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.

中文翻译：

---

改变齿轮和争取时间：一项探索英格兰和威尔士心理健康法案评估推荐后 AMHP 实践的研究

根据英格兰和威尔士 1983 年《心理健康法》(MHA)，经批准的心理健康专业人员 (AMHP) 的作用是对精神科拘留的转介做出回应，并在他们认为有必要时提出拘留申请。本文报告了我在转介 MHA 评估时对 AMHP 决策的博士研究结果。采用基于优势的欣赏性探究方法，定位于社会建构主义范式。为一个地方当局工作的九名 AMHP 参与了这项研究，其中包括我作为内部研究员。在五个多月的四场为期一天的研讨会中，参与者定义了他们的最佳实践，使用名义小组技术在研讨会上一起分析新出现的数据。服务开发包括创建分诊角色和定制报告，以在服务中优先考虑此决策，开辟改变方向的途径并为此时进行更彻底的评估争取时间，并促进与推荐者之间的更广泛合作。在评估途径中提倡采用多机构方法来寻找限制较少的选项。这项研究的结果提供了对这一重要实践领域的研究见解，为实践和政策发展提供了证据基础。