Mental Health Act 1983 and Statutory Independent Mental Health Advocacy (IMHA)
Independent Mental Health Advocacy (IMHA) was introduced following changes to the Mental Health Act in 2007. A legal duty was placed on local authorities to provide IMHA provision from April 2009, in all areas for all ‘qualifying patients’.
An IMHA is an independent advocate who is specially trained to work within the framework of the Mental Health Act 1983 to support people to understand their rights under the Act and participate in decisions about their care and treatment. The IMHA does not replace existing advocacy, legal advice or support, but works alongside them.
Qualifying patients should be informed that they are eligible for the services provided by an IMHA as soon as is practicable. An IMHA will meet with a patient following the request of the patient, the nearest relative, the responsible clinician or an AMHP.
There is a duty on hospital managers, responsible clinicians and social services (in the case of Guardianship orders) to:
- Inform patients about the advocacy service.
- Take all practicable steps to ensure patients understand what is available to them and how they can access help.
- There is also a duty for information to be given to the nearest relative of detained patients, unless patient requests otherwise.
An IMHA has a right to see any hospital or local authority records relating to their patient if their patient consents. If a patient lacks the capacity to consent, the record holder can still allow access to such records if it is appropriate and relevant to the help the IMHA will provide to the patient.
IMHAs also have a right to meet patients in private and to visit and interview anyone professionally concerned with the patient's medical treatment.
The Act also states that hospital managers cannot withhold correspondence between patients and their advocates.
Under the Mental Health Act 1983 a ‘qualifying patient’ is someone who is eligible for, and has a legal right to, an IMHA. In England this includes people who are:
- detained under the Mental Health Act 1983, except where they:
- have been detained in an emergency under section 4
- are detained under section 5 holding powers
- have been taken to a place of safety under section 135 or 136 of the Mental Health Act
- “liable to be detained” – this includes when:
- they are on leave of absence from hospital
- they are absent without leave from hospital
- where a court order or application for admission has been made in relation to them
- subject to a community treatment order (CTO)
- subject to guardianship
- a conditionally discharged restricted patient
- a voluntary/informal patient and certain treatments, including electroconvulsive therapy (ECT) and neurosurgery, are being considered.