Advocacy in mental health

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What are IMHAs in Wales?

This page covers:

• When am I entitled to an IMHA?
• How can an IMHA help me?
• What should my IMHA be able to do?
• How can I access an IMHA?

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

When am I entitled to an IMHA?

In Wales, you have the right to an IMHA if you are a “qualifying compulsory patient” or a “qualifying informal patient”.

You are a qualifying compulsory patient if:

• you are detained under the Mental Health Act 1983, except where you have been taken to a place of safety under section 135 or 136
• 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
• certain treatments, including electroconvulsive therapy (ECT) and neurosurgery, are being considered as treatment options for you

You are a qualifying informal patient if:

• you are in hospital as a voluntary patient.

How can an IMHA help me?

For qualifying compulsory patients

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 to which you are subject (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
• raise concerns or make a complaint about your care or treatment
• explore alternatives to the proposed treatment
• enforce your rights and get what you are entitled to
• make an application to the Mental Health Review Tribunal for Wales
• present your views and support you at a hearing before the Mental Health Review Tribunal for Wales
  access legal advice and representation
• by representing you and speaking on your behalf – for example at review meetings or hospital managers’ hearings
• understand and follow up any decisions or directions made by the Mental Health Review Tribunal for Wales or hospital managers
• make an application to displace your nearest relative
• access your medical or other records (see our pages on personal information for more information on what your rights are regarding your records)
• in relation to arrangements made for your aftercare (see our pages on aftercare for more information)

For qualifying informal patients

An IMHA can help you understand:

• any medical treatment that you are receiving or might be given
• the reasons for that treatment or proposed treatment
• the legal basis for providing that treatment

On a practical level, an IMHA can:

• accompany you to meetings about your care and treatment
• help you express your views about your care and treatment
• help you make a complaint about your care or treatment
• help you access legal advice

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 services 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 compulsory patient or qualifying informal 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?

If you are a qualifying compulsory patient, the following people can also ask an IMHA to visit you:

• your nearest relative
• an AMHP
• your responsible clinician
• the hospital managers
• a social worker involved with your care, treatment or assessment
• your donee or deputy (if you have one). (A donee is another word for an attorney appointed in a lasting power of attorney.)

If you are a qualifying informal patient, the following people can also ask an IMHA to visit you:

• your carer
• the hospital managers
• a social worker involved with your care, treatment or assessment
• your donee or deputy (if you have one). (A donee is another word for an attorney appointed in a lasting power of attorney.)

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.

This information was published in October 2017. We will revise it in 2020.

References are available on request. If you would like to reproduce any of this information, see our page on permissions and licensing.

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