Story updated 9 April 2021
The government has found £1.2m to “urgently” address gaps in the approved mental health professional (AMHP) workforce.
Set out in the Covid-19 mental health and wellbeing recovery plan, published last week, the money is part of a £3m package that will also go on preparing for the planned reform of the Mental Health Act 1983. This will include starting to address the significant racial disparities in the use of the act, which the government said had “been further exposed by Covid-19”.
While the Department of Health and Social Care (DHSC) could not elaborate on how the £3m – including the portion allocated for AMHPs, former mental health social work lead Mark Trewin said on Twitter that £1.2m would be spent on AMHP training, including to fund course fees and help employers backfill trainees’ roles.
Trewin said a system for distribution is being arranged by the DHsC.
AMHP shortage concerns
Concerns have been raised repeatedly about AMHP shortages, with the most recent workforce data showing that a third of AMHPs were over 55 – compared with 23% of social workers. Sector leaders have warned that employers were finding it increasingly difficult to support practitioners through the training process because of the challenge of backfilling their roles.
At the same time, the government’s planned reforms to the Mental Health Act would require the AMHP workforce to grow by 7% above current estimates by 2023-24, while the workforce is also due to take on a new role next month referring people in mental health crisis for a debt relief scheme.
Robert Lewis, AMHP service manager for Devon County Council, said he understood there had been discussions around targeting the new money at bringing AMHP trainees through the qualification process, which he said could take close to two years from recruitment through to approval.
“Quite how this happens I am less clear, as there is no centralised co-ordination of such initiatives to the knowledge [of the AMHP leads network] – with each local authority having their own approach to these operational and workforce considerations,” Lewis said.
Trewin said that AMHP shortages could not be sorted in one year.
“We need to plan an application in the next spending review and each area should have an AMHP workforce plan that includes NHS staff,” he said.
‘You can’t just magic up AMHPs’
Steve Chamberlain, chair of the AMHP leads network, echoed Lewis’ concerns, saying that “you can’t just magic up AMHPs by adding water (or £10 notes)” because of the length of the training and qualification process.
In an interview with Community Care in March, Chamberlain had highlighted the challenge of employers training up AMHPs, saying: “If you release staff for a major piece of training, who’s going to take on their work? Once upon a time you were backfilled routinely, now you aren’t and a lot of places will only release one person per year for training for example, so that struggles to maintain the numbers.
“If you want to increase numbers you’re going to have to send a group of people, which will increase pressure on the whole service because they are going to be away for their day-to-day work for three or four months.”
AMHPs are already due to take on a new role in May referring people in mental health crisis treatment to have a moratorium placed on certain debts while their treatment continues.
Impact of new AMHP role
Known as the Breathing Space programme, AMHPs will assess people receiving mental health crisis services who are in debt, so they can gain access to a freeze on their debt repayments and any enforcement action for the duration of their treatment plus a month.
Chamberlain said the impact assessment for the scheme assumed that the process would take AMHPs 22.5 minutes per person, involving the completion of the evidence form (15 minutes) and notification of the end of the crisis (7.5 minutes).
However, he said this did not take into account the requirement for AMHPs to obtain consent from the person in crisis to complete the form.
“This is highly sensitive information confirming that the person is receiving crisis mental health support or treatment and will be sent to the Insolvency Service, who are managing the programme, and clearly onto the person’s creditors, which can include their landlord, for example,” Chamberlain said.
While it is likely that most people would be happy to consent to this, Chamberlain said for a significant minority their mental capacity to consent to this may be in doubt.
“This will require an assessment of mental capacity of the person to consent to this evidence being given, and if they lack capacity, a decision whether provision of evidence is in the person’s best interests,” he said.
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Chamberlain added: “The government clearly considered the provision of evidence by the AMHP to be nothing more than an administrative process, otherwise they would have estimated a significantly longer time requirement than 15 minutes per form.”
With additional statutory responsibilities placed upon AMHPs, such as the Breathing Space initiative, and those being proposed through the MHA white paper, Lewis said any funding that helped bolster AMHP workforce was to be welcomed.
“What is required, I would argue, is clear leadership centrally working with local authorities and AMHP services on the ground to get the most from this money,” he added.
Trewin said that the impact assessment described ‘was challenged’ and that funding would be provided to local authorities for the Breathing Space programme.
Departure of government mental health lead
Meanwhile, with Trewin’s secondment to the Department of Health and Social Care as mental health social work lead coming to an end after three years, concerns had been raised about the delivery of initiatives for the workforce.
