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.

Annual report on the use of the Mental Health Act (MHA), looking at how providers are caring for patients, and whether patients’ rights are being protected. The report sets out CQC’s activity and findings from our engagement with people subject to the MHA and review of services registered to assess, treat and care for people detained using the MHA during 2020/21. It is largely based on feedback letters on the 620 remote monitoring letters following reviews of 682 wards carried out during 2020/21. These involved private conversations with 1,895 patients and 1,111 carers. The report highlights three key findings. Firstly, the workforce is under extreme pressure; the pandemic has placed additional stresses on staff, patients and carers; staff are now exhausted, with high levels of anxiety, stress and burnout, and the workforce is experiencing high levels of vacancies. The negative impact of working under this sustained pressure poses a challenge to the safe, effective and caring management of inpatient services and to the delivery of care in a way that maintains people’s human rights. Secondly, community services are key to reducing levels of detention in hospital. Not getting the right help at the right time can lead to symptoms worsening and people needing inpatient care. During the pandemic this has been a particular concern for children and young people. We have seen an increase in the numbers of children and young people being cared for in inappropriate settings while they wait for an inpatient bed. Thirdly, urgent action is needed to address longstanding inequalities in mental health care. We remain concerned that Black or Black British people are more likely to be detained under the MHA, spend longer in hospital and have more subsequent readmissions than White people.