Over the last year, I have been very pleased to have additional support focusing on mental health social work from Mark Trewin, Mental Health Social Work Lead at DHSC and social work advisor to NHS England.
Together, we have been working with people from across the sector to develop practice and improvements to support social workers and Approved Mental Health Professionals (AMHPs) who have such a vital role in making sure the Mental Health Act is applied correctly with consistency and compassion.
Here is an update from Mark on the plans underway ahead of day of debates, discussions and workshops this week at the offices of our valued sector partners, Skills for Care.
A challenging brief
AMHPs have one of the most challenging and stressful jobs in mental health. They work 24 hours a day across different systems, agencies and professional groups to organise Mental Health Act assessments. They support some of the most vulnerable people in our communities – working to uphold their rights and to work in the least restrictive way.
Writing in 2015, academic Lisa Morriss interviewed AMHPs who described their role as both highly skilled and advanced social work, as well as highly stressful and challenging.
It is one of those professions that demonstrates how systems are working on the ground. AMHPs and the people they serve are often the first to feel how systems are responding to change. Currently, they are telling us that system is under pressure.
Over the last year, there has been a great deal written about the problems faced by AMHPs and the people they are trying to assist. CQC did a very helpful survey of 12 areas in May 2018 that laid out how systems worked.
The Mental Health Act review supported their essential role in upholding the human rights of people assessed under the act. It made recommendations on community and prevention, alternatives to hospital, bed availability, conveyance by ambulance and working with the police.
In March 2019, the task and finish groups set up to consider the new and existing roles needed in mental health services made recommendations that included support for the workforce issues affecting AMHPs and the continued development of the approved clinician role.
Implementing change for hard working front line AMHPs can be complicated. Most are employed by the Local Authority (95 percent are social workers) and all are authorised by their local authority.
The areas in which they work, however, are largely provided by NHS Trusts and CCGs and so practical changes must be agreed across agencies and the AMHP role needs to be seen within a complex ‘whole system’ approach that includes the police and community providers.
Nationally, the development of the NHS Long Term Plan will have substantial implications for AMHPs. The NHSE mental health team really values their contribution, but they are not the responsibility of the NHS, or of the integrated care systems now being set up. Their role is so specific to mental health services that they don't always fit neatly into central or local government, or the wider social care agenda.
It has become increasingly clear that we all need to work together to create some practical actions that can cross these systems and be implemented by local areas. To achieve this, a group of people interested in the AMHP role have got together to organise a mini conference on 2 July 2019.
The purpose of this is to celebrate, develop and support the role of the AMHP and to come up with practical answers to the challenges faced by AMHP colleagues. The organising group consists of representatives from the Chief Social Worker's office, Skills for Care, the AMHP leads network and the Social Work for Better Mental Health project.
A range and AMHPs and their leads will be in attendance, as well as colleagues and service users from the DHSC mental health act review team, professional leads for the staff involved, NHSE Adult MH team and Social Work England.
The aim of our session is to come up with some clear positive actions that can be taken now to support AMHPs in their role and also to develop systems that work more effectively for vulnerable people and the staff who support them.
To help this process along, our event will consider a draft AMHP national workforce plan and how this might be used across regional partnerships. As part of this, we will be introducing new, draft AMHP standards and review some brilliant work by Manchester University on updating the essential AMHP competencies to consider as part of new mental health act legislation.
Finally, we are going to test drive some updated guidance and tools to help regional NHS and social care leads develop their approach to s140 of the MHA – the importance of identifying appropriate beds for people who are especially vulnerable or need urgent admission to hospital.
We will report back on any progress made, so watch this space!