The Decision by Approved Mental Health Professionals to Use Compulsory Powers under the Mental Health Act 1983: A Foucauldian Discourse Analysis

Abstract

This study uses a Foucauldian discourse analysis approach to explore the use of compulsory powers under the Mental Health Act 1983 as amended in 2007 (MHA) amongst a group of Approved Mental Health Professionals (AMHPs). Semi-structured interviews were conducted with ten AMHPs currently practising in one local authority in the south of England and then analysed. Findings indicate significant variation within and across AMHPs' accounts. A range of discursive shifts commonly occur in relation to the use of compulsory powers, however, including the move from social worker to AMHP and a service user's first detention. Categories of mental disorder and risk were explicitly problematised by participants but normative discourses relating to mental illness and its treatment in hospital were then reproduced within the accounts. Together with the apparent importance of factors such as ethnicity and gender, this complicates the recurrent evocation of universal human values by AMHPs within the interviews. The implications of these findings for policy and practice, when contradiction and uncertainty are integral to the work undertaken by AMHPs, are then discussed. Lastly, it is suggested that developing the use of Foucauldian understandings of power and explorations of discourse within AMHP practice and research may provide a means of further considering the application of the MHA.