换档和争取时间:英格兰和威尔士心理健康法评估转介后助理心理保健师实践探索研究

Matthew Simpson
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引用次数: 0

摘要

在英格兰和威尔士,1983 年《精神健康法》(MHA)规定的核准精神健康专业人员(AMHP)的职责是对转介的精神科拘留案件做出回应,并在他们认为有必要的情况下提出拘留申请。本文报告了我对转介进行 MHA 评估时的 AMHP 决策进行博士研究的结果。该研究采用了社会建构主义范式下以优势为基础的欣赏式探究方法。在一个地方政府工作的九名助理医疗保健师参与了这项研究,包括作为内部研究者的我本人。在为期五个月的四次为期一天的研讨会上,参与者确定了他们的最佳实践,并在研讨会上使用名义小组技术共同分析了新出现的数据。服务发展包括设立分流角色和定制报告,以便在服务中优先考虑这一决定,开辟换档途径,为在这一点上进行更全面的评估争取时间,并促进与被转介者的更大合作。在评估路径中,提倡采用多机构方法来寻找限制性较小的方案。本研究的结果为这一重要实践领域提供了研究视角,为实践和政策发展提供了证据基础。
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Changing Gears and Buying Time: A Study Exploring AMHP Practice Following Referral for a Mental Health Act Assessment in England and Wales
The role of the Approved Mental Health Professional (AMHP) under the Mental Health Act (MHA) 1983 in England and Wales is to respond to referrals for psychiatric detention and make an application for detention where they consider this necessary. This article reports the findings of my doctoral study into AMHP decision-making at the point of referral for an MHA assessment. The strengths-based methodology of Appreciative Inquiry was adopted, positioned in a social constructionist paradigm. Nine AMHPs working for one Local Authority participated in the study, including myself as an insider researcher. During four one-day workshops over five months participants defined their best practice, analysing emerging data together within the workshops using nominal group technique. Service developments included the creation of a triage role and a bespoke report to prioritise this decision within the service, opening avenues to change gears and buy time for a more thorough assessment at this point, and promoting greater collaboration with those referred. A multi-agency approach to searching for less restrictive options was advocated within an assessment pathway. The results of this study offer a research insight into this important area of practice, offering an evidence base to inform practice and policy developments.
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