Independent mental health advocacy

Last updated

Independent mental health advocacy, IMHA, is advocacy for someone being treated, possibly involuntarily, for a mental disorder provided by someone not involved in the treatment. IMHA can help a service user understand and exercise their rights and ensure their views and preferences are expressed. [1] Advocacy seeks to address unequal power relations between mental health professionals and those using their services. [2] :281 Those who provide such advocacy are called Independent mental health advocates, IMHA.

Contents

IMHA complement the best interest advocacy where others make decisions based on what they think is in a service user, such as a psychiatric inpatient, best interest with representational advocacy which provides support for the patients autonomy, their ability to have a role in decisions made about them. [3] :8 IMHA can help support testimonial justice, allowing a service users voice to be heard; and hermeneutic justice, having one's understanding taken in account in decision making. [2] :289

In some regions, psychiatric services are required to provide access to IMHA to all detained patients or those who are subject to community treatment orders. [4]

History

Voluntary sector mental health advocacy organizations began to emerge in the 1980s in the United Kingdom growing out of service user movements. [5] :399 A revision to the Mental Health Act 1983 in 2007 created a duty to provide advocacy to all detained patients and those subject to community treatment orders. [4] :18 [6] The introduction of IMHA in the United Kingdom may be related to campaigning by the Mental health alliance in response to the introduction of community treatment orders. [5] :400

Role

IMHA advocates respresent the wishes of the people they advocate for regardless of the wishes of the family. They share all the information they have with a service user regardless of what impact they think this information will have. They ask the questions necessary to mediate in decision making but do not make decisions on the behalf of patients. Minor decisions such as filling out paper work may be delegated to IMHA advocates. [7] :7

IMHA advocates will help service users exercise their rights, express their views, make complaints, make applications to mental health tribunals, access legal advice by meeting service users in private to understand their situation and views, accessing medical and social records, meeting with professionals involved, and attending meetings or hearings. [1]

Patients' perception of advocacy

Some patients perceive advocates roles as supporting them in understanding their rights under mental health law and ensuring these rights are upheld. [2] :285 In a study, young people viewed IMHAs role as independently understanding a service users viewpoint and ensuring that it was presented at meetings. [2] :285 In a study with, African and African Caribbean men, service users viewed IMHAs as defenders of rights, and viewed an advocate as a partner, emphasising self-advocacy as being important. [2] :284

Attitudes of clinicians

Clinicians support advocacy but often conceptualize it as advocating for the best interests of a patient rather than supporting their autonomy or rights. [8] :6 Attitudes towards IMHA are less positive amongst professionals working in community care than those working in an inpatient setting. [8] :7

International status

Australian State of West Australia

IMHAs have statutory status in the Australian State of West Australia. [8] :2

Australian State of Victoria

There is not an independent advocacy service on a statutory basis in Victoria, but a service called the IMHA to provide advocacy was created in 2015 and is recognised by legislation. [8] :2

Canada

Some Canadian provinces such as New Brunswick, Newfoundland, Labrador, Nova Scotia, Ontaria, Saskatchewen have independent advocacy offices that provide advice and must be independent from the treatment team. [9] :20

England and Wales

A revision to the Mental Health Act 1983 in 2007 created a duty to provide advocacy to all detained patients and those subject to community treatment orders. [4] :18

Scotland

IMHAs have statutory status in Scotland. [8] :2

Northern Ireland

IMHAs have statutory status in Northern Ireland. [8] :2

Related Research Articles

Outpatient commitment—also called assisted outpatient treatment (AOT) or community treatment orders (CTO)—refers to a civil court procedure wherein a legal process orders an individual diagnosed with a severe mental disorder to adhere to an outpatient treatment plan designed to prevent further deterioration or recurrence that is harmful to themselves or others.

A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care provider.

