Detained mental health patients denied right to advocacy

Detained mental health patients are losing out on their right to independent advocacy because of underfunding and inadequate commissioning, campaigners have found.

Providers of independent mental health advocacy (IMHA) are over-stretched and unable to help all of the people who need their support, found the report by the Mental Health Alliance, a coalition of mental health leaders and campaigners.

Some patients were not being made aware of their right to advocacy because of a lack of communication between service providers and hospital staff.

The report, based on a Freedom of Information survey of English primary care trusts and a survey of IMHA providers, found significant problems with PCT commissioning.

While some good practice existed, it found PCTs underfunded services because they failed to predict demand, and some did not have proper contracts with providers.

A rushed commissioning process meant most PCTs failed to put the service out to tender and used existing advocacy providers. This meant services failed to meet the needs of black and minority ethnic groups, who are disproportionately affected by detention under the Mental Health Act and community treatment orders.

Detained patients and those subject to CTOs have a right to independent advocacy under the Mental Health Act 2007, which alliance chair Alison Cobb described as a “vital safeguard”. Ministers postponed implementation in England until April 2009 to give commissioners and voluntary sector organisations more time to prepare.

The report recommended that:

• Commissioners should carry out IMHA needs assessments and put new contracts out to tender so that comprehensive services are provided.

• Mental health service providers should ensure that service users are made fully aware of their rights to an IMHA.

The report comes with responsibility for commissioning IMHA services due to shift to local authorities under the Health and Social Care Bill, because of the abolition of PCTs by 2013.

“It is vital that local authority commissioners are given clear guidance to help them to commission advocacy services to meet all of their local needs,” said Cobb.

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