Advocacy case-study: Rethink Manchester Mental Health Advocacy
Imagine what it’s like to be detained in hospital under the Mental Health Act against your will. You’re frightened, you may be alone and you may not know what your rights are, far less how to make sure they are protected.
Now imagine five or six professionals appearing by your bed on a ward round, discussing your case and making decisions about your future. It can be a terrifying situation for someone who has a mental illness, and who may find it hard to communicate with people in authority.
Now imagine how different that scene would feel if you had an advocate beside you –
someone who was on your side and there to speak up for you. What’s more, someone who understands the system, knows your rights and can ensure that any decisions made takes your best interests into account.
Rethink’s Manchester Mental Health Advocacy service works on behalf of mentally ill in-patients in NHS and independent hospitals throughout Manchester. It began operating in 2006, commissioned by Manchester Joint Commissioning Team after winning a competitive tender. Previously advocacy was provided by several agencies but the PCT wanted one comprehensive service.
“The vast majority of people who’ve been detained don’t wish to be there,” says area service manager Brian Burke. “Our advocates aren’t lawyers, they’re lay advocates who basically speak and listen to the person, ensure their voice is heard in terms of being in hospital, their medication, care planning and discharge out of hospital. We ensure their rights are protected and upheld, and give them information.
“Our service means these in-patients have someone on their side who can speak up. Some of them are elderly and have dementia – they haven’t got a voice at all, so we represent their needs as well.”
The service operates in three NHS hospitals and three in the independent sector. It is targeted at detained patients on adult wards, and sometimes involves adolescents who are placed on adult wards.
One service worker is nominated to work with black and minority ethnic patients, who are disproportionately represented in mental health services and who have typically not taken up traditional methods of advocacy. Our advocate works proactively to get these patients involved – by going on the wards, talking to them and encouraging them to use the service.
The service was established in July 2006 and now has five advocates and a service manager. In autumn 2006 we were asked to extend this contract to deliver an Independent
Mental Capacity Advocate (IMCA) service which started on April 1st 2007. This advocate will have more authority and rights than other advocates as its role is a statutory one to protect the rights and needs of people who haven’t got any friends or family to speak up on their behalf.
