Independent Mental Health Act Advocacy

Elizabeth* was detained under Section 3 of the Mental Health Act. She had been in hospital for a year, following various trials and seemingly ineffective treatments. Elizabeth’s multi-disciplinary team (MDT) at the hospital were considering electro-convulsive treatment.

During the first lockdown, our Advocate was asked to explore Elizabeth’s views about the proposed treatment. The Advocate got to work, researching and asking questions of the MDT to ensure she had all the information she needed in relation to the treatment.

Elizabeth was a non-native English speaker so to ensure that she was involved in the process as much as possible, we arranged for an interpreter to join their Skype meeting – normally such meetings would happen face to face but due to COVID-19 restrictions, this was not an option. With the help of the interpreter, our Advocate was able to gather Elizabeth’s views, wishes and feeling around electro-convulsive treatment.

How we supported Elizabeth

Our Advocate built a trusting and honest relationship with Elizabeth, giving her the time and space to consider the treatment. We helped Elizabeth access information in her own language. Our Advocate also worked with the MDT to ensure that a person-centred approach was being taken throughout this decision-making process - this included professionals agreeing to speak with Elizabeth on a one to one basis outside of meetings and allowing her time to process information.

Elizabeth was against the treatment and was able to explain her reasons for this. Our Advocate supported Elizabeth in communicating her wishes and outlined the ways in which she had recalled information, weighed up aspects of the decision and showed understanding of the procedure and her rights.

A meeting was called and during this time, the responsible clinician explained the procedure to Elizabeth in more detail. This explanation included why the treatment was being proposed, the effects, practicalities and risks associated with treatment and the necessary general anaesthesia, and the alleged benefits and burdens of the procedure as well as what the Mental Health Act says about it.

During this meeting it was felt that Elizabeth had capacity in relation to this decision, and as she was refusing to have the treatment, this could not be forced on her. 

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

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