Mental Health Act assessments: does a community treatment team make a difference?

There is an extensive body of research into home treatment for acute mental illness, but this is the first one to examine any association with Mental Health Act Assessments. It examines the question of whether there is any impact of a home treatment team on the numbers and circumstances of Mental Health Act Assessments in its area. The 1983 Mental Health Act created the role of the Approved Social Worker, among whose duties is that of ensuring that any disposal is the least restrictive possible. For this duty to be carried out meaningfully, as wide a range of alternatives as possible needs to be available. The move from institutional to community care for the mentally ill which has been the 'big idea' of recent decades has given rise to intense interest in home treatment for acute mental illness, which can offer a potential alternative at a time of crisis for ASWs and thus patients. This study examined over 200 reports written by ASWs following Mental Health Act Assessments in the two areas, and it was found that the home treatment team appeared to have an impact. It was hypothesised that such a team might have an effect on the sorts people presenting for assessment. It was concluded that area with the team had an absolute and a relative reduction in the numbers of assessments. It was also found that there was a decrease in the likelihood of detention under Section 3 of the Act for people living in the area of the team. Finally it was found that the involvement of the team in an assessment reduced the likelihood of a Section 3 decision even further. Analysis indicated that the home treatment team was able to absorb some of the people, mainly male, who were suffering from a psychotic illness, and who were inclined to re-present on more than one occasion.