Wednesday, September 22, 2021

Steps towards improving mental health advocacy

VoiceAbility and over 50 other signatories have written to the Secretary of Health and Social Care (see webpage) calling on the government to make an unequivocal commitment to improving advocacy as part of the reform of the Mental Health Act (MHA) (see eg. previous post). I think an opt out approach to advocacy is essential in any new legislation. Extension to informal patients is also important, although priority will need to be given to detained patients. I have supported VoiceAbility’s call as a step to what is needed in the new Bill.

I would also emphasise what the letter says about ensuring high quality advocacy services. I think the best way to do this is for Independent Mental Health Advocates (IMHAs) to work much more closely with mental health lawyers and independent professional experts, ideally, I would say, in an integrated nationally provided advocacy service. As the letter says, such an improvement in advocacy would need to be properly funded. I came across the agreed common themes from the Mental Health Act Reform Group (which became the Mental Health Alliance) formed in the context of the last time the MHA was reviewed leading to the 2007 amendments. This was before advocacy had been introduced by those amendments. As far as I know, there has not been an official review of the effects of the introduction of those changes. I suspect any such review would confirm that there is a very variable advocacy service nationally. I think this is partly because of current piecemeal commissioning arrangements, which may be better replaced by a nationally provided service.

I think the government still needs to provide adequate resources nationally for advocacy, as originally suggested by the Mental Health Act Reform Group. The interests of detained patients need to be better represented, if necessary before the Mental Health Tribunal, on matters both of detention and treatment (see eg. previous post). I think there are savings that can be made by abolishing Second Opinion Approved Doctors (SOADs) and reorganisation of the Tribunal (see another previous post) that could be invested in advocacy.

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