Independent Mental Health Act Advocacy

Jane* was detained under Section 3 of the Mental Health Act, on a secure mental health ward. She had been detained on the ward for several months and felt very anxious about her care and treatment plan. Jane felt her mental health had improved and she did not believe she required detention anymore, but she wanted to remain in hospital as an informal patient. Jane was particularly worried that she would be discharged with a plan which she would be unable to engage with, due to her high level of anxiety triggered by appointments with Mental Health Professionals.

When the advocate met with Jane, they explained her rights under the Mental Health Act. As Jane stated she did not wish to be detained, the advocate ensured Jane understood her right to appeal her section. The advocate also ensured Jane was aware of who her nearest relative was and understood the nearest relative’s right to request her discharge. Following this, Jane decided she did wish to appeal, and her advocate supported her to complete and submit the Tribunal request form and contact a solicitor of her choice.

Jane explained that she felt ignored by the nurses and doctor and that she had tried to explain why she felt the current medication and discharge plan would not work for her. However, the doctor had not confirmed that he would change the plan to reflect this – this was causing Jane additional anxiety. Jane felt that progress with her discharge planning was too slow, and that nothing had changed for several weeks. Jane was unsure what her current diagnosis was and was also anxious about her housing and finances. Jane said she found ward rounds overwhelming and felt frustrated that the doctor did not understand her full history.

How we supported Jane

The advocate supported Jane to prepare for her ward round by writing down a clear list of the points and questions she wished to see addressed and together, Jane and her advocate agreed a plan. The plan was that Jane would use the list as a prompt to ask the doctor questions, and that the advocate would ask questions on her behalf if she became too anxious or overwhelmed. They also agreed that the advocate would make a note of the doctor’s responses, as Jane found it difficult to remember what was said due to the stress and anxiety she was experiencing.

Jane felt less anxious having been supported to prepare for her ward round and felt supported by the presence of her advocate. As a result, Jane’s consultant was able to reassure her and provide answers to some of her questions, although she remained frustrated by the slow progress in some areas of her discharge planning.

Jane felt happier that she had shared her history with the consultant and that she had gained his assurance that he would write a letter to her GP so that they are also fully informed. The doctor was able to address her specific concerns and make suggestions and alterations to her care plan which were more person centred.

The advocate took the time to listen to Jane and to understand why she was feeling so anxious and helped her to explore different ways of addressing her anxiety.  Jane felt more confident asking questions, felt listened to and felt more in control as she was aware of her rights and knew how to exercise them.

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