AMHP Report (MHA Assessment) (version 7 01.11.

19)

AMHP Report of MENTAL HEALTH ACT 1983 Assessment for detention

This report is based primarily on information gleaned at the time of assessment and cannot be
relied upon as a full or accurate account of the client’s circumstances.
Complete for all AMHP assessments, regardless of outcome. Only complete relevant sections.
Upload onto SPFT Care Notes & send to hospital if outside of Sussex Partnership foundation Trust.
Copy will be sent to GP
Please ensure times are in 24 hour clock.

1. Personal contact details

Name Adam Ivey

Dob & Age 03/03/2001 (21)
SPFT CIS number 3193189
NHS Number 643 259 4936
Home address 14 Willetts Field, Great Sampford, Essex, CB10 2SE.

Student House in Brighton:

81 Washington Street, Brighton, BN2 9CR
Home phone
Mobile phone 07961 841757
Email address
Can the report be shared ☒ Yes ☐ No
with the person? If NO please
specify sections of the form
to be withheld.

2. Summary information

Date & time of the MHA 19/09/22 at 09.30

assessment
Assessing AMHP Lorna Cornett
Type of location of assessment ☐Community ☐Psych Hospital ☐Hospital PoS ☒RSCH
A+E ☒RACH ☐OOA Hospital ☐Custody ☐Other
Legal status pre-assessment (if S136 MHA
applicable or state nil)
Legal status post- MHA nil
assessment (if applicable or nil)
Admitting location/hospital (if n/a
applicable)
Date & time of admission n/a

3. Demographics

Relationship status Single

Ethnicity White: ☒ British ☐ Irish ☐ Other
Asian: ☐ Pakistani ☐ Indian ☐ Bangledeshi
Black: ☐ African ☐ Caribbean ☐ Other
Mixed: ☐ White/Black African ☐ White/Black Caribbean

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Gender
Preferred Pronoun
Religion
Sexual orientation
First & other languages
Interpreter used (details)
Signer or similar used
(details)
Any learning/physical
disability?
4. Key professionals (name & contact details)
GP
CCG
Lead Practitioner
Consultant/RC (if applicable)
Other professionals
5. Referral details
Date & time of referral
Assessment request by
Is this a nearest relative
request under s13(4)?
Has CRHTT or other
alternatives to hospital
detention already been
offered/tried?
Immediate risks/concerns at
time of referral
☐ White/Asian ☐ Other Mixed
☐ Gypsy/Irish traveller ☐ Arab ☐ Chinese ☐ Other ☐ N/K
☒ Male ☐ Female ☐ Unknown/prefer not to disclose
☐ Non-binary ☐ other (specify as defined by the person)
☒ He/his/him/himself ☐ She/hers/her/herself
☐ They/their/them/themselves ☐ Xe/xyr/xem/xyrself
☐ Other (specify)
☐ Atheist ☐ Christian ☐ Hindu ☐ Jewish
☐ Muslim ☐ Any other (specify) ☐ Own belief system
☒ Unknown
☐ Heterosexual/straight ☐ Gay/queer ☐ Bi-sexual
☐ Other (specify as defined by the person) ☒ Unknown
English
n/a
n/a
n/a
The Freshford Practice
The Freshwell Health Ctr.
Wethersfield Road
Finchingfield,Braintree
Essex CM7 4BQ
Tel: 01371 810328
NHS MID ESSEX CCG
n/a
n/a
18/09/22 at 14.00
Phil Hill, MHLT
No
No
Adam had been initially arrested in the early hours of 17/09/22 at
the student house he rents. He had been behaving oddly and had
a knife which had frightened his flat mates who had phoned the
police. Police report that he was arrested and taken to custody.
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His flat mates don't want to press charges. Police report he wasn't
under the influence in custody and that the team in custody feel
he is mentally unstable so removed him from custody under s136
MHA.
Police have spoken to his Mother who lives in Essex.
Mother reported to police that he has taken hallucinogenic drugs
recently.

