Here is a touchy one! – I was directly asked what the police think of AMHPs? The question struck me as a strange one as there are over 136,000 police officers and thousands of AMHPs – neither is an easily described group of people demonstrating personal or professional conformity!
However, the question got me thinking: I mulled over various things and decided only a blog will suffice as there are many strands to any attempt to answer! And of course, there’s MY answer which because of my interest in this subject may look a bit different to the more general, distant impression of a frontline police officer who isn’t especially interested in this area of work. It is undoubtedly impossible to answer the question directly, a synthesis of 136,000 views is unrealistic; even just my experience of different AMHPs is varied – as will be yours of police officers (if you are an AMHP). These joint experiences will probably probe the heights and depths of admiration and respect; frustration and obfuscation.
We do this stuff to each other where it doesn’t work so well.
Firstly, I’m not sure that all police officers know what an AMHP is – there’s no clue in the title. I know that some still think of the old ‘Approved Social Worker’ title and perhaps because of the clue ‘Social Worker’ that spoke for itself. There is certainly less clarity about what the new title actually represents. Usually, experiences are restricted to two types of situation: s136 MHA detentions and Mental Health Act assessments; either on private premises or in police custody after people have been arrested for offences.
What I thought would be useful to get close to an answer, is to list questions that have been posed in my direction following incidents. I think the questions where police officers come into contact with AMHPs represent a balance of uncertainty, ignorance, and frustration; enquiry, interest and expedience.
- Haven’t AMHPs got all the powers of constable after ‘sectioning’ someone? – why don’t they ever use them? This usually alludes to use of force debates.
- If an AMHP knows someone needs to be ‘sectioned’, but there’s no bed available isn’t their job to find one – I know the answer is no, but it is often assumed the AMHP is in overall charge of the bed identification and overcoming the problem if there are any.
- If there’s no bed available for a ‘section’ application to be made and we’re running out of time to legally hold them; how can someone just be left in the cells?
- Why do several AMHPs tell me you can never do a mental health assessment on someone who’s got any alcohol in their system at all, but some AMHPs are prepared to do it as long as someone is not obviously drunk and can engage?
- When they’re sorting out MHA assessments, why don’t we get a full picture of the risk history if the police are being asked to then manage that risk? We’re sometimes sent in blind of half-prepared.
Two of my own from getting more involved in this work – because I’ve only ever ONCE seen the first point done; I’ve known the lack of answer to the second point be something that has caused police forces to take legal advice and start legal proceedings against NHS organisations where patients are otherwise left illegally in police cells:
- If someone’s in custody for a criminal offence, why do the MHA assessment professionals not think about Part III MHA as an opportunity to balance care that’s needed and public protection. It’s only ever “Part II or nothing” and this sometimes misses a trick.
- Are AMHPs aware of, and what do they think of, s13 MHA, taken together with s140 MHA and the guidance published (after legal advice) by the former Mental Health Act Commission (now the Care Quality Commission) in their Eighth and Ninth Biennial Reports – paras 4.45 and 2.49 respectively? – what do we think this means? <<< This is a genuine question, not a dig. It’s ultimately untested in the courts, but I know what I think it means (for whatever that is worth).
The final thing I’d say – those of you how ‘know’ me well will recall this is a recurring theme in my interaction with AMHPs:
- Most AMHPs I’ve met, don’t properly understand s135(1) MHA and this misunderstanding can be a causes of significant operational friction.
- It is frequently misunderstood that an AMHPs delegation of detention and conveyance authority under s6 is not something that can be directed. It is dependent upon acceptance of that authority.
Penultimately, the Richard Jones Mental Health Act manual contains opinion and views that are at odds with various examples of legal advice to the police service from barristers who specialise in Mental Health law. I’ll let you decide for yourself what you think that means and I hope this post is seen as an effort to engage a debate. Fire it back!
I’d like to say this: many AMHPs I’ve known and worked with a very impressive people, and those I now network with on social media are commanding professionals full of knowledge and experience. They have to balance far longer term implications in their decisions the most police officers and have a confidence about how to do so in circumstances where most of us would want to just err on the side of caution and keep someone detained or locked up.
I’ve known officers ask, “How can they not section him?!” whilst demonstrating a lack of insight into the role, the law and the complexity of turning someone’s chaotic medical and social circumstances into a “YES / NO” decision about detention when operating on occasions with very limited information. And there’s an over emphasis on these decisions where they were supposedly invaldiated by a later outcome. There seems little recognition of where these (often brave) decisions worked to the benefit of a vulnerable person and in no small way contribute to their longer term recovery and prosperity.
I would also add that I think AMHPs are often left in a position of some isolation within the broader health monolith that they operate. Why can’t AMHPs who need to co-ordinate coercive activity call upon trained health professionals to help them coerce where this is low level and consistent with the dignity of managing vulnerable people? I’ve known AMHPs express regret when they ask for police assistance because they, like the officers concerned, know it’s not necessarily the best way through the woods of delicate situations. But for the want of other options they have no choice but to ask.
I wondered what the reasons were behind changing the role from a social work monopoly to one that involves other (often very suitable) professionals. Now that we’re seeing mental health social work being excluded from CMHTs, I am asking myself that question afresh because as I’ve become fascinated by this area, I think that the social work role in particular brings something precious to both community and inpatient care that would be (or will be!) sadly missed as we appear to re-medicalise our approach to mental illness.
The Mental Health Cop blog
– won the ConnectedCOPS ‘Top Cop’ Award for leveraging social media in policing.
– won the Digital Media Award from the UK’s leading mental health charity, Mind
– won a World of Mentalists #TWIMAward for the best in mental health blogs
– was highlighted by the Independent Commission on Policing & Mental Health
– was referenced in the UK Parliamentary debate on Policing & Mental Health
– was commended by the Home Affairs Select Committee of the UK Parliament.