Mental Health Information Directory

What is advocacy?
Advocacy means getting support from another person to help you express your views and wishes, and to help make sure your voice is heard.
Someone who helps you in this way is called your advocate.

Unfortunately, having a mental health problem can sometimes mean that your opinions and ideas are not always taken seriously, or that you are not always offered all the opportunities and choices you would like. This can be difficult to deal with, especially when you need to communicate regularly with health care professionals, or other professionals.

What does an advocate do?
How your advocate helps you is up to you – they're there to support your choices. For example, they can:

• listen to your views and concerns
• help you explore your options and rights (without advising you in any particular direction)
• give you information to help you make informed decisions
• help you contact relevant people, or contact them on your behalf
• accompany and support you in meetings or appointments

An advocate will not:

• give you their personal opinion
• solve problems and make decisions for you
• make judgements about you

Who can be my advocate?
There are lots of different kinds of advocate you could approach, depending on your situation and the kind of support you want. For example:

• You can access a professional advocacy service through some organisations and charities.
• Your friends, family, or carers can act as an advocate for you.
• You can also be an advocate on your own behalf (called self advocacy).

Do I have a legal right to an advocate?
In some circumstances, you may be legally entitled to a professional advocate, such as an Independent Mental Health Advocate (IMHA) or an Independent Mental Capacity Advocate (IMCA) – this is called statutory advocacy. See 'What is statutory advocacy?' on p.15 for more information on whether this applies to you, and how to access this kind of advocacy.
Advocates are so important!... Mental illness at times can make it hard to do what needs to be done, [to] stand up for yourself, to be listened to or taken seriously.

What types of advocacy can I access?
Advocacy can be helpful in all kinds of situations when you are finding it difficult to have your opinions and choices heard. There are lots of different advocacy services that can help you, depending on your situation and what sort of help you want.

Community advocacy services
Community advocacy refers to all advocacy that is not a legal entitlement. It can support you to cope with a range of situations you may come across in your daily life.
You can find out more about community advocacy services from organisations like:

• POhWER
• seAp
• VoiceAbility

Advocacy for a specific cause
There are also charities and organisations which support a specific cause and may be able to offer you advocacy if your problem is related to their cause. For example:

• Shelter offers advocacy for people experiencing housing problems.
• PACE offers mental health advocacy anyone who is lesbian, gay, bisexual, transgender or identifies as part of the LGBT+ community.
• Coram Voice offers mental health advocacy for young people in care.

Group advocacy (also known as collective advocacy)
This is where a group of people with similar experiences meet to support each other and collectively strengthen their voice. You can find more information from:
•Mental health charities, like the National Survivor User Network for Mental Health (NSUN), which has a network of mental health service-user groups across the UK.

• Your local Mind
• Mind's Infoline

Peer advocacy
Peer advocates have lived experience of a mental health problem and can support you to cope with a range of problems you may be experiencing. You can find more information from:

• Your local Mind
• Mind's Infoline

Statutory advocacy
In some circumstances, you may be legally entitled to an advocate. These are Independent Mental Health Advocates (IMHAs), Independent Mental Capacity Avocates (IMCAs) and advocates supporting people under the Care Act 2014.

Can my family, friends or carer be my advocate?
If you're not able to get support from an advocacy service, you may be able to get support from someone close to you, who you trust. Friends, family or carers can be an advocate for you, if you want them to. They can help you feel reassured and supported by:

• discussing treatment options with you
• helping you to find information
• coming with you to appointments
• making phone calls for you
• encouraging you and helping you to feel more confident about making decisions
• acting as your attourney if you appoint them under a lasting power of attourney. They don't have to be a lawyer to do this, but they do have to be over 18 and be someone you trust to make decisions for you if you lose capacity.

You may find that just talking to a family member, friend or a carer helps you work out what your questions and concerns are. If your family and friends want ideas about how to support you, you could show them the friends and family section of our guide The Mind guide to seeking help for a mental health problem.

Can I be my own advocate?
You can act as your own advocate if you want. This is called self-advocacy. Self-advocacy is about learning skills and building confidence to have a stronger voice for yourself. Some organisations run training sessions teaching self-advocacy skills, such as:

• CoolTan Arts
• VoiceAbility

You can also contact organisations that can give you more information about setting up a self-advocacy group in your area, such as:

• Rethink Mental Illness
• VoiceAbility

What questions should I ask my advocate?
It is important you feel comfortable with your advocate and feel able to talk to them about your situation. As a starting point, you may find it helpful to talk to your advocate about how you can work together and what you do – or don’t – want them to do. You may find it helpful to put together some questions to ask them, such as:

• How will I contact you, and when are you available?
• What issues can you help me with?
• What can’t you help me with?
• Can you come to meetings and appointments with me?
• Can you work with me if I am in hospital or if I am in the community?
• What records do you keep and who sees them?
• What is your confidentiality policy? What things won’t you keep confidential?
• If you do something I am not happy with, how can I complain?

What can an advocate help me with?
How you work with an advocate is up to you. Depending on what type of advocacy you access, and what sort of issues you'd like support in handling, an advocate can be involved in different ways. For example, an advocate could support you with:

• a GP or health appointment
• a dispute at work
• benefit claims and appointments
• a housing problem

The support of an advocate is often particularly useful in meetings when you might not feel confident in expressing yourself. They can:

• support you to ask all the questions you want to ask
• make sure all the points you want covered are included in the meeting
• explain your options to you without giving their opinion
• help safeguard your wellbeing during the meeting – for example, if you find the meeting upsetting, your advocate can ask for a break until you feel able to continue.

A GP or health appointment
You may have a GP or doctor's appointment you want support with, or you may want support accessing treatment. An advocate can come with you to appointments or help you communicate with your doctor, whether by phone, letter or in person. See The Mind guide to seeking help for a mental health problem more information on how to talk to your doctor.

