‘Role Over’ or Roll Over? Dirty Work, Shift and Mental Health Act Assessments

The rise in numbers of applications for people being formally detained in hospital is one of the reasons given for the independent review of the Mental Health Act in England and Wales. These figures have led to concerns that the legislation might be flawed, including in relation to the process of Mental Health Act Assessments. Discussed in this article are two of the roles involved: the doctor who is responsible for conducting a medical assessment and the Approved Mental Health Professional (AMHP) who is responsible for assessing the social circumstances and in addition making the application. Using data from a study into AMHPs and the lens of the sociological theory ‘dirty work’, we discuss shift, an aspect of dirty work not yet applied in this context. We focus on AMHPs’ perceptions of the behaviour of doctors as encapsulated in the verbatim phrase ‘role over’. We argue that AMHPs, including social workers, justify or, to play on the words of the verbatim quote, roll over. This finding adds to the understanding of behaviour as it is understood within psychiatric occupations, including social work, during Mental Health Act Assessments.

“A People that Dwells Alone”?

No Hebrew reader, at least no reader with some Hebraic literacy, would be able to ignore the strong national resonance of the biblical phrases that Amalia Kahana-Carmon—one of Israel's foremost writers, the recipient of the 2000 Israel Prize—inserted into the masterful opening of the title novella of her 1984 triptych, Up on Montifer. Indeed, the evocative power of these intertexts is inescapable. “עAm levadad yishkon,” a verbatim quote from Balaam's prophecy (Numbers 23:9), is one of the sources for the construction of the Israelite and Jewish national identity, connoting uniqueness, exclusivity, and chosenness. The slightly veiled phrases “עover(et) lifnei hamaḥaneh” and “hanshei ḥalutz kovshim” add allusions to the foundational myth of the conquest of Canaan. In fact, they invoke the story of the tribes Gad and Reuben (Numbers 32), whose role as vanguard, crossing the Jordan before the rest of the Israelites (actually, “before the Lord,” as the biblical text insists), no doubt stands behind the modern Zionist use of the biblical term ḥalutz (vanguard) as “pioneer.”