Patients Lose Out as 1 in 7 Psychiatric Wards Break the Law

PRESS RELEASE: with immediate effect

Patients Lose Out as 1 in 7 Psychiatric Wards Break the Law

Action for Advocacy (a4a) has called on the Department of Health, PCTs and Mental Health Trusts to take action to address the failures in commissioning and implementation of the Independent Mental Health Advocacy (IMHA) service which have put patients’ rights at risk.

Despite being recognised as an important safeguard that supports patients to understand and exercise their legal rights, funding is not sufficient to meet demand and many ward staff do not tell patients about the service. 20,000 people are subject to the compulsory powers of the Mental Health Act at any one time, 16,000 as in-patients; 4,000 on community treatment orders (CTOs). a4a estimates that, at this very moment, at least 5000 people are being denied access to their statutory right to advocacy.

The Care Quality Commission report - Monitoring the Mental Health Act in 2010/11 shows a large scale failure in the Mental Health system. As the report states, “some staff who should have been fulfilling the detaining authority’s legal duty to explain the advocacy service to patients did not understand it, or even know of its existence.”

Despite having a legal right of access to Independent Mental Health Advocates (IMHAs) people on mental health wards are being routinely denied access to this service. The scale of the shortfall is shocking. Only 68% of wards have regular access to IMHA. 85% of wards were found to have access to IMHA on request, but even this generous interpretation means that legal rights are being ignored on more than 1 ward in 7.

Rick Henderson, Chief Executive of a4a says “The CQC report shows that in some areas, commissioning of the IMHA service demonstrates the worst kind of tokenism. These problems were highlighted by a4a in 2009 and have still not been addressed.”

The report shows that commissioning is inhibiting access to advocacy. Funding levels have left advocacy providers with insufficient resources to meet demand so that, for some people access to IMHA is theoretical. Access is particularly poor for people who are placed out of their local area and people on Community Treatment Orders (CTOs). Advocacy services which support people before they reach crisis point are having their funding cut in direct contradiction of commissioning guidance.

Martin Coyle, Deputy Chief Executive of a4a said, “The report confirms findings from a4a’s own experience and research. However it does not even take account of the failure of ward staff to make referrals to IMHA when people are unable to do so themselves. A whole category of people are being denied some important safeguards”.

The echoes some of the findings of a4a’s report Advocacy in a Cold Climate which shows a worrying trend in cuts to advocacy provision which could see tens of thousands of people at risk of abuse losing access to advocacy services.