This briefing paper gives our findings from a review of the way Approved Mental Health Professionals (AMHP) services are being delivered across the country.
We carried out this work following a recommendation by the Crisis Care Concordat that we and the Department of Health and Social Care should look at the effectiveness of the current monitoring of AMHP services.
A previous review found wide variation in the way AMHP services are provided across the country. It recommended further work to support local services and national monitoring should be completed to provide evidence in this area and identify future improvements.
What we did
To collect further evidence, we combined meeting with local AMHP services with visits to services when looking at the rising number of Mental Health detentions. This work included gathering information from three sources:
- Data review: we checked data on the use of the Mental Health Act nationally. We wrote to areas that we visited requesting information from their local systems to help us understand how AMHP services were being delivered in their area.
- Site visits: during 2017, we visited 23 local authorities, 8 NHS trusts and 2 independent mental health service providers. We interviewed or held focus groups with more than 60 detained patients, 30 carers and more than 250 staff.
- Engagement: we shared and tested emerging findings with our Mental Health Act External Advisory Group, Service User Reference Panel and other stakeholders.
This report is a summary of the AMHP findings from this activity.
What we found
Factors supporting the effective delivery of AMHP services
- Leadership: Most AMHPs described good peer support, supervision and training arrangements.
- Recognising the value of the AMHP role: Across most services, AMHPs felt that their skills, expertise and knowledge base were recognised in their local area teams.
- Innovation and partnership: AMHPs reported that reduced access to partner agencies could create delays when organising assessments.
- Crisis and prevention: AMHPs shared positive examples of how improved access to crisis services helped them deliver least restrictive alternatives for patients.
Challenges and barriers to the AMHP role
- Acute care system capacity: AMHPs reported that a national reduction in beds affected their ability to complete assessments in a timely manner.
- Workforce: AMHPs talked about an inability to recruit and retain AMHPs.
- Variation in health and social care integration: Integration of services varied across areas and services.
- Mental health commissioning: AMHPs recognised the importance of good, integrated, local commissioning arrangements to their role.