6. Nearest relative

Name of nearest relative Catherine Ivey

Address 14 Willetts Field, Great Sampford, Essex, CB10
2SE
Home phone
Mobile phone 07704 454490
Email
Identification of person appearing to be ☐ Husband/ Wife/ Civil Partner/person
nearest relative (s26 Mental Health Act 1983 living as if Husband/Wife/Civil Partner for > 6
as amended 2007) months
☐ Son or Daughter
☒ Father or Mother
☐ Brother or Sister
☐ Grandparent
☐ Grandchild
☐ Uncle or Aunt
☐ Niece or Nephew
☐ Individual ordinarily living with them for
more than 5 years
☐ Providing substantial and sustained care/
normally living at the same address
☐ No Nearest Relative within s26 MHA
☐ County Court appointment under s29
☐ Person to whom role has been delegated
Information in support of identification of Adam is single with no children. Parents are
Nearest Relative: (explain with reference to S26 divorced and he lives with his Mum who I have
MHA) identified as NR as she is highest on the s26
MHA list.

Date and time of informing/consulting 18/09/22 at 15.00 and 19/09/22 at 10.30

Method of informing/consulting ☒ Phone ☒ Face to face ☐ Text
☐ Email ☐ Other (specify)
Rights leaflet sent to nearest relative ☐ Yes ☐ AMHP to send ☒ No
What are the views of the nearest relative regarding the need for admission or other care for the
person being assessed?
T/c to Adam's Mum, Catherine Ivey, returning her call - She gave me some background - Adam is
a final year student at Brighton Uni studying Digital Media.
No mental health history prior to starting 1st year at Uni during lock down when he didn't make

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many friends and was very isolated. Mum reports that his mood has declined throughout his time
at Uni and she described him as "very depressed" currently. He speaks very negatively about
himself. Some improvement noted over the summer when he was back home living with his Mum
in Essex and using less substances.
Catherine says Adam has fallen behind with his Uni work and there is a risk he may not be able to
finish his degree.
Catherine says Adam smokes cannabis and has used other hallucinogenic substances.
On Mon 12th September he took "Ayahuasca" which he bought on the dark web. His Mum
reports he became very paranoid and went out into the woods at the back of their family home.
His Mum followed him as she was concerned for his safety. Catherine said in the woods Adam said
"you have a knife, you're trying to get me". Catherine reassured him she didn't have a knife and
persuaded him to come back inside. Catherine said she and Adam's Dad are divorced and his Dad
came over and they spoke to Adam together. She remained awake all night fearing he might go
out again. Catherine said with hindsight he should not have returned to Uni on Wed 14th
September.
Adam has moved into a student house with 6 or 7 other students, men and women, who he does
not know. His Mum said that they seem like nice people and they were watching a film together
last night trying to get to know each other when Adam was behaving strangely, he went into the
kitchen, got a knife and sat with it on his lap. One of his housemates called the police and he was
arrested and spent the night in custody.
His Mum suspects that he may have used Ayahuasca or another substance.

Catherine lives a 2 hour drive away and would like to come and see Adam with a view to taking
him back home but only if the right support is in place for him.
I agreed to keep Catherine informed of the plan to assess Adam and the timings.

Is any of the above information or views No

confidential? If YES Please clarify.
If NO contact made with a nearest relative
State reasons for not making contact
(irrespective of proposed outcome)
Consultation with significant other
Set out any information or views from other
family/carers or friends (state who).
SECTION 2
Section 2: Rights given? (to order discharge ☐ Yes ☐ No
(s23), restrictions on discharge (s25), to request
examination by med prac. (s24)
SECTION 3
Section 3: Does the nearest relative object to ☐ Yes ☐ No
an application for s3 admission?
If YES what are the AMHPs’ views on ‘unreasonable objection’ and any action to be taken?

