Appreciative Angst
By Matt Simpson
After 13-years as an ASW/AMHP I made the leap into AMHP education. The AMHP role has its challenges and rewards, and my new goal was to consider how I might contribute to the development of upcoming AMHPs in a way that aligned with my values but accepted some of the harsher realities of practice. As AMHPs, we all strive to achieve certain ideals, with the reality being that these ideals are often just over the horizon. The challenge is to maintain a commitment to practice in a way that remains coherent with our values, and I think we are largely successful in this venture.
I’m keen to remain authentic as an educator, and as such continue to practise as an AMHP once a week, but with this comes the challenge of practising what I preach. The authenticity I may gain from continuation in practice is supported by my honesty about the experience of being an AMHP, and a recognition of my fallibility: decisiveness does not preclude criticality. This can feel exposing, and I have seen the dual impact of this being both worrying and reassuring for the trainees: AMHPs portray a sense of confidence in their practice, but maybe this isn’t the whole story.
Like many AMHPs I’ve met, I have always struggled to recognise my strengths. Being an AMHP on duty less frequently limits both my sense of success and failure, though my self-critical stance focusses on the latter reflexively. Many AMHPs practise with this kind of frequency, and my experience over the last year has given me insight into the struggles faced by those AMHPs. Working as an AMHP every day might be stressful but doing so once a week (or less) makes me feel like an imposter. I’ve begun to accept and explore this feeling with curiosity, knowing I’m far from alone.
Becoming an educator has helped me to recognise how much knowledge, skill, and expertise we hold as AMHPs. The role seems infinitely complex, and so contributing to the learning of trainee AMHPs feels like quite a challenge at the start of a new course. Bringing examples of my practice into teaching appears to have been well received by the trainees, and interestingly it has proven very cathartic for me too: like a good debrief after a complex assessment, discussing my assessments with the trainees has helped me to recognise the positives in my practice as well as accept my limited control over outcomes I have perceived as negative. I have been inspired by the contributions and reflections from the trainees, who have shown aspirational qualities that have highlighted to me how exceptional the AMHP workforce is. Despite the challenges faced by AMHPs every day, there are innumerate examples of a tireless drive for practice rooted in promoting the rights of those referred to the service. The result of my exposure to this optimism has liberated me to connect with my practice ideals and passion for the AMHP role despite, or perhaps because of the challenges inherent to it. I am now more able to celebrate my efforts irrespective of outcome, and to see it all in the context of a professional role at the forefront of an ever-evolving mental health system.
Research was always something I had little time for, usually because it either seemed disconnected from practice or critical of practice in some way. Bridging my transition from AMHP to educator has been my PhD, researching AMHP decision-making at the point of referral for an MHA assessment. My interest in this topic is shared by many AMHPs, and my colleague and good friend John Mitchell has written a piece for this blog about it. As a counter to negativity, this research was conducted appreciatively and collaboratively with my AMHP colleagues, generating positivity and optimism about future practice development. My experience of this research, as both a participant and a researcher, is that a focus on the positive helps in a way that trying to solve problems never will: AMHP practice is hard enough, so celebrating its complexity and our ability to navigate that is both liberating and meaningful. We make some important decisions in this role, and those decisions have a profound effect on people’s lives. We are bound to question our decisions afterwards, and there will always be someone who can be critical of our practice. We advocate a focus on strengths for those in contact with our service, and the benefits of viewing our own practice in this light are transformative. We all know the problems we face, so rather than dwell on them let’s think positively about how our strengths will overcome them.
In my research, education, and practice I have been reminded that however autonomous we consider ourselves, we benefit from talking to our colleagues for advice and validation. These discussions create a reality of practice and provide us with much needed support through complexity. This blog represents another piece of this puzzle, creating the space for us all to share our views and reflect on our practice. There are some truly amazing people among the AMHP community carrying out exceptional things in their own areas. Sharing these experiences will make us all the richer, amplifying our contribution within mental health services. Together, and with appreciation, we will make a difference.