award, in memory and in honour of Mark Hanson.
The Awards celebrate the “best portrayals of and reporting on mental health in the media.”
- a World of Mentalists 2012 #TWIMAward for the best in mental health blogs.
It was described as “a unique mix of professional resource, help for people using services and polemic.”