Mental health
Feature
Who ?
An approved clinician is required to be ‘ a senior professional , sufficiently experienced to capably , and with authority , exercise the autonomous decision making required of an approved clinician ’ ( HEE 2020 ).
Competence is required to be demonstrated in both learning disability and mental health . Confirmation that the required level of competence is achieved is via a rigorous portfolio and panel review process .
Why ?
The Mental Health Act 1983 provides the legal framework in England and Wales that underpins the compulsory assessment , treatment and rights of a person with a mental disorder of a nature or degree that warrants urgent intervention to protect the health or safety of the individual or others .
In 2007 , it was reviewed to expand who could implement aspects of the Act – mental health and learning disability professionals working as social workers , psychologists , learning disability and mental health nurses and occupational therapists were now eligible to undertake training and gain approval from the appropriate national authority to become an AC ( HEE 2021 ).
This decision recognised eligibility based on competency rather than profession and the recognition of the value of a broader range of approaches to better meet the treatment needs of the service user .
Certainly , occupational therapists bring a particular skill set , with a focus on the recovery approach , functionality , strengths-based model and promotion of independence .
When asked what motivated her to take up the training to become an AC , Donvé Thompson-Boy , our only occupational therapy approved clinician stated : ‘ To be in a clinical leadership role I could see ... how we could use this as an opportunity to demonstrate the value the occupational therapist can bring to leading a multidisciplinary team . And , potentially , a different approach to the care and treatment of someone whose occupational engagement was being restricted because of being detained under the Mental Health Act .’
Why is this important ?
Nationally , there is only one occupational therapist in England and one in Wales that has qualified as an AC . Occupational therapists in AC roles can offer a different skill set to best meet an individuals ’ treatment needs . AC roles offer opportunity for senior occupational therapists to progress into a senior clinical role rather than into management .
AC roles offer increased opportunity to influence the therapeutic focus and culture of services and occupational therapists in senior clinical roles such as an AC role can enhance the standing of the profession within their service and beyond .
HEE has identified the need and benefit of increasing occupational therapy uptake in this area and has created funding routes and an implementation guide to support this . As a result , there are three occupational therapists currently undergoing the AC training currently .
Donvé was successfully approved as an AC five years ago and you can read her case study , along with that of other MPACs , on the HEE website .
How ?
The application process to become an AC involves demonstrating competency in eight core areas ( nine core areas in Wales ):
• Competency areas of the multi-professional AC framework .
• Comprehensive understanding of the AC role , legal responsibilities and key functions of the AC and RC role .
• Applied knowledge of legal and policy framework , codes of practice and National Institute of Health and Care Excellence ( NICE ) guidelines .
• Assessment .
• Treatment .
• Care planning .
• Clinical leadership and multidisciplinary team working .
• Equality and diversity .
• Communication .
• Values based practice ( in Wales ).
For a more detailed description of these competencies , see HEE ’ s Multi-professional approved / responsible clinician : Implementation guide and the Mental Health Act 1983 Approval of Approved Clinicians ( Wales ).
Portfolio
Achievement of the competencies is demonstrated through completion of a detailed and comprehensive portfolio , which is then submitted to the regional authority ( in England ) and the approval team ( in Wales ) for appraisal .
The collection of evidence for the portfolio can take a couple of years and part of the process includes regular mentoring and shadowing by an AC . It is important that the applicant is supported
November 2022 OTnews 31