Making Decisions in Compulsory Mental Health Work: Boundaries, Frames and Perspectives

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Making Decisions in Compulsory Mental Health Work: Boundaries, Frames and Perspectives
Copyright information
Table of Contents
Notes on contributors
Acknowledgements
1 Introduction
	Boundaries
	Framing
	Outline of the book
	References
2 Lived experience and the boundaries between professionals and others
	Introduction
	Neil’s experiences
		Life before the mental health system
		Experiences of the mental health system
		Problems with the construct of ‘mental illness’
		Problems with medication
		Least restrictive alternative
	Jen’s experiences
		Life before the mental health system
		Problems with coercion
		Working with families
	Conclusion
	Notes
	References
3 Frames and boundaries of race and ethnicity in Mental Health Act assessments
	Introduction
	Race and ethnicity
	Racial inequalities and institutional racism
	Race and ethnicity in compulsory mental health work
		Personal development to engage critically with race and ethnicity
		The referral
		Risks and the racialised patient
		Recording
	Conclusion
	Note
	References
4 Gender and forensic services
	Introduction
	Gendered preconceptions
	Restrictive practices
	Progression
	Power disparity
	Eliminating restrictive practices
	Flattening the hierarchy
	Conclusion
	Note
	References
5 Boundaries of risks and rights and personality disorder
	Introduction
	Personality disorder and contested narratives
	The practice and the principles
	Weighing up rights and risks
	Pressures on the decision makers
	Experiencing alienation
	Some suggestions for practice
	Conclusion
	References
6 Reflective supervision, emotional containment and the framing of self and others
	Introduction
	Why is reflective practice of value?
	Methodology
	Why a case?
	Firmly managed boundaries encourage free expression
	How does the RPG work?
	Psychosocial researchers’ observations of the work of the group
	Theorised sense-making
	Organisational defences?
	Impact on Sarah
	Role of senior managers
	Conclusion
	Note
	References
7 Reflective practice, truth-telling and safe spaces
	Introduction
	Context
	Lack of AMHP supervision
	Personal liability
	Complexity of the AMHP role
	Organisational impact
	Accountability in practice
	Safe spaces for reflection
		Supervision
			Peer one-one-supervision
			Peer group supervision
		Group work discussion
		Recording as an act of reflection
		What needs to occur in reflection
	Conclusion
	References
8 Practice education
	Introduction
	Preparation of self and context
	Supporting trainees remotely
	Learning processes
	Modelling good practice
	Direct observation
	Decision making under mental health legislation
	Supervision of trainees
	Placement outcomes: pass or fail?
	Factors that impact practice educators’ decisions
	Conclusion
	Acknowledgements
	References
9 Compulsory mental health work and multi-professional frames
	Introduction
	The value of occupational therapy
	Health enablers
	Alternatives to hospital
	Independence
	Occupational therapy skills
	Occupation therapy and AMHPs: the research
	The case for occupational therapy
	Conclusion
	References
10 Nurses as AMHPs
	Introduction
	Background
	Methods
	Findings
		Stage one: convergence – ‘there’s no difference’
		Stage two: overcoming divergence: from ‘unclean’ to ‘honorary social worker’
		Stage three: change to medical processes – nurses as AMHPs
		Stage four: changes to the AMHP role: nurses as AMHPs
	Discussion
	Conclusion
	References
11 Who do you think you are?
	Introduction
	The context of AMHP practice
	Hybridity definitions
	Professional role(s) and boundaries of practice
	Boundary working
	Hybrid Identities Project: a case study of the AMHP role
	Conclusion
	Note
	References
12 Framing mental capacity and mental health legislation in decision making
	Introduction
	The freedom to make decisions
	The establishment of the Mental Capacity Act
	Mental capacity, consent and compulsory treatment
	Knowing what law requires of professionals
	Balancing people’s wishes and feelings against a need for care or treatment
	Conclusion
	References
13 Navigating communication boundaries
	Introduction
	Statutory contexts, policy contexts and principles
	Shared decision making
		The problem of ‘insight’
		The problem of jargon
	Paternalism, values and attitudes in mental health services
	What is important to service users?
	Developing and enabling reciprocity and decision sharing in practice
	Communication: attitudes, styles and skills
	Repair
	Barriers to SDM
	Taking the power elsewhere? The kitchen conversation
	Incorporating principles of Open Dialogue
	Conclusion
	References
14 Compulsory mental health work: framing the future
	References
Index