Written and recorded by Steph Barber, Law Hound
Hello. Welcome to this mental health law training session from Data LOL. This session is going to look at the role off the independent mental health advocates in England. My name is Steph Barber. I'm a retired solicitor with Law Hound, and I was previously a member off the law society's accredited panel relating to mental health law. Independent mental health advocates or I am Hey chaise. Our specialist advocates who are trained specifically toe work within the framework off the Mental Health Act 1983 or the MH A, and this session is examining the role off the I m Hey Che in England. So let's start with looking at who are independent mental health advocates. Section 1 38 off the MH A places a duty on each local social services authority in England to make such arrangements as it considers reasonable to enable I m hate Che's to be available to help qualifying patients for whom that's authority is responsible for, and local authority. Responsibility is defined under section 130 c on is primarily when a patient is liable to be or actually detained in a hospital or registered establishments or under a community Treatment order, or CTO, in that authorities area or the local social services authority is acting as a guardian. All the authority has being nominated by the court off protection, and local authorities should ensure that there I am a chase. Sources reflect the diversity of the local population and ensure that the I am a chaise are sufficient in number and that they have specialized understanding off the specific needs off patients. They also need to ensure that the I am hey chaise concur communicate effectively with all patients, including those from minority cultural or ethnic backgrounds with physical impairments on door sensory impairments on door patients with learning disabilities on door autistic inspection disorders. And they should also ensure, so far as is practicable, that the I am a chaise are independent off any person who is being professionally involved in the patient's medical treatment. On that's in accordance with Section 230 a subsection four Section 1 30 b subsection will lay off the MH A clarifies that I have hate chaise should be available to qualifying patients aunt in accordance with section 1 30 c, subsection two, irrespective off their age, our patient is a qualifying patients on DSO eligible for support from on i m Hey Che. If the patient is detained under the MH J. That excludes patients being held under the holding powers emergency or is a place of safety, so that excludes Section four, Section five and Section 135136 A patient would also be a qualifying patient if they're liable to be detained under the MH J, even if they're not actually detained. So that would include, for example, a patient currently on leave of absence from ah hospital or absent without leave or those for whom, and application or court order for admission for detention has been completed. Qualifying patients would also be conditionally discharged restricted patients, patients subject to guardianship on patient subject to community treatment orders and in accordance with Section 1 30 c, subsection three certain informal patients can be eligible on that includes those being considered for treatment to which section 57 off the MH A applies, or those who are under 18 on being considered for electro convulsive therapy that CCT or any of the treatment to which section 58 a off the MH A applies and those patients would remain qualifying patients for the purposes of accessing support to a ni mh A. Until either the proposal for treatment is withdrawn, all the treatment is completed or has discontinued. We know that from Section 1 30 c, subsection four. So what about the duty to provide information about the I Am hey Chase services? Insofar as patients are concerned, there are various duties to provide information about the I M H A services, including its availability and how to access them. The information must be given both orally and in writing. Two detained patients and CTO patients they must be in forward by hospital managers assumes they're liable to be detained or subject to a CDO as applicable guardianship. Patients must be informed by the responsible local authority assumes they become subject to guardianship. Conditionally discharged patients must be informed by the patients responsible condition When the patient is being conditionally discharged on, informal patients must be informed by the doctor or approved condition, who first discusses with the patient the possibility of them being given a section 57 or 58. A treatment on the patient should be provided with that information regarding I M H A Services during the discussion that initially raises the question of that treatment and the Department of Health's code of practice in relation to the Mental Health Act or the code confirms there was responsible from forming the patient out. I am a Chase Services must be aware that certain patients within each of the patient types might need particular encouragements and assistance to seek the support off a ni mh A. For example, those who only have limited capacity who have sensory impairments are from minority ethnic communities or are under 18 years of age. If a patient has limited capacity or lacks capacity to decide whether or not to obtain help from I M. H. A, the hospital managers must ask on I am hey Che to attend that patients so that the I M. H. A can explain what they can offer to the patient directly on what's about the duty to inform nearest relatives about the I. M. Pei Chase services. Unless the patient requests otherwise on subject to the normal considerations about involving nearest relatives, those you have a duty to inform the patient about I m. Hey, Chase services must take whatever steps are practicable to give a copy of the written information, which is provided to the patient to the patients nearest relative. This duty doesn't apply to informal patients, nor part three patients unless they subsequently become community patients. However, the information that was provided to relatives must make it clear that the advocacy service is for patients on DNO for the nearest relatives themselves. What about accessing the I. M. H. A service? If a patient has a limited capacity or lacks capacity to decide whether or not to obtain help from an I M. H. A. Then the hospital managers must ask on I m h A to attend the patient so that the I Am H A can explain directly to the patient what they can offer them. A qualifying Patients can request access to the I Am a Chase services, although not a particular named individual advocate at any time. Once they become a qualifying, patients on patients have the right to meet with an I M H A in private on access a telephone so that they're able to contact the service and speak to them in private. And what's that requests from others While The code advises that both A m hey H P's and Responsible conditions should consider requesting on i m. H A to visit qualifying patient if they think that the patient might benefit from a visit but is unable or unlikely for whatever reason to request on I am h hes help