Mental Health Act - What is the purpose of Guardianship?
The purpose of Guardianship is to provide a legal framework to support vulnerable services user in the community where you may not be able to achieve positive outcomes for them without the use of such authority.
What is the criterion for Guardianship?
Guardianship can be used for service users who are 16 years of age or over who have a mental disorder or nature of a degree which warrants their reception into their Guardianship. And that it is in the interests of the service user’s welfare or the protection of the others that they should be received into Guardianship. Guardianship can also be used for those with a learning disability who do not also have mental disorder. However, there needs to be evidence of abnormally aggressive or seriously irresponsible conduct.
What are the powers of Guardianship?
Guardianship has 3 powers. These are Residence, Attendance and Access. Unlike other sections of the Mental Health Act, Guardianship is a local authority power. The local authority has the power under Guardianship to ensure the person resides in a place that will meet their needs, to give access to certain professional such as doctors, AMHP or other people name in their care plan in order to check on their welfare. It can also require people to attend places such as for education, employment or for treatment. However, treatment cannot be enforced.
What is the process of Guardianship?
The process of Guardianship is via application. They can be made via an Approved Mental Health Professional (which is in the majority of cases) or via a court. Via the Approved Mental Health Professional it is accompanied by two medical recommendations like any other applications in the Mental Health Act. A big part of the application process is a case conference which must involve all relevant professionals, the service user, relative / carers and other important people to the service user so that a really detailed conversation about whether the grounds are met, how the persons needs are going to be met and whether the Guardianship is in fact the right piece of legislation to used. It is really important that the Approved Mental Health Professional is present at the case conference so they can provide guidance round the next steps.
Who accepts the application for Guardianship?
The application for Guardianship must be accepted by the Local Authority before the person is officially under Guardianship.
How long does Guardianship last and can it be renewed?
Guardianship must be renewed like other sections in the Mental Health Act. It is very much like a section 3 in terms of time scale. There is the initial 6 months, a further 6 months and further 12 months if it is renewed. The renewal must happen within the last 2 months of the Guardianship period and is led by Responsible Clinician. This is best done at a multi-disciplinary review and the care plan must be reviewed by the Care Co-ordinator.
Can Guardianship be discharged?
Guardianship can be discharged and at every renewal point the professionals must consider whether Guardianship can be discharged. The discharge must be accepted by the Local Authority and the Responsible Clinician can recommend the discharge, the Local Authority itself could recommend discharge or the Tribunal could recommend discharge.
What are a person’s rights under Guardianships?
It is really important that servicer user has access to their rights whilst they are subject to Guardianship. They have right to ask for a Tribunal and also a right to an Independent Mental Health Advocate, but whereas in hospital there is a Mental Health Act administrator process this is not the case in the Local Authority. The responsibility to trigger an appeal is with the Care Co-ordinator or Social Worker responsible for the case. They are the link person between the service user and the Tribunal office.
How does Guardianship work in practice?
A good example of Guardianship in practice is where we had a service user living in a long stay secure environment and they wanted to move back into living in their own home. The service user had a lot of understandable anxieties about moving and what would happen if they became unwell again. The team who knew him well felt he could be supported in the community and early warning signs could be acted upon quickly. They did not feel he would need a hospital environment at an early stage, but would benefit from the support available in a care home. Guardianship in this case was used to enable the service user to reside permanently at his home address, but at times provide for a “share care arrangement” between his home and a residential setting at times when things became difficult. The arrangement has avoided the need for the person to be re-admitted to hospital and a much more positive life style.