Section 3: Rights given? (to order discharge n/a

(s23), restrictions on discharge (s25), to request
examination by med prac. (s24)
Section 3: If not consulted explain why it was not practicable to consult and any follow up actions
needed by the AMHP.

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Nearest relative request (s13(4))

Was this a nearest relative request (s13(4)? ☐ Yes ☒ No
If YES and the person was not detained, has the
letter of reasons been written by the AMHP?
Summary of reasons (upload letter under MHA tab on CareNotes)

If nearest relative is unhappy with a decision not to detain under the MHA
If the nearest relative was unhappy with the outcome of not detaining, comment on how code
14.101 (informing NR to right to make application) was addressed?

If NO nearest relative/nearest relative not suitable

Is any action required?
State reasons (include views of person
concerned & others as appropriate).
If yes (action is required) select:
Who will take this forward?
Other
Any other comments on nearest relative
☐ Yes ☐ No
☐Further enquiries to identify
☐Delegation of the role of NR (MH (Hospital
Guardianship + Treatment) (England
Regulations 2008. Reg 24)
☐Application to County Court to displace NR
☐Application to County Court to appoint a NR
☐Other (state what)

7. 136 detentions (only answer if s136 was applied by the police)

Was S136 applied by the police?

☒ YES - answer below
☐ NO - move to Part 8.
Was street triage involved prior to the ☐ Yes ☒ No ☐ Not known
s136?
Was the person arrested and in ☒ Yes ☐ No ☐ Not known
custody prior to s136?
Date, time & location of s136 Brighton Police Custody 18/09/22 at approx. 12.15
detention (e.g. specific
town/street/building)
Vehicle used to convey to first PoS? ☐ NHS ambulance ☐ Private ambulance
☒ Police vehicle ☐ Street triage (unmarked)
☐ N/K
First PoS used? ☐ MVH PoS ☐ other SPFT based PoS
☒ A&E ☐ other designated health based
PoS
☐ other (specify) ☐ N/K
If A&E used – reason? ☐ Medical reason ☒ No available PoS ☐ N/K
Any subsequent PoS used ☐ Yes ☒ No ☐ Not known
If YES, list
Date & Time of arrival at first PoS 18/09/22 at 13.00 approx

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(include any hospital)

Was the 24 hours extended? No
If YES, why and by whom?
Time discharged from s136 19/09/22 at 10.30
Any other s136 related comments?

8. 135(1) warrants (only complete if a s135(1) warrant was applied for / used)

Was S135(1) warrant applied for?

☐ YES - answer below
☒ NO - move to Part 9.
S135(1) applied for? (upload information under ☐ on line ☐ at Court ☐ Magistrates
MHA tab) Home
Working hours? ☐ in working hours ☐ out of working
hours
S135(1) granted? ☐ Yes ☐ No
If Not granted stated reasons
Police requested to attend? ☐ Yes ☐ No
Was the warrant Executed?(upload under MHA ☐ Yes ☐ No
tab)
Was the assessment completed in the home ☐ Yes ☐ Commenced but not completed
address? ☐ Not commenced in home address
Was the person Removed to PoS? ☐ Yes ☐ No
If YES, first PoS used ☐ MVH PoS ☐ other SPFT based PoS
☐ A&E ☐ other designated health based PoS
☐ other (specify) ☐ N/K
If A&E used – reason? ☐ Medical reason ☐ No available PoS
Date & Time of arrival at first PoS
Time Discharged from s135(1)

9. 135(2) warrants (only complete if a s135(2) warrant was applied for or used)

Was S135(2) warrant applied for?

