Responsible Clinicians - does anyone give a toss?

And while you’re about it tell me if there are any professionals other than nurses keen to take on the Approved Mental Health Professional role. I’m thinking specifically here about OTs, who in my experience, have never been keen to do the less popular jobs in psychiatry.

Here down under I can be an AMHP - I haven’t as yet but in some posts it’s necessary as your isolated position sometimes requires you to admit. The ‘powers’ only permit you to set up an emergency exam order which means they must be seen and either discharged from it or admitted. Ambulance drivers & police can use this power too.
I think the isolated geography and the fact psychiatry/mental health is a different kettle here makes for the necessity.

I wouldn’t want to! Then again, I’m not in mental health, nor am i particularly responsible at the best of times. Not a particularly useful comment. Sorry.

I’m with your ASW friend here. When I was working in acute, I got very sick of people dodging out of doing unpleasant or unpopular things because it would ‘damage their therapeutic relationship’. What about MY ‘therapeutic relationship’?

i went to an open day at the ministry of justice (more exciting than it sounds, honest) a few months ago, and a lot of the psychiatrists in the room had seemingly completely missed the fact that this was coming in (!) & were up in arms about it.

i’m not sure how i feel about it really … it makes sense that a service user whose treatment is mainly talking therapy rather than medication based should have a psychologist as their RC for example … and that’s my sole thought on the matter for this evening … :o)

It strikes me that those people who opt out of the difficult or unpopular jobs for fear of damaging their therapeutic relationship with a patient, can’t have such a good therapeutic relationship in the first place. Surely a lot of this is how the problem is dealt with, so I agree with beakie and the ASW.

all i can add is that everyone, nurse/ot/other in my trust is keeping their head down and hoping someone else gets voluntered.
Despite this i feel the amhp role will eventually be a positive development (except if your an asw), agree with zarathustra about the rc role however. Thats looks like it could be a major pain in the nether region.

Just curious.. but does anyone know why they’ve deemed it necessary to make the RC role?

It strikes me that those people who opt out of the difficult or unpopular jobs for fear of damaging their therapeutic relationship with a patient, can’t have such a good therapeutic relationship in the first place.
I disagree. You should be right, of course. But somehow it doesn’t quite work out that way. You can have a good relationship but when you know and the patient knows that you can detain them pretty much on your whim, there’s a very different rapport.

I know, I know, there are oodles of safeguards and it shouldn’t be like that. Before being lynched, I detain very very few folk and see it as A Very Big Thing, but it can happen pretty much on whim. It’s a rare GP or ASW (i.e. I’ve yet to meet one) who hasn’t gone along with what I’ve suggested. Thus psychiatrists are seen in a different way to CPNs.

As a RC the psychologist or nurse can’t initially detain but, when they’re in on a s2 or s3 they can then determine all their treatment. And all their leave (or lack of). And on leave under an SCT they can drag them back, kicking and screaming, to be detained under s3 again without any medics being involved. For CPNs to be saying, “Do it my way” and patients to know if they don’t then the CPNs duty of care and RC status will mean they’re back in hospital will change the relationship. Dynamics of how collaborative the relationship can be will shift. I know, because that’s how I have to work. Most CPNs do not have to work in such a fashion. I can certainly see why they’d wish for things to remain that way.

Just curious.. but does anyone know why they’ve deemed it necessary to make the RC role?
I asked this of the Department of Health. On meeting with one of the DoH she gave me the frank response :
It’s cheaper than using psychiatrists.

Thank you for an interesting response Shrink.
I suppose the point I was trying to make is, why should any particular professional’s therapeutic relationship with a patient be any more protected than any other. Ward based nursing staff have to make unpopular decisions and give bad news, and then have to be around that person afterwards and repair damage, so why not others?

Some people are very precious about their “therapeutic relationship”, with no good reason if you ask me. Even if they might not be able to detain a person directly, said person can surely be in no doubt that their worker can have a huge influence over the decision to detain, and decisions about when they’re discharged, where they’re housed, what benefits they receive and so on.

Some people use the shibboleth of their “therapeutic relationship” to avoid doing jobs they don’t want to do.