Dr Kevin Stone

Seeking ethical approval and conducting research in an ethical manner are necessary components of research with human participants. Using the experiences of four individual studies undertaken separately into the same role, that of the Approved Mental Health Professional (AMHP), this article critically examines the challenges for multi-site research in health and social care settings. Issues arising are discussed: these are systemic and procedural, or barriers encountered using the integrated approach of the National Research Ethics Service. We discuss the lessons learned and argue that seeking ethical approval in multi-site research is currently a static construct involving the satisfying of what are in effect closed systemic and procedural requirements. We suggest that being a virtuous social work researcher, which we explore in the context of contemporary debates in social sciences, should instead afford open-ended integrity whereby the ‘permission’ granted is constantly revisited by the researcher or, in other words, that the integrated approach should allow being a virtuous researcher. We suggest that this cyclical activity has particular resonance for those researchers who are, simultaneously, health and social care practitioners. The article adds to the literature on ethics, conduct and integrity in health and social care.

Abstract

Research shows that tensions between family carers and professionals become acute where the issue of compulsory admission to hospital is at stake. In England and Wales, a specific family member is appointed to safeguard the interests of a person assessed under the Mental Health Act 1983. This currently occurs through the Nearest Relative (NR) role. The Government is proposing to replace this with a Nominated Person role, chosen by the service user. Drawing on the concept of carer burden, this study reports on the views of nineteen NRs in England to discover their experiences of being involved in a Mental Health Act assessment. Participants identified that they undertook the role due to a sense of duty. Their experiences were mixed with participants highlighting both feelings of distress during the assessment and feelings of relief once their relative had been detained. Participants reported feeling conflicted when their relative was detained and feelings of frustration towards mental health services. The findings have implications for proposals to reform the Mental Health Act 1983. They show that education and support programmes should be created for NRs/Nominated Persons and that research is needed to assess whether such support is effective at reducing carer burden.

The enactment of the Mental Health Act (MHA) 2007 introduced the role of the multidisciplinary Approved Mental Health Professional (AMHP) in England and Wales by amending The MHA 1983. The role can now be performed by a range of professionals including a psychologist, an occupational-therapist, a social worker or a mental-health/learning difficulties nurse. This amendment amongst other legal provisions replaced the earlier Approved Social Worker role. This is an exploratory qualitative research that aimed to identify if the decision-making relating to management and assessment of risk varied according to the professional background of the AMHP. The decision-making of 10 social work and 10 nursing AMHPs were examined through the use of an experimental vignette containing audio-visual and written materials in order for participants to reach a decision about whether or not to detain. Proposed detention rates between social work and nurse AMHPs were identical although variation was found across the whole sample in terms of the risks that were identified in the vignette. The paper concludes by arguing that these results suggest that differences in the way AMHPs reach decisions may well relate to a variety of individual differences rather than reflecting initial professional identity and training as so often argued in the literature.

The role of nearest relative (NR) is intended as a safeguard in the Mental Health Act 1983 (as amended in 2007) to curb the excesses of professional discretion and protect patients from unwarranted compulsory hospitalisation. It is unique to the mental health compulsory detention process in England and Wales. There are, however, evident tensions in the role and a lack of clarity surrounding the precise functions of the NR. There is also some uncertainty and confusion among practitioners about the scope of the NR involvement, and government plans announced recently to review mental health legislation will include a focus on the role of family and carers in the care of detained patients. Despite long-standing concerns about the role, there is remarkably little published research available to date on its use and effectiveness, in so far as evaluating the extent to which it provides an adequate safeguard for patients, as intended by the legislation. This article will briefly explore the background to the role, highlight some of the difficulties and tensions within it and conclude with some observations about where further research and reform may be needed to provide greater protection and clarity for patients, relatives and health and social care practitioners.