☐ YES - answer below
☒ NO - move to Part 10.
S135(2) applied for? (upload information under ☐ on line ☐ at Court ☐ Magistrates
MHA tab) Home
Working hours? ☐ in working hours ☐ out of working
hours
S135(2) granted? ☐ Yes ☐ No
Police requested to attend? ☐ Yes ☐ No
Was the warrant Executed?(upload under MHA ☐ Yes ☐ No
tab)
Was the person Removed to PoS or directly ☐ to PoS ☐ direct to hospital bed
admitted to hospital?
If PoS, first PoS used ☐ MVH PoS ☐ other SPFT based PoS
☐ A&E ☐ other designated health based PoS
☐ other (specify) ☐ N/K
Date & Time of arrival at first PoS

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Date & Time d/c from s135(2)

10. Arrests and other police involvement (only answer if police were involved in addition to
s135/s136)

Were the police involved in any other way?

☒ YES - answer below
☐ NO - move to Part 11.
Was the person Arrested or in Custody ☒ Yes ☐ No
regarding a suspected offence?
Custody record number
Date & Time of arrival in Custody?
Has the person been seen by SLDS or ☐ SLDS ☐ FME ☐ FNP
other health care professional? ☐ other (specify) ☐ N/K
Was the person removed from ☒ before ☐ after ☐ not removed on s136
Custody before or after the MHA
assessment on s136? (complete s136
data above)
Comments?
Police involvement in the community
Did police attend the MHA assessment ☐ Yes
in the community without a warrant?
Comment
Any other Police involvement? (If YES ☐ Yes ☐ No
please state what).

11. Other people consulted

Is the person known to SPFT? ☐ Yes ☒ No

Have you consulted their records? ☒ Yes ☐ No ☐ N/A
Is the person known to another MH Trust or ☐ Yes ☒ No (as far as is known)
other service?
If YES, please give details of the service (name,
contact number)
Have you obtained information from this ☐ Yes ☐ No
service?
If YES, please summarise

If NO, please explain rationale for not consulting

Other workers/sources consulted (name,

summarise their views)

12. The assessment

Social circumstances (accommodation, family, occupation, financial, etc)

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Adam is a final year student at Brighton Uni studying Digital Media. His Mum suspects he has
fallen behind with his studies and may be at risk of not completing his degree.

No mental health history prior to starting 1st year at Uni during lock down when he didn't make
many friends and was very isolated. Mum reports low mood since Adam started Uni.

Adam uses cannabis and more recently a hallucinogenic called Ayahuascahe bought from the
internet.

On 14/09/22 Adam moved into a student house with 6 or 7 other students all unknown to him.
SUMMARY of mental health history (make reference to specific reports consulted that give a history or
recent assessment in more detail if these prove useful rather than fully replicating)
No formal MH history.
His Mum reports no mental health difficulties prior to starting 1st year at Uni during lock down
when Adam didn't make many friends and was very isolated. Mum reports that his mood has
declined throughout his time at Uni and she described him as "very depressed" currently. He
speaks very negatively about himself. Some improvement noted over the summer when he was
back home living with his Mum in Essex and using less substances.
Declared/known disability

General comment on medication for physical or mental health needs

SUMMARY of any care or crisis plan taken into account e.g. Advice on admission or alternatives
to admission

Exact location of the interview (e.g. bedroom, lounge)

In the MHLT interview room in A+E, Royal Sussex County Hospital, Brighton.
People present at the interview
Dr Sabine Munzinger, Dr Jugnu Bothra and Lorna Cornett AMHP
Summarise Events leading to the MHA Assessment
See above
Account of the interview with the person. (to include presentation, behaviour, objective and subjective
perspectives, statements made by the person, any explanation or account of what has been or is going on
for them)
When seen Adam was lying on a mattress on the floor in the interview room, looking tired; he had
only just woken up; he stated that he was feeling cold and was visibly shivering. Adam is a white
British man of average build.
Adam reports that he is a habitual Cannabis user, which helps him to relax most of the time. He
described stress related to his studies, friendships and finances. At times it can also make him feel
paranoid, when he avoids making direct eye contact with people.
Adam admitted to consuming Ayahuasca 3 weeks ago and then 1 week ago. He described the
positive effect of having more confidence; however the downside was that he felt people were
after him. A week ago he ran into the forest at his Mum's address in Great Sampford in Essex; he
was convinced that his Mother was chasing him with a knife, but felt reassured both by her and
his father when they were talking to him. His Father took him back to Uni on Wednesday
14.09.2022. On Friday was another incident with his flat mates when he looked perturbed and sat
down with a knife in his hand, which had made his flatmates feel unsafe. Adam himself cannot
recall in detail what exactly happened, but he was certain that he never had any thoughts of
either harming himself or ending his life. He also never had any thoughts about harming others.
All he was able to recall was that he had been feeling unsafe. This led to his arrest and transfer to

