Overview of presentation. Advocacy as it was
1. What difference does it make? Mental Health Act (1983) Amendments (2007)
The Independent Mental Health Advocate (IMHA)
2. Overview of presentation
Advocacy as it was – working definition
IMHA – what is it?
IMHA – how is it different?
Other Amendments to the Mental Health Act
How has it worked in Leeds?
How have the amendments affected you and your work?
Did you have all the info and support you needed?
What do you need now?
3. Advocacy a – working definition
Advocacy is taking action to help people say what they want, secure their rights, represent their interests and obtain services they need.
Advocates and advocacy schemes work in partnership with the people they support and take their side.
Advocacy promotes social inclusion, equality and social justice.
4. IMHA – what is it?
1st statutory right to advocacy people subject to the Mental Health Act (2007 amendments)
A legal right for the majority of people detained including those on Community Treatment Orders and Guardianship
IMHA will provide information and support to people concerning their rights, treatment and any conditions they are subject to
Not available to those on short term emergency sections – sect 4, 5, 135, 136
Long process of development – consultations that A4MHD were involved in. Durham Uni commissioned to research and report on MH advocacy for people detained – Di Barnes / Durham Report 2001. included in the rewrite of the MHA that was subsequently scrapped. Then included in the amendments following significant lobbying from the survivor movement. Not available to those on short term emergency sections – sect 4, 5, 135, 136
Long process of development – consultations that A4MHD were involved in. Durham Uni commissioned to research and report on MH advocacy for people detained – Di Barnes / Durham Report 2001. included in the rewrite of the MHA that was subsequently scrapped. Then included in the amendments following significant lobbying from the survivor movement.
5. IMHA - what is it?
DoH discharge duty to local health commissioners (PCTs) to ensure IMHA is available in each locality. No additional ring fenced money though
IMHA providers should be independent of service provision IMHA should work alongside existing advocacy provision
IMHA themselves should be experienced in advocacy and / or trained as IMHA
6. So, how is it different?
Eligible people have a RIGHT to support of an IMHA
NHS funders (PCTs) have a DUTY to ensure a service is available
Advocacy providers have a DUTY to respond to referrals (specifically from patient, AMHPs, RCs and Nearest Relatives)
Detaining Authorities have a DUTY to inform eligible people of the IMHA service and support them to access it
7. So, how is it different?
IMHA have the RIGHT to access medical notes, records and reports (subject to consent)
The RIGHT to meet with eligible people in private
The RIGHT to interview anyone concerned with the person’s care and treatment (subject to consent)
8. But what remains the same?
Independence – of service providers, both organisationally and psychologically
Service user led service
On person’s side
Not making decisions on behalf of someone
Not deciding what is in someone's best interest
Not part of the MDT
9. How has it worked in Leeds?
NHS Leeds commissioned Advocacy for Mental Health and Dementia to provide the IMHA service
A4MHD extended their services to include Older People eligible for IMHA (The Mount) and the Rehab and Recovery Services
Information leaflets and posters, and presentations provided to various services and teams
Demand has meant a waiting list has been instigated for hospital advocacy services
10. Other amendments to MHA
Community Treatment Order / Supervised Community Treatment
Approved Mental Health Practitioners (AMHPs) replace ASWs
Responsible Clinicians (RCs) replaced Responsible Medical Officer (RMO)
Introduction of Approved Clinicians
Nearest Relative – can now be displaced by the patient
11. Other amendments to MHA Detained patients with capacity now have the right to refuse ECT (unless it is life saving emergency treatment).
New definition of Mental Disorder “any disorder or disability of the mind”
replaces the 4 definitions of mental illness, mental impairment, severe mental impairment and psychopathic disorder
Appropriate Treatment – must be available