<span class="mw-page-title-main">Voluntary commitment</span> Choosing to admit oneself to a psychiatric hospital

Voluntary commitment is the act or practice of choosing to admit oneself to a psychiatric hospital, or other mental health facility. Unlike in involuntary commitment, the person is free to leave the hospital against medical advice, though there may be a requirement of a period of notice or that the leaving take place during daylight hours. In some jurisdictions, a distinction is drawn between formal and informal voluntary commitment, and this may have an effect on how much notice the individual must give before leaving the hospital. This period may be used for the hospital to use involuntary commitment procedures against the patient. People with mental illness can write psychiatric advance directives in which they can, in advance, consent to voluntary admission to a hospital and thus avoid involuntary commitment.

Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.

Laura's Law is a California state law that allows for court-ordered assisted outpatient treatment. To qualify for the program, the person must have a serious mental illness plus a recent history of psychiatric hospitalizations, jailings or acts, threats or attempts of serious violent behavior towards self or others. A complete functional outline of the legal procedures and safeguards within Laura's Law has been prepared by NAMI San Mateo.

<span class="mw-page-title-main">Mental Health Act 1983</span> Law in England and Wales

The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom. It covers the reception, care and treatment of mentally disordered people, the management of their property and other related matters, forming part of the mental health law for the people in England and Wales. In particular, it provides the legislation by which people diagnosed with a mental disorder can be detained in a hospital or police custody and have their disorder assessed or treated against their wishes, informally known as "sectioning". Its use is reviewed and regulated by the Care Quality Commission. The Act was significantly amended by the Mental Health Act 2007. A white paper proposing changes to the act was published in 2021 following an independent review of the act by Simon Wessely.

In England, the First-tier Tribunal , more commonly known as the Mental Health Tribunal, is an independent quasi-judicial body established to safeguard the rights of persons subject to the Mental Health Act 1983. It provides for consideration of appeals against the medical detention or forced treatment of a person who was deemed to be suffering from a mental disorder that was associated with a risk to the health or safety of that person or others.

Involuntary treatment refers to medical treatment undertaken without the consent of the person being treated. Involuntary treatment is permitted by law in some countries when overseen by the judiciary through court orders; other countries defer directly to the medical opinions of doctors.

The Mental Health Act is an Ontario law that regulates the administration of mental health care in the province. The main purpose of the legislation is to regulate the involuntary admission of people into a psychiatric hospital. Since the changes brought about in 2000 under Bill 68, the Act allows for a community treatment order by the attending physician. This order is intended to provide comprehensive treatment outside of a psychiatric facility.

Kendra's Law, effective since November 1999, is a New York State law concerning involuntary outpatient commitment also known as assisted outpatient treatment. It grants judges the authority to issue orders that require people who meet certain criteria to regularly undergo psychiatric treatment. Failure to comply could result in commitment for up to 72 hours. Kendra's Law does not mandate that patients be forced to take medication.

<span class="mw-page-title-main">Mental health trust</span> Social care services for people with mental health disorders in England

A mental health trust provides health and social care services for people with mental health disorders in England.

<span class="mw-page-title-main">Deinstitutionalisation</span> Replacement of psychiatric hospitals

Deinstitutionalisation is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the late 20th century, it led to the closure of many psychiatric hospitals, as patients were increasingly cared for at home, in halfway houses and clinics, in regular hospitals, or not at all.

Patient advocacy is a process in health care concerned with advocacy for patients, survivors, and caregivers. The patient advocate may be an individual or an organization, concerned with healthcare standards or with one specific group of disorders. The terms patient advocate and patient advocacy can refer both to individual advocates providing services that organizations also provide, and to organizations whose functions extend to individual patients. Some patient advocates are independent and some work for the organizations that are directly responsible for the patient's care.

The psychiatric survivors movement is a diverse association of individuals who either currently access mental health services, or who are survivors of interventions by psychiatry.

<span class="mw-page-title-main">Mental Health Act 2007</span> Law of England and Wales

The Mental Health Act 2007 is an Act of the Parliament of the United Kingdom. It amended the Mental Health Act 1983 and the Mental Capacity Act 2005. It applies to people residing in England and Wales. Most of the Act was implemented on 3 November 2008.