This article reports on an exploratory study comparing mental health social work (MHSW) in Europe. There has been very limited previous research comparing approaches to MHSW in Europe and so the aim of the study was to develop a better understanding of the similarities and differences between and, where relevant, within countries (referred to as jurisdictions). An online survey was distributed mainly through existing European networks and social media to seek information on the role, nature, extent and context of MHSW in a range of European jurisdictions. Conducted during the COVID-19 pandemic, there were 158 responses from 10 jurisdictions. Data were analyzed using thematic analysis. From this analysis, four main themes were identified, relating to: role; law, policy and education; the distinctive contribution made by MHSW; and the key challenges for MHSW. The study demonstrates that MHSW, although it is described and provided in different ways and is confined by a range of factors, plays an important role in mental health services across jurisdictions. There are also interesting differences between contexts, especially in the balance of therapeutic, legal and specialist/generic approaches, some of which reflect the World Health Organisation’s vision and objectives for mental health. Lastly, the study illustrates a need and provides a valuable basis for further comparative and collaborative work to define MHSW and enhance the contributions it makes.

Involuntary detention is used internationally to detain and treat people who are deemed to have a mental disorder. In England and Wales, approved mental health professionals (AMHPs) co-ordinate Mental Health Act assessments which allow for patients to be detained. AMHPs have legal duties to identify, inform and consult with a patient's nearest relative (NR), who are, in turn, given powers to initiate or challenge detention. Our study takes an original approach through examining how AMHPs interpret their duties towards nearest relatives. We adopted a two-stage design, which involved an online questionnaire with 55 AMHPs and focus group discussions with 33 AMHPs. The research was conducted in England between 2017 and 2018. Our questionnaire found that a high proportion of AMHPs reported that they had spoken to NRs for background information when assessing patients under the Mental Health Act. However, AMHPs were less likely to ask patients about their views of involving the NR prior to assessment. Focus group findings showed that AMHPs saw the NR role as offering an important ‘safeguard’ on the basis that NRs could provide information about the patient and advocate on their behalf. AMHPs identified practical difficulties in balancing their legal obligation towards NRs and patients; particularly where issues of potential abuse were raised or where patients had identified that they did not want NR involvement. While AMHPs stated that they sought to prioritise patient wishes regarding confidentiality, their accounts identified that patient consent about information sharing was sometimes implied rather than sought explicitly. Our findings reinforce conclusions by the recent Independent Review of the MHA, which states that current NR provisions are ‘outdated, variable and insufficient’. We identify that current practice could be improved using advanced choice documents and outline implications for AMHP practice.

The coronavirus pandemic, referred to here as Covid-19, has brought into sharp focus the increasing divergence of devolved legislation and its implementation in the United Kingdom. One such instance is the emergency health and social care legislation and guidance introduced by the United Kingdom Central Government and the devolved Governments of Wales, Scotland and Northern Ireland in response to this pandemic. We provide a summary, comparison and discussion of these proposed and actual changes with a particular focus on the impact on adult social care and safeguarding of the rights of citizens. To begin, a summary and comparison of the relevant changes, or potential changes, to mental health, mental capacity and adult social care law across the four jurisdictions is provided. Next, we critique the suggested and actual changes and in so doing consider the immediate and longer term implications for adult social care, including mental health and mental capacity, at the time of publication.several core themes emerged: concerns around process and scrutiny; concerns about possible changes to the workforce and last, the possible threat on the ability to safeguard human rights. It has been shown that, ordinarily, legislative provisions across the jurisdictions of the UK are different, save for Wales (which shares most of its mental health law provisions with England). Such divergence is also mirrored in the way in which the suggested emergency changes could be implemented. Aside from this, there is also a wider concern about a lack of parity of esteem between social care and health care, a concern which is common to all. What is interesting is that the introduction of CVA 2020 forced a comparison to be made between the four UK nations which also shines a spotlight on how citizens can anticipate receipt of services.

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role.

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role. In this chapter we will explore the occasions where AMHPs engage community provisions, under the MHA, other than through MHA assessments, and under other legislation. Inpatient treatment, care and support will, for the vast majority of people, only be a temporary phase in their life. Notwithstanding that, for some, detention under the MHA may recur again in their lives. To this end, some people need a legal framework around them to enable them to remain in the community. To this end, the MHA permits a person’s freedom to be restricted to enable community living, but these restrictions must fall short of depriving that person of their liberty. This position has been crystallised by two important cases, MM v Secretary of State for Justice [2018] UKSC 60 and Welsh Ministers v PJ [2018] UKSC 66, which will be discussed later. The Guiding Principles of the MHA express that ‘where it is possible to treat a patient safely and lawfully without detaining them under the [MHA], the patient should not be detained’, and that the person’s reasonably ascertainable past and present views, wishes and feelings should be considered (DH, 2015a, paras 1.2 and 1.8). To this end, enabling people to successfully reintegrate and live, or remain, in the community is the ambition, so as to promote recovery and uphold people’s rights. Indeed, section 13(2) of the MHA requires that AMHPs, before they make an application, must be satisfied that detention in hospital is in all the circumstances of the case the most appropriate way of providing the care and treatment that the person needs.