But according to Trewin, there is now a plan to develop another mental health social work support role in the chief social worker’s office, with details currently being finalised.
Trewin, who was mental health service manager at Bradford Council is due to take on a role at mental health charity Rethink. He had overseen a programme of work to develop the role of mental health social workers, including AMHPs, and fed into the government’s plans to reform the Mental Health Act.
Mark Harvey’s secondment as chief social worker, held jointly with Fran Leddra, also came to an end at the end of March.
Leddra will remain in post until the end of June, by which point Lyn Romeo will return from her leave and resume her position.
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Given two years of training just about produces at best an averagely competent AMHP, perhaps the problem is either that social workers can’t cut it in statutory mental health work, or that an over academised two year training programme is not fit for purpose. Time AMHPs accepted that they are not and never will be skilled lawyers and psychiatrists. We might then have training that equips them to function as social workers. It might even be achieved in the 6 weeks of training that used to produce confident ASWs content to lead as social workers.
I don’t believe Amhps are striving to be accepted as skilled psychiatrists or lawyers. I believe they have their own niche and are respected for that by other professionals, including psychiatrists and lawyers. Also the AMHP role although predominanly fulfilled by social workers, is also undertaken by other professionals.
I don’t know which ASW course you think took 6 weeks. I trained as an ASW in 1993 and our course was 4 months, which is the same as it is now!! And AMHPs don’t want to be psychiatrists or lawyers but over time we develop knowledge of MH Law and aspects of mental health that Psychiatrists and CPNs cover. We are respected by other mental health professionals because of our knowledge base, experience and independent thinking.
Sometimes I do think as AMHPs we do ourselves no favours. We moan about there not being enough AMHPs, when some attempt at supporting more training comes along we moan about that as well.
The AMHP leads network worries about how LAS are not backfilling to release or taking the numbers issue seriously but aren’t you the AMHP leads of said LAs? Therefore isn’t part of the solution and resolution at your door?
Too easy to moan and critique without solution. This may not be the right answer but take the money and use it to backfill and support group training. Speed up warranting processes. Lead!
As an AMHP I see very little drive or ownership by AMHP leads themselves. If we continue to just moan we will reinforce a growing perception that we are old school, stuck in our ways and precious. Not a good look.
Where are these backfill social workers going to come from though?!
Wrong prescription for the problem. The AMPH Leads Network might want to discuss funding and backfilling but the problem is with the AMPH role not just to do with that. I am an AMPH in London, perhaps the best funded region. My experience and almost all of those I speak to from other services, is that we are now resource and medically led practitioners. No AMPH reflecting honestly on how they function can deny that bureaucracy, poor supervision, inadequate post warranted training, over reliance on the mental health act rather than creative mental health work is the daily reality. The role is not fit for purpose from the moment remote to practice trainers are entrusted to ‘equip’ us for the role. Rather than the hollow “if only xxxx” internal debates, let’s have an open an non-defensive discussion. Lets actually hear when those who experience us tell us that we don’t really involve them in our ‘interventions’, that we are sometimes frightening, that rather than do creative mental health work mental health act is our default option, that we spend the time we think we need to rather than the time they want from us, that we are too easily swayed by medical opinions, that we don’t function as independent practitioners, that we have internalised ‘dangerousnes’ as the defining factor in to respond or not to referrals rather than distress. Mental illness is a complex set of emotions and experiences to unravel and understand but we should not be scared to forcefully challenge our now over reliance on formal mental health act assessments to address this. For every person and family who thank me, I hear from many more for whom a compliment is the never thought. Ofcourse it may be that I am an incompetent and useless AMPH. But I do wonder if its just me when the common feedback is that we rarely listen, we grandstand for doctors, we are too ready to see danger rather than distress, we dismiss family concerns too readily, we spout “law” when challenged, we excuse incompetence by blaming lack of resources rather than acknowledge our failings, our supposed independence is too rarely witnessed, we talk about but do next to nothing to challenge discrimination and inappropriate medical treatments. The list is far longer sadly. Lets talk about why the AMPH role is seen as being on the side of services rather than users of services. Resources matter, training matter but how we function and how we are experience so matter. Lets hear some honesty from the AMPH Leads Network rather than this constant obfuscation. Lets hear what value is added by training consortiums, lets hear whether the current training route is the best use of public funding. Lets also acknowledge that there are some conflicts of interest for some shaping this debate. What’s so contentious about admitting that it’s not lack of funding that gives us the current poor quality training that churns out skilled bureaucrats obsessing about the law without understanding its purpose, inadequate support and poor supervision? Change and honesty has a painful price but is it not worth the embarrassment to get back the respect we once had?