A dispute at work
An advocate can support you by helping you understand your rights in the workplace. In some situations, for example, if you feel you are being discriminated against because of your mental health problem, they might be able to speak with your employer on your behalf, or support you during meetings.

Benefit claims and appointments
You may need to:

• make a benefit claim
• attend a work capability assessment (WCA)
• appeal a benefit claim that has been turned down

An advocate can:

• help you understand your welfare rights
• support you to claim benefits you're entitled to
• make phone calls
• attend appointments with you
• help you understand the process of challenging a claim

Your local Mind and Citizens Advice can also offer you support and information.

A housing problem
If you have a housing problem, such as rent arrears, you may feel you need help managing it. An advocate could help you understand your rights around housing and help you talk with local authorities.

• Shelter offer advocacy services for people experiencing housing problems. They also have a helpline and run face-to-face advice centres in the UK.

How can I find an advocate?
Depending on your situation and what you want help with, there are various organisations that can help you find statutory and non-statutory advocacy services in your local area:

• Mind Infoline will be able to give you contact details of your local advocacy groups and advocacy organisations.
• your local Mind may offer advocacy services and can offer you information and support in finding out about your rights and
• entitlements.
• Rethink Mental Illness has an online directory of advocacy services across the UK on their website.
• Advocacy organisations, such as VoiceAbility and POhWER, provide advocacy services in many areas. You can contact them directly to see if they cover your local area.

What if there's no advocacy service in my area?
Unfortunately, if you're not entitled to a statutory advocate, you may find there are limited advocacy services in your area – or none at all. This can be really tough, especially if you feel you don't have people around you who you can ask for support. If you're in this situation, there are still some things you can try:

• Some organisations, like Rethink Mental Illness and VoiceAbility can support you to set up group advocacy in your area. This can involve people with similar experiences of a problem coming together to support each other to have their voices heard.
• If you have people you can ask, a family member, friend or carer can also act as an advocate for you.
• Be your own advocate. It might feel like a challenge, but you can learn to advocate for yourself.

What is statutory advocacy?
Statutory advocacy is when you are legally entitled to an advocate. There are three types of statutory advocates in England and Wales. These are:

• Independent Mental Health Advocates (IMHAs). These are specially trained advocates who can support certain patients under the Mental Health Act 1983. The law regarding IMHAs is different in England and Wales. For more information on whether you're entitled to an IMHA, and how to access one, see the following sections on:
• IMHAs (England)
• Independent Mental Capacity Advocates (IMCA). These are specially trained advocates who can support certain people under the Mental Capacity Act 2005.
• Care and Support Advocates. These can support certain people under the Care Act 2014. You can find more information about advocacy under the Care Act on the Social Care Institute for Excellence (SCIE) website.

What's the difference between an IMHA and an IMCA?

• IMHAs support people who are being assessed or receiving treatment under the Mental Health Act 1983.
• IMCAs support people who lack capacity to make certain decisions and are provided under the Mental Capacity Act 2005.

The same person might be qualified to act as both an IMHA and an IMCA, but they are very different roles.

If you're not entitled to any advocacy by law, there are still lots of ways you can access and get support from an advocate in the community.

When am I entitled to an IMHA?
You have the right to an IMHA if:

• you are detained under the Mental Health Act 1983, except where:
• you have been detained in an emergency under section 4
• you are detained under section 5 holding powers
• you have been taken to a place of safety under section 135 or 136 of the Mental Health Act
• you are “liable to be detained” – this includes:
• where you are on leave of absence from hospital
• where you are absent without leave from hospital
• where a court order or application for admission has been made in relation to you
• you are subject to a community treatment order (CTO)
• you are subject to guardianship
• you are a conditionally discharged restricted patient
• you are a voluntary/informal patient and certain treatments, including electroconvulsive therapy (ECT) and neurosurgery, are being considered for you.

How can an IMHA help me?
An IMHA can help you understand:

• your rights under the Mental Health Act 1983 and why certain decisions have been made
• the rights which other people (such as your nearest relative) have in relation to you under the Mental Health Act 1983
• the parts of the Mental Health Act 1983 which apply to you (such as the basis on which you are detained) and make you eligible for an IMHA
• any conditions or restrictions you are subject to (for example, relating to leave of absence from hospital or a CTO)
• any medical treatment that you are receiving or might be given,

including:

• the reasons for that treatment or proposed treatment
• the legal basis for providing that treatment
• the safeguards and other requirements of the Mental Health Act 1983 which would apply to that treatment.

On a practical level, an IMHA can help you:

• exercise your rights under the Mental Health Act 1983
• express your views about your care and treatment
• make a complaint about your care or treatment
• enforce your rights and get what you are entitled to
• make an application to the Mental Health Tribunal
• present your views and support you at a Mental Health Tribunal hearing
• access legal advice
• by representing you and speaking on your behalf – for example at review meetings or hospital managers’ hearings.

What should my IMHA be able to do?
Your IMHA should be able to:

• access the ward or unit where you are staying
• meet with you in private, unless you object or it is otherwise inappropriate (for example, if you pose a risk to the IMHA's safety)
• accompany 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 access an IMHA?
You can request support from an IMHA at any time after you become a qualifying patient. You can ask:

• a member of the ward staff
• your responsible clinician
• approved mental health professional (AMHP)

Whilst in hospital, you should have access to a telephone which you can use to contact an IMHA and talk to them in private.

Can other people ask an IMHA to visit me?
The following people can also ask an IMHA to visit you:

• your nearest relative
• an AMHP
• your responsible clinician

It is important to remember that you do not have to see an IMHA if you don’t wish to and that 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 so that they can explain to you directly what help an IMHA can provide.