SAR Conference Presentation 29.5.18 Natasha Bowler & Rob Evans Bucks AMHP Manager Bucks AMHP Senior Practitioner

Mental Health/Mental state assessments Usually start with a Mental Health Assessment unless already detained under MHA 1983 eg S136, S135(1), S2 or S 5(2). Mental Health Assessments are undertaken by MH workers in a number of settings eg individual’s own homes, at A & E, MH community based settings eg Valley Centre High Wycombe, Whiteleaf Centre Aylesbury, custody. Mental Health Assessments – Includes Mental state examinations, assessment of social care needs - least restrictive.

Mental Health/Mental state examinations Mental Health Assessments to consider needs due to Mental health, community treatment and support options and informal admissions. Mental Health Assessments carried out by MH professionals eg in the assessment and treatment functions within adult mental health teams, duty workers, care co- ordinators, PIRLs, Criminal Justice Liaison & diversion workers, Street Triage etc.

Mental Health Act Assessments Mental Health Act Assessments ( MHAA )- formal, 2 Drs and an AMHP, can be oppressive. Referrer can be anyone however usually MH workers, police and Place of Safety. If the individual is refusing community support/treatment, admission indicated and lacks capacity/ refusing admission. Immediate high risk to self or others and acute symptoms of mental disorder. Take place within individuals own homes, A & E depts, police custody suites, Place of Safety, Community team bases.

Mental Health Act Assessments Potential Outcomes from MHAA – No further involvement from Mental Health services, community follow up from Mental Health services, informal admission and admission/detention under the MHA 1983. Legal Criteria of detention– suffering from a Mental Disorder of a nature or degree which warrants detention. Ought to be detained in the interests of his own health or safety or with a view to the protection of other persons. Mental Disorder – any disorder or disability of the mind.

Warrants under the MHA 1983 (S135(1) ) Warrant to search for and remove patients. A person believed to be suffering from a mental disorder- has been, or is being, ill-treated, neglected or kept otherwise than under proper control, in any place within the jurisdiction of the justice or; being unable to care for himself, is living alone in any such place. Consider application for s135 if risk assessment indicates a significant risk of harm either to the patient, family, the assessing team or others ( including absconding, aggression, insanitary/crowded living conditions) . Based on current or past history it’s likely the person will either refuse to admit you or may ask you to leave prior to the conclusion of the assessment.

Warrants under the MHA 1983 There isn’t anyone except the person that can provide the legal authority to be on the premises and conduct the assessment, and they are refusing or likely to start refusing. A relative has a key but the person is not willing to allow access. When giving evidence - the court doesn’t require that professionals should have tried to see the person at home already and been refused entry. However magistrates will want to know reasons for the application and if visit not attempted the reasons for this.

Warrants under the MHA 1983 S135(1) Applications by an AMHP to Magistrates court. Execution of S135 (1) warrants undertaken by a police constable, AMHP and a registered medical practitioner. Ambulance providing transport. To enter, if need be by force to the premises specified in the warrant and remove to a Place of Safety with a view to an assessment by a Dr and an AMHP (‘making an application under Part II of MHA 1983 or of other arrangements for his treatment or care’).

Warrant under the MHA 1983 S135(1) Place of Safety- residential accommodation provided by local social services authority under Part 1 Care Act, a hospital , a police station ( only in exceptional circumstances ), an independent hospital or care home for ‘mentally disordered persons’ or any other suitable place ( including a house, flat or room where the person is living – new addition in Policing and Crime Act 2017). Need authorisation from Place of Safety.

Warrants under the MHA (S135(1) Policing and Crime Act 2017 – Period of detention within a Place of Safety reduced to 24hrs from the time person arrived at Place of Safety.