What does an Independent Mental Health Advocate (IMHA) do?
8th February 2023 / Posted by Family Welfare
An Independent Mental Health Advocate represents the views of individuals who have been detained in hospital under the Mental Health Act. They help them understand what medical care, treatment and medicines have been prescribed by clinicians. An IMHA supports individuals by helping to express their views and upholding their rights under the Mental Health Act.
An IMHA is different to an IMCA, or Independent Mental Capacity Advocate, in that they support people who have the mental capacity to articulate their thoughts and feelings.
To explain exactly what an Independent Mental Health Advocate does and what kind of support they offer, we caught up with our Family Welfare IMHA, Chloe Aspinall.
How does the day start for a Family Welfare IMHA?
A typical morning begins when I log on and check my messages to see what new referrals have come in that day. I can receive referrals from relatives, healthcare and hospital clinicians, and from individual patients who self-refer.
I’ll check for updates on my open cases and make a note of any people I need to go and visit. I organise my own diary so I’ll call ahead to the hospital to make sure it’s convenient to visit the ward. Then I jump in my car and head off to that day’s appointments.
What happens when you arrive at the hospital?
When I arrive, I like to check in with the ward manager, nursing staff and clinicians to discuss new and current cases. I need to understand each individual’s circumstances and treatment needs.
How long would an IMHA spend in hospital on an average day?
I usually see four or five people a day. The amount of time I spend on the ward depends on the number and complexity of cases. For example, if the patient is due to be discharged, our conversation may be short and sweet. If it’s a new case and the patient has a lot of concerns about their treatment, I could be with that person for up to 3 hours. I’ll be there however long it takes. Independent Mental Health Advocacy is about being there for that person when they need you.
I always leave my contact details on the ward, so if a person changes their mind or wants a follow-up conversation they can get in touch.
Describe a typical IMHA/patient conversation
People detained under the Mental Health Act are often distressed and confused. My job is to put people at ease, encourage them to talk and listen to their concerns. If they are new to the hospital they might be frightened about potential treatment and what will happen to them. Some patients don’t quite understand why they have been admitted and/or are unable to express their views.
Every conversation is confidential and takes place in a quiet room. Common themes include concerns about the doctor or clinician treating them, confusion about medication prescribed, and worries around being discharged.
What do you do if a person is unable to express their opinions?
In a recent case, a gentleman had been admitted and English wasn’t his first language. The ward manager contacted me and asked me to visit. The hospital didn’t have access to a translator and staff were finding it very difficult to communicate with him. This clearly was very distressing for the gentleman.
On my next visit to the hospital, I arranged to call a language line translator who helped me reassure him and explain his rights under the Mental Health Act. We discussed his options and he made a Tribunal Appeal, which resulted in him being able to leave the hospital accompanied by a member of staff.
I managed to find someone who worked at the hospital who was able to translate all the gentleman’s medication information into his native tongue. He began to understand the benefits and possible side-effects of the medication he’d been given, which kept him informed and more confident about his treatment.
What if a person chooses not to talk to you?
In cases where a person cannot communicate with me I rely on non-verbal communication to make a connection. Gestures, drawing, writing, and sign language are all useful.
If a person chooses not to talk, I use a rights-based approach. This means talking with their doctor to ensure their basic rights are continuously upheld. I will always persevere and try to build a rapport with that person. Sometimes they just need a little time to find the words and express how they are feeling.
It sounds like an emotional role. How does an advocate switch off at the end of the day?
It can be an intense job and it’s important to have boundaries. Although I leave my contact details on the ward, I do switch my phone off when I’ve finished work for the day. The Family Welfare team is very supportive if I need guidance or someone to talk to confidentially. At the end of the day, I love what I do!
How to refer to an IMHA
An Independent Mental Health Advocate can only work with people who qualify for support. More details on the qualification criteria can be found here.