Independent Mental Health Advocacy (IMHA)

The experience of an inpatient admission, whether voluntary or under a section of the Mental Health Act (MHA), can be confusing and disempowering. Exercising your right to be informed and involved in your own care and treatment is difficult when you are distressed or when your views may be discounted as part of your ‘illness’. In hospital, an advocate will help you get information about your legal rights under the Mental Health Act, including your care and treatment, medication or discharge plans. They can also explain your rights as an informal patient. An advocate is independent and can help you to express your views in a constructive way. They do not work for the hospital and will keep your information and discussions confidential. Advocates can be helpful in preparing for Mental Health Review Tribunals and other meetings, and can often attend meetings with you. If you want support on day-to-day issues in hospital, such as getting food that is appropriate to your religious or cultural background, or making sure your belongings are safe, an advocate will support you in making your concerns known to the staff. An advocate can assist you in finding out about the services that might be available when you leave hospital. Where you are unhappy with the service you are receiving, an advocate can support you through the complaints process. If you are in hospital under a section of the Mental Health Act (MHA), you may be entitled to help from an Independent Mental Health Advocate (IMHA).

Advocacy under the Mental Health Act 1983 (MHA)

Certain people – called ‘qualifying patients’ – are entitled to help and support from Independent Mental Health Advocates (IMHAs). This includes people who have been detained under the MHA for longer than 72 hours, such as those under sections 2 and 3, and people living in the community under Mental Health Act guardianship, conditional discharge and supervised community treatment (CTOs). Others who are not ‘qualifying patients’ but who are receiving treatment in hospital for mental health problems may also be entitled to IMHA support if they are considering certain treatments under the MHA, such as neurosurgery and electro convulsive therapy. Our community advocates can also help people who do not qualify for IMHA support under mental health act. Information on IMHAs and how to contact them should be given to a person if they are admitted to hospital or accepted into guardianship. IMHAs can also be contacted by family members, nearest relatives, and certain mental health professionals involved in the person’s care and treatment. Note: a person is not obliged to accept help from IMHAs if they don’t want to. The role of an IMHA is to provide information or help obtain advice on any rights that a person or others, such as their nearest relative, may have under the MHA, on any MHA powers being used by professionals which affect them, and any medical treatment offered to them, or being considered, in connection with their care under the MHA. It may be possible for IMHAs to assist with complaints about a person’s care and treatment under the MHA or to resolve problems with the services received under the MHA while in hospital or in the community. An IMHA cannot apply to a mental health tribunal on a person’s behalf, but can obtain information needed for a tribunal or assist in other ways, such as providing contact details for mental health solicitors and attending the tribunal hearing with you. IMHAs are entitled to interview professionals and inspect medical records in connection with their role in assisting a person, as long as that person agrees. When a person is discharged from a section or supervised community treatment and they are no longer receiving care and services under the MHA, their entitlement to IMHA assistance will end, but advocacy support is available for Salford based clients from our community mental health advocates.

Where we provide hospital advocacy

We provide mental health advocacy at Meadowbrook and Woodlands hospitals in Salford, and in specialist wards in Prestwich Hospital and attached services. Our advocates regularly visit wards on the hospitals and will introduce themselves to patients.

IMHA Referral Form

Download the Independent Mental Health Advocacy Referral Form.

Independent Care Act Advocacy (ICAA)

You have a right to be actively involved in:

• Identifying your care needs and
• Planning and reviewing your care & support

An advocate can help if you:

• Find it difficult to be involved and
• Have no-one appropriate to support you

The Care Act creates a new legal framework for care and support, focussed on welfare and involving the individual, and enshrining advocacy in law.

What does a Care Act Advocate do?

An advocate will obtain information relevant to you and your situation, including

• Asking you your views, wishes and beliefs
• Reviewing relevant health and care records, with your permission
• Consulting anyone else who may be involved in your care, such as carers, friends and family, also with your permission

We will represent your views, your wishes and your beliefs, not those of others who may be involved, and we will help you communicate these. We will support your involvement and participation, and help you understand your rights and how your needs can be met under the Care Act. We can help you weigh up the different care and support options to come to an informed decision. We offer one to one support in private, and our service is free, confidential and independent. The Care Act says we must challenge the local authority where we have concerns with the decision-making process.

Care Act Referrals

Any professional involved in an eligible persons's care or assessment may refer a person to us for Independent Care Act Advocacy using the referral form on the left.

