Actors have been used in some of the scenes in this film.
More and more people are being detained in hospital
and on Community Treatment Orders.
The nurse said to me that I'll end up on a section
and I didn't even know what that meant.
I can't leave and the medication that I take,
I don't know what effect it's having on me.
I just don't know what to do.
I feel like I don't have freedom in my own home
and I don't know what my rights are.
Independent Mental Health Advocacy or IMHA
is a specific safeguard under the Mental Health Act.
Put simply, advocacy is a must do.
It is a statutory right for service users to have access to an IMHA
whenever they arrive on a ward for inpatient treatment
or are offered treatment in the community under a Community Treatment Order.
A service user has the right to access an IMHA,
they should be given information by a nurse on how to access the service.
It is important for the service users to know that there are independent people
who can look objectively at their situation and not judge them,
not make assumptions about them.
They're there to support them and to get their voice heard.
The essence of our job is to have a meaningful dialogue
with our service users.
Some service users may not have English as their first language,
they may have a learning disability, they might be very unwell.
It's fantastic from my point of view
that an advocate helps the staff have a dialogue with a patient.
So we should always see that as a huge opportunity, as a huge benefit.
Service users value being listened to.
Respectful listening and cooperative relations will result in better outcomes.
An advocate can help service users
feel less confused, alone, frustrated and angry.
This can make a positive difference to relations with care teams.
Their input can open up meaningful channels of communication
and can help service users understand their care and treatment decisions.
When an advocate listens to you, is there to support you,
just being in a meeting and just being there is support itself.
You might tell the advocate something more personal
you wouldn't tell a doctor or nurse.
What can staff do to help?
It's important for the IMHA when they come on to the ward
or when they're seeing the service user
to have some privacy to speak to that person.
There should be little interview rooms available.
It's very important for staff to work collaboratively with the IMHA
who at the end of the day isn't making decisions on behalf of the service user
but trying to represent those opinions and choices.
Sometimes they may be exactly the same perspectives as the multidisciplinary team
and other times there may be a difference of opinions
and it would be important to discuss those difference of opinions
and try to find a way forward that is most useful to the service user.
It is a statutory right now for patients to be able to access their clinical notes
via the IMHA, it's obviously very important for staff to realise that.
They are independent,
in some circumstances an advocate, for instance,
may not want to come into the office and sit and chat to staff
and joke and chat in the office
because the patient would be looking through the window.
I think it's so important for the advocate to be kind of neutral,
to be independent.
Some practical ways to support advocacy include:
Making referrals, raising awareness,
involving service users and advocates in decision making
and informing the commissioning of inclusive services.
Most of all staff can help
by developing positive working relationships with IMHAs,
that take care to preserve independence
because service users have the right to be heard.