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The right to be heard: review of the quality of Independent Mental Health Advocate (IMHA) services in England
- Authors:
- NEWBIGGING Karen, et al
- Publisher:
- University of Central Lancashire. School of Health
- Publication year:
- 2012
- Pagination:
- 292
- Place of publication:
- Preston
Independent Mental Health Advocate (IMHA) services were introduced in the Mental Health Act 2007. Primary Care Trusts (PCTs) became responsible for ensuring the availability of IMHA services in April 2009. An IMHA is a specialist type of mental health advocate, granted specific roles and responsibilities under the 2007 Act. The role of the IMHA is to help qualifying patients understand the legal provisions to which they are subject under the Mental Health Act 1983, the rights and safeguards to which they are entitled, and to help these patients to exercise their rights through supporting participation in decision-making. This review of the quality of IMHA provision across England was commissioned by the Department of Health. The study was undertaken by researchers at the University of Central Lancashire (UCLan) in partnership with Equalities National Council, Aawaz, Manchester African Caribbean Mental Health Services and Comensus, a University-wide forum supporting the involvement of service users and carers in teaching and research. The main aim was to look at how IMHA services are providing help to patients under the 2007 Act, what makes for a good IMHA service, and what factors influence the quality of service provided. The study used different methods to gather information about how IMHA services are working in practice. A first stage involved: a focused literature review; 11 focus groups held across England with a range of stakeholders (advocates, mental health service users, IMHA partners, carers and mental health professionals); and shadow visits to IMHA services. A second stage involved gathering data in eight case study sites (mental health providers) to understand the experience of qualifying patients, the commissioning and delivery of IMHA services, and their relationship with mental health services. The case study sites were selected to reflect differences in the local population and the way IMHA services were organised and delivered. In total 214 people were interviewed, including 90 qualifying patients, 61 of whom had experience of using IMHA services. The report presents key findings on: experiences of the 2007 Act; access to, and understanding and provision of IMHA services; IMHA services and the diversity of qualifying patients; the mental health services context; the benefits of the service; commissioning IMHA services; and determining the quality of IMHA services. The report makes recommendations for government, the Care Quality Commission, commissioners, mental health services, IMHA services, service user, carer and community organisations, and higher education and training providers. This research has found that the IMHA role is valued and appreciated by service users, although its potential is not fully realised. Action is required to strengthen the capacity of such advocacy services; and future research needs to explore gaps in the evidence base and to further evaluate the impact of IMHA practice. (Edited publisher abstract)