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role.

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role. As an AMHP engaging in mental health work with young people and adults, you will be using and interpreting the legislation contained within the MHA and the Mental Capacity Act (MCA) 2005, as well as the accompanying case law. When accepting a referral for an MHA assessment, the person being referred for assessment may be considered to lack capacity to make decisions regarding their care and treatment. In such cases, you will need to navigate the sometimes complex relationship between the two legal frameworks. In England and Wales, the non-consensual care and treatment of people with mental health problems is governed largely by two parallel legal schemes: the MHA and the MCA 2005. In very broad terms, the MHA provides mainly for the detention and treatment of people in hospital for mental disorder on the basis of protection of the person and the public, and irrespective of mental capacity. The MCA 2005 applies only to those who lack the relevant decision-making capacity, covers (nearly) all decisions, and provides for deprivation of liberty based on the person’s best interests. There is considerable overlap between the two regimes, and the relationship can be extremely complex. This chapter briefly sets out how the MCA 2005 enables care and treatment to be delivered. It then explores the three primary interfaces between the two Acts: inpatient care and treatment, deprivation of liberty in hospital, and community MHA powers. Whereas the MHA has no age limit, the MCA 2005 applies to those aged 16 and over. The interface therefore only arises in relation to people aged 16 and over; consequently this chapter does not address the position of children aged below 16.

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role. AMHPs are employed in varied employment contexts throughout England and Wales: working within dedicated AMHP teams in local authorities (LAs); embedded in National Health Service (NHS) trusts, including mental health community teams; or working sessionally on a rota. Such diversity means that service delivery can be different from area to area and these differences may be reflected in practice. Alongside this, AMHPs are working within a legislative and policy context which can be interpreted differently across geographical regions. Therefore, it is necessary for the AMHP to understand their working context, to recognise these differences and to reflect on how this impacts on their work. This chapter aims to consider the AMHP in context, and explores the issues and themes that arise. The AMHP role is probably one of the most powerful within England and Wales, and therefore for good reason is independent and autonomous. On the one hand an AMHP can be directed to consider a referral for an MHA assessment, yet on the other hand an AMHP makes decisions independently and cannot be directed to use their powers. The AMHP is central to coordinating professionals and resources for the purpose of assessing need and risk, and deciding if it is proportionate for a person to lose their liberty, even temporarily. We return to the issues of independence and proportionality in Chapter 3. Through the making of an application for detention founded on medical recommendation(s), an AMHP can remove a person’s liberty: for up to 28 days (under MHA, s 2) or for up to six months, initially (under MHA, s 3).

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role. Welcome to The Approved Mental Health Professional Practice Handbook. This book has been written to acknowledge the complexities of being an Approved Mental Health Professional (AMHP) and the decisions to be taken under the Mental Health Act 1983 (MHA). The book focuses on the practice of undertaking the role, as well as on training and continuing professional development (CPD). Engaging in MHA work is much broader than simply applying and interpreting mental health and other legislation correctly. This work requires an AMHP to focus on the practicalities, the ethical dilemmas involved and to engage in critical reflection to enable the outcomes for the person concerned to be at the forefront of the AMHP’s thinking. This handbook has been written in consultation with practitioners and those who can be subject to the provisions of the Act (persons being assessed, carers, Nearest Relatives [NRs]) to include as many perspectives as possible. Where relevant, these narratives are included in the chapters. This handbook is designed for those who have already been approved as AMHPs, trainees and those who manage and educate both. It aims to be both a practical and reflective guide as well as a resource to apply and critique the complexities of the role. It will draw on relevant legislation, case law, Codes of Practice and Reference Guides but is not intended to be a law text. We recommend reading it alongside one of a number of law texts that exist, such as Richard Jones’ Mental Health Act Manual (Jones, 2019) or Brenda Hale’s Mental Health Law (Hale, 2017).

