‘Beautifully masked’: hidden tragedies at the heart of Mental Health Act assessments in England

Abstract

ABSTRACT This article considers the difficulties faced by social workers and others who have concerns about the reliability of information provided by people they are assessing in England under the Mental Health Act 1983. The article is in two parts, the first part includes descriptions of case studies which highlight difficulties in assessments when assessors need to note what they are told and yet sometimes also fear that the truth of this information might be knowingly or unknowingly masked. The second part of the article argues that a understanding of Shakespeare and other creative writers can enhance and expand empathy and thereby promote more sensitive and aware social work practice. Advantages of allowing as much time as possible for conflicting realities to emerge throughout assessments are advocated along with acknowledgement of the essentially unseeable complexities of attempting to assess people at any one point in time.