The aims of this research project were to further understand Approved Mental Health Professionals (AMHPs) and Best Interests Assessors’ (BIAs) views and feelings on their professional identity (in terms of their regulated profession) and the effect it has on their practice; and the experiences of people who have received services from AMHPs and BIAs, or those who work with them, and whether their experiences and perceptions differ across the professions; and whether BIAs intend to convert their status to AMCP and ways in which this has been influenced. A multimethod research approach was used, comprising a survey qualified and practising AMHPs; a survey of practising BIAs; focus groups of AMHPs and BIAs; interviews with people with experience of Mental Health Act assessments with AMHPs or ASWs. The study found that both the AMHP and BIA workforces are predominantly made up of social workers and predominantly employed by local authorities. Both professions, to varying degrees, believed that their specialist work was advanced, relational and values-based and for many it went beyond an extension of their primary qualification with enhanced legal literacy that was creative and nuanced. Overall, the majority of AMHPs and BIAs believed that social work had the greatest influence on the work. Generally, aspects of social justice and advocacy, as well as a high level of legal literacy, were clear indicators of the contribution of social work to both AMHP and BIA work. AMHPs and BIAs seem to experience very similar impacts on their health and wellbeing arising out of the challenges they experience. The main difference in this area was that AMHPs report finding their role more challenging than BIAs experience which is likely due to workload pressures and a lack of resources which is beyond their control.

Independent advocacy is crucial to make sure a person’s voice is heard and their human rights are protected. This is especially important when a person is subject to compulsory and restrictive powers. Consistent and effective advocacy must be provided to people who most require it, whenever they require it, including to people with learning disabilities, autism or both, who are subject to long term segregation. Improvement to the delivery and commissioning of advocacy is required to achieve this. This briefing highlights the key features of advocacy for people with learning disabilities, autism or both who are in long term segregation, which must be accessible, highly competent, holistic, independent and perceived to be so, connecting, supporting and joined up. The paper also sets out two commissioning options: national commissioning – the model could be specified clearly, activated promptly, its delivery easily monitored, and there would be a clear line of sight on the resources; and local commission – this would allow locally commissioned services to align with most existing statutory provision. Irrespective of the commissioning arrangements, the service must be able to undertake the full range of statutory advocacy duties, rather than referring the person on and requiring that they relate to several advocates. The paper conclude with eight recommendations, including ensuring that advocacy for people in long term segregation is provided on an opt-out basis, to ensure a greater number of people in long term segregation receive the timely advocacy support and representation they need for their voice to be heard and their rights upheld.

This report draws on an examination of the literature and consultation with stakeholders directly involved in advance decisions to refuse treatment (ADRT) to identify ways of increasing awareness and uptake of ADRTs in Wales. The report looks at the current legal position in England and Wales, the current update and effectiveness of advance treatment refusals, attitudes to advance decisions and the views of health and social care practitioners. Barriers to the uptake up of ADRTs identified, include: misunderstanding about what is involved; scepticism about whether the patient’s wishes will be respected; and the mistaken belief that an ADRT is unnecessary if someone has already informed family members or healthcare professionals of what they would want. The report recommends actions for the Welsh Government, charities and other organisations to ensure people understand their options for advance care planning and their right to refuse treatment, if they so wish. These include: an increase in public education; correcting official forms that may mislead people about the legal status of their own or a relative’s expressed wishes; facilitating access to well designed ADRT forms/guidance and skilled support; normalising ADRTs (e.g. offering registration when patients sign up with a GP); training relevant practitioners to ensure that they understand what ADRTs are (and when they are valid and applicable), are able to provide appropriate guidance or referral, and can act in accordance with the law concerning them.

Explains what the Mental Capacity Act 2005 is and why it matters and is intended to help board members of care providers ensure vulnerable service users are not missing out on protections which are their legal right. The paper briefly discusses: capacity and consent; consent on someone else’s behalf; acting where people lack capacity to make their own decisions; best interests; restraint and restriction of liberty; deprivation of liberty; and ill-treatment and neglect. The paper includes a table setting out some questions board members of care providers might want to ask their officers and managers to get assurance that the MCA is being properly applied throughout their organisations.

Case law highlighting the tensions inherent in depriving someone of their liberty in reliance upon Schedule A1 where the primary reason is not to safeguard them against harm but the public against harm.

