Advocacy in mental health

Explains what advocacy is and how it can help you. Gives information on different types of advocacy, including statutory advocates, what sort of situations an advocate can help you with, and how to find an advocate.

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Note: This page is about Independent Mental Health Advocates (IMHAs) in England. If you live in Wales, see our page on IMHAs (Wales).

This page covers:

See our legal glossary for explanations of legal terms used on this page.

When am I entitled to an IMHA?

In England, you have the right to an IMHA if:

you are detained under the Mental Health Act 1983, except where:
- you have been detained in an emergency under section 4
- you are detained under section 5 holding powers
- you have been taken to a place of safety under section 135 and 136 of the Mental Health Act
you are “liable to be detained” – this includes:
- where you are on leave of absence from hospital
- where you are absent without leave from hospital
- where a court order or application for admission has been made in relation to you
you are subject to a community treatment order (CTO)
you are subject to guardianship
you are a conditionally discharged restricted patient
you are a voluntary/informal patient and certain treatments, including neurosurgery, are being considered for you

What is a qualifying patient?

If you are eligible for an IMHA, you are referred to as a “qualifying patient” under the Mental Health Act 1983.

As a qualifying patient, you have a legal right to support from an IMHA. You can’t, for example, be told that there is no IMHA service in your area, as every local authority has a legal obligation to ensure that there is provision in place. If you are a qualifying patient and you have been denied the support of an IMHA, you should seek legal advice from a mental health or community care solicitor.

See Citizens Advice's page on the legal system for more information on how to find legal help and taking legal action.

For more information about being detained under the Mental Health Act, see our legal pages on the Mental Health Act 1983 and sectioning.

How can an IMHA help me?

An IMHA can help you understand:

your rights under the Mental Health Act 1983 and why certain decisions have been made
the rights which other people (such as your nearest relative) have in relation to you under the Mental Health Act 1983
the parts of the Mental Health Act 1983 which apply to you (such as the basis on which you are detained) and make you eligible for an IMHA
any conditions or restrictions you are subject to (for example, relating to leave of absence from hospital or a CTO)
any medical treatment that you are receiving or might be given, including:
- the reasons for that treatment or proposed treatment
- the legal basis for providing that treatment
- the safeguards and other requirements of the Mental Health Act 1983 which would apply to that treatment.

On a practical level, an IMHA can help you:

exercise your rights under the Mental Health Act 1983
express your views about your care and treatment
make a complaint about your care or treatment
enforce your rights and get what you are entitled to
make an application to the Mental Health Tribunal
present your views and support you at a Mental Health Tribunal hearing
access legal advice
by representing you and speaking on your behalf – for example at review meetings or hospital managers’ hearings.

What should my IMHA be able to do?

Your IMHA should be able to:

access the ward or unit where you are staying
meet with you in private, unless you object or it is otherwise inappropriate (for example, if you pose a risk to the IMHA's safety)
accompany you to meetings with professionals involved in your care and treatment when you ask them to
see any medical, social care or other records about your detention, treatment and aftercare (an IMHA can only do this with your consent, unless you lack capacity to consent)
meet and talk to anyone who is professionally involved with your medical treatment

How can I access an IMHA?

You can request support from an IMHA at any time after you become a qualifying patient. You can ask:

a member of the ward staff
your responsible clinician
approved mental health professional (AMHP)

Whilst in hospital, you should have access to a telephone which you can use to contact an IMHA and talk to them in private.

Can other people ask an IMHA to visit me?

The following people can also ask an IMHA to visit you:

your nearest relative
an AMHP
your responsible clinician

It is important to remember that you do not have to see an IMHA if you don’t wish to and that IMHAs support patients, not nearest relatives or carers.

If you lack capacity to decide whether or not to get help from an IMHA, the hospital manager must ask an IMHA to visit you so that they can explain to you directly what help an IMHA can provide. See our legal pages on the Mental Capacity Act 2005 for more information about what lacking capacity means and what your rights are.