An honest stance., thank you.
As London people we have asked the same London MH Trust for over 20 yrs why they dont have a feedback forum or mechanism for those of us subjected to what only ever feels like extreme antagonism at best and extreme aggression at worst.
You know full well as AMHPs we or our loved ones are being sent often hundreds miles away into abusive violent wards where there is no care and certainly nothing therapeutic about it.
Not a single person has a good word to say about psychiatric hospitals.
If you are a woman you are almost guaranteed to be a victim of sexual violence on a mixed ward.
If you have sensory or physical disability AMHPs and s12 Drs are perfectly happy to send you in to wards with no disabled adaptions or aids or additional care required whatsoever.
Have been detained under the MHA in this one London borough 5 x by AMHPs and more by police under s136. And of course along with everyone else in London dragged away under the MCA as a contrivant ” solution ‘ to an AMHP not being available to someone’s home. Been detained out of area as well.
My kin have been told they dont matter, that they have no rights and that it is their job to look after me in a MH crisis Not once have they ever been notified or contacted when act as NR. Let alone consulted. The idea that a crisis plan is referred to is as laughable as the suggestion a birth plan will be followed when pregnant.
And throw in as a family we have had preventable deaths ( as defined by the coroner).
So, as one family alone we have hundreds yrs experience of supporting relatives in crisis. Yet no one thinks we should help mould what an AMHP should look like. Thats more experience about an individiual than a MH professional has in an entire professional lifetime .
Those of us detained are only ever asked about MH things if a MH Trust approves the subject matter, is allowed to chair any discussions and can choose and veto ( the same) service users, who we will continue to call pts just to remind all this is the NHS.
Given the role of an AMHP and fact you are employed by the LA mostly is it that impossible to actually speak up about NHS policies that ate harming those you assess?
Why isn’t there a critical friend forum for both post detention and post assessment?
Why is there no automatic requirement for an exit interview once discharged off a section?
Why is this a closed shop of seemingly ( even in London) mostly white middle class social workers ?
Obviously at this point I would be happy to see the role disappear because all the AMHP does is whatever the s12 dr says ( from our experience) and what is available is determined by the bed managers at the Trust. Plus throw in the ability of crisis teams and houses to automatically refuse certain types of pts ( mostly thosec with a psychosis diagnosis).
It certainly seems to be the goal of MH Trusts to get rid of the role given none of what you or we refer to EVER gets addressed by the NHS.
Do they need or want you?
So, we have lost sight at whatever it was an AMHP role was thought to be when an ASW. No clue. Nada.
Well said colleagues. “Lead” isn’t necessarily converted to Leadership in my experience. Hear what we are saying. Ofcourse resources and AMPH numbers matter. But we also want dynamism and advocacy not the paralysis of leads spouting on about rotas and duty AMPH numbers. Not a particularly inspiring mantra at the best of times and certainly not when uttered by seniors from their front rooms via dodgy wi-fi in a pandemic. The AMPH Leads Network need to move on from podcasts and BASW propaganda and serve our interests.
I have to agree with these comments and also note a wider cynicism creeping into social work as a whole. Any good news or suggestions is met with derision and moaning by our more ‘experienced’ AMHPs and SWs who let’s face it should be offering the solution not the whinging.
You’d think everyone hated being a social worker sometimes. The vast majority love their jobs and of the AMHPs I work alongside they do too but we don’t see that in some senior AMHPs with a national voice.
From this report and recent work of the CSW office it strikes me they have done more for profile and support of AMHPs than the AMHPs leads network.
I have simple question about the length of the training. Other than the ‘technical’ aspects of the role, knowledge of legislation, code of practice, types of ‘mental disorders, impact of physical health on mental health and vice-a-versa, treatment options and medication and the like, why are experienced social workers on AMHP training also required to demonstrate skills they already have by dint of their social work training? Why am I after 4 years of practice having to “demonstrate” I have good communication skills? Presumably my local managers believe I can express clearly, I understand and practice in an anti- oppressive way, that I respect users of our services, that I have aptitude to learn and am empathetic. Cut out the repeating, cut out the nonsense of the magic powers attributed to the Portfolio, cut out the endless introspection of the trainers and we wouldn’t need to be away for months cutting and pasting references from our social work student days to satisfy a never clearly defined “standard”. One would think that training providers had an incentive to re-invent and re-emphasise the already learnt. Wouldn’t do to speculate what that is though, I want to pass. Would really appreciate if the Leads Network, BASW, SWE, Practice Educators or more experienced colleagues can offer an explanation. I am being genuine not cute or cynical in asking.