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role. In this chapter we will consider what is needed to survive as an AMHP, both in training and in practice. Of late, there has been increased focus on building and sustaining resilience of AMHPs as an important consideration when ensuring good practice and maintaining a sustainable workforce. First, we will focus on the practicalities and implications of an experienced member of staff returning to full-time study as an AMHP trainee, and managing feelings of being de-skilled and frustrated by returning to education. Moreover, going on a placement with an organisation they already work in can impact on practitioners’ resilience. The chapter will also explore why it is valuable to become an AMHP, how it fits into continuing professional development (CPD), engagement with research and how to maintain learning in this specialist role. All this is highly relevant as the AMHP role can be challenging, and therefore there is a need for AMHPs to reflect on how they maintain their resilience and self-esteem in diverse and complex situations, including conflict management and acknowledging the emotional labour of the role. Finally, there will be an emphasis on reflective practice as an AMHP and ensuring that practitioners know what sources of support are available. As an experienced health and social care professional, you will know how challenging your work can be and how much energy it takes to do your job well. Social work and work in other health and social care professions is stressful, but practitioners also report that their work is rewarding, has meaning and provides the opportunity to help improve service users’ lives (Huxley et al, 2005a; Beddoe, 2011; Collins, 2017).

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role. In this chapter we will consider the nature of the AMHP role in terms of its unique features and key responsibilities in relation to reaching a decision. AMHPs have to make significant decisions as part of their role, most obviously whether they apply for a person to be compulsorily admitted to hospital or not. However, AMHPs have to make a host of other practice decisions before and after the decision whether to detain under the MHA, including involvement of the Nearest Relative and family, the correct form of transport, whether to use 14 days to decide to detain or not, protection of property, and caring responsibilities, including pets, and these are discussed in Chapters 6 and 7. This chapter will support AMHPs to reflect on the factors that impact on their decision-making, introduce frameworks to support ethical decision-making and consider interprofessional working in the AMHP context. This chapter will also link to the discussions on risk and AMHPs’ understanding their own risk thresholds, and the implications of this for practice. In AMHP practice you may find that some aspects of decision-making are more straightforward than others. Social care and health professionals make countless decisions in the work they undertake with people, their families and the support systems they engage with. Decision-making often appears fast and intuitive, powered by the professional’s accumulated knowledge and practice experience. Decision-making in AMHP practice warrants specific consideration because the principal decision – whether to make a formal application for detention, and in doing so temporarily deprive a person of their liberty – is so serious.

The United Nations Convention on the Rights of Persons with Disabilities (hereafter CRPD) has provided a radical imperative for the reform of mental health and capacity legislation around the world. The interpretation of the CRPD has been controversial, ranging from complete abolition of detention, forcible treatment and substitute decision making, to acceptance that elements of these measures need to be retained but based on non-discriminatory criteria, additional safe-guards and a comprehensive shift towards supported decision-making. While the potential ef-fects of the CRPD on mental health social work and social work generally are considerable given their shared commitment towards social justice, to date there has been no review of research evi-dence exploring their relationship. In addressing this knowledge gap, this study held a prelimi-nary discussion with practitioners and academics at the European Association of Social Work Mental Health Special Interest Group in Amsterdam 2022, followed by a scoping literature re-view on the question: What impact, if any, has the CRPD had on social work practice? The review produced four main findings: impact on legislation; positive impact on practice; limited impact on practice; and impact on social work education and research. In sum, while there were some positive indications of social work and mental health social work practice being influenced by the CRPD, these were scant. Barriers to change included tendencies among some social workers to practise substitute decision-making, in part related to resourcing and policy contexts, and under-standings of disability aligned to individualised/medical rather than social perspectives. The results indicate that legal reform on its own is insufficient to impact social work practice, and that realising the potential of the CRPD will necessitate good quality training, as well as improv-ing social workers’ knowledge of the human rights of people with mental impairment.