by themselves. However, they should not ask Can I am h A to visit where they know or strongly suspect that the patient doesn't want on? I am Hey Chase help or the health of the particular I am Hey Che in question and I am hey chaise must comply with any reasonable request to visit an interview. Ah, qualifying patient which is made by a patient's nearest relative or an approved mental health professional. That's the A M H P or a patient's responsible clinician. So let's examine the role off the independence Mental health advocates. Their role is additional safeguard for patients who are subject to the MH A. As the code advises, the I am hey changed role is to enable patients to participate in decision making, for example, by encouraging patients to express their views on supporting them to communicate the views. The role is not intended to replace any other advocacy and support services that are available to patients such as independent mental capacity advocates as I M. C. A's or representatives for patient who lack capacity. As the code advises, the I am hate chaise are intended to operate in harmony with those services on, and it is possible for the same individual to be qualified to act as both on I am Hey Che Andi on I M c. A and likewise, the involvement of a ni mh A does not affect the right of either the patient or the nearest relative to seek independent legal advice on it shouldn't affect any legal aid entitlement if applicable. So what type of support is available from the I M. H A. Well under section 130 be the I Am H. A. Is there to assist the qualifying patient on to help in obtaining information about and understanding the following. Firstly, the basis under which the patients detained on the particular parts of the MH A, which apply to them. Secondly, the patient's rights and rights of others, such as the rights of the nearest relative. Thirdly, any conditions or restrictions as applicable to which the patient is subject to such as, for example, conditions of leave. Fourthly, what if any medical treatment is to be given to the patient or is proposed or discussed? Fifth, really, why the treatment is given proposed or discussed. 60. The legal authority under which it is or would be given on. Finally, the safeguards on requirements of the MH A, which apply or would apply in connection with the giving off that treatment to the patient. For example, a section 57 treatments and I am a chaise help patients to exercise their rights, including in accordance with Section 1 30 b, subsection three by help in obtaining information about and understanding any rights which can be exercised under the MH A by or in relation to the patients, but also help by way of representation or speaking on their behalf in exercising off their rights. So, for example, the I am Hey Trey could ensure patient can participate in the decisions that are made about their care and treatments, or accompany the patient toe hospital managers, hearing or a review meeting. Help the patient to access legal advice. Assist the patient in making an application to the tribunal or support the patient at a tribunal hearing. What about the patient's confidentiality? Well to enable the I. M. H. A to fulfill their role. Section 1 30 b Subsection three makes it clear that the I am a chain must be able to visit an interview. The patient in private on visit an interview Any person who is professionally concerned with that patient's medical treatments on require the production off and inspect any records relating to the patient detention or treatments in any hospital or registered establishment or to any after care services on Finally require the production off and inspect any records off or held by a local social services authority which relate to the patients. However, that is provided that the patient has capacity on consents or when the patient does not have capacity. The I am hey chaise access to those records may be relevance to the help to be provided by them on the production or inspection is appropriate on. The disclosure would not conflict with the decision made on the patient's behalf by the patient's attorney or deputy or by the court of protection. Otherwise, there is no right or entitlement to the production off ought to inspect patient records in relation to their detention or treatment or to any aftercare services or records from local Social Services Authority. Hospitals should have a procedure foreign i m Hey Che to access patient records, and the code advises that where a patient doesn't have capacity, the record holder at the hospital should ask the i m. H. A to explain what information they think is relevant to the help that they are providing to the patient on why they think it's appropriate for them to be able to see that information. And since the MH A doesn't define when the I am hey, chaise, access to records would be appropriate. The code advises that the decision maker must consider the following the patient's wishes and feelings, including any written statements made in advance. They should also consider what would be in the patient's best interests on not, for example, what would be the most convenient for the organization, which holds the records. The starting point should usually be that it's a likely to be in the patient's interests to be represented by an I m. Hey Che, who is knowledgeable about their case. The decision makers should also consider all the facts of the case on whether disclosure off the confidential patient information contained in the records is justified. The code advises that if the record holder thinks that disclosing the confidential patient information in the records to the I M. H. A would be in the patient's best interests, it's likely to be appropriate to allow the i. M. H A access to those records in all but the most exceptional cases. The code also advises that conditions hospital managers on local authorities for guardianship patients should ensure that I m hate chaise are able to access wards and units on which patients are resident. They're able to meet the patients there helping in private, unless the patient objects or its otherwise inappropriate, such as, for example, where the risk is too great. On the I am, Akshay must be able to attend meetings between patients on the professionals involved in the patient's care and treatment went asked to do so by patients. The code also reminds healthcare professionals that the normal rules on patient confidentiality applied to conversations with I m hey chaise. Even when the conversation is at the patient's request on should be careful not to share confidential information with I am a Chase. Unless the patient has consented to the disclosure or the disclosure is justified on the normal grounds, a lot of the patient quite simply changes their mind on. Wants to end the relationship with the I am Hey Che, while a patient can refuse to be interviewed, doesn't have to accept help from a ni mh A. If they don't want it on contar, terminate the support they're receiving from an I M h a at any time. And that brings us to the end of this session on Thank you for joining me, Steph Barber.
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