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A Very Involved Assessment

22nd July 2016 | Categories: Mental Health

A Very Involved AssessmentHave you been subject to an assessment recently? Perhaps an appointment with a bank manager, a driving test, or a job interview. What was the experience like, maybe rather nerve-wracking! Who did the assessing – probably someone you’d not met before. I’m trying to draw the comparison between our own experiences of being subject to some form of assessment and the reality of people being subject to an assessment under the Mental Health Act.

Guiding principles

So how should a Mental Health Act assessment be undertaken? Well the Mental Health Act Code of Practice gives us a set of guiding principles which cover all aspects of how we operate under the Mental Health Act. In particular the empowerment and involvement principle guides staff to give patients the opportunity to be involved in developing their own care and treatment, have their wishes and feelings taken into account, and be informed of any support they can be given.

Difficult circumstances

Now the risk of many good value based principles is they sound as though they were designed for an ideal world. The circumstances of a Mental Health Act assessment can often be less than ideal, in that the situation may be urgent, and the person and their family may well have been through a difficult emotional time in the lead up to the assessment. Having said that, basic principles of respect and dignity should always be shown, and there will be opportunities to try and include the person’s participation. Some Mental Health Act assessments may take place in someone’s own home, but many take place in care homes or hospitals where they be more scope for finding a quiet room.  The person can be asked if there is a family member they want with them. You are obliged to interview the person and consult with their relative, but there may be others who are professionally and personally concerned with the person who may be able to give you the person’s perspective.

Power relationships

One of the issues in any assessment is the power imbalance – in the example of a job interview the employer enjoys a distinct advantage over the prospective employee, and in the same way mental health staff have to be aware of the power imbalance in the relationship between professional and patient. Now in your role you may not be actually undertaking Mental Health Act assessments, but you may work in a setting where you are facilitating these. So you can have a role in identifying issues of capacity, possible communication barriers, cultural issues and who might have more information about the person, and their views. These can all contribute to an effective and genuinely participative assessment.

David Beckingham – QCS Mental Health Specialist


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