Eligible relatives are given rights and powers in the compulsory treatment of people with mental health problems in several international jurisdictions, including within England and Wales. However, little attention has been given to whether relatives feel legally literate or competent to fulfil such roles. This article examines this issue through focussing on the experiences of Nearest Relatives, who are given rights and powers during Mental Health Act 1983 (MHA) assessments for compulsory admission in England and Wales. Interviews with nineteen Nearest Relatives in England were conducted and were thematically analysed. Three themes were identified. First, NRs spoke about their awareness and knowledge of the role. They predominantly reported negative experiences in which they received no or little information. They also reported that professionals assumed they possessed legal knowledge, and their legal knowledge was largely self-taught. Secondly, NRs reported uncertainty about their own rights and powers, noting the role lacked status or informational or emotional support. Third, NRs highlighted areas for legal reform, stating that the NR role was important, but required specialist support systems for NRs. The findings of this study indicate greater attention needs to be given by law and policy makers to support relatives' understanding of their rights and powers under the MHA, if the NR role is to be effective in helping to safeguard patient rights under the European Convention on Human Rights. These include the right in Article 5 not to be arbitrarily deprived of one's liberty and the right to a private and family life in Article 8. Legislators also need to take account of these factors when considering proposals to reform mental health law in England and Wales.

The United Nations Convention on the Rights of Persons with Disabilities (hereafter CRPD) has provided a radical imperative for the reform of mental health and capacity legislation around the world. The interpretation of the CRPD has been controversial, ranging from the complete abolition of detention, forcible treatment, and substitute decision-making to accepting that elements of these measures need to be retained based on non-discriminatory criteria, additional safeguards, and a comprehensive shift towards supported decision-making. While the potential effects of the CRPD on mental health social work and social work generally are considerable given their shared commitment towards social justice, to date there has been no review of research evidence exploring their relationship. In addressing this knowledge gap, this study held a preliminary discussion with practitioners and academics at the European Association of Social Work Mental Health Special Interest Group in Amsterdam 2022, followed by a scoping literature review on the question: What impact, if any, has the CRPD had on social work practice? The review produced four main findings: impact on legislation; positive impact on practice; limited impact on practice; and impact on social work education and research. In sum, while there were some positive indications of social work and mental health social work practice being influenced by the CRPD, these were scant. Barriers to change included tendencies among some social workers to practise substitute decision-making, in part related to resourcing and policy contexts, and understandings of disability aligned to individualised/medical rather than social perspectives. The results indicate that legal reform on its own is insufficient to impact social work practice, and that realising the potential of the CRPD will necessitate good quality training, as well as improving social workers’ knowledge of the human rights of people with mental impairment.

Arising from the inauguration and subsequent development of the Mental Health Special Interest Group of the European Social Work Research Association (ESWRA), this edited collection was commissioned for the Research in Social Work book series which ESWRA hosts. It sets out to explore social work in mental health settings internationally. Simultaneously, it affords an opportunity for its readers to home in on particular aspects of practice that evidence the impact the profession of social work has in mental health settings. Acknowledging the common themes and tensions that exist between and within countries, this first edition brings together a variety of chapters exploring the development of social work in mental health settings in a range of countries. In so doing, the volume explores: the emergence of social work in these settings, how the context has shaped the role of social work, the impact of social work on the way services are delivered and the professional identity of social workers who practise in mental health settings. We believe this collection provides a strong basis for understanding the role of social work in mental health settings internationally, but we are also aware that it is just a start upon which we plan to build in the future. Social Work in Mental Health Settings brings together leading academics and practitioners to explore how mental health social work is shaped and practised around the world. In so doing, it responds to a striking lack of comparative literature in the field and offers a timely, global lens on the discipline. Combining macro-level analyses with in-depth country case studies – from Brazil and Bosnia and Herzegovina to China and Trinidad and Tobago – the book interrogates how mental health policy, law, political conflict and social movements influence practice. Essential reading for scholars and professionals working in social work and mental health, this book engages with urgent contemporary themes – from feminist care ethics and community care to self-harm and mindfulness – offering invaluable guidance for those seeking a deeper understanding of mental health social work in the global context. The Introduction outlines the context, purpose and scope of the edited collection. It discusses terminology, definitions and the writing process. It then provides an overview of the book’s structure and a summary of each chapter.

