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Independent Mental Health Advocacy (IMHA)
Mental Health Matters Wales
provides the Independent Mental Health Advocacy service for Caerphilly,
Blaenau Gwent, Torfaen, Newport,
& Monmouthshire.
For IMHA service providers in other areas of Wales
please click HERE
Statutory
Independent Mental Health Advocacy was introduced on the 3rd
November 2008 in Wales (1st April 2009 in England)
for qualifying patients. These arrangements are introduced by way of
amendment to the Mental Health Act 1983 by section 30 of the Mental Health
Act 2007. Under these arrangements, Independent Mental Health Advocates
(IMHAs) provide qualifying patients with support and help.
Independent mental health advocates provide an
important safeguard for certain patients treated under the compulsory
powers of the Act. The following provides guidance about the role and
functions of IMHAs.
The Mental Health (Wales) Measure 2010 (Part
4) will on the 3rd
January 2012 expand the existing
IMHA scheme to include compulsory patients under sections 4 and 5 Mental
Health Act 1983
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Patients who qualify for advocacy
support from the 3rd January 2012 are:
·
All patients detained under the Mental Health Act 1983 (The Act)
·
Patients discharged to guardianship
·
Patients on a Community Treatment Order
·
Patients conditionally discharged
·
Informal patients who discuss with a registered medical
practitioner or approved clinician the possibility of being given a form of
treatment to which section 57 treatment applies
·
Informal patients under the age of 18 who discuss with a registered
medical practitioner or approved clinician the possibility of being given a
form of treatment to which section
58A applies.
Please Note: Patients subject to detention under Sections 135 or 136 are
excluded from IMHA advocacy support
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How does a qualifying patient find out about an IMHA service?
Section 130D of the
ACT places
a duty on a “responsible person” to provide verbal and written information
about IMHA services to qualifying patients. This may be a hospital manager,
responsible clinician, local social services authority, the
patient’s doctor or approved clinician.
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Responsibility for informing
patients of IMHA service
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Qualifying patient
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Person
responsible for informing the
qualifying patient
(the “responsible person”)
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Patient liable to be detained
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The hospital managers
(delegated to nursing staff)
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A patient who is liable to be
detained but has been conditionally discharged
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The responsible clinician
(for the patient)
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Patient subject to
guardianship
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The responsible local social
services authority (LSSA)
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A community patient
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The hospital managers (for the responsible
hospital)
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A patient for whom treatment under
section 57 is proposed, if they do not already fall under one of the
categories above
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The registered medical
practitioner or approved clinician with whom the patient first discusses
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A patient under 18 years for whom
the possibility of such treatment under section 58A is proposed, if they
do not fall under one of the categories above
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The registered medical
practitioner or approved clinician with whom the patient first discusses
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The Code of Practice explains the
responsible person duties:
• They must ensure
that they tell the patient, both orally and in writing, that support is
available to them from an IMHA, and how they can obtain that support.
• That if a patient
has a nearest relative, the responsible person should, unless the patient
requests otherwise, provide a copy of the same information, in writing, to
the nearest relative.
• As well as
telling people about the availability of independent mental health advocacy,
the responsible person must also ensure that the patient has the
opportunity of making use of IMHA support.
• If the patient
would like an IMHA, the responsible person should support them in making
contact for example, make
arrangements for the patient to meet the IMHA if the patient would
otherwise be unable to do this, but they should not at this stage disclose
any personal information about the patient to the IMHA service.
• They should
record in the patient’s medical records the steps taken to tell that
patient about IMHA support. Other people who support the patient should
also be informed about whether the patient would like support from an IMHA,
and any follow-up action required, if the patient has agreed to such
information being shared.
If a patient has been fully informed about IMHA support, and
chooses not to involve an advocate in their case, the responsible person
should:
· record in the
patient’s medical records that the patient was informed about independent
mental health advocacy and did not want it
· check with the
patient again at a later date in case they have changed their mind
· tell the patient that
legal representation is available and how to access it.
