A mental health advocate is someone who can listen to you and support you in times of need. Advocates should be independent from any person or organisation involved in delivering your care. An advocate should support you to:
- express your views and concerns
- access information and services
- defend and promote your rights and responsibilities
- explore your choices and options.
There are many forms of advocacy in mental health – see the entries for different types of advocate below. (See for more information.)
A citizen advocate is a volunteer, who works as part of a citizen advocacy scheme. A citizen advocate would usually work with you on a long-term and one-to-one basis. Unlike a peer advocate, a citizen advocate does not have to have personal experience of a mental health problem. (See Peer advocate below)
Independent mental capacity advocate (IMCA)
An independent mental capacity advocate (IMCA) can support and represent you if it has been decided that you lack capacity to make decisions under the Mental Capacity Act. An IMCA provides information to work out what is in your best interests and, if necessary, will challenge decisions that they do not believe are helpful for you.
Independent mental health advocate (IMHA)
An independent mental health advocate (IMHA) helps you understand and use your legal rights if you are being treated under the Mental Health Act. For example, if you have been detained under the Mental Health Act (sectioned) or are being treated on a community treatment order (CTO).
An inpatient advocate works with people who have been admitted to hospital. Inpatient advocates can be helpful in several ways, including helping you to claim benefits, challenging detention and supporting you to express your preferences and concerns to doctors during ward rounds. Most advocacy services will have inpatient advocacy as part of their service.
A peer advocate is someone with experience of using mental health services who can support you to understand and defend your rights. Because a peer advocate has experience of using mental health services, they can often use their own experiences to help you understand your situation and give you practical advice.
Self-advocacy is about you expressing your own needs and rights as a mental health service user. Some examples of tools for self-advocacy are:
- assertiveness training
- using crisis cards or advance statements which set out your wishes in the event of crisis.
Self-advocates often form self-advocacy groups – a group of mental health service users and ex-users who work together. A self-advocacy group might:
- act collectively to influence service provision and treatment
- support an individual to advocate for themselves.
If you are held by the police and they realise, or are told, that you have a mental health problem, you have the right to be accompanied by an appropriate adult.
An appropriate adult should be an adult who is independent of the police, such as a member of your family or a mental health worker, but it cannot be your solicitor. You can’t choose who your appropriate adult is, but you may be asked you about your preferences.
An appropriate adult should make sure that you get a solicitor, request that you are seen by a doctor and help you to communicate with the police. They should also be present if you are questioned about an offence. (See .)
Approved mental health professional (AMHP)
An approved mental health professional (AMHP) is responsible for organising and coordinating assessments under the Mental Health Act.
An AMHP can recommend that you are detained in hospital under the Mental Health Act (sectioned) or that you receive a community treatment order (CTO).
The role is often held by specially trained social workers, but can also be carried out by occupational therapists, community mental health nurses and psychologists. This role has replaced the role of approved social worker (ASW). (See .)
Assertive outreach team (AOT)
An assertive outreach team (AOT) may work with you in the community (i.e. outside of hospital) if you have found working with other community-based mental health services difficult or unhelpful. If you have experienced severe mental health symptoms along with other problems such as violence or homelessness, it is more likely that you will work with an AOT.
The care coordinator within an AOT will generally be responsible for a smaller number of service users than in a community mental health team (CMHT), which means they can devote more time to each individual they see. (See Community mental health team (CMHT) below)
An AOT contains a range of different mental health workers, such as social workers, support workers, community mental health nurses (CMHNs) and psychologists.
A care coordinator is the main point of contact and support if you need ongoing mental health care.
They keep in close contact with you while you receive mental health care and monitor how that care is delivered – particularly when you’re outside of hospital. They are also responsible for carrying out an assessment to work out your health and social care needs under the care programme approach (CPA).
A care coordinator usually works as part of the community mental health team (CMHT). (See Community mental health team (CMHT) below.)
A care coordinator could be any mental health professional; for example, a nurse, social worker or other mental health worker. This is decided according to what is most appropriate for your situation.
Care Quality Commission (CQC)
The Care Quality Commission (CQC) is the independent regulator for health and adult social care in England. It registers, monitors and routinely inspects all hospitals, care homes and home care agencies to ensure that they meet national standards of quality and safety.
