Story updated 15 May 2022
Social Work England has issued proposed training standards for approved mental health professionals (AMHPs) and the new role of approved mental capacity professional (AMCP) for consultation.
The standards – when agreed – will be used to approve and reapprove AMHP training courses and approve programmes to train up AMCPs once these are up and running. The AMCP role is being brought in under the Liberty Protection Safeguards (LPS), which are due to replace the Deprivation of Liberty Safeguards (DoLS), potentially in 2023, though a date has not been set. It will, in effect, replace the existing best interests assessor (BIA) role, though will have different functions.
Though AMHPs and AMCPs can come from multiple professions – social workers, nurses, occupational therapists and psychologists, in both cases, and speech and language therapists as well, in the case of AMCPs – Social Work England is the regulator assigned to oversee the training of both roles.
What the proposed standards say
Both standards set the following requirements for providers of AMHP and AMCP courses:
- Admissions: to ensure that applicants have “suitable prior experience” of applying appropriate legislation and policy, including in relation to mental health, mental capacity and human rights, and an “advanced level of legal literacy”.
- Course management: to ensure there is adequate provision of appropriately qualified and experienced teaching staff, and that they are supported to maintain their knowledge and understanding.
- Supporting students: to ensure that students have access to resources to support their health and wellbeing, including through confidential counselling services and careers advice.
There are also several standards specific to each role, for example:
- AMCP: to ensure the student has at least two opportunities to carry out AMCP tasks under observation by a suitably qualified professional.
- AMHP: to ensure practice placements are integral to the course, their number, duration and range are appropriate to meeting learning outcomes and, through collaboration with providers, that they provide a safe and supportive environment and have an adequate number of appropriately trained and qualified staff.
Both consultations will run for 12 weeks, until 1 August, with the AMHP standards due to be agreed in the autumn. Social Work England said it would publish guidance to help course providers meet the standards, which will replace existing guidance.
It will also publish guidance to help providers meet the AMCP standards, though the implementation of these will depend on the government’s plans for introducing the LPS.
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My suggestion would be that training includes a one month placement on a mental health ward with trainees there for the whole of an early, late and week end shift to really understand what an “admission” actually means. This is the opportunity to once and for all to get rid of the ‘handing over’ culture. People have had their distress compartmentalised for the convenience of professionals, me included, for far too long. If SWE is really committed to empowering peoples lived experience of mental health experiences, it can make a start at eroding the silo mentality of professionals.
I don’t understand what actual benefit spending a month on the ward would achieve, home treatment teams would be far more beneficial. Mental health wards are fake environments and it’s far better to see people in their own environment. As part of the training for AMHP qualification you’d be visiting MH wards to speak to people or attend ward rounds or MDT meetings .. you’d see all you need on the ward there.
So as an AMHP you get some insight in to the violent abusive settings we are sent to? And the impact of the professional bystander culture ?
Personally wouldn’t let the trainee go home or have food or communation devices or bathroom doors. And of course don’t forget the routine threats of all male prone restraint – especially if you are a woman. Let’s ensure no sexual safety in line with the norm.
And the obligatory 83 hr wait in the MH suite of the local ED manned only by security guards with no enhanced DBS checks who in any other arena would be arrested for assault. Before sending the would be AMHP hundreds of miles away to an out of area private placement for well over 28 days and at least long enough to ensure you lose uour income and in turn your housing .
Can’t see the problem really…..
I’d suggest you make a complaint about your experience as an in patient rather than erroneous assumptions about the AMHP role. All AMHPs have a duty to consider and document that they have considered the least restrictive options and the needs of the patient. Acute wards aren’t necessarily therapeutic environments and concerted efforts are made to avoid them but of course this often isn’t possible.
That’s why we have AMHPs taking all circumstances into account rather than evidence of a mental disorder, degree and capacity to consent to admission as the focus for doctors.
Not the case actually. The first thing an AMHP always asks at the point of referral is “is there a bed”? That’s hardly starting from looking for the least restrictive option. I make no erroneous assumptions about the AMHP role. I am one. We just need to be honest and acknowledge that our practice is resources led. The world in which we do our bit isn’t the world of the sacred Jones manual.
Nice try. If “taking all circumstances into account” is the focus pray tell us the last time an AMHP declined to make an application and put in place an alternative that they made sure was implemented. Asking families to be the “least restrictive option” isn’t the bullseye when they “request” their loved one is cared for and treated professionally. Here’s a real world conversation with an AMHP in Staffordshire. “Can’t you persuade “mum” to take him in? The home treatment team has a two week waiting list and there are no beds today. There’s no point in organising an assessment if we can’t admit him. We could try again in a fortnight if she agreed”. Whose therapeutic benefit was that plan for?
A better example of the “handing over culture” is unlikely to be made. Thank you Anony.
So that the AMHP mindset on “the fake environments” that are the “actual real environments” of the people you dump them on to changes and they have understanding and accountability. Ofcourse AMHPs love home treatment teams, it means they don’t have to engage with people themselves. That’s why Anony.
To Carol. We would love to engage with our local Crisis team but it is malfunctioning and not fit for purpose. There are so few beds available (waiting list of 14 people today who have already been assessed under MHA) that we have no danger of getting into the “handover” culture that is illustrated in the article!
Oh, OK. Everybody else at fault except the impeccable professional that is the AMHP. Reprimand accepted, lesson learnt, sort of. One question though: what do AMHPs do when they are failed by the not fit for purpose crisis teams and the non-existent beds for the people they want to admit? They don’t surely think it’s someone elses responsibility to sort those out do they? Admitedly that Richard Jones thingy is a big old thing to lug around but dip in, flit out, move on sounds exactly like “handing over” to me.
I have no particular criticism of AMHPs. There are 2 here who I would hope would be the kind that would see me if I was distressed and 8 I would barricade myself away from who shouldn’t really be anywhere near a sentient being. Left on their own SWE will mess up this consultation too. We all need to respond so that there isn’t yet another top down pre-determined “guidance” in the offing. Meaningful training in real situations where understanding of the life circumstances of people should be the aim rather than bureaucracy driven “standards”. In my opinion compared to ASWs, the AMPH role is a tad too legalistic and medical focused. That is probably unavoidable given the disparate backgrounds of warrant holders. The magic entity that is the OT AMPH is with us here. It may be that inorder to accommodate different professional backgrounds, the bureaucracy of the role has to be the primary focus. Negative “patient” experiences suggests it’s not working for them though. “Suitable prior experience” used to mean 3 years post qualifying before undertaking training. Perhaps its time to value that again.
I am glad that training is being re-appraised. In my opinion the approval process has become too portfolio driven. However non-AMHPs have to understand that we are focused on law and psychiatry because we are required to. That is the job. I agree that often this is in conflict with social work values but that doesn’t mean we forget to be social workers outside of an formal MHAA. We sign up for the AMHP role knowing we will compromise our social work values but our practice is still ethics based.
Why is the response from some AMHPs on comments they are annoyed with to blame all and sundry of spouting “erreneous assumptions”. Self awareness alone would lead a person to acknowledge that what one thinks of oneself isn’t necessarily how others see one. No one likes us because they don’t understand us a bit overdone I think. It’s like claiming a party is only a party if our Prime Minister attends. We see what we see, we experience what we experience and the two sometimes makes us exasperated. That doesn’t mean we don’t understand though does it? The AMHP role isn’t as complex as John would like us to believe. Start with resources and proceed from there is the task isn’t it?