Mental health law assessments: interagency cooperation and practice complexities

Abstract

Background

Assessments under mental health law, to determine whether compulsory admission is necessary, tend to be complex, multidisciplinary and inter-agency processes. This article presents the results of a regional audit of assessments under the Mental Health (Northern Ireland) Order 1986.

Aims

The aims of the audit were to examine routine practice, identify any issues and so inform how policy and practice may be developed.

Method

The audit was designed by an inter-agency advisory group and audit team. Data were collected for a sample of 189 assessments. The sample was weighted to ensure all Health and Social Care Trusts and settings were appropriately represented.

Results

These assessments involve high levels of need, risk and complexity. There were no major issues or concerns identified in the majority of assessments. The issues that were identified were mainly due to the difficulties in coordinating professionals and in securing a bed. In 3/189 (2%) of assessments, these issues were identified as contributing to increased distress and risk.

Conclusions

The results highlight the complexities of these processes and confirm the need for opportunities, such as joint training and inter-agency interface groups, to further promote cooperation and identify when pressures on resources are increasing risk and distress.

Keywords:

• Mental health law
• compulsory admission
• inter-agency working
• risk
• decision-making

Acknowledgements

Thanks to the Project Advisory Group; Ruth McDonald, Assistant Trust Clinical & Social Care Governance Manager in the Lead Trust (NHSCT); and Robert Mercer, Regional Clinical Audit Facilitator for the Guidelines and Audit Implementation Network, for their advice and help throughout the project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was funded and supported by the Guidelines and Audit Implementation Network (which is now part of the Regulation and Quality Improvement Authority).