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Patients’ rights to an IMHA
A qualifying patient may ask for the support of
an IMHA at any time. Certain professionals have a duty to tell qualifying
patients that independent mental health advocacy is available and how they
may obtain it. Patients may want to consider accessing an IMHA in the
following circumstances:
· soon after arrival
in an inpatient unit to obtain reassurance and understanding of their
situation within the hospital environment and mental health system;
• when they know
that their care and treatment is going to be discussed in a meeting or ward
round and they want help in preparing for the meeting, or support or
representation at the meeting itself
• when they are
concerned about particular aspects of their care or treatment and wish to
meet with their doctor/responsible clinician
• when they are going to be examined by a second opinion
appointed doctor (SOAD)
• When they want to
express concern about any aspect of their hospital experience or access the
complaints process
• when applying for or attending a hospital manager’s hearing
• when applying to
the Tribunal for a hearing, obtaining legal representation, needing support
at a hearing or help in understanding the decisions made by a Tribunal
• when they have questions about their rights in relation to
their nearest relative
• why they need
help to understand, apply to and obtain legal representation for County
Court hearings about changing their nearest relative
• when they are being considered for supervised community
treatment (SCT)
• when they are
talking to their guardian about requirements the guardian is imposing on
them (e.g. about where they should live)
• when they want support to access medical or social services
records
• prior to a discharge
planning meeting to explore all their options and raise concerns about
appropriate after-care
• when they want
support in accessing other services
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who can refer to the IMHA
service
The Mental Health (Wales)
Measures states that IMHAs must comply with any
reasonable request to visit and interview a Welsh qualifying compulsory
patient, if the request is made by:
• the patient themselves
• someone the IMHA thinks is the patient’s nearest relative
• the patient’s responsible clinician (if they have one)
• an approved mental health professional (AMHP)
• a registered
social worker who is professionally concerned with the patient’s care,
treatment or assessment
• the managers of
the hospital (or a person Duly authorised by them where the patient is
liable to be detained (if this is the grounds for the person being eligible
for independent mental health advocacy)
• the patient’s donee or deputy (if
they have one)
In respect of Welsh qualifying
informal patients, the duty on IMHAs to visit and
interview the patient is the same, but only engaged if the request is made
by:
• the patient themselves;
• the managers of
the hospital (or person duly authorised by them) where the patient is an
in-patient;
• someone the IMHA thinks is the patient’s carer
• the patient’s
done or deputy (if they have one)
• a registered
social worker who is professionally concerned with the patient’s care,
treatment or assessment.
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The role of the independent mental health advocate (IMHA)
The IMHA provides
support to qualifying patients to ensure they understand the Act and their
own rights and safeguards. This may include support in obtaining
information about any of the following:
- the patient’s rights under
the Act
- the provisions of the Act
under which the patient qualifies for an IMHA
- any conditions or
restrictions which affect the patient
- the medical treatment the patient
is receiving, or which is being proposed or discussed, and the reasons
for this
- the legal authority for
providing such treatment
- the requirements of the Act
which apply to treatment.
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What will the IMHA do?
The IMHA will:
- ensure that the patient’s voice
is heard by supporting the patient to articulate their views and to
engage with the multi-disciplinary team
- support patients to access information,
and to understand better what is happening and what is planned, and to
understand better the options available to them
- support patients
in exploring options, making better-informed decisions and in engaging
with the development of their care plans
- supporting the
patient to ensure they are valued for who they are
- support the patient to
counteract any actual or potential discrimination.
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Supporting the role and work of the IMHA
Patients should
have access to a telephone to speak to an IMHA in private.
The
IMHA has the right to:
- visit and interview the patient in private
- visit, interview and get the views of anyone
professionally concerned with the patient’s medical treatment.
IMHAs should be enabled, as appropriate, to:
- have access to the unit and ward where the patient
under detention is staying
- have access to facilities
in the community where the patient is a community patient
- attend relevant meetings and ward rounds when
asked to do so by the patient.
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Access to records
Subject to
conditions, the IMHA has a right to access and inspect the patient’s
relevant records, including any records:
- about the patient’s detention or treatment in any
hospital or registered establishment
- about any after-care services provided to the
patient under section 117
- of
or held by an LSSA about the patient
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Confidentiality
IMHAs are expected to follow an agreed
confidentiality policy. Under this, any information a patient share with an
IMHA should remain confidential unless the patient want it to be disclosed,
or the IMHA has reasons to disclose it.
In most circumstances the IMHA will tell the patient all the
information they have received on their behalf.
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Further
Information
The IMHA service is not a substitute for independent advocacy
as practised in the Health and Social Care sectors. IMHAs
specifically provide specialist advocacy within the framework of Mental
Health Legislation. Please read Myth buster for additional information.
For additional information please see Chapter 25 of the
Mental Health Act 1983 Codes of Practice for Wales
Viewed or downloaded HERE
(please note the file is 6.51mb in
size so may take some time to view or download on a slow connection)
For additional information on the Mental
Health (Wales) Measure 2010 (Part 4) please click HERE
For IMHA service providers in other areas of Wales
please click HERE
For additional information (England) please see Chapter 20
of the Mental Health Act 1983 Codes of Practice Viewed or downloaded HERE
(please note the file is 1.33mb in size
so may take some time to view or download on a slow connection)
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