January saw the publication of the White Paper proposing changes to the Mental Health Act. The government has opened up the proposals for consultation until 21st April. The Advonet Group will respond to the consultation and through an informal network of advocacy organisations, which has looked at the documentation itself.
There is much about improving rights and enabling choice to welcome in the White Paper. Starting with the core principles:

  • Choice and autonomy – making sure people’s views and choices are respected
  • Least restriction – making sure the act’s powers are used in the least restrictive way
  • Therapeutic benefit – making sure patients are supported to get better, so they can be discharged from the act as quickly as possible
  • The person as an individual – making sure patients are viewed and treated as rounded individuals

Recognising needs

The paper includes recognition of the needs from detained patients from diverse cultural backgrounds and improves the way that people with learning disability and autism will be dealt with under the Act.
In addition, the White Paper sets clearer, stronger detention criteria and more regular reviews of detention to provide greater assurance that people will only be detained if this will help their recovery or if there is a substantial likelihood of significant harm to the individual, or the safety of someone else.
It also strengthens and impro the patient’s right to choose and refuse treatment.
One key feature of the proposals concerns advocacy. It sets out the government plans to expand the role of Independent Mental Health Advocates (IMHAs) so that they can:

  • Support patients to take part in care planning
  • Support individuals to prepare advance choice documents
  • Challenge treatment decisions where they have reason to believe they are not in the patient’s best interests
  • Appeal to the tribunal when patients are too unwell to do so themselves

Again, this is to be welcomed with the caveat that if the IMHA role is expended but the resources remain the same, careful thought will need to be given to how quality is maintained.

Quality of provision

The White Paper addresses quality of IMHA provision suggesting that the role should be professionalised and, as part of the consultation, asks if standards or accreditation should be enhanced or regulation improved.
This represents a challenge to advocacy providers who want to provide consistently excellent services which are fully independent of the health and social care system.
We need to find a way of being regulated which enables us to stay friendly and approachable, and unquestionably on the side of the people we support.
One imagines by being very innovative about creating a regime that takes account of this. Whatever is introduced can’t just work for IMHA, it will need to work across the whole of advocacy.
The government also include the need to pilot culturally appropriate advocacy for people of all ethnic backgrounds and communities. Such projects will be a brilliant opportunity to test out how achieve the right balance.
Do you have any thoughts about this debate or the bill? To read it, please click on this link: https://www.gov.uk/government/consultations/reforming-the-mental-health-act
We would love to hear from you.