Frank* is a 66 year old man who has been diagnosed with depression and has suffered two strokes that have affected his mobility and speech. Frank uses a wheelchair and as a result of the strokes he has poor speech. To communicate he writes his wishes down, makes gestures and expressions and responds with single words.

Frank was referred for an Independent Mental Health Advocate (IMHA) as he was detained under section 3 of the Mental Health Act 1983 and had an upcoming tribunal. Upon the IMHA meeting with Frank, they explained his rights, how advocacy could support him and the role of an Independent Advocate.

Frank expressed a wish to leave hospital and that he was very unhappy and that the ward environment was proving difficult for him due to other patients being unwell. The IMHA explained the tribunal process to Frank and obtained the reports review with him.

How we helped

The IMHA supported Frank through the tribunal and along with the solicitor put forward his views and wishes. When the section 3 was upheld, the IMHA supported Frank to exercise his right to submit an appeal to the hospital manager’s meeting. As Frank did not wish to attend the hearing, he gave permission for the IMHA to go on his behalf. When his section 3 was upheld again, the IMHA continued to support Frank throughout his hospital stay and attended CPA meetings to discuss options for when he is discharged.

When a discharge Care Programme Approach (CPA) meeting was held, Frank agreed that he required 24 hour care for his mental health and mobility needs and had been to view a care home that he liked. Prior to the discharge CPA, the IMHA met with Frank and established with him any questions he would like to ask and anything he wished to discuss with the MDT (Multi-Disciplinary Team). During the meeting the IMHA ensured that Frank understood the proposed plans for his care and ensured professionals were aware of Frank’s views and wishes.

The IMHA conducted a follow up visit to the care home Frank had moved to. It was discovered that he did not like the care home due to the noise, other patients’ conditions (such as advanced dementia) and the lack of privacy. The application for a Deprivation of Liberty Safeguarding (DoLS) standard authorisation had been granted. The IMHA then took the role as paid Relevant Person’s Representative (RPR) under the DoLS. Frank remained very consistent in his wish to return back to his flat and expressed high levels of frustration due to his restricted mobility.

The RPR supported Frank to seek legal advice and an application for a section 21A challenge was submitted. The RPR supported Frank throughout this process alongside his solicitor, and the local authority agreed they would put a plan in place for Frank to work with the community rehab team to improve his mobility so he could be assessed to return home. With this plan in place, Frank’s mood improved significantly as a result of his improved mobility. It was then felt by the local authority that Frank would benefit from a six week residential rehab placement then to move home.

Frank moved from the care home to the rehab placement and then back to his own flat with a package of care, this was in line with his views and wishes and was the least restrictive option available to Frank. The Advocate achieved a positive outcome for Frank and improved his wellbeing and gave him back his independence.  

*Names have been changed to protect the identity of the people we support