A Hidden Dynamic: Examining the Impact of Fear on Mental Health Officers’ Decisions to Use Powers of Compulsory Detention

Abstract

Informed by literature identifying the role of fear in decision making processes, the study upon which this paper is based sought to explore Mental Health Officers’ (MHOs) experiences of fear and whether this influences their decisions to use powers of compulsory detention under the Mental Health (Care and Treatment) (Scotland) Act (Scottish Government 2003). Semi-structured interviews exploring the experience of fear in mental health assessments were undertaken with eight MHOs employed by a Scottish Local Authority and findings indicated that it had a marked impact on MHO decision making. Two central themes emerged: first, a fear of doing harm to service users, their families or the wider public though making the ‘wrong’ decision; second, fear of public and professional scrutiny, should any such harm arise. The findings raise a number of recommendations for policy and practice in the statutory mental health field, in particular, the importance of acknowledging fear and identifying strategies to manage it in training and post qualifying practice for MHOs and equivalent roles in the UK and other jurisdictions. The findings also add weight to calls for additional research exploring the MHO role.

Keywords:

• fear
• mental health assessment
• compulsory detention
• mental health officers

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Sophie Allen

Sophie Allen is a newly qualified social worker, having graduated with an MSW from the University of Edinburgh in 2019. She is currently employed by the City of Edinburgh Council within the Adult Health and Social Care Partnership. Sophie is a member of the Mental Health Officer (MHO) Research Network which is a partnership between the University of Edinburgh, MHOs and Social Workers in the East of Scotland. In this, she is keen to further develop research that can inform and be informed by practice.

Pearse McCusker

Dr Pearse McCusker is a Senior Lecturer in Social Work at the University of Edinburgh and is the Programme Director of the Post Grad Cert. Advanced Professional Practice – MHO Award. His research and teaching activities are focused on mental health and well-being, including developments in ethics, law and the use of compulsory measures. He is also passionate about knowledge exchange and co-produced research and is leading on the development of the MHO Research Network in Scotland. Email: [email protected]