I gave up my AMHP status in 2018 after 14 years working in a very busy Local Authority. I loved my years as an AMHP, I was a Practice Educator and also did a lot of teaching at the University too for those undertaking their AMHP course alongside working both in hours and out of hours as an AMHP. This was all valuable experience and I have enjoyed it but I found with austerity, many years of austerity and poorly funded services I found it draining working as an AMHP. The delays in finding beds, beds in the local vicinity and very few decent alternatives to admissions; alongside poor practising Crisis Teams led primarily by nurses who all tend to be very focused on the medical model made me give this up. It was a long time coming and sad to come to the conclusion to give up being an AMHP but it was the right thing for me. I would not want to go back to being an AMHP now and this current government and the AMHP leads need to consider these current issues . I would have fallen into the bracket of those older workers but I can see where I did work they are struggling to keep their AMHPs now and there is a real turnover in staff now which was unheard of at one time . I don’t think the crisis teams have got any better either and this is a worry too. I have found people are left with no services for a long period of time, then when they become ill they are detained but only for short periods of time and the revolving door nature has not reduced or gone away despite crisis services allegedly offering an alternative to admission. It seems access to services is very poor and I am clear this is austerity driven again with limited funding since 2010 and is it any wonder workers and my fellow AMHP colleagues have had enough . It’s a service in a very sorry and poor state, sadly . I hope that all revisions will be well funded and truly person centred for once with decent services around those in a mental health crisis but I don’t have faith in this Government to address this well and do the right thing by those who need the services .
I just read in a twitter feed an AMHP ridicule interposed tupos of the P by telling us to “do the math.” I suspect bad typing on my part is less of a crime than the deliberate misuse of language but hey ho. Also what arrogance to question whether ” both of them” are who they claim to be. Sorry for not conforming to prescribed groupthink. If you dont like the comments challenge the content. I’ll learn how to spell practitioner but where would you get your cheap laughs then?The like minded talking to the like minded does not a professional make. Please come on to this forum and challenge us so we can have the discussion openly. What’s so scary about diverse opinions? I hope you publish this because not all of us partake in twitter, we prefer nuance even if we struggle to use spellcheck. In the meantime please chuckle at the deliberate spelling mistakes left for your amusement. No need to flee the country, its just opinion not rocket science.
The same leaders making the same excuses validated by the same mates perpetuating the same mess.
It strikes me that pumping money into AMHP training/recruitment is a bit like turning on the bath tap without putting the plug in! I hope there are plans to look at retention of current AMHPs…
I completed the AMHP course and then had my first child. On returning to my LA role after maternity leave I found AMHP work fairly incompatible with having a young family and sadly made the decision to move into a non-AMHP role. It was not the AMHP assessments/ decision making that became unmanageable but all the trappings that go with an extremely poorly resourced and clunky system e.g. waiting for beds to become available, waiting for S.12 doctors to respond, waiting hours for an ambulance to convey people, waiting hours in magistrates courts to apply for a warrant… Not to mention the fact that the role is pretty abysmally recompensed!
I get really frustrated when l read such because l am an agency social worker with over 10years experience and would like to undertake the AMHP Training but it’s honestly mission impossible and yet there are shortages like this ?
If you think AMHPs, who happen to be predominantly social workers, don’t yearn for validation as wanna be lawyers and psychiatrists you’ve had the good fortune never to have attended an appeal tribunal Cburn. AMHPs fetishise how many mental health act assessments they have on the go, the threads talking about beds and warrants give the game away about what their function and “niche” is. AMHPs are the Territorial Support Group equvilant enabling an authoritarian, oppressive mental health service I and many others have been dehumanised in. I used to be a social worker but AMHPs put an end to that. Congratulate yourselves on a falsehood of human rights based interventions all you want but you are closed minded to our reality and truly ignorant of “the patient experience.” It’s not your numbers, it’s what you facilitate that needs to change. But maybe that’s just another rambling delusion of my “mental disorder” into which I lack “insight.”
Cynthia Orton: two lines, brilliant; spot on.
Trainee AMPH: not sure whether the sarcasm of your title or the “Magic powers attributed to the Portfolio” will enrage the most.
That’s because you are not directly employed by an LA or the NHS Tia. Why would they invest £4000 plus to train you instead of one of their own permanent employees?
