Independent Mental Health Advocates (IMHAs)
IMHAs are specially trained advocates. They can support certain people under the Mental Health Act.
The law regarding IMHAs is different in England and 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 get support from an IMHA?
- Can other people ask an IMHA to visit me?
See our legal glossary for explanations of legal terms used on this page.
This page is part of our guide to:
You have the right to an IMHA if you're a 'qualifying patient'. This means if you're any of these things:
- Detained under the Mental Health Act. This is unless you've been detained in an emergency (section 4) or detained under section 5 holding powers. Or you've been taken to a place of safety under section 135 and 136 of the Mental Health Act. In these situations, you are not entitled to an IMHA.
- 'Liable to be detained' – this includes where you're away from hospital with or without permission. Or where a court order or application has been made to admit you to hospital.
- Subject to a community treatment order (CTO).
- Subject to guardianship.
- A conditionally discharged restricted patient.
- An informal patient and your doctors are considering certain treatments for you, including neurosurgery.
Every local authority or local health board has a legal obligation to make sure that it can provide advocacy.
Sometimes, you might be denied access to an IMHA, even if you qualify for one. In this situation, you should seek legal advice from a mental health solicitor or community care solicitor.
See Citizens Advice's page on the legal system for more information on how to find legal help and take legal action.
If you don't qualify for an IMHA, you could still get support from a community advocate or an NHS complaints advocate.
In Wales, you have the right to an IMHA if you're a 'qualifying compulsory patient' or a 'qualifying informal patient'.
You're a qualifying compulsory patient if you're:
- Detained under the Mental Health Act 1983. This is except for if you've been taken to a place of safety under section 135 or 136
- 'Liable to be detained' – this includes where you're away from hospital either with or without permission, or where a court order or application has been made to admit you to hospital
- Subject to a community treatment order (CTO)
- Subject to guardianship
- A conditionally discharged restricted patient
- Being considered to have certain treatments, including neurosurgery
You're a qualifying informal patient if you're in hospital voluntarily, as an informal patient.
Every local authority or local health board has a legal obligation to make sure that it can provide advocacy.
Sometimes, you might be denied access to an IMHA, even if you qualify for one. In this situation, you should seek legal advice from a mental health solicitor or community care solicitor.
See Citizens Advice's page on the legal system for more information on how to find legal help and take legal action.
If you don't qualify for an IMHA, you could still get support from a community advocate or an NHS complaints advocate.
How can an IMHA help me?
An IMHA can help you:
- Understand your rights under the Mental Health Act. If you've been detained under the Mental Health Act, they'll be able to explain why.
- Understand the rights that other people have in relation to you, under the Mental Health Act. For example, the rights of your nearest relative.
- Understand any medical treatment you're receiving or might be given, and the reasons for it.
- Have your say about any treatment and explain what you want and don't want.
- Complain if you're unhappy with the way you've been treated.
- Take a complaint further if needed, and apply to the Mental Health Tribunal in England or Mental Health Review Tribunal for Wales.
- Prepare for leaving hospital, including making plans for the care and support you'll need.
What should my IMHA be able to do?
Your IMHA should be able to:
- Visit the ward or unit where you're staying.
- Meet you in private, unless you don't want this to happen or it's not safe. For example, if you pose a risk to the IMHA's safety.
- Go with 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 get support from an IMHA?
You can ask for support from an IMHA at any time after you become a qualifying patient in England. Or any time after you become a qualifying compulsory patient or qualifying informal patient in Wales.
You can ask:
- A member of the ward staff
- Your responsible clinician
- An approved mental health professional (AMHP)
You could also look for posters or other information in the ward about who the advocacy provider is. Or ask friends and family to help you get support.
While you're in hospital, you should have access to a telephone which you can use to contact an IMHA. You should be able to talk to them in private.
There's more information on our page about your rights while you're sectioned. It includes some examples of how an IMHA could help you.
Can other people ask an IMHA to visit me?
If you're a qualifying patient in England or a qualifying compulsory patient in Wales, these people can ask an IMHA to visit you:
- Your nearest relative
- An AMHP
- Your responsible clinician
In Wales, these people can also ask an IMHA to visit you as a qualifying compulsory patient:
- 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're a qualifying informal patient in Wales, your carer can also ask an IMHA to visit you.
It's important to remember that you don't have to see an IMHA if you don't want to. 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. The IMHA can explain to you directly what help they can give you. Our pages on the Mental Capacity Act have more information about what lacking capacity means.
Guardianship
This is where someone called a 'guardian' is appointed instead of being sectioned and kept in hospital. Your guardian could be a person or a local authority.
You can only be placed under guardianship if it's necessary for your welfare or to protect other people. Your guardian has the power to make certain decisions about you and to make conditions that you will be asked to keep to, such as where you live.
Guardianship lasts for up to six months and can be renewed: initially for a further six months, and then for a year at a time. You can appeal to the Mental Health Tribunal once in each of these periods.
Visit our full listing of Legal TermsConditional discharge
This is where you are discharged from hospital but will have to follow some conditions, such as living at a particular place or meeting healthcare professionals. If you break these conditions, you can be recalled to hospital.
You can only be put under a conditional discharge if you have been:
- sectioned by a court under certain sections of the Mental Health Act and have been charged with a crime and you are a restricted patient under a restriction order, or
- transferred to hospital from prison under the Mental Health Act and you are a restricted patient under a restriction direction.
Responsible clinician (RC)
This is the mental health professional in charge of your care and treatment while you are sectioned under the Mental Health Act.
Certain decisions, such as applying for someone who is sectioned to go onto a community treatment order (CTO), can only be taken by the responsible clinician.
All responsible clinicians must be approved clinicians. They do not have to be a doctor, but in practice many of them are.
Visit our full listing of Legal TermsApproved mental health professional (AMHP)
AMHPs are mental health professionals who have been approved by a local social services authority to carry out duties under the Mental Health Act. They are responsible for coordinating your assessment and admission to hospital if you are sectioned.
They may be:
- social workers
- nurses
- occupational therapists
- psychologists.
See more on advocacy
What can an advocate help me with?
- Independent Mental Health Advocates (IMHAs)
Published: December 2024
Next review planned: December 2027
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