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

Vicary, Sarah; Young, Alys and Hicks, Stephen (2019). ‘Role Over’ or Roll Over? Dirty Work, Shift and Mental Health Act Assessments. The British Journal of Social Work, 49(8) pp. 2187–2206.

DOI: https://doi.org/10.1093/bjsw/bcz014


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.

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