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Increase in serious mental health problems sees more people facing hospital detention, Nottinghamshire County Council hear

More people with serious mental health problems are ending up facing the prospect of being detained in hospital, a health committee has been told.

Experts say there is some evidence more cases in Nottinghamshire are becoming more severe, leading to an increase in the number of people needing significant support at specialist units.

Approved Mental Health Professionals — or AMHPs — coordinate mental health act assessments and make applications for hospital admissions.

County Hall, headquarters of Nottinghamshire County Council.
County Hall, headquarters of Nottinghamshire County Council.

The teams, coordinated by the county council, are seeing a 30% increase in demand for support.

They provide independent decisions about whether or not there are alternatives to detaining someone.

The teams usually involve social workers but can also be nurses, occupational therapists and psychologists.

They act on behalf of a council but they cannot be told by the local authority, or anyone else, whether or not to make an application for admission to hospital.

The issue was discussed at a Nottinghamshire County Council health committee on March 4.

The public health team at the authority said challenges include growing demand for support and recruitment and retention.

Ainsley Macdonnell, service director at the authority, said: “One of the things we have seen over the last few years is quite a stark increase in the number of Mental Health Act assessments that we’re being asked to undertake.

“The total number in 2020 was 1,722 and last year it was 2,478. That represents a 30% increase which is quite significant in terms of how we use our resources and the nature of the demand.

“We are anecdotally seeing an increase in the complexity and acuity of people. People are presenting much more unwell at the point our AMHPs get involved.”

Claire Sawyer, who works as an AMHP, said the teams work 12-hour shifts and are available 24 hours a day.

She told the committee: “Night-time work has started to increase, predominantly in hospitals and police stations because we try to respond within three or four hours.

“Our work is ageless. The youngest I’ve detained was 12 and the oldest was 99.

“We are available to anybody that steps into the county.

“The power of the AMHPs is quite significant. We can sign an application and deprive a person of their liberty for up to six months. We use the power very humbly and respectfully.”

Matt Barney said: “I have to say, the work the AMHP teams do is probably some of the most difficult work that anybody in our local authority setting gets to do.

“It touches more acutely at the core of humanity that any other area.”

Mike Pringle said: “Claire, you should have a medal every day to be quite honest.

“It’s an incredible thing that you do. We can’t thank you enough so please pass that on.

“If we’ve had a 30% increase we certainly need to do something more.”

Roger Jackson said: “The figures speak for themselves in terms of the increase recently.

“We need to identify the cases, why are these figures going up.

“We need to support these people before it gets too far, that is something we need to do as a council.”

Melanie Williams, corporate director for adult social care and public health, said: “Every person that takes their own life is a missed prevention opportunity.

“Every mental health detention is an early opportunity missed.

“We do work within the team and with partners about those missed opportunities.”

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