Hmmm…..as an AMHP victim I might answer that it’s not exactly hard to sponsor outsiders, unless you dont want to expand the pool.
Just like student social workers used to be sponsored through LAs and were then required to work for a period of time to ‘ pay back’ .
Of course you might just have been being tongue in cheek but as the victims of this traumatising mess all we EVER see and hear are MH professionals in fighting. We provide you with solutions which are kicked in to touch only to reappear 15 yrs later as some amazing new strategy where researchers and highly paid bods have earned enormous sums doing what could have been undertaken better and before the chaos of those extra layers of silos.
Whilst local authorities continue to have closed shop non externally advertised posts then the culture of same old, same old pervades . It undermines diversity of anything.
This is a dangerous mess. How do new AMHPs ever get recruited ?
All I know from sharing office space with the “Specialist AMHP and Rapid Response Team” is that no opportunity is ever wasted slagging off other services with the most peculiar relish. Exasperated with all, dismissive of any criticism, undermining of and sneering at the only non-social worker AMHP employed by the NHS, it’s like watching a group of market traders competing with each other over how many mental health act assessments they’ve got to “do.” Eveasdropping a recent Forum discussion was like being assailed with Titania Mcgrath tweets, all so self reverential but little substance. It’s all about the “peeps” apparently whatever that means. Parody aside, we do need to reform statutory mental health services and I see and appreciate the challenges grappled with by AMHPs. Unfortunately they are too insular and too defensive to lead and shape future reforms. But what do I know, I work with older adults.
I am an AMHP and frankly I think most posts here don’t merit a response but I will engage never the less.
1. AMHP work is the most complex role in social work requiring specialist knowledge, training and resilience.That’s a fact so no apologies for owning it.
2. The odd non-social worker AMHP will have a protected workload. They don’t face the same intensity social work trained AMHPs face. That may explain why some of us think them a bit precious and semi-engaged.
3. Until you have set up and completed a MHA assessment, you have no reason to beleive you understand the law, the complex negotiations we routinenly have with inpatient services, police, ambulance service and beligerent families. Our routine work is the exception in other services which is why I make no apologies for bigging us up.
4. Ever had to convince a magistrate to give you a warrant to enter premises to remove someone from danger when they have barricaded the said premise and are threatening to kill you? Thought not.
5. No other staff group are scrutinised so throughly to ensure their practice is lawful and ethical. No other staff group have to justify their interventions to a judge presided tribunal and solicitor acting for the patient at least once a week.
6. You may think it funny to call yourself Trainee AMPH, but I sincerely hope you understand the seriousness of what you are being trained for
I could go on. Unless you practice as an AMHP I am afraid comments are mere anectode.
How dare you, as a well paid professional earning a top up to do this role, refer to families as ‘ beligerant’.
How arrogant, how aggressive considering the fact that for the vast majority the assessment itself is so traumatising that the individual at the centre will in ALL likelihood be harmed irreparably.
That beligerant family have been doing 24 hrs a day care day in day out for often weeks on end without the luxury of being paid or clocking off or having days off. Unlike you.
They will have lost their jobs because guess what- most of us dont have the hugely generous work contracts you as local authority staff have. We dont get leave to do this. We dont have unions. We dont have professional bodies. We dont have OH counselling services.
‘Beligerant families’ own health needs, chemo, vital surgeries , wedfings, children, education and their own childhood often will have been put on hold.
As carers they will have been dumped on by every single statutory service passing the buck without the 6 weeks annual leave you get. Plus some if longstanding.
How much do you get paid as a starting salary in London? A nurse starts on 24k. A nurse in an itu gets 24k plus 3k London weighting. A CARER GETS PAID £67 A WEEK. And you ?
You have often literally turned up days beyond the legal time limit if held on another section ,but hey it’s only a vulnerable person so what does it matter. Weeks if you think they have family and here 10 days after that ‘urgent’ application to the magistrate – which wouldn’t have been necessary had you and your colleagues actually respected the fact that this is meant to be a person centre rights based approach. And that person at the centre is not meant to be you.
You work in a world where you KNOWINGLY send vulnerable persons to be assaulted including by your ward colleagues. Yet stay silent because it isn’t YOUR job .You know FULL well the likelihood of women being sexually assaulted on a ward is extremely high yet that too isn’t a matter for you to be concerned about.
And let’s not forget the small matter that as a black person I am 4 x more likely than a white person to be recommended for detention by you.
