The Approved Mental Health Professional: Decision Making
Research type
Research Study
Full title
Approved Mental Health Professional Practice: Decision making, complexity and uncertainty
IRAS ID
160110
Contact name
Jill Hemmington
Contact email
Sponsor organisation
University of Central Lancashire
Duration of Study in the UK
4 years, 3 months, 28 days
Research summary
Approved Mental Health Professionals (AMHPs) undertake Mental Health Act (MHA) assessments and have overall responsibility for deciding to detain (or not) an individual in hospital without their consent. They are required to act autonomously and make independent decisions. Yet decision-making is not straightforward, and uncertainty is inherent. Outcomes for service users are reported to be inconsistent.
In addition, practitioners experience a sense of powerlessness linked with uncertainty, concern about risk and increased complexity. However organisational responses can create further stress, pressure to work to rules and procedures, focus on parts rather than whole and outcomes rather than processes (Fook and Gardner, 2007).
An aspiration within this research is to develop acceptance of uncertainty and complexity, limiting helplessness and powerlessness. Yet humans have a psychological aversion to uncertainty. ‘Negative capability’ is the ability to contemplate the world without the desire to try and reconcile contradictory aspects or fit it into closed and rational systems.
AMHPs' practice wisdom is reflected in their decision-making. Thinking in a rigid ‘rule-bound’ way may be the mark of a ‘novice’, with critical thinking underpinning ‘expertise’ Tyreman (2000). Experts make effective decisions in situations that appear un-responsive to the usual rules. The expert is technically competent, and able to evaluate complex and unique situations creatively and in service users' interests.
The study is interested in professional knowledge that is gained in the midst of practice. This is difficult when systems prioritise technical approaches, efficiency and outcomes rather than practical reason, relational practices, compassion or care (Kinsella, 2010).
Research Questions:
1. How do AMHPs arrive at independent decisions to detain (or not)? What factors influence the decision-making process?
2. How do AMHPs navigate and tolerate uncertainty and complexity in practice and decision-making?
3. How do AMHPs develop practice wisdom?REC name
Social Care REC
REC reference
15/IEC08/0019
Date of REC Opinion
8 Jun 2015
REC opinion
Further Information Favourable Opinion