Arising from the inauguration and subsequent development of the Mental Health Special Interest Group of the European Social Work Research Association (ESWRA), this edited collection was commissioned for the Research in Social Work book series which ESWRA hosts. It sets out to explore social work in mental health settings internationally. Simultaneously, it affords an opportunity for its readers to home in on particular aspects of practice that evidence the impact the profession of social work has in mental health settings. Acknowledging the common themes and tensions that exist between and within countries, this first edition brings together a variety of chapters exploring the development of social work in mental health settings in a range of countries. In so doing, the volume explores: the emergence of social work in these settings, how the context has shaped the role of social work, the impact of social work on the way services are delivered and the professional identity of social workers who practise in mental health settings. We believe this collection provides a strong basis for understanding the role of social work in mental health settings internationally, but we are also aware that it is just a start upon which we plan to build in the future. Social Work in Mental Health Settings brings together leading academics and practitioners to explore how mental health social work is shaped and practised around the world. In so doing, it responds to a striking lack of comparative literature in the field and offers a timely, global lens on the discipline. Combining macro-level analyses with in-depth country case studies – from Brazil and Bosnia and Herzegovina to China and Trinidad and Tobago – the book interrogates how mental health policy, law, political conflict and social movements influence practice. Essential reading for scholars and professionals working in social work and mental health, this book engages with urgent contemporary themes – from feminist care ethics and community care to self-harm and mindfulness – offering invaluable guidance for those seeking a deeper understanding of mental health social work in the global context.

Arising from the inauguration and subsequent development of the Mental Health Special Interest Group of the European Social Work Research Association (ESWRA), this edited collection was commissioned for the Research in Social Work book series which ESWRA hosts. It sets out to explore social work in mental health settings internationally. Simultaneously, it affords an opportunity for its readers to home in on particular aspects of practice that evidence the impact the profession of social work has in mental health settings. Acknowledging the common themes and tensions that exist between and within countries, this first edition brings together a variety of chapters exploring the development of social work in mental health settings in a range of countries. In so doing, the volume explores: the emergence of social work in these settings, how the context has shaped the role of social work, the impact of social work on the way services are delivered and the professional identity of social workers who practise in mental health settings. We believe this collection provides a strong basis for understanding the role of social work in mental health settings internationally, but we are also aware that it is just a start upon which we plan to build in the future. Social Work in Mental Health Settings brings together leading academics and practitioners to explore how mental health social work is shaped and practised around the world. In so doing, it responds to a striking lack of comparative literature in the field and offers a timely, global lens on the discipline. Combining macro-level analyses with in-depth country case studies – from Brazil and Bosnia and Herzegovina to China and Trinidad and Tobago – the book interrogates how mental health policy, law, political conflict and social movements influence practice. Essential reading for scholars and professionals working in social work and mental health, this book engages with urgent contemporary themes – from feminist care ethics and community care to self-harm and mindfulness – offering invaluable guidance for those seeking a deeper understanding of mental health social work in the global context. This chapter provides an overview of mental health locally and globally and the social work role in this area, taking a national and international perspective. It considers why knowledge of mental health law and practice is important to all social workers and discusses the perspectives social workers bring. It will be seen that social work in mental health settings is a significant area of practice. Although legislation provides a framework for compulsory care and treatment of mental health, it does not provide answers in practice, nor are statutory functions the only work in which social workers in mental health settings are involved. In both, there are tensions and conflicts that social workers must also deal with daily.

Approved Mental Health Professionals are specialist professionals authorised to make ethically complex and difficult decisions on the behalf of people with severe mental health difficulties. In this complex and challenging role, AMHPs must possess and deploy a range of skills, knowledge and values. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role, including: • working with mental health law; • risks and challenges in a Mental Health Act assessment; • staying safe as an AMHP; • resilience as a trainee and practitioner. Packed with helpful features such as illustrations, chapter summaries, discussion questions and further reading lists, this clear and concise book will be invaluable to students on AMHP and Best Interests Assessor programmes, as well as for professionals in the field. Approved Mental Health Professionals must possess and deploy a range of skills, knowledge and values in order to make ethically complex decisions on behalf of people with severe mental health difficulties. This invaluable handbook considers these challenges and provides in-depth guidance on all key aspects of the role.

Essential reading for scholars and professionals working in social work and mental health, this book engages with urgent contemporary themes – from feminist care ethics and community care to self-harm and mindfulness – offering ...