To mark Mental Health Awareness Week 2024 (13th-19th May), Sandra Nunn, one of our Universal Advocates, shares her experience of moving from our Independent Mental Capacity Advocacy (IMCA) team to our Independent Mental Health Advocacy (IMHA) service. Sandra discusses the difference between the two services, as well as how IMHAs work to uphold the rights of the people they work with.

Main differences

I have found the main differences between the two types of advocacies to be:

  • The model of advocacy used is Instructed Advocacy and obtaining instruction can be difficult, as can creating and maintaining a relationship with clients due to:
    • Client’s medication, both its’ effects and side effects, which can make engagement difficult.
    • The behaviour of other patients on the ward can sometimes hinder relevant communication and affect the client negatively.
    • Newly admitted client’s can be too ill to engage.
    • All these can affect the Empowerment Principle and getting the client’s voice heard can be difficult.

Accessibility Principle

  • The Accessibility Principle can be affected if a client is not offered/referred for advocacy by ward staff, especially if the client rarely leaves their room, is not exposed to posters and leaflets offering advocacy information and does not see the advocate around the ward making visits to other patients.
  • The Rights Based Approach to advocacy is the main approach used, following the Mental Health Act.
  • To ensure the client’s well-being and ensure that least restrictive practices are being used, doctors and nursing staff need to be questioned for alternatives when the client reports side-effects from drugs or dislikes their form of treatment. Likewise, reasons need to be sought for refusal of leave. Medical staff should be held to account for their decisions.
  • The time restraints for appeals can be difficult to meet. For example, someone on a Section 2 has only 14 days to appeal and they may be feeling over-whelmed by being admitted to hospital or suffering side-effects from starting new drugs and so not react quickly enough to appeal their section.