Approved Mental Health Professionals and the compulsory detention of Black service-users under the Mental Health Act

根据《心理健康法》批准的心理健康专业人员和对黑人服务使用者的强制拘留

• 批准号: 2279477
• 金额: --
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2019
• 资助国家: 英国
• 起止时间: 2019 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2279477
• 关键词: Approved; Mental; Health; Professionals; compulsory

OverviewResearch studies and data monitoring have consistently shown that Black and Minority Ethnic (BME) groups in Britain are disproportionally represented in compulsory detention under the Mental Health Act 1983 (MHA) compared to White groups (NHS Digital, 2018). The role of the Approved Mental Health Professional (AMHP) is "to provide an independent decision about whether or not there are alternatives to detention under the MHA, seeking the least restrictive alternative and bringing a social perspective to bear on their decision" (Department of Health, 2015, p. 23). This PhD research will apply institutional ethnography (IE) as a social theory and methodology to answer the guiding research question: How do the operational and institutional structures within the role of social worker AMPHs influence the process of compulsory detention of BME service-users under the MHA?This research will also explore: 1. What are the daily operations and institutional practices of social worker AMHPs?2. What is the role of social worker AMHPs within the process of compulsory detention under the MHA of BME service-users?3. How is the process of compulsory detention of BME service-users influenced by social worker AMHPs institutional operations and culture?MethodologyIE is an approach to inquiry that combines theory and method (Smith 2005, 2006). IE is premised on praxis, accomplishing social change for disempowered individuals, by revealing disjoints between institutional policies and actual practice. IE will inform this study's exploratory qualitative research methodology. IE will form a narrative that describes the systemic ways in which the role of social worker AMHPs conducting sectioning processes under the MHA is structured and operationalised, its impact on BME service-users subject to this process, and the challenges this poses on social worker AMHPs' ability to provide independent decisions seeking the least restrictive alternative and bringing a social perspective to bear on their decision.This study's original contribution to knowledgeThe literature suggests that despite past governments' implementation of race equality training, strategies and policies to support equality in BME mental health care, treatment and outcomes the phenomenon of the overrepresentation of BME people in the British mental health system persists. The existing literature has focused on sociological explanations for this phenomenon, which center on the social exclusion of service users. Little is written on institutional factors such as organisational and professional culture and practices. Thus a new agenda, which explores professional structures and their impact on mental health services and a wider approach to mental public health, is required. By making use of this innovative research method, this will be the first known IE study in Britain to address this gap in the literature. This study represents a substantial and original contribution to the knowledge base of BME mental health, which may provide insight and understanding of the phenomenon of overrepresentation. This information is crucial to service-users, professionals and policy makers within Britain's mental health system.

概述研究和数据监测一直表明，根据1983年《精神健康法》(MHA)，与白人群体相比，英国黑人和少数民族(BME)群体在强制拘留中的比例不成比例(NHS Digital，2018)。经批准的精神卫生专业人员(AMHP)的作用是“就是否有根据《精神卫生法》拘留的替代办法作出独立决定，寻求限制性最小的替代办法，并将社会观点纳入他们的决定”(卫生部，2015年，第23页)。本博士研究将以制度人种学(IE)作为一种社会理论和方法来回答以下指导性研究问题：社会工作者AMHP角色内的运作和制度结构如何影响MHA下的BME服务使用者的强制拘留过程？本研究还将探索：1.社会工作者AMHP的日常运作和制度实践是什么？2.社会工作者AMHP在BME服务使用者的MHA强制拘留过程中扮演什么角色？3.社会工作者AMHP的制度运作和制度运作如何影响BME服务使用者的强制拘留过程文化？方法论IE是一种理论和方法相结合的探究方式(Smith 2005，2006)。IE是以实践为前提的，通过揭示制度政策和实际实践之间的脱节，为被剥夺权力的个人实现社会变革。IE将介绍这项研究的探索性定性研究方法。IE将形成一个叙事，描述在MHA下执行分区过程的社会工作者AMHP的角色是如何被系统地组织和运作的，它对BME服务使用者受这一过程的影响，以及这对社会工作者AMHP提供独立决策的能力构成的挑战，寻找限制性最小的替代方案，并将社会视角应用于他们的决策。这项研究对知识的原始贡献文献表明，尽管过去的政府实施了种族平等培训，战略和政策，以支持BME心理健康护理，治疗和结果平等，但BME人群在英国精神卫生系统中代表性过高的现象仍然存在。现有文献对这一现象的社会学解释主要集中在对服务使用者的社会排斥上。关于组织和专业文化和实践等制度因素的文章很少。因此，需要制定一项新的议程，探讨专业结构及其对精神卫生服务的影响，以及更广泛地处理精神公共卫生问题。通过使用这种创新的研究方法，这将是英国第一个已知的解决这一文献空白的IE研究。本研究对BME心理健康的知识基础做出了实质性和独创性的贡献，可能会对过度表征现象提供洞察和理解。这些信息对于英国心理健康系统中的服务使用者、专业人士和政策制定者来说至关重要。