Aim of the IMHA Service

shutterstock_207838036Section 130A of the MHA introduced the duty for the relevant authority (delegated to the Local Authority via the Health and Social Care Act 2012), to make arrangements to enable “qualifying patients” to have access to an independent mental health advocate (IMHA).

IMHA services give qualifying patients with mental health difficulties access to dedicated, reliable, independent support in getting the right information they need to understand what is happening to them and what their choices and rights are, and in getting their voice heard and listened to.  They help to preserve a patient’s dignity and self-respect, as well as protecting their legal and human rights.  IMHA services provide an additional safeguard for patients who are subject to the MHA and are specialist advocates who are trained to work within the framework of the Act.


The Role of the IMHA

An IMHA is a specialist type of mental health advocate, granted specific roles and responsibilities under the MHA.  IMHAs help qualifying patients understand the legal provisions to which they are subject under the MHA and the rights and safeguards to which they are entitled.  This could include assistance in obtaining information about any of the following:

  • The provisions of the legislation under which s/he qualifies for an IMHA;
  • Any conditions or restrictions s/he is subject to for example any arrangements made for S17 leave
  • The medical treatment being given, proposed or being discussed and the legal authority under which this would be given;
  • The requirement that would apply in connection with the giving of the treatment;
  • Their rights under the Act and how those rights can be exercised.

IMHA also help qualifying patients to exercise their rights. This help may include:

  • Supporting qualifying patients in accessing information and better understanding of their detention and their rights
  • Supporting qualifying patients in exploring options, making better informed decisions and actively engaging with decisions that are being made about their care and treatment including care plans and discharge plans
  • Supporting qualifying patients in articulating their own views
  • Speaking on the qualifying patients behalf and representing them including raising concerns or making complaints
  • Supporting qualifying patients in other ways to ensure they can participate in the decisions that are made about their care and treatment
  • Helping qualifying patients prepare for Mental Health Review Tribunals and understanding any decisions made by a Tribunal

IMHAs have the following statutory powers:

  • To visit and interview the patient in private
  • To visit, interview and get the views of anyone professionally concerned with the patient’s medical treatment.
  • Where the patient agrees, to see any clinical or other records relating to the patient’s detention or treatment in any hospital, or to any after-care services and any local social services authority records.

If the patient is unable to consent because they lack capacity, the holder of the records must allow the IMHA access if they think that it is appropriate and that it is relevant to the help the IMHA will provide.


IMHA Clients

The MHA calls patients who are eligible for the support of an IMHA, “qualifying patients”.

Qualifying patients are those patients who are:

  • Detained under the MHA (even if they are currently on leave of absence from hospital) with the exception of those patients detained under sections 4, 5(2), 5(4), 135 or 136;
  • Conditionally discharged restricted patients
  • Subject to Guardianship under the Act; or
  • under Supervised Community Treatment Orders

Other patients, who are informal, are eligible for IMHA services if they are:

Being considered for electro-convulsive therapy (ECT) or any other treatment to which section 57 applies (i.e. treatments requiring consent and a second opinion);

Under 18 and being considered for ECT or any other treatment to which section 58A applies (“a section 58 treatment”).

People detained under emergency sections (e.g. section 4) do not qualify for IMHA services, although may of course use other advocacy services.