Hope Davis-McCallion explains the Law Commission’s ’urgent’ safeguard suggestions. In March 2017, the Law Commission delivered its final recommendations on reforming the Deprivation of Liberty Safeguards system. This came after the Commission concluded that the current system was “in crisis” and needed to be replaced “as a matter of pressing urgency”. The name being suggested for the reformed system is “Liberty Protection Safeguards”.

This collection of e-booklets and factsheets covers many of the symptoms and practical and legal issues associated with a brain injury. The legal issues section contains factsheets and guidance on disability discrimination law; insurance policies after brain injury; personal injury trusts; Adults with Incapacity (Scotland) Act; the Mental Capacity Act; the Mental Health Act in Scotland; claiming compensation after brain injury; and supporting decision making after brain injury.

This code of practice provides guidance to mental health professionals and other practitioners on how they should carry out their duties under the Mental Health Act. As well as providing guidance for professionals, the revised code of practice also guides patients, their families and carers on their rights. Chapters are grouped into seven areas: Using the Act; Protecting patient’s rights and autonomy; Assessment, transport and admission to hospital; Additional considerations for the needs of specific patients; Care, support and treatment in hospital; Leaving hospital; and additional information for professional with specific responsibilities under the Act. Subjects covered in individual chapters include: the nearest relative; independent mental health advocates; mental capacity and deprivation of liberty; detention in hospital; police community treatment orders; guardianship; after care; and care programme approach. The code of practice will come into force on 1 April 2015, depending on Parliamentary approval.

This introductory guide is for people detained under sections 2 and 3 of the Mental Health Act, or people who are in hospital as a voluntary patient. A voluntary patient (also called an informal patient) is someone who is in hospital but is not detained under the Mental Health Act. Sections cover: why am I being detained; how should the decision to detain me be made; your right to speak to an independent mental health advocate; what can you or your nearest relative do if you think that you shouldn’t be in hospital; and additional guidance for those who need to stay in hospital and extra help for disabled people.

This introductory guide is for people detained under section 35, 36, 37, 37/41, 38, 45A, 47, 47/49, 48 or 48/49 of the Mental Health Act. These are people who are suspected or have been convicted of a crime and the courts and doctors have decided that they need to stay in a mental health hospital to get support and care for their mental health condition. The guide explains what rights individuals have and what should happen to them at different stages through their journey in hospital. There are six parts to this guide. The first four parts (A-D) relate to the different stages of stay in hospital in time order, covering: the decision to detain; being detained in hospital; staying in hospital; and leaving hospital. Part E explains how to make a complaint at any stage of one’s stay in hospital; and Part F explains some of the key terms used in this document.

This introductory guide is for people detained under section 35, 36, 37, 37/41, 38, 45A, 47, 47/49, 48 or 48/49 of the Mental Health Act. These are people who are suspected or have been convicted of a crime and the courts and doctors have decided that they need to stay in a mental health hospital to get support and care for their mental health condition. The guide explains what their rights are and what should happen to them at different stages through their journey in hospital. Sections cover: which section of the Mental Health Act can I be detained under; how should the decision to detain me be made; your right to speak to an independent mental health advocate; what can you or your nearest relative do if you think that you shouldn’t be in hospital; and additional guidance for people who need to stay in hospital and how disabled people can get extra help.

This annual report on CQC monitoring of the Mental Health Act (MHA) puts a specific focus on the impact that the COVID-19 pandemic has had on patients detained under the MHA, and on the services that care for and treat them. The findings indicate that: planning for individuals’ discharge from hospital continues to be essential and is particularly important during the pandemic period due to the increased burden on all services, including those in the community; some services showed exemplary practice in the co-production of care with patients, including infection control measures; in many services the physical environment requires modernisation and doing so would have the added positive impact of making infection control easier; some services continued to uphold restrictions on patients’ movement, activities and leave for longer than seemed necessary; many services invested in software to help detained patients to stay connected with their family and other sources of support during the pandemic; detained patients’ access to advocacy services was made more difficult during the pandemic, but such services played an even more crucial role where patients’ lives were more limited by infection control measures; there needs to be careful evaluation of using remote technology should aspects of them continue after the pandemic abates.