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hospital on Section 136.

Adam has never been seen by mental health services in the past. He has a history of negative
automatic thoughts about himself, the world and his future and has low self-esteem.
Adam was calm and friendly; his answers were coherent, spontaneous and relevant.
He stated that he was not sure that what he had taken was actually Ayahuasca. He was keen to
return with his Mother to Essex and engage with the Crisis Team.
Specifically summarise the views, wishes and feelings of the person being assessed regarding the
outcome of the assessment

SUMMARY of any other of information not covered elsewhere in this report (state source)

13. Risk information summary

Historical risk events See above re incident on 17/09/22 when he was arrested.

Any specific known

forensic /criminal history
(specify)
Current risks to self Low - denies any thoughts of self-harm or thoughts that life is not
worth living.
Current risks to others Low - denies he had any intent to harm his housemates.
Current risks from others Low

14. CRHTT and alternatives/least restrictive options

Were CRHTT requested to attend? No - lives out of area

If YES, did CRHTT attend?
Was the person taken on (or continued to be Referred to CRHTT in North Essex for follow up
supported by) CRHTT? assessment.
If no, why not?
What other options were considered to be put
in place as an alternative to hospital admission?

15. Doctors & discussion

First Doctor name Dr Sabine Munzinger

S12 approved? ☒ s12 approved ☐ previous knowledge
First doctor Med recommendation made? ☐ Yes ☒ No
First Doctor’s views
When seen Adam was lying on a mattress in the interview room, looking tired; he had only just
woken up; he stated that he was feeling cold. He was calm and friendly; his answers were
coherent, spontaneous and relevant. His mood and affect were subdued. There was no evidence
of thought disorder, delusions or hallucination. There was no evidence of reality distortion. His
cognition was grossly intact and his insight was good. He stated that he was not sure that what he
had taken was actually Ayahuasca. He was keen to return with his Mother to Essex and engage

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with the Crisis Team.

There was no need to use the provisions of the Mental Health Act , as Adam was fully concordant
with suggestions for community treatment options and had full capacity to give informed consent.

Risk to Self: Low; no suicidal ideation, plan or intent

Risk to Others: Low; no homicidal ideation, plan or intent
Risk of Self-neglect: Low; no risk indicators
Protective Factors: Supportive family and friends

Contingency Plan:
Discharge from S136
Home to Essex with his Mother
Follow-up by Crisis Team in Essex
Adam to link in with Substance misuse services and explore the options of counselling and a
Reintegration Circle in his local area.
If no med rec, did the doctor write a case note? ☒ Yes ☐ No ☐ N/A

Second Doctor name Dr Jugnu Bothra

S12 approved? ☒ s12 approved ☐ previous knowledge
Second Med recommendation made? ☐ Yes ☒ No
Second Doctor’s views
Adam is 21years old. He is studying at Brighton university.
He was detained under section 136 following concerns about his mental health.
Adam was arrested for possession of an offensive weapon at the university.
He lives with his mum and following conversation with Mum, she reported Adam is struggling at
the university. She informed us he used Cannabis and had used Ayahuasca (psychedelic drug,
hallucinogenic) which he ordered online a week ago. She also informed us he used Cannabis on a
regular basis.
After taking the drug he left his mum's home and went to the forest. Mum was concerned so she
followed him. Adam was paranoid and, he believed his Mum was carrying a knife and was there to
get him.
He settled the following day and was then brought by his dad to Brighton university.
Since being in the hospital He has slept.
During assessment he talked about his experience with the drugs, cannabis and Ayahuasca.
He talked about using cannabis to relax himself and this was his first experience with the other
drug.
He remembered becoming anxious and picking up a knife from the kitchen.
He probably misinterpreted the conversation and the actions of the students when they were all
sitting together, getting to know each other ,having drinks and watching TV. He felt unsafe.

