Jill Hemmington

AMHPs undertake statutory assessments and have overall responsibility for the decision to detain (or not) in hospital without service users’ consent. AMHPs are required to act autonomously and make independent decisions within complex systems. They are required to embed the Empowerment and Involvement statutory Guiding Principle whereby service users should be ‘fully involved in decisions’. This indicates that MHA assessments are a place for Shared Decision Making (SDM). Jill’s research evaluates the significant factors affecting AMHPs in the decisions that they make; develops further understanding of the dynamics and power relations between AMHPs and service users in assessments and considers how AMHPs can facilitate empowerment and involvement and promote SDM in assessments. Jill conducted an ethnographic study and gathered in-depth information about AMHPs’ experiences and perspectives of the work, particularly how this was influenced by different AMHP service and team configurations. Jill then observed and audio-recorded Mental Health Act assessments in order to evaluate patterns of communication and decision-making, using Conversation Analysis to analyse the data. This method supports examination of content and style of communication as well as power relations. AMHPs and service users were interviewed following the assessments. Research addressed views that service users do not have capacity to take part in decision-making, and Jill’s work further explores ways of facilitating this. In particular, this focuses on ways in which patters of communication take place and how power sometimes operates at a subtle level around negotiated decisions. Research supports broader evidence that formal SDM methods are not well-developed within a mental health setting, and are not always considered within MHA assessments. Professionals can have difficulty understanding what service users’ priorities are, and there is more to be understood around the way that communication patterns can forward or block conversations. Jill’s research continues to focus on the process of MHA assessments and future work will look at enhancing SDM within revisions to the Mental Health Act 1983 (as amended 2007).