And of course the not so small matter of all the years of AMHP ‘ advice ‘ to first responders asking where the hell you are to try and remove the person under the MCA as a legal contrivance.
Your comments are an illustration of what is wrong with your profession.
How disgusting to call families ‘ beligerant ‘ because they are trying to protect their loved ones lives in a sysyem that brutalises and kills at times.
You are paid to do the job and a hell of a lot more than NHS staff are . Your arrogance is dangerous. Your comments as offensive as it gets.
My manager has laminated Cynthia’s words and stuck it on his office door. Who says managers don’t listen. (He is retiring in June mind.)
‘re Breathing Space. AMHPSs need to be urgently aware that it is NOT just those they assess or detain their new role demands IT IS ALL THOSE RECEIVING FORMAL CRISIS CARE – INCLUDING THOSE WHO NEVER COME ACROSS AN AMHP. It is clearly an error based on the belief the treasury ( who commissioned this) that ALL those in a MH crisis only get supported in hospital . They ONLY consulted with the insolvency service and the provider, the Money Advice Trust.
The duty is to refer to a qualified debt adviser. So AMHPs need to be asking their MH Trusts how on earth those under the crisis team or crisis house will be referring across – because THAT is where the gap lies until someone explains to the Insolvency service and provider that the WRONG professional has been selected for this role.
There is a listed group of professionals and ‘lesser others ‘ ( my quotes) who can refer pts to the AMHP but at the moment no Trust seems to have a mechanism. Crisis teams and staff know NOTHING about the fact that this is a regulated duty. These debts include rent arrears and evictions.
If as a professional group you don’t sort this mess out then no creditors will believe someone isn’t able to manage their debt situation as it is fair for them to state that if that was the case an AMHP would have acted ( consent issues aside as the debt world can act retrospectively ).
Imagine the potential legal action that is going to be immediately advised the moment it is realised someone lost their home or ended their life because an AMHP didn’t act . For want of lack of communication channels and admin pathways at the moment.
Particularly when the same local authority that employs the AMHP may also be the social landlord evicting for rent arrears ( again, with a nod to consent which we have to say doesnt seem to ever raise its head in any other area of MH and data sharing so guess it is a start…. But a judge might well do some comparisons .).
Can we respectfully request that Steve Chamberlain immediately contacts the Insolvency service AND the Money Advice Trust to advise that they are simply the WRONG professional and it is a clear drafting error as AMHPs weren’t consulted. There is no reason why this role can’t be undertaken by a crisis team or house.
Ask them for the treasury liaison member who can get this redrafted and in the interim issue urgent guidance that the role can be delegated. BECAUSE RIGHT NOW THERE IS A GAPING CHASM IN THE GUIDANCE .. We have seen it – suggest if you havent request it urgently.
The legislation and guidance talks about AMHPs role being one where you all offer on going crisis support. There are VERY few people in the advice world whose role crosses over with MH but there are some absolute experts who have an overlap. There are even some welfare rights advisers lurking in MH Trusts and MANY LAs have a welfare rights team. Be good to know how many AMHPs have contacted their colleagues in the same employing authority to explain that no, you dont see most in crisis and no, you dont provide any crisis care.
If Steve Chamberlain wants to be able to contact senior people in the advice sector ( who were not even aware this was an issue until the last few weeks ) then can be arranged. Just give consent to be contacted and some liaison can happen to try put this right.
It is a mess that can be fixed. Solutions are obvious. Solutions and fixes are the bread and butter of advisers , including the specifically qualified debt advisers. This isn’t hard to fix if the will is there but it takes strategic action from the AMHP professional body to do so. And immediate referral pathways have to be built in as well as immediate guidance ‘re the ability for the AMHP to delegate the role which is an almost instant interim fix given the legislation and regulation around this us as woolly as it gets.
Please act.
Typo.
Money and Pensions Service (MaPS) are the provider.
For chrissake just contact them and the insolvency service
Hi Callum, there are indeed many self declared leaders and experts mesmerised by their navels and the laughably faux American narcissism of their pals. I doubt your invitation to debate outside twitter will be taken up. Much safer to ridicule for likes from ‘buds’ than expose oneself in a proper debate. I well remember being told to “chill out,” when I disagreed with the same esteemed colleague in a previous debate. As it happens I think Steve Chamberlain makes some valid points. But in my opinion the Network is too compromised by their BASW/SWE intimacy to make the radical proposals needed. Its not just about an ageing workforce and too few practitioners. We know the training is not fit for purpose. We are all frustrated by the narrowing of the role and the erosion of our autonomy. We know that the workforce doesn’t reflect let alone represent the communities we work in. If we are honest not many of us would want to use our services if we needed to. I am certain none of us would want to be patients in the wards we admit people onto either. Yet we have never really joined with our health service colleagues to tackle these issues they also find dispiriting. We need leadership to cut through self interest and status. We need to find grassroots spaces to work together. If necessary we have to be brave enough to challenge our own managers to truly embrace a new vision. Our professional and ethical interest should entwine with that of users of services not collide against them. Community Care is the forum to do this not the inanity of twitter in my not so humble opinion.
