Professionals lack knowledge of patient advocacy rights

Mental health professionals have a “troubling” lack of knowledge and appreciation of advocacy services for people detained under the Mental Health Act, a government commissioned report has found.

Resistance to advocacy “remains strong in some quarters” of the mental health profession, the Department of Health commissioned review of independent mental health advocate services in England revealed.

Some professionals saw advocacy services “as challenging, even irritating and inappropriate”, the research found. One professional told researchers advocates were “amateurs meddling” and a “bloody nuisance”. Others, particularly approved mental health professionals (AMHPs), supported advocacy “but had little or no direct experience” of service users using it.

The report, produced by academics at the University of Central Lancashire, recommends further training for professionals on their obligation to inform patients of the right to independent advocacy services.

Training for the majority of staff was “generally cursory” and done as part of an overview of the Mental Health Act, the report found. An exception was AMHPs, who were the group most likely to have received “thorough training” with regular refresher courses.

The report also recommends that mental health services should:
• Develop an organisational culture that promotes advocacy as a right, not something that is done in the patient’s “best interests”
• Promote the advocacy service to patients directly, not just rely on posters and other written information
• Ensure that patients can meet their advocate in private
• Take care to involve advocacy services in relevant meetings and provide advance notice to the patients and the advocate.

Black and minority ethnic communities, children and young people, dementia patients and people with learning disabilities, are among the groups “under-served” by advocacy services, the report found.

Karen Newbigging, principal lecturer at the University of Central Lancashire, said: “There are specific access problems for black and minority ethnic communities, and older people. Some of these challenges reflect the way services have developed.”

“One of our recommendations is that all people detained under the Mental Health Act should automatically be referred to independent mental health advocacy services with the option of opting out. This may overcome the problems of access for particular groups,” she said.