Suffolk County Council (21 011 630)

Category : Adult care services > Assessment and care plan

Decision : Not upheld

Decision date : 21 Mar 2022

The Ombudsman's final decision:

Summary: There was no fault by the Council in a complaint that a mental health assessment of the complainant’s son was not properly conducted.

The complaint

  1. I refer to the complainant as Mr X. Mr X says a mental health assessment of his son was not properly conducted. Mr X says the Approved Mental Health Professional (AMHP) was complicit in allowing the assessment to be completed with full knowledge that some of the information the decision was based on was false. Mr X says the AMHP refused to allow correct information to be presented.
  2. Mr X says the assessment caused distress to his family and they were left in a position where they were unable to keep their son safe. They were not offered any immediate help or care plan that would keep their son safe and so they had to admit him to a private clinic which cost them a lot of money.
  3. Mr X wants the AMPH to receive further training or be removed from her position. He wants compensation for the distress his family suffered and the expenses they incurred.

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The Ombudsman’s role and powers

  1. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word fault to refer to these. We must also consider whether any fault has had an adverse impact on the person making the complaint. I refer to this as ‘injustice’. If there has been fault which has caused an injustice, we may suggest a remedy. (Local Government Act 1974, sections 26(1) and 26A(1), as amended)
  2. If we are satisfied with a council’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)

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How I considered this complaint

  1. I examined the complaint and background papers provided by Mr X and the Council. I discussed the complaint with Mr X by telephone. I sent a draft decision statement to Mr X and the Council and considered the comments of both parties on the statement.

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What I found

The assessment process under the Mental Health Act

  1. The Mental Health Act 1983 as amended (MHA) lays down the legal framework in which people can be compulsorily admitted and detained in psychiatric hospitals. The involvement of an AMPH is necessary in order to make decisions about whether or not someone needs to be admitted.
  2. Assessing doctors can make recommendations about whether or not someone should be detained in hospital but it is up to the AMPH to make the final decision. The AMPH should conduct an assessment under the MHA and reach their own conclusion based on the evidence.
  3. The AMPH’s duties are:
    • To interview the patient “in a suitable manner”
    • To respond to a request by a nearest relative to assess someone under the MHA
    • To consult the patient’s nearest relative when considering a section 3 detention
    • To inform the patient’s nearest relative when detaining under section 2
    • To interview a person removed to a place of safety by police under section 136
    • To consider an application for a patient to be made subject to supervised community treatment under section 17A
  4. Nearest relative is a legal term used in the MHA. The nearest relative will have some legal rights. Most of the rights can only be used if a person is detained under the MHA.
  5. Under the MHA, a nearest relative can apply to section a person or place the person under a guardianship. The nearest relative can object to a person being sectioned or placed under a guardianship.
  6. The nearest relative can discharge a person who is sectioned and apply to the Mental Health Tribunal if discharge is refused.
  7. The nearest relative can be consulted and/or given information about a person who has been sectioned.

Background

  1. Mr X made a referral for a mental health assessment of his son following his son’s suicide attempt. The assessment was arranged to take place at a local hospital. The assessment was conducted by two psychiatrists and an AMPH.
  2. Before the assessment, Mr X was sent a text message by his son’s mental health care co-ordinator which stated that he should make sure he had ‘a voice in the assessment’ and that he was clear about what his son can manage at home.
  3. Mr X says the assessment team asked his son if he wanted him to be in the room for the assessment. So he showed them the message from the care co-ordinator and this led to a discussion. The assessment team then agreed they would first speak to his son separately and then speak to Mr X.
  4. Mr X says he was not given the opportunity to give his input as the assessment team had already concluded the assessment when he was invited into the room. Mr X says his son and he were told that his input would be taken into consideration but it was not. Mr X therefore states the assessment was not properly carried out. Mr X says there is no legal instrument that requires assessors to ignore pertinent information that may be available to them. Mr X says the information the assessors relied upon was incorrect or incomplete.
  5. The AMPH decided not to detain Mr X’s son.
  6. Mr X sent me a signed letter from his son. His son says that the assessors asked him if he wanted his father in the room when they spoke to him. He told them it was his preference that his father should not be in the room. He says that he never told them he wanted his father excluded from the assessment. His understanding was that they were going to get his father’s input after they had spoken to him.

Finding

  1. I do not find fault by the AMPH because Mr X was not involved in the assessment process before the assessors reached their decision.
  2. I note Mr X’s belief that he was entitled to be involved in the assessment process because the community care co-ordinator told him his voice should be heard. However, under the MHA, the nearest relative has a right to be consulted after a person has been sectioned. The MHA does not create a right for the nearest relative to be involved in an assessment.
  3. A friend or family member can stay with a person during a mental health assessment but the person has to give their consent for the friend or family member to be present. Mr X’s son did not give his consent for Mr X to be in the room for the assessment.
  4. I note Mr X’s son’s statement that he refused to give consent for his father to be present while he was assessed on the understanding that his father’s input would be taken afterwards. However, the case history, as stated by both Mr X and his son, suggests otherwise. I note Mr X’s son had asked to be interviewed alone before Mr X queried that decision with the assessors. It is therefore unlikely that he was unduly influenced by a promise from the assessors to discuss matters with Mr X afterwards.
  5. As to the content of the discussion surrounding an interview with Mr X, in particular Mr X’s understanding that he would then have an input into the assessment, there is no independent recording of the discussion. I cannot therefore making a finding of fault by the Council on the basis of Mr X’s understanding of the discussion.

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Final decision

  1. I have closed this complaint because I do not find fault by the Council in the matters raised here by Mr X.

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Investigator's decision on behalf of the Ombudsman

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