Decision Making by Practitioners in the Social Professions Involved in Compulsory Admission to Mental Health Hospital: A Scoping Review

This scoping review examined the literature on decision making by practitioners in the social professions involved in compulsory admission to mental health hospital in the UK. This aimed to find out(i) what processes shape social profession decision making about compulsory admission to mental health hospitals in practice? and (ii) what methods have informed studies in this area, and how have these shaped the current state of knowledge? Three main themes emerged are: professional positioning; characteristics of the person assessed; and organisational factors. The literature has approached answering this question by focusing on social professional jurisdictional perspectives, emphasising concern whether a social perspective is privileged in decision making. Lack of realistic options to avoid in-patient care underpins decisions to detain. The process involves a logistical challenge for the social profession. The social milieu of those assessed is associated with social vulnerability and social deprivation, highlighting the relevance for social work. Concerns about risk and a citizen's lack of mental capacity to make decisions about care are associated with decisions to detain. Implications for social work include a need for research that explores the institutional and social context of decision making. Finally, implementing supported decision making in social work practice is proposed as an imperative for future research. This study reviews research on decision making by social professions, who hold a pivotal role implementing mental health law in the UK. The social professional occupies the role of an Approved Mental Health Professional (England and Wales), Approved Social Worker (Northern Ireland) and Mental Health Officer (Scotland). They bring a social perspective and consideration of less restrictive alternatives to bear on the decision whether a person should be compulsorily admitted to a mental health hospital for assessment or treatment (; ; ). The study reveals the processes shaping social profession decision making, exploring methods used and finally analyses gaps in the current state of knowledge. The study found several influences on the processes shaping social profession decision making. These are grouped into three themes, underpinned by a systems framework; 'professional positioning', 'characteristics of those assessed' and 'organisational factors' are discussed. Implications for social work research and practice are highlighted, including a need for collaboration with those who use services and carers. The study highlights a need to broaden the focus of decision making to include contextual factors leading to assessment under compulsory mental health law and to focus research on implementing supported decision making.