Independent Mental Health Advocates (IMHAs)

Under Section 130A of the Mental Health Act 1983, "qualifying patients" — those with a right to an IMHA — include:

• Patients detained under Sections 2, 3, 4, 35, 36, 37, 38, 45A, 47, or 48 of the MHA 1983
• Patients subject to a Community Treatment Order (CTO) under Section 17A
• Patients subject to guardianship under Sections 7 or 37
• Informal patients who are being considered for certain treatments that require special consent (such as ECT, psychosurgery, or medicine beyond 3 months)

Patients who are voluntary (informal) and not in any of the above categories do not have a statutory right to an IMHA under the MHA 1983, though general advocacy services may be available in some areas.

An IMHA can:

• Help you understand your rights under the MHA 1983 — including the right to appeal, the right to a nearest relative, and your rights around treatment
• Attend ward rounds, CPA (Care Programme Approach) meetings, and other clinical discussions with you (or on your behalf with your consent)
• Accompany you to Mental Health Tribunal hearings and other formal processes
• Help you access your medical records and other information about your care
• Help you communicate your wishes, views, and concerns to clinical staff and decision-makers
• Assist you in making a complaint about your care or treatment
• Help you understand your medication and treatment options

An IMHA does not make decisions on your behalf — they support you to be heard and to make informed decisions. They are entirely independent of the clinical team.

The hospital must inform you of your right to an IMHA in writing upon admission, and must inform you how to contact the IMHA service. Steps to access an IMHA:

1. Ask a member of nursing or ward staff to contact the IMHA service on your behalf, or ask them for the contact details so you can do so yourself.
2. If you are on a CTO, your care coordinator or community nurse can arrange IMHA contact.
3. IMHAs can also be contacted directly — the hospital should have contact details for the commissioned IMHA provider for your area.
4. Friends or relatives can contact the IMHA service on your behalf with your consent.

If you are being denied access to an IMHA, this is a breach of your statutory rights and should be raised formally as a complaint with the hospital managers or the Care Quality Commission.

IMHAs and solicitors provide complementary but distinct forms of support:

• An IMHA provides general support and advocacy throughout your detention or CTO — attending ward rounds, helping you understand your rights, and supporting you to communicate your views. They are available from the start of your detention.
• A solicitor provides legal representation, particularly for Mental Health Tribunal proceedings. Legal aid is automatically available for Tribunal work. Solicitors give legal advice and represent your case at the hearing.
• You should have both — an IMHA for day-to-day support and a solicitor for Tribunal representation. They work together in your interests.

If you want to make a complaint, an IMHA can support you through the hospital complaints procedure; a solicitor or the Citizens Advice Consumer Service can advise on more formal legal steps.