Summary: We will not investigate this complaint about the way a Mental Health Act assessment was undertaken. Investigation into the actions of the Approved Mental Health Professional is unlikely to find significant failings in the process they followed.

The complaint

1. Mr A complains about the circumstances of a Mental Health Act 1983 (MHA) assessment of his daughter, Miss A, in March 2023. East Sussex County Council (the Council) was responsible for the assessment. Mr A complains the assessment took place with only an Approved Mental Health Professional (AMHP) and psychiatrist present but should have included another doctor as well. Further, Mr A complains that the MHA assessment was not conducted professionally and did not take account of Miss A’s presenting symptoms.

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The Ombudsman’s role and powers

2. The Ombudsman investigates complaints about ‘maladministration’ and ‘service failure’, which we call ‘fault’. We must also consider whether any fault has had an adverse impact on the person making the complaint, which we call ‘injustice’. We provide a free service, but must use public money carefully. We do not start or may decide not to continue with an investigation if we decide:

• there is not enough evidence of fault to justify investigating, or
• any fault has not caused injustice to the person who complained, or
• any injustice is not significant enough to justify our involvement.

(Local Government Act 1974, section 24A(6))

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How I considered this complaint

3. I considered information provided by the complainant and the Council.
4. I considered the Ombudsman’s Assessment Code.
5. I shared a confidential copy of my provisional decision with Mr A and invited his comments on it. I considered the points he made and the information he provided in response.

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My assessment

6. Under the MHA, when someone has a mental disorder and is putting their safety or someone else’s at risk they can be detained in hospital against their wishes. This is sometimes known as ‘being sectioned’.
7. Usually, three professionals need to agree that the person needs to be detained in hospital. These are either an AMHP or the person’s nearest relative, plus a doctor who has been specially approved in MHA detentions and another doctor. The AMHP is responsible for deciding whether to go ahead with the application to detain the person and for telling the person and their nearest relative about this. Admission should be in the best interests of the person and they should not be detained if there is a less restrictive alternative.
8. Sections 14.30 to 14.76 of the Mental Health Act Code of Practice (the Code of Practice) provides directions and guidance about how professionals should assess people before applying to detain them under the MHA.
9. The Ombudsmen cannot make or remake professional judgements about whether detention under the MHA is right. The LGSCO’s role is to consider if the AMHP followed the steps set out in the MHA and the associated Code of Practice. Where an AMHP has followed process, we would not question the judgements they made at the end of it.
10. In its response to the complaint the Council noted that, while it is felt to be good practice and is preferable, it is not a requirement for a MHA assessment to involve two medical professionals. The Council also, more broadly, did not identify any shortcomings in the process the AMHP followed in reaching a decision about whether to apply to detain Miss A.
11. The records show it was a professional from a Psychiatric Liaison Service in a hospital Emergency Department who made the referral for a MHA assessment. They phrased it as a ‘first recommendation’ and noted why they felt Miss A should be detained.
12. The papers show the AMHP spoke to Miss A’s Nearest Relative ahead of the assessment and included them in their interview of Miss A. There was also one doctor present when they interviewed Miss A, and this doctor was an approved s12 doctor. The AMHP listed the Psychiatric Liaison Service professional as the other assessing doctor and documented that they were not present for the interview. They included the Psychiatric Liaison Service’s professional’s full referral (first recommendation) in the form.
13. Part 14.45 of the Code of Practice notes that “patients should, where possible, be seen jointly by the AMHP and at least one of the two doctors involved in the assessment”. As such, there is no requirement for assessments to be completed with two medical professionals present.
14. Overall, the evidence I have seen suggests the AMHP followed the relevant procedures and requirements making the decision about whether to apply for Miss A to be detained in hospital. Where an AMHP has followed the proper process we would have no call to question the judgements they made at the end of it. As such, it is improbable an investigation would find fault in the process the Council followed.

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Decision

15. We have decided not to investigate this complaint. This is because an investigation is unlikely to find evidence of fault.

Investigator’s decision on behalf of the Ombudsman

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Investigator's decision on behalf of the Ombudsman