Independent mental health advocacy

rdf:langString Independent mental health advocacy

rdf:langString Advocacy as a concept was understood in varying ways by different groups of service users. African and African Caribbean men in Study 1 conceived of advocates as “defenders of rights”. Drawing attention to the politics of race and mental health, they outlined a model of advocacy that was collective and political in nature. In contrast to a more individualised notion focussed on a relationship between an advocate and an individual – referred to as a “partner” – African and African Caribbean men emphasised self-advocacy as the key goal, linking this to cultural identity in which self-reliance and the need to “stand on your own two feet” were core values.

rdf:langString Representational advocacy has been defined as advocacy which: ensures that people are supported to speak for themselves and have someone ‘on their side’ who can represent their views, wishes and concerns. Advocates take their instruction from the [Patient] and ensure that they do not take action without the [Patient’s] express permission. Representational advocacy promotes what the [Patient] wants for his or herself not what other people think they should have or not have.15

rdf:langString In general terms, advocacy seeks to address unequal power relations between those using health and social care services and professionals, ensuring personal perspectives and interests are represented and heard, especially in situations where individuals can feel disempowered.

rdf:langString And, secondly, the Mental Health Act 1983 was revised , which led to a statutory IMHA service and created a duty ‘to provide advocacy services for all detained patients..., guardianship patients and patients subject to community treatment orders.’

rdf:langString While all of the mental health professionals interviewed supported some version of individual advocacy in principle, many conceptualised this from a ‘best interests’ perspective. Many did not appreciate the nature of the rights-based representational model used by the IMHA service and most were not aware of supported decision making ap- proaches.

rdf:langString Qualifying patients in study 2 understood an IMHA as being there to support them to better understand their individual rights under the MH Act, and to ensure these rights were upheld

rdf:langString rguably, the introduction of statutory IMHA ser- vices in England and Wales could be seen as a conces- sion to campaigning on Mental Health Act reforms by the Mental Health Alliance , smoothing introduction of CTOs .

rdf:langString The majority of young people in Study 3, some of whom had little or no prior experience of advocacy, expected an advocate to be someone who would speak on their behalf, an adult that they “could talk to that isn’t a member of staff”, in other words, that they were independent of mental health service

rdf:langString Having impact on process aligns closely with testimonial justice , while change outcomes align with hermeneutic justice . Both are clearly needed, and importantly, are valued by service users.

rdf:langString Independent mental health advocacy, IMHA, is advocacy for someone being treated, possibly involuntarily, for a mental disorder provided by someone not involved in the treatment. IMHA can help a service user understand and exercise their rights and ensure their views and preferences are expressed. Advocacy seeks to address unequal power relations between mental health professionals and those using their services. Those who provide such advocacy are called Independent mental health advocates, IMHA. IMHA complement the best interest advocacy where others make decisions based on what they think is in a service user, such as a psychiatric inpatient, best interest with representational advocacy which provides support for the patients autonomy, their ability to have a role in decisions made about them. IMHA can help support , allowing a service users voice to be heard; and , having one's understanding taken in account in decision making. In some regions, psychiatric services are required to provide access to IMHA to all detained patients or those who are subject to community treatment orders.