Power as Perceived in MHA Assessment Contexts: A Scoping Review of the Literature

The Mental Health Act (MHA) 1983, is the primary legislation by which people can be assessed, detained and treated on the grounds of mental disorder in England and Wales. This paper is a scoping review of the existing qualitative literature relating to the most common participants within MHA assessments, including the person assessed, friends and relatives, Approved Mental Health Professionals (AMHPs) and doctors. It does so with a view to reflecting on how power relationships within these assessments have been understood, drawing on a wide range of studies, given that little existing research has explicitly focussed on power. It argues that MHA assessments and their wider contexts are often deeply unequal and experienced as such, at odds with a broader policy rhetoric of collaboration and recovery. Looking across research it concludes that the main preoccupations of the different groups of people at MHA assessments are often significantly different. The article considers the implications of these different perspectives in relation to the contemporary context of MHA assessments.