Care Act Presentation for Professionals

We are briefing all social service teams, CMHTs, the safeguarding board and other organisations involved in care to ensure people get their right to advocacy. View Care Act Presentation

Independent NHS Complaints Advocacy

The National Health Service (NHS) provides care and treatment in a range of settings and services. Many people who use an NHS service are happy with their care and treatment however, there may be times where this is not the case. If you're not happy with the care or treatment you've received for example from a hospital, doctor or local surgery or you've been refused treatment for a condition, you have the right to complain, have your complaint investigated, and be given a full and prompt reply. The NHS Constitution explains your rights when it comes to making a complaint. You have the right to:

• Have your complaint dealt with efficiently, and properly investigated,
• Know the outcome of any investigation into your complaint,
• Take your complaint to the independent Parliamentary and Health Service Ombudsman (PHSO) if you're not satisfied with the way the NHS has dealt with your complaint.

It’s important if you’re not happy with any aspect of your care and treatment that you raise your concerns or make a complaint. This will enable services to learn from your experiences.

NHS Complaints Advocacy leaflet

Download the NHS Complaints Advocacy leaflet

How Can We Help?

Mind in Salford provides free, independent and confidential NHS Complaints Advocacy that can support you to raise your concerns or make a complaint. As our service is independent of the NHS you can speak in confidence to an advocate. Information on the complaints process is on our website www.mindinsalford.org.uk. An advocate can help you in the following ways:

• Provide information on the complaints process
• Help you think about what you would like to achieve which may be an apology, explanation or information on how your experience can improve NHS services.
• Help you to write a complaint letter
• Support you at local resolution meetings
• Speak to third parties with your consent
• Giving you the opportunity to speak confidentially to someone who is Independent of the NHS

Advocates work under instruction which means we listen to what you want.

When should I complain?

You should complain as soon as possible. Complaints should normally be made within 12 months of the date of the event that you're complaining about, or as soon as the matter first came to your attention. The time limit can sometimes be extended (so long as it's still possible to investigate the complaint). An extension might be possible, such as in situations where it would have been difficult for you to complain earlier for e.g. you were too ill.

Where Do I Start?

Before starting the complaints process it is important to be clear about what aspect of the service you have received you are unhappy with. This may include:

• Care and treatment
• Attitude of staff
• Waiting times
• Poor communication

For example:

• You may not have been given the correct information to make an informed decision
• Staff may not have treated you with respect
• Delays in receiving treatment

The NHS Complaints Procedure cannot be used in the following:

• Financial compensation for clinical negligence
• To take disciplinary action against a member of NHS staff
• Private healthcare complaints unless your treatment was funded by the NHS
• If your care home or nursing home is paid for privately

Who can complain?

You can complain about any NHS service you have received that you have been unhappy with. Usually you should make the complaint yourself; however, someone else can make a complaint on your behalf provided you have given them your written permission. If someone is ill or does not have capacity you do not need their written permission to raise a concern or make a complaint. You can still make a complaint if the person the complaint relates to has died. If you are under 18 you can complain independently. If for any reason you need help to complain you can ask someone else to make your complaint with your permission.

Who should I complain to?

You can complain to either the Provider or the Commissioner of the health service you are unhappy about. The provider is the organisation that provides the service to you, for instance a GP, dentist, pharmacist or a hospital.

• NHS England is the commissioner or purchaser of Primary Care i.e. GPs, dentists, opticians, pharmacy and some specialised services.
• Clinical Commissioning Groups commission hospital services, mental health services, out of hours services and 111 services amongst others.

You can raise a concern or make a complaint by:

• Speaking directly to a member of staff involved in your care and treatment
• Contacting the Patient and Liaison Service (PALS)
• Make a complaint using the NHS Complaints Procedure
• Contacting NHS England.

NHS Complaints Procedure

Since April 2009, the NHS complaints process has had two stages. Stage 1: Local Resolution Local Resolution is important because it gives you an opportunity to explain what you are unhappy about and what you would like to happen. This may be an explanation of what when wrong, an apology or improvements to current practices and procedures. The aim of the NHS Complaints Procedure is to resolve issues at a local level where possible and many complaints are resolved at this stage. Stage 2: The Health Service Ombudsman If after progressing through stage 1 of the complaints procedure you are still unhappy with how your complaint has been dealt with you can refer the matter to the Parliamentary and Health Service Ombudsman (PHSO), which is independent of the NHS and government. If you would like more information about the Health Service Ombudsman you can visit their website: www.ombudsman.org.uk or by telephone on 0345 015 4033.

Independent NHS Complaints Advocacy Referral Form

Download the NHS Complaints Referral Form.