Commissioning advocacy services for a new Mental Health Act

I've mentioned that the UK government has published a draft Mental Health bill (see previous post). Opt out advocacy arrangements are proposed, which is a welcome development (see another previous post). 

The draft bill imposes a duty on social services to ensure that providers of Independent Mental Health Advocates (IMHAs) arrange a visit and determine if inpatients want to use IMHA services. If a patient does want a service, presumably, the expectation is that the IMHA service will provide it. But as I have mentioned before (eg. see previous post), I do not think IMHAs were ever properly funded when they were first introduced by the 2007 Mental Health Act (MHA) amendments. There must be a question mark about whether there are sufficient resources to meet this requirement, although the impact assessment has calculated some figures. Still, it does require a commitment from government to provide additional resources which I think is still awaited.

I think the bill also should change the wording to “needs” IMHA services rather than “wants to use” them, so that people without capacity are accommodated. In general I find it a problem of the draft bill that there is apparently better protection for those with capacity rather than those lacking capacity, when it’s the latter group that’s more likely to need advocacy services and protection in general. 

Anyway, pre-legislative scrutiny of the draft bill is likely to encourage a focus on commissioning of advocacy services. As I’ve said before (eg. see previous post), I’m keen on an integrated service of IMHAs, lawyers and experts being commissioned (with the latter two groups continuing to be paid via legal aid, although the amounts paid, I think, need to be increased as seems to be happening with the rest of legal aid eg. for criminal cases).