BASW England launch 'Impact of Covid-19 on AMHP survey'

New research commissioned by BASW England and the Department of Health and Social Care reveals a significant increase in people accessing mental health services during the first lockdown.

The Impact of Covid-19 on AMHP services survey is the first to provide significant information on the role of Approved Mental Health Professionals (AMHP) during the pandemic and the changing pressures on the service.

Around three-quarters of England’s local authorities were surveyed, with 96% of them reporting an increase in number of first-time presentations of people suffering mental distress/ill-health who had not been previously known to mental health services.

“In the early part of the pandemic … there was an increase in … requests linked to people with no known history of mental illness slipping into a highly anxious state” – Anonymous quote from AMHP

The author of the report, Steve Chamberlain ((Chair of AMHP Leads Network & BASW England member) said: “The reality is that AMHPs only see people who are in a mental health crisis – most people don’t reach that point.

“Therefore, the increase in those numbers strongly suggests that this is just the tip of the iceberg and that the pandemic has caused considerable mental distress for a great many people.”

The survey also asked a variety of questions regarding changes in demand for Mental Health Act (MHA) assessments both during the first lockdown and following the easing of restrictions, the possible reasons for the changes and the impact of the pandemic and the resulting restrictions on staff.

Feedback from over 100 AMHPs revealed an increase of MHA assessments during the lockdown period and into the post-lockdown period in summer. This amounts to a higher level of demand than prior to the pandemic.

Since lockdown eased end of July, 60% of respondents said the level of demand for mental health services was above pre lockdown levels, while 28% said they returned to the same levels – Key stat from survey

Another major finding is the mixed picture regarding the use of s136 – where a person can be detained for safety reasons – during the lockdown period. Approximately 60% of respondents identified a change, but almost 40% of those reported a reduction, with the rest identifying an increase

There was significant level of concern expressed from AMHP respondents that withdrawal of face-to-face visits and monitoring by community services, and reduction of contact to telephone only, led to requests for MHA assessments which would not otherwise have been made and which did not warrant consideration of detention in hospital.

“[I] do not feel remote MHAA assessments are appropriate given the magnitude of the potential outcome” – Anonymous quote from AMHP

“AMHPs have continued to see people face to face throughout the pandemic, often in situations where distancing is difficult or impossible,” said Chamberlain.

“Add to that the intense nature of the work and the fact that many people they see are in acute distress, creates a particularly taxing environment in which they are working.”

He added: “It is vital that specific consideration is given to issues of health and safety to enable them to continue to fulfil their role to the best of their ability.”

Among many recommendations for the ongoing handling of the pandemic and any future virus-related pandemics is better understanding of the AMHP role, especially regarding PPE.

Many respondents highlighted the ineffectiveness of wearing masks in a role working with people potentially suffering from a range of serious mental illnesses, where face to face communication is vital.

The use of see-through face masks or reusable face shields was mentioned to address the concerns over the impact of PPE on the assessment process.

“Given that AMHPs across the country were one of the few front line staff continuing to work face to face it would have been helpful if that role had been recognised in PPE guidance as none of it seemed to cover the unique sort of role AMHPs have” – Anonymous quote from a AMHP

A launch event worth also mentioning the launch event at 11am for this survey is scheduled for 11am today with guest speakers from BASW England, DHSC and ADASS.

Supporting quotes

“AMHPs have played a pivotal role throughout the pandemic and have worked incredibly hard to maintain and deliver essential services to people experiencing distress and mental health crisis. The research findings have highlighted an increase in the number of people presenting for the first time to AMHP services, withdrawal of ‘mainstream’ mental health services from face-to-face contact and increase in requests to AMHP service which did not lead to Mental Health Act Assessments. We need to consider if and why AMHP services were fulfilling a function normally undertaken by community mental health services and question inequalities of access to support services and the impact of PPE and health and safety of the workforce.  We look forward to working in partnership with AMHPs, people with lived experience, DHSC and other key partners in taking forward the report recommendations.” – Maris Stratulis, BASW England national director

BASW England and the office of the Chief Social Worker in Department of Health and Social Care (DHSC) commissioned an important piece of research undertaken by BASW England and the Approved Mental Health Professional (AMHP Leads Network). It highlights new and emerging issues as a result of the pandemic and emphasised a need to address existing and historical issues. ADASS supports the strong key considerations and recommendations the report makes to continue to deliver high quality services and transform the lives of people in need of care and support” – James Bullion, ADASS president

“We really welcome this new report on AMHP services and COVID-19. The Chief Social Worker’s office commissioned this research because we were very aware of how hard AMHP services, emergency duty teams and mental health crisis support services have been working during the pandemic and we wanted to understand how it has affected professionals and people using services. The report illustrates how individual AMHPs and AMHP services have adjusted and stepped up to deal with the additional pressures. AMHPs have carried on with face to face interactions with people in mental health crisis and they have adapted to the challenges experienced by partner agencies while also dealing with a rise in requests for mental health act assessments – including people new to mental health services. This report will help government, local authorities and NHS colleagues to work together to improve support for AMHP services and implement lessons learnt from pandemic” – Joint-Chief Social Worker for England, Mark Harvey

Survey commissioned by BASW England and the Department of Health & Social Care

Written by Steve Chamberlain (Chair of AMHP Leads Network & BASW England member)

Supported by: Claire Barcham (Chair of BASW England Mental Health group) l Wayne Reid (BASW England Professional Officer & Social Worker) l Maris Stratulis (BASW England National Director) Mark Trewin (Department of Health & Social Care)