All providers of health and social care have to be registered with the CQC. It publishes its inspection reports on the CQC website, so you can see whether a particular health or social care provider has met the required national standards.
The CQC does not investigate or resolve individual complaints, but you can contact them if you feel that you, or someone you know, have received poor care. Any information you provide is used to help the CQC decide when and where to inspect services.
A carer is anyone who supports someone experiencing mental health problems. This could be a parent, partner, son or daughter, neighbour or friend. A carer can be an adult or a child. Carers are often unpaid, but some receive benefits to provide full-time care. A lot of carers live with the person they care for, but many do not.
The term carer may also refer to someone who is employed as a professional carer, but it is used less frequently in this sense. (See for more information.)
A CBT practitioner provides cognitive behavioural therapy (CBT) – a short-term talking treatment (usually six weeks – six months) designed to change patterns of behaviour and thoughts. CBT is recommended as the initial treatment for many mental health problems.
CBT practitioners may offer individual or group therapy as well as other kinds of talking treatment. A CBT practitioner could be a psychiatrist, psychologist or another mental health professional who has had specialist CBT training.
CBT practitioners may work for the NHS, as private practitioners or for a voluntary organisation, such as a local Mind. All CBT practitioners should be registered with an appropriate professional accreditation body. There are a number of such bodies. (See Useful contacts.)
Citizens Advice Bureau (CAB)
The Citizens Advice Bureau (CAB) is an independent organisation providing the public with information across many social and legal issues. Specialist advisors working at CAB can answer queries on a broad range of topics, including employment, housing rights and benefits.
Community mental health nurse (CMHN)
A community mental health nurse (CMHN) is a registered nurse with specialist training who works with you if you receive community-based mental health care (i.e. care outside of hospital).
The role of a CMHN is very wide and can include:
- counselling or anxiety management
- exploring coping strategies
- helping you with day-to-day life
- administering psychiatric drugs such as injections.
CMHNs may also have a particular specialism, such as children, elderly people, or drug or alcohol problems.
Some CMHNs are attached to GP surgeries or community mental health centres, and others work in psychiatric units. Most work as part of a community mental health team (CMHT). (See Community mental health team (CMHT) below.)
Community mental health team (CMHT)
A community mental health team (CMHT) organises and coordinates your care if you receive community-based mental health care (i.e. care outside of hospital). This includes carrying out mental health assessments, treatment and care.
You are normally referred to a CMHT if you have complex mental health problems and need more specialist help than a GP can offer.
A CMHT contains a range of different mental health workers, such as psychiatrists, psychiatric nurses, social workers and occupational therapists.
Community psychiatric nurse (CPN)
A community psychiatric nurse (CPN) is another term for community mental health nurse (CMHN). (See Community mental health nurse (CMHN) above)
A counsellor offers counselling – a talking treatment that aims to help you find ways of coping with problems that you are experiencing. The overall aim of counselling is to provide an opportunity for you to work towards living in a more satisfying way where you feel able to cope with life’s challenges. (See .)
A counsellor may offer individual or group therapy, and may deal with specific problems, such as grief, anxiety, violence or shyness.
A counsellor may be a professional counsellor, a psychologist or another mental health professional. Counsellors may work for the NHS, for private practitioners or for a voluntary organisation, such as a local Mind.
All non-NHS practitioners should be registered with a professional self-regulating body. The body they register with will depend on their exact role and qualifications. (See Useful contacts.)
Crisis resolution and home treatment team (CRHTT)
A crisis resolution and home treatment team (CRHTT) offers you intensive support and advice if you are experiencing a mental health crisis.
The aim of the CRHTT is to provide the support you need to recover at home and avoid you being admitted to hospital if possible. They may also work with your care coordinator and your carer(s) to develop and review your care plan.
During a crisis, they will visit you at home, often on a daily basis. Once you start to feel better, their involvement in your care will decrease and you will either be referred to another team for ongoing care or you will be discharged.
If a crisis gets worse, or continues for longer than expected, your CRHTT may work in partnership with a hospital, possibly including arranging for your admission.
A CRHTT contains different mental health workers, such as psychiatrists, community mental health nurses (CMHNs), social workers and community support workers.