Independent mental health advocacy should be offered on an ‘opt-out’ basis in the future, according to the Care Quality Commission’s latest annual review of how it monitors the Mental Health Act (MHA).
The review found that detained patients’ access to advocacy services ‘was made more difficult’ during the pandemic at a time when they needed even more support than usual due to extra restrictions on their daily lives.
Some wards had been happy to pass on letters of introduction from local advocacy providers to patients on admission or facilitate phone or video calls between advocates and patients. But the CQC also found wards where staff did not routinely refer any eligible patients to an IMHA, even where the patient lacked capacity to do so themselves.
‘In the physical absence of the advocate on the ward, this effectively undermined some patients’ right to advocacy at a very vulnerable time,’ the review states. This included advocates not being told about the admission of patients under section 2 of the MHA until after the patient’s 14-day deadline for applying to the Mental Health Tribunal had passed.
The review adds: ‘We hope that commissioners of advocacy services will learn from this experience of the value of facilitating a regular advocacy presence on wards. In the longer-term, we believe the law should provide more stringent duties on services to refer patients immediately on admission, with advocacy as an ‘opt-out’ service. This was recommended by the Independent Review of the MHA and we hope to see it taken up in future reform.’