He denied any thoughts of self harm or harm to others.

There was no evidence of any depressive or psychotic features.
Cognitively grossly intact.
He was discharged home to his mother's place, to be supported by the crisis team.
His mother was present and She had come to pick him up.
He was advised to contact services for substance misuse.
He was not detained under MHA.
If no med rec, did the doctor write a case note? ☒ Yes ☐ No ☐

Any further discussion between AMHP and

doctors?

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Did the AMHP and doctors assess together? If Yes

not please identify dates/time and whether
there has been a discussion between all
parties?

16. Mental Capacity

What decision(s) did the person being assessed To accept referral to the CRHTT
need to make? (e.g. did they need to accept the
offer of an admission, or to go home?)
Did you assess their capacity to make this ☒ Yes ☐ No Dr Munzinger assessed
decision(s)?
If you did assess capacity, what was your Adam was fully concordant with suggestions for
conclusion regarding this decision? community treatment options and had full
capacity to give informed consent.
Any other comment?

17. Outcome of the assessment

FOR THOSE ADMITTED TO HOSPITAL

Admission to hospital? Informal? Section? ☐ Informal ☐ s4 ☐ s2 ☐ s3 ☐
DOLS ☐ Other (specify)
Name and location of hospital & ward Continuation of her admission to The Royal
Alex for physical health treatment
Was the person initially ‘admitted’ under s2/3 ☐ MVH PoS ☐ Other SPFT PoS
to somewhere other than the psychiatric ☐ RSCH CDU/Short stay/Other A&E ward
hospital bed that was needed? If YES tick box ☐ RSCH (medical ward)
Date &Time bed was requested
Date & time bed became available
Date & time person arrived at the hospital
If there was a delay in admission what
contingency plans were put in place while
admission was awaited?
Any comments regarding the location or
provision of the bed?
FOR THOSE NOT ADMITTED
If not admitted, what was the plan for follow up or any further action? (Including management of
risk)
Contingency Plan:
Discharge from S136
Home to Essex with his Mother
Follow-up by Crisis Team in Essex - AMHP to refer.
Adam to link in with Substance misuse services and explore the options of counselling and a
Reintegration Circle in his local area.
Mum advised to call 999 if concerned about immediate risk to Adam or others.

Date and time the assessment and 09/09/22 at 10.45

arrangements was concluded (i.e. the time at
which the person was ‘free to go on their way’)

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Did the AMHP provide the person with a ☐ Yes ☒ No

written copy of the outcome plan?
For ALL assessments – weighing & reasoning for the AMHP’s decision
Reasoning for the outcome (here demonstrate your weighing up of the information, history, the risks,
the interview and views of all relevant parties and how you arrived at your conclusion. Guiding Principles
maybe referenced. How has the criteria of the MHA been considered? Note down any differences of views
and how these have been or will be addressed if relevant)
No evidence at assessment of a mental disorder of a nature or degree to meet the statutory
criteria for further detention under the MHA.
Adam was fully concordant with suggestions for community treatment options and had full
capacity to give informed consent.