“The greatest evil is not done now in those sordid dens of crime Dickens loved to paint. It is not even done in concentration camps or labour camps. In those we see its final result, but it is conceived and ordered, moved, seconded, carried and minitued in clear carpeted, warmed and well lighted offices by quite men with white collars and cut fingernails and smooth shaven cheek who does not need to raise their voice.” C.S. Lewis
Janet and Anon tell us they experience us as oppressive and on cue we have Proud Commended AMHP lecture us about “beligerent families.” Jargon obsessed automatons versus real human emotion. Why would any profession advocate for more of this?
Thank you.
My very unwell loved one who believes I am trying to harm them will have been threatening to kill me in perceived self defence for weeks before an AMHP turns up.
Yet us expecting the AMHP plus 2 s12s plus 8 police plus 4 paramedics to look after them makes us ‘beligerant’.
Believe me as a family we would do almost anything to keep AMHPs away because of this sort of attitude and the inherent dangers that come with.
We dont get the luxury of police protection Proud Commended AMHP. You do.
And the reason you get scrutiny is because you remove people’s liberty without a single protection in place even on par with those afforded in the criminal justice system.
“I don’t know which ASW course you think took 6 weeks” sums up the it’s only real if I have experienced it fact averse mindset sadly ascendant in social work now. The answer is I trained as an ASW in 1985 and at the end of 6 weeks sat an exam. After a campaign by NALGO and Mind, exam was scrapped and we ended where we are today. Sorry to disappoint.
I wish AMHPs would stop going on about being Independent. You are not. You are part of a network and you discharge your duty according to what resources made available to you. The percentage of applications not made by AMHPs against medical recommendations is the acid test. Anyone able to provide the statistics? If not why isn’t this collected?
I would love to know what is the unique/specialised knowledge base of AMHPs. By dint of their articles based legal training lawyers have superior knowledge and experience of legislation. By dint of their 7 year medical and psychiatry training doctors have the knowledge and skills to diagnose, prescribe and treat mental disorders. By dint of their 3 year nursing training and continious professional development, nurses have superior knowledge and skills in medication management. By dint of their caseloads and engagement with users of mental health services, Support Workers, OTs, Psychologists and Social workers have a bigger impact. Compared to all this the routine administrative skills of AMHPs is akin to a mechanic changing the oil in my car. Now if AMHPs actually worked over time with people in distress, if they tackled social, housing, income and other challenges faced by people they only seem to know when they “detain” them, they would have the tenacity, knowledge and inter agency advocacy skills to make a positive intervention in peoples lives.They might even properly support families in the process also. Waving pink forms and moaning about magistrates while behaving as if they are not an integral part of the problem: is that the specialist AMHP skill?
Pompous, arrogant with an undeserved over inflated self importance some AMHPs may but not all have the curse. The issue for me is that a humane mental health service wouldn’t need AMPHs. The AMHP role facilitates the crises and the emergency responses. Without AMHPs, compulsory in-patient treatment wouldn’t be the default option. That all said, they do what they are tasked to do with little support. I include AMHP leads in that from my experience. I certainly don’t regret handing my warrant back. The pay cut is worth it. I just wish AMHPs would be more prominent in challenging the failing service they are a prominent cog in. Like all social workers AMHPs should have the humility to really listen to criticism even if it’s unfair. We should all engage with opinions we don’t like so that we can have proper discussions and build alliances. That all said, the set up is the current one so I think AMHPs should be cut some slack. I appreciate that Janet Tiernan and Anon may disagree.
My problem is that all in MH services have seemingly forgotten that there is a vulnerable person at the centre of these silo mentalities and failings to follow the law.
I read this publication but are MH professionals really that unaware that you dont all realise your interprofessional arguments are played out loudly and dangerously within earshot of pts and their families?
