Approved Mental Health Professionals and the compulsory detention of Black service-users under the Mental Health Act

Overview

Research studies and data monitoring have consistently shown that Black and Minority Ethnic (BME) groups in Britain are disproportionally represented in compulsory detention under the Mental Health Act 1983 (MHA) compared to White groups (NHS Digital, 2018). The role of the Approved Mental Health Professional (AMHP) is "to provide an independent decision about whether or not there are alternatives to detention under the MHA, seeking the least restrictive alternative and bringing a social perspective to bear on their decision" (Department of Health, 2015, p. 23).

This PhD research will apply institutional ethnography (IE) as a social theory and methodology to answer the guiding research question: How do the operational and institutional structures within the role of social worker AMPHs influence the process of compulsory detention of BME service-users under the MHA?

This research will also explore:
1. What are the daily operations and institutional practices of social worker AMHPs?
2. What is the role of social worker AMHPs within the process of compulsory detention under the MHA of BME service-users?
3. How is the process of compulsory detention of BME service-users influenced by social worker AMHPs institutional operations and culture?


Methodology

IE is an approach to inquiry that combines theory and method (Smith 2005, 2006). IE is premised on praxis, accomplishing social change for disempowered individuals, by revealing disjoints between institutional policies and actual practice.

IE will inform this study's exploratory qualitative research methodology. IE will form a narrative that describes the systemic ways in which the role of social worker AMHPs conducting sectioning processes under the MHA is structured and operationalised, its impact on BME service-users subject to this process, and the challenges this poses on social worker AMHPs' ability to provide independent decisions seeking the least restrictive alternative and bringing a social perspective to bear on their decision.

This study's original contribution to knowledge

The literature suggests that despite past governments' implementation of race equality training, strategies and policies to support equality in BME mental health care, treatment and outcomes the phenomenon of the overrepresentation of BME people in the British mental health system persists. The existing literature has focused on sociological explanations for this phenomenon, which center on the social exclusion of service users. Little is written on institutional factors such as organisational and professional culture and practices. Thus a new agenda, which explores professional structures and their impact on mental health services and a wider approach to mental public health, is required. By making use of this innovative research method, this will be the first known IE study in Britain to address this gap in the literature. This study represents a substantial and original contribution to the knowledge base of BME mental health, which may provide insight and understanding of the phenomenon of overrepresentation. This information is crucial to service-users, professionals and policy makers within Britain's mental health system.