18. Safeguarding (children and adults) and Carers

Any children in connection with the individual No

assessed – (list names, ages/dob and addresses)
Did/Will you be informing Front Door for N/a
Families of the MHA assessment and its
outcome? Explain your reasons
If YES, have you informed the parents/ those
with parental responsibility/ the person
assessed?
Are there any safe safeguarding adults that No
need to be considered?
If YES state what action you are taking and
recommending?
Are there any Carers that need to be referred No
for an assessment or any immediate action
taken? Explain
Does the person need to be referred to ☐ PREVENT ☐ MARRAT ☐ MARRAC
PREVENT, MARRAT, MARAC or other ☐ Other (specify)
professional body?

19. Protection of Property (answer only if relevant)

Securing home address? Action

taken/needed
Securing personal belongings Action
taken/needed
Securing car Action
taken/needed
Attending to/boarding pets Action
taken/needed
Any other comments?

20. Admission information for nursing staff (answer only if relevant)

Smoker? Comment on information given and ☐ Yes ☐ No

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response of the person

Belongings
What belongings has the person brought in with
them? (e.g. medication)
Who packed their bags?
Any particular items or issues to be noted?
(specify)
Any other arrangements, such as a contact
person for belongings?
Personal needs – if YES please describe and specify aids/equipment needed
Dietary needs/wishes (e.g. chosen diet/religious
needs/allergies)
Visual impairment; e.g. do they wear ☐ Yes ☐ No
glasses/registered blind
Hearing impairment e.g. hearing aids ☐ Yes ☐ No
Any specific communication needs? ☐ Yes ☐ No
Any falls risks? Any recent falls ☐ Yes ☐ No
Skin integrity: e.g. are they at risk of pressure ☐ Yes ☐ No
sores, do they currently use any pressure
relieving equipment? Wound care
requirements?
Mobility issues e.g. walking aids, zimmer frame ☐ Yes ☐ No
or wheelchair? Can these be accommodated
safely on the ward?
Chronic physical health condition: e.g. ☐ Yes ☐ No
Parkinson’s disease/ cardio vascular disease/
impairment from a stroke/ brain injury/
diabetes/ pain and pain management
Support needs around food and nutrition: e.g. ☐ Yes ☐ No
specialist cutlery and crockery, food
supplements, dental issues, any dietician
involvement
Acute / recent physical health concern: e.g. ☐ Yes ☐ No
UTI/ chest infection / injury
Continence: do they have continence issues? ☐ Yes ☐ No
Medication for physical health needs which are ☐ Yes ☐ No
not immediately available from mental health
hospital stock medicines? Is the patient able to
bring this medication with them?

21. Conveyance to hospital (answer only if relevant)

In what vehicle was the person conveyed to ☐ NHS ambulance ☐ Private ambulance
hospital ☐ Hospital/AMHP car ☐ Relative car
☐ Police vehicle ☐ other (specify)
☐ Walked
Any additional escort? ☐ AMHP ☐ SPFT staff
☐ Police ☐ Relative ☐ other (specify)
Any comments on how the conveyance was
experienced/managed

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22. Delays & Issues to be raised (comment where appropriate)

In the view of the AMHP was there a delay in ☐ Yes ☒ No

the assessment / admission beyond that which
was reasonable?
If YES, indicate the causes of delay ☐ AMHP availability ☐ s12 availability
☐ Provision of appropriate bed
☐ Police availability ☐ Transport availability
☐ Other (please state)
Any comments?

For Admissions
Time of the admission following the assessment ☐ < 2 hours
☐ 2-4 hours
☐ > 4 hours
Are there any issues to be raised through the No
AMHP Manager? (please notify by email with
reference to your report)
Was s140 was considered as applicable; ‘bed ☐ Yes ☒ No
required in case of special urgency’?

23. Report writing

Was there any incident that required an No

incident report or complaint to be made?
(details)
Date of interim case note 19/09/22
Date MH1 report uploaded/sent to hospital 19/09/22
Name/signature of assessing AMHP Lorna Cornett
Name of trainee AMHP if writing this report
Address of AMHP AMHP Team, Mill View Hospital, Nevill
Avenue, Hove, East Sussex, BN3 8PQ.
Tel 0300 3040075.

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