Government mental health policy

An introduction to the main mental health policy papers in England, Scotland, Wales and Northern Ireland

The main policy paper in England is 'No Health Without Mental Health' (D.H. 2011). This cross-goverment strategy covers all ages and the whole mental health spectrum from mental wellbeing to mental illness. It has six key objectives, including Recovery, physical health, stigma and discrimination.
 
Download COT Briefing 121 England Mental Health Legislation and Policy

Mental health policy in Northern Ireland

The main policy paper in Northern Ireland is A Strategic Framework for Adult Mental Health Services (Bamford 2005). The document is part of a whole system plan to improve service provision for people with mental health problems, embracing services, policy and legislation. It emphasises that services must promote recovery and sustain meaningful lives
 
Download COT Briefing 123 Northern Ireland Mental Health Legislation and Policy

Mental health policy in Scotland

The main mental health policy paper in Scotland is Delivering for Mental Health – the mental health delivery plan for Scotland (Scottish Executive 2006). From this, Realising Potential – an action plan for AHPs in mental health (Scottish Government 2010) emphasises early intervention and timely access, supported self management and recovery, delivering psychological interventions and vocational rehabilitation.
 
Download COT Briefing 124 Scotland Mental Health Legislation and Policy

Mental health policy in Wales

The main mental health policy paper in Wales is Raising the Standard - the revised adult mental health national services framework and an action plan for Wales (Welsh Assembly Government 2005) which set the priorities for mental health services. These include social inclusion, health promotion, tackling stigma, service user and care empowerment, normal patterns of daily life, equitable and accessible services, effective assessment and care pathways.
Download COT Briefing 122 Wales Mental Health Legislation and Policy

Mental Health Act: New roles for occupational therapists in England and Wales

Occupational therapy practice has changed considerably over the past years with increased emphasis on cross boundary working particularly in mental health services. Continuing in this direction are the two roles that are open to occupational therapists under the Mental Health Act (2007) in England and Wales:

• Responsible Clinician (RC)
• Approved Mental Health Professional (AMHP)

 
Under the Mental Health Act (1983) the person who had overall responsibility for a service user’s treatment whilst subject to compulsion was known as the Responsible Medical Officer (RMO). The 2007 amendments to the Mental Health Act changed this role to that of the Responsible Clinician (RC) which can be drawn from one of the five core mental health professions, namely a doctor, clinical psychologist, nurse, occupational therapist or social worker.
 
The Responsible Clinician should be the most appropriately skilled professional available to meet the primary needs of the service user’s care plan. Occupational therapists who wish to become Responsible Clinicians would be required to meet with nationally set competencies, which are also set out in law, in order for their employing organisation to nominate them in this role. The duties of a Responsible Clinician under the Mental Health Act (2007) have all the functions and responsibilities of the previous RMO:

• To assess a service user as part of the detention process
• To make decisions about the interventions required
• To make recommendations for the lifting or continuation of the detention
• To make decisions regarding supervised Community Treatment and Community Treatment Orders including recall to hospital.

 
The second role introduced is that of the Approved Mental Health Professional which replaced the Approved Social Worker (ASW). Again this role, which is set out in law, has been opened to a range of professions, namely those of nursing, social work, occupational therapy and chartered psychology. As with the Responsible Clinician, the AMHP will need to meet with nationally agreed competencies prior to the clinician being nominated for training by their employing organisation. All AMHP courses are approved by the General Social Care Council on behalf of the professional bodies and the courses will be based on a nationally agreed core curriculum.
The duties of the AMHP under the Mental Health Act (2007) will have all the functions and responsibilities as the previous ASW:

• To provide an independent non-medical assessment of a service user as part of the detention process, make the application and follow the application through
• Production of reports for the Mental Health Review Tribunal and managers’ hearings.

 
Further information
Carr J, Smyth G (2008) New roles: are you ready? Occupational Therapy News, 16(11), 24-25.
Hewit- Moran T, Jackson C (2009) New Roles Early Implementer Site Project. London:NIMHE
NIMHE (2008) Mental Health Act 2007 New Roles. London: NIMHE.
Mason K (2008) A legitimate role for OTs? Occupational Therapy News, 16(7), 13.

Please contact genevieve.smyth@cot.co.uk if you have any queries regarding these roles.