My duty as an AMHP (Approved Mental Health Professional) is fundamentally to co-ordinate and carry out assessments according to the Mental Health Act (1983 – as amended 2007).

So in the case of a community assessment, I will request the doctor’s attendance – if a warrant is required for entry, I will attend the local magistrate’s court and request police assistance if needed.

I book the ambulance and although the Mental Health Act Code of Practice is clear in vesting the responsibility for bed finding to the doctors involved, our current practice where I work would mean that I would alert our Trust ‘bed manager’ of the impending assessment who would then inform me of the bed that I can use.

I am obliged to accompany the patient to the ward if they are admitted under section (compulsion) to ensure that the admission papers travel with the person themselves – although this can be delegated, I have never done so – and even if it were, it would remain my responsibility as the AMHP.

Once on the ward, I hand the papers to the member of staff whose role is to ‘accept papers’ who will then check everything is correct. I will, if I can, stay to see the patient settled but one of the other matters that I am tasked with is to under Section 48 of the National Assistance Act (1948) which explains

(1)Where a person—

(a)is admitted as a patient to any hospital, or

(b)is admitted to accommodation provided under Part III of this Act, or

(c)is removed to any other place under an order made under subsection (3) of the last foregoing section,

and it appears to the council that there is danger of loss of, or damage to, any movable property of his by reason of his temporary or permanent inability to protect or deal with the property, and that no other suitable arrangements have been or are being made for the purposes of this subsection, it shall be the duty of the council to take reasonable steps to prevent or mitigate the loss or damage.

(2)For the purpose of discharging the said duty, the council shall have power at all reasonable times to enter any premises which immediately before the person was admitted or removed as aforesaid were his place of residence or usual place of residence, and to deal with any movable property of his in any way which is reasonably necessary to prevent or mitigate loss thereof or damage thereto.

Put briefly, I have to ensure the property is secure. This is usually done by enlisting a locksmith to attend the assessment so that if the lock does have to be broken it can be replaced immediately.

‘Moveable property’ though, also ensures that any pets are taken care of and I have a legal responsibility to ensure the well-being of any pets left behind in a property.

And so it was that I learnt of the existence of a device called a ‘cat trap’ (obviously one of those humane traps!).

image AmbHain at Flickr

I had carried out an assessment a couple of days ago. It was relatively fraught, as is often the case. Mr Y though had a very timid cat. After he had been admitted I called our animal warden to see if we could arrange a cattery for the cat in question (as that is invariably what we do).

He was happy to agree it but we needed to find Ginger. Along with Mr Y’s daughter (whose own child was allergic to cats), we went to try and find him. And we couldn’t. He is a timid cat at the best of times but the uproar and noise of strangers padding in and out of his ‘den’ must have had some kind of impact.

That was when the warden suggested a trap. He explained that it wasn’t as scary as it sounded and just involved putting food inside a cage which would close down when kitty entered.

And the trap was left overnight. The next morning, sure enough, there was Ginger. Looking disshevelled but rather plumply satisfied and with the warden, we waved him on his way to his own ‘place of safety’ for a couple of weeks at least.

Sometimes you really never do know what the day will bring.

Love and Death

At 8.58am yesterday I was just about arriving at work and Mr A’s death was certified. I didn’t know about it though. I didn’t know until about half an hour later because Mrs A’s carer had arrived at 8am that morning and had found Mrs A in a distressed state because she couldn’t rouse her husband.


When the care agency phoned to tell me about the recent death, a lot of thoughts raced through my mind. Firstly, Mr A was relatively young – late 60s. I had been to visit Mr and Mrs A last thing on Friday. Secondly my thoughts flitted to Mrs A. She needed pretty much constant care. We have a substantial care package as it is but there wasn’t any way we’d be able to leave her alone. Her upset and distress as well were to the forefront. It was a content and companionable second marriage for Mrs A after a first marriage marked by great tragedy and significant abuse.

So I made a few phone calls to explore possibilities of placement. There was a bed available on one of the wards but fortunately, there was also a bed available at a nursing home where Mrs A had been for respite care – they knew her – they knew Mr A. They could accept her immediately. More telephone calls for transport. Oh, and the animal warden.

And so, just over an hour after an official certification of death, I arrived at the flat. The police were still present as they were waiting for an undertaker to arrive. So I sat with Mrs A and the corpse of her husband all morning.

It was hard to ignore the body, although it was covered. The flat was warm, the photographs were plastered all over the walls. One cat mewed around our feet – the other we think, was too curious about the body in the next room.

The police flitted in and out – checking identities, trying to find out information. Mrs A cried. She has a fairly advanced dementia, but she cried. She sat in her wheelchair and cried. There was an absolute awareness – although I had been told by the police on my arrival that she was confused and therefore didn’t know what was going on. She certainly did when I spoke to her. She told me about not being able to wake her husband. Just as had happened with her first husband. In the same flat.  She pointed to the fruit in the bowl that Mr A had bought for her the previous evening. And the other things he had done for her.

For he had done a massive amount for her. My first meeting was in hospital when trying to arrange a return home for her. He came to the hospital every day and sat with her through the entire visiting period. Devotion was an understatement. And for Mrs A, her eyes quite literally lit up when she saw him and when she spoke about him. When making a plea for a return home over the more favoured move to residential care, it was the relationship with Mr A that sealed it. Her clear joy at being with and around him. I think it almost moved me to tears as I explained in probably over sentimental ways to the funding panel the need for a return home for Mrs A. Against most of the advice of the hospital.

I have done some courses in bereavement counselling. Granted it was years ago and you draw on what you can. But I’m not sure about those moments, minutes and hours after a death. But I sat with her. I held her hand when I couldn’t think of what to say. Most of the time, I didn’t say anything except an explanation of what we had arranged. We both knew she wouldn’t be returning to the home.

A neighbour who had seen the police and ambulance arrive popped by. He spoke to the police at length as he had known the couple well. I’d met him before in other circumstances. Another neighbour offered to take the cats. Which was fortunate because the animal warden wasn’t being very good at returning telephone calls.

I travelled with Mrs A to the nursing home. The police stayed on at the flat, still waiting for the undertaker. When we arrived,  the care staff and residents at the nursing home who knew her from the respite recognised her. There was a lot of hugging. And more than a few tears. They all knew Mr A too, because even during the respite, he had visited daily. He was a cheerful and affable man who would never pass anyone without a greeting.

It was an out of borough placement so by the time I got back to the locality, I just about made my 4pm visit with minutes to spare. I held it together through that hour – fortunately, it was a joint visit with a colleague. I told her to lead on it.

Today, I go back to the flat and then to Mrs A with some clothes. We hadn’t been able to take any because the position of the body had barred access to the wardrobe.

So just after 5pm yesterday,  having left my desk just before 10am that morning without having been back to the office, I got on the bus home. And I started to cry. Not the full-blown sobbing or even the, I’m ashamed to say, more common stress-induced tears of frustration , but more the occasional tear forming, kind of crying. I wasn’t sure what exactly I was crying for.

The uncertainty and unfairness of life and death I think and of a man and a woman who loved each other so much when neither had any other family, but they had created a relationship from loneliness that had added so much joy to both.

He was a good man. The police found no trace of any family. He never spoke of any family except Mrs A.  The neighbours told me that he was well-loved in the community and that doesn’t surprise me. The coroner was given my details as a contact for Mrs A though, so I can be informed about the autopsy and funeral.