Advocacy

I am sure, of course, that all commissioners have ensured that robust, effective advocacy services are in place for next week. Because they have had to do so. They got the cash last November, but it wasn't ring fenced, so I'm a little uneasy about how much has been used to commission front line staff to do this work.

Why does it matter?

Because every patient in my corner detained under section 2, 3, 7, 37, a Supervised Community Treatment order (SCT) or conditionally discharged will, from next week, be a "qualifying patient" and entitled, nay obliged to have offered to them, an Independent Mental Health Advocate (IMHA). Why? The Mental Health Act 1983 was ammended in 2007 and from next week advocacy is a statutory requirement.

Does it matter? Well, quite probably. There are very few patients detained, in my corner. Although I've a typical (according to the Royal College) size of patient population in my patch, who I'm responsible for, my team and I don't use the Mental Health Act 1983 very often, at all. In case my memory failed me, and in the interests of determining how often SCTs may be considered, my Mental Health Act office kindly let me know how often I've had patients under my care detained under section 3. Since 2003, there have been 3 of them. Not many, then. What can I say, I'm blessed to work with exceptional staff. Nationally, it's a different story. The total number of people detained under the Mental Health Act 1983 is about 42000 in a year. That's a lot of pink forms.

Quite how we'll suddenly, from next week, be awash with advocacy services (that are qualified or will have the national level 4 City & Guilds IMHA qualification within a year), to manage the advocacy needs of 42000 people perplexes me. Every detention, every meeting, every Hospital Managers hearing, every Tribunal, an IMHA should be offered.

The IMHAs have powers. They have a right to see the patient in private. They have a right to interview clinical staff (nurses, psychiatrists, whoever). With the patient's consent, or without if they're incapacitated and it's in their best interests, the IMHA has a right to access the patient's medical records. Good luck to them accessing the electronic medical records in my corner. And even more luck in deciphering the meaning of what's documented. Interesting times.

Okay, I've no patients detained under the MHA 1983 and haven't had any for an age. But in forensic and LD corners, I can see April being a very, very busy month . . .