We dont trust because professionals can’t even get the basics of human communication right. You openly detest each other and believe me if I had a penny for just how many times we as family members or, even worse , our ill relatives are told how crap others are at their jobs, we would be very very rich.
And no, I dont see a role for AMHPs because they are not and do not act independently. And yes, we also know the MHA inside out because guess what, after this long, many families and pts actually know that AND the guidance.
If any AMHP is prepared to submit to ECT, take medication that reduces their blood cells, think diabetes and brittle bones are a price worth paying for their own “treatment”, then I will cut AMHPs some slack. All I know is the chasm between the reality of what AMHPs enable and their supposed human rights based practice. We are all hypocrites in our job roles at various points but only AMHPs perpetuate a pretence that covers up the physical, sexual and psychological abuse experienced daily in mental health settings.The quote from C.S.Lewis sums the functionaries of oppressive practice. The risk is that if you open up your heart to these realities you end up leaving social work altogether like me. Better to tally up the S136s, the ‘burden’ of trying to find a bed, the rush of executing whatever version of S135 powers and the rest. Better to not admit where the activities end. A sexual assault on a ward is your responsibility as much as that of inpatient staff. Never heard a single AMHP own the violence, the unneccesary restraint, the bullying, the forced medication, the seclusion, the everyday neglect of a person they proudly brought into hospital on the absurd catch all of safety and treatment. Fight for a better Mental Health Act if you see merit in the State legislating for health, fight for or better still be in the midst of a true and effective oversight of wards and treatment decisions. What price do patients pay for the warm glow you get from cosy chats with your doctor chums? Admit that your “independence” is compromised daily. Admit that you work in organisations that allow you little to no autonomy. If we must have AMHPs, time they rediscovered their once proudly owned reputations as the awkward squad.
EXACTLY.
I tend to agree that we haven’t always helped our cause as AMHPs. We should be less opaque when explaining the role. What we do is complex and stressful but also very narrowly defined. We are not mental health workers, we don’t do any long term case work. Advocacy at a pinch, sorting out social care, housing and benefits rare as hens teeth if ever. It will be interesting what deficits in our knowledge and skills debt management duties will expose. We discharge the statutory tasks defined for us in the Mental Health Act/Code of Practice. That’s it. Whatever add ons we embrace is our shout.
The debt management drafting mess is fixable if your professional leads would just like to go address it.
Very true Anon but do my esteem leaders have the confidence to do that?
So why dont you just directly ask Steve Chamberlain this?
Why dont you as an individual professional write to the Money and Pensions Service and the insolvency service and tell them the assumptions underpinnig the drafting are wide of the mark and the AMHP is not the correct professional?
You’ve been given the information so just do it.
THIS is exactly what AMHP victims mean: you know this scheme will cost people their homes and debt costs lives and yet as individuals none of you speak out.
SO easy to fix.
But silo mentalities even within AMHPs themselves…
I hope this does not sound patronising, it’s from my heart, but I think every AMHP training consortia, AMHP service, Leads and managers should provide staff with a copy of what Anon has so movingly and eloquently reminded us of here. What a contrast to the contemptuous comment from Proud Commended AMHP. There’s nothing to be proud about or commend in a mindset that rubbishes colleagues and denigrated families in such a horrible way.
Thank you
Proud Commended AMHP might have been a tad harsh but they are not wrong about the challenges AMHPs grapple with daily. Some families are obstructive and harmful to their relatives. I don’t know why it’s offensive to acknowledge that.
Because you are meant to be professionals.
That is why.
The fact you dont even get why those statements are offensive is so, so telling.
You call that attack on families as a ‘ tad harsh ‘.
Seriously? You invalidate when families and carers explain the blindingly obvious to you and wonder why the AMHP service is absolutely detested by most in a caring role.
And apparently by so many colleagues in health and social care.
So , given the longer detail baffled you so much – let’s keep it to fewer words:
AMHP service failings are causal to extreme irreparable harm to vulnerable people plus those without the professional privilege the largely white middle class social workers have.
AMHP service failings kill people. AS IN THEY DIE.
Including collateral damage to those who support.
That is the price of such dangerous arrogance.
That is the price of the silence and contrivance in abuses of law and rights.
That is the price of AMHPs silo mentalities that is about protectionism of the role to the detriment of those considered seemingly, as lesser beings.
We will not miss your role if it disappeared tomorrow- in fact we would argue strongly the world of MH would be a hell of a lot more transparent and safer.
Perhaps the offence is in who is allowed to be the arbiters of abuse and harm Jason. Not all of us beleive in the veracity of how such judgements are made.