<span class="mw-page-title-main">Community mental health service</span>

Community mental health services (CMHS), also known as community mental health teams (CMHT) in the United Kingdom, support or treat people with mental disorders in a domiciliary setting, instead of a psychiatric hospital (asylum). The array of community mental health services vary depending on the country in which the services are provided. It refers to a system of care in which the patient's community, not a specific facility such as a hospital, is the primary provider of care for people with a mental illness. The goal of community mental health services often includes much more than simply providing outpatient psychiatric treatment.

Services for mental health disorders provide treatment, support, or advocacy to people who have psychiatric illnesses. These may include medical, behavioral, social, and legal services.

<span class="mw-page-title-main">Mental health tribunal</span> Tribunal hearing for mental health treatment disputes

A mental health tribunal is a specialist tribunal (hearing) empowered by law to adjudicate disputes about mental health treatment and detention, primarily by conducting independent reviews of patients diagnosed with mental disorders who are detained in psychiatric hospitals, or under outpatient commitment, and who may be subject to involuntary treatment.

Involuntary commitment or civil commitment is a legal process through which an individual who is deemed by a qualified agent to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily.

The United States has experienced two waves of deinstitutionalization, the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability.

References

  1. 1 2 "IMHAs in England". www.mind.org.uk. Retrieved 2022-08-19.
  2. 1 2 3 4 5 Ridley, Julie; Newbigging, Karen; Street, Cathy (2018-11-07). "Mental health advocacy outcomes from service user perspectives". Mental Health Review Journal. 23 (4): 280–292. doi:10.1108/MHRJ-10-2017-0049. ISSN   1361-9322. S2CID   80903364.
  3. Bennetts, Wanda; Maylea, Christopher; McKenna, Brian; Makregiorgos, Helen (2018-10-25). "The 'Tricky Dance' of Advocacy: A study of non-legal Mental Health Advocacy". International Journal of Mental Health and Capacity Law. 2018 (24): 12. doi:10.19164/ijmhcl.v2018i24.746. hdl: 10292/13240 . ISSN   2056-3922. S2CID   149725402.
  4. 1 2 3 Morgan, Geoff (2017). Independent advocacy and spiritual care: insights from service users, advocates, health care professionals and chaplains. London. ISBN   978-1-137-53125-4. OCLC   974649659.{{cite book}}: CS1 maint: location missing publisher (link)
  5. 1 2 McKeown, Mick; Ridley, Julie; Newbigging, Karen; Machin, Karen; Poursanidou, Konstantina; Cruse, Kaaren (2014). "Conflict of roles: A conflict of ideas? The unsettled relations between care team staff and independent mental health advocates: Independent Mental Health Advocacy". International Journal of Mental Health Nursing. 23 (5): 398–408. doi:10.1111/inm.12069. PMID   24890285.
  6. "Mental Health Act 2007, Chapter 3, Section 30". Legislation of the United Kingdom.
  7. Maylea, Chris; Susan, Alvarez-Vasquez; Dale, Matthew; Hill, Nicholas; Johnson, Brendan; Martin, Jennifer; Thomas, Stuart; Penelope, Weller. "Evaluation of the Independent Mental Health Advocacy Service (IMHA)" (PDF). RMIT University.
  8. 1 2 3 4 5 6 Weller, Penelope; Alvarez-Vasquez, Susan; Dale, Matthew; Hill, Nicholas; Johnson, Brendan; Martin, Jennifer; Maylea, Chris; Thomas, Stuart (2019). "The need for independent advocacy for people subject to mental health community treatment orders". International Journal of Law and Psychiatry. 66: 101452. doi:10.1016/j.ijlp.2019.101452. PMID   31706387. S2CID   196580245.
  9. Cheung, Iva W.; Silva, Diego S.; Miller, Kimberly J.; Michalak, Erin E.; Goldsmith, Charles H. (2021-03-18). Biller-Andorno, Nikola (ed.). "A qualitative study of clinicians' perspectives on independent rights advice for involuntary psychiatric patients in British Columbia, Canada". PLOS ONE. 16 (3): e0247268. Bibcode:2021PLoSO..1647268C. doi: 10.1371/journal.pone.0247268 . ISSN   1932-6203. PMC   7971454 . PMID   33735273.