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Low pay and stress putting practitioners off Approved Mental Health Professional role

Researchers at King's College London investigated why few health workers become AMHPs...

by Andy McNicoll

Low pay, stress and disputes in councils and NHS teams over releasing staff for training are contributing to a shortage of Approved Mental Health Professionals, a study has found.

Researchers at King’s College London's Social Care Workforce Research Unit investigated why few health professionals become AMHPs – specially qualified workers that oversee Mental Health Act assessments.

More than 95% of AMHPs are social workers despite changes introduced in 2007 allowing psychiatric nurses, occupational therapists and psychologists to take on the role.

The study, Who wants to be an Approved Mental Health Professional?, is based on than 50 interviews with people involved in AMHP services and a survey of AMHP leads. Three quarters of AMHP leads said they had too few AMHPs, with most reporting difficulties enabling health staff to take on the role. The report found:

  • Pay had an “important and mainly negative” effect on AMHP recruitment. Differences in council and NHS pay scales and “inconsistencies” in AMHP rates at different councils didn't help.
  • Organisational barriers, such as difficulties managing AMHPs across separate council and NHS teams, deterred many health workers.
  • Health staff faced opposition from managers to becoming AMHPs and struggled to get training. Some AMHP leads reported NHS trusts having a “blanket ban” on AMHP training for their staff. Some councils reportedly only allowed their own staff to train.
  • There was a lack of awareness the AMHP role was open to health staff. There was also a “generally negative” image of the role involving “stressful work" and unpredictable hours.
  • While in social work the AMHP role was often a “rite of passage”, in health it was not always seen as benefiting careers. Some staff felt an “anti-health” prejudice amongst AMHP trainers and managers.

The report recommended giving NHS trusts and councils “joint responsibility” for running AMHP services. The duty currently sits with local authorities.

Researchers also said an “overall increase” in pay for AMHPs would boost recruitment from all professional groups. They recommended pay rates be decided nationally to address inconsistencies.

Steve Chamberlain, a member of BASW’s mental health policy group, told PSW better arrangements between NHS trusts and councils around AMHP training could help but he felt statutory responsibility for the AMHP service should remain with local authorities.

“The whole reason why the Approved Social Worker role – which became the AMHP role - was created was to have a specific focus on the social context and social element. As soon as you move it over to partially the NHS, it feels like the start of a slippery slope,” he said.

Chamberlain said boosting the resources for social care, including preventative mental health services, and addressing the “logistics” issues AMHPs face on assessments would improve recruitment and retention.

“You need resources before people reach crisis and you need to improve the ability of AMHPs to do their jobs when they’re out on assessment.

“People value being AMHPs – it is challenging, important work. But they also see AMHPs are working late into the night, they’re struggling to get beds or ambulances or other support for people who need it.

“Those are the things that make AMHPs say they don’t want to do the job anymore and they’re the things that put off other professions, and new social workers, from doing it.

"In terms of the attractiveness of the role to all of the professions, I think addressing some of those issues would make the biggest difference.”

andy.mcnicoll@basw.co.uk