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.