The Royal College of Psychiatrists sets out the definition of those doctors who are allowed to train to become Mental Health Assessors under DOLS. The page with full details is here
Contrary to what I believed, what most people say, and what have written, the Mental Health Assessor does not have to be approved under S12 of the Mental Health Act 1983. The Royal College of Psychiatrists is clear that Mental Health Assessors are either
- MHA Section 12 Approved doctors (psychiatrists and non-psychiatrists). Non-psychiatrists are usually GPs with a special interest in mental heath
- Medical practitioners who have at least three years post registration experience of the diagnosis or treatment of a mental disorder from a variety of medical specialties and who are not MHA Section 12 Approved.
My experience however is that most Mental Health Assessors are either psychiatrists or GPs with a special interest. I remember chatting to doctor colleagues who were GPs about becoming s12 registered. Psychiatry is not a popular career choice among medical students, even though advancement is usually quicker in this speciality, due to the lower number of doctors choosing this career path. For GPs in practice, even where they do have a strong interest in Mental Health, after they’ve seen patients every ten minutes from 7am to 7pm, they don’t really want to go out and do an assessment under the Mental Health Act. Add to this the fact that there are lots of other ways for doctors to earn £200 quid, and you get the reason why there is a scarcity of Mental Health Assessors. The Form 4 is less work than the Form 3 for a long way, so when Mental Health Assessors do get cracking they can hoover up assessments and do maybe 5 in a day which maybe close to £1500. A BIA could never do 5 assessments in a day, even with this new DOLS pro software.
This creates a potential problem.
As a Best Interests Assessor, you have done your Form 3, except you need to consult that Mental Health Assessor about the impact of the DOLS authorisation on the patient’s mental health. You need to check that box before your assessment is complete. What if you are waiting a month for the doctor to do his or her bit? That’s adding a month before you get paid. Add to this that most local authorities are only going to pay on 30 day invoices or longer and independent BIAs have a cashflow problem.
One way round this is to have your own Mental Health Assessor. I know clever BIAs who have contacts with specialist MH assessors – they will use one for ABI cases, one for Dementia Cases and one for LD cases, so they take on the whole job and sub-contract the doctor. They invoice the LA for both their fee and that of the doctor and the doctor invoices them.