SCIE Resource guide 10: Commissioning and providing mental health advocacy for African and Caribbean men

Background: Current legislation

Current legislation and policy provide a framework within which mental health advocacy services for black and minority ethnic (BME) communities are commissioned and provided.

Equality Act

The Equality Act 2006 (1) moves away from a reactive approach, reliant on the individual taking action, to a proactive approach, with public sector bodies required to actively promote equal opportunities, eliminate discriminatory practices and to review progress and outcomes in terms of gender, race, disability, age, religion or belief and sexual orientation.

The Equality and Human Rights Commission aims to end discrimination, tackle inequality, promote good relationships between people and protect human rights. It brings together the work of the three former equalities Commissions: the Commission for Racial Equality (CRE); the Equal Opportunities Commission (EOC); and the Disability Rights Commission (DRC). The Commission was established under the Equality Act 2006 and is independent of government.

Mental Capacity Act and Mental Health Act

These acts introduce certain requirements for advocacy and new advocacy roles – Independent Mental Capacity Advocates (IMCA) and Independent Mental Health Advocates (IMHA).

Link: Good advocacy practice

The Mental Capacity Act 2005 (2) includes the statutory duty to provide an independent advocate for people who lack the capacity to make their own decisions about medical treatment or changes in their care arrangements and have no friends or family to support them. There are also discretionary powers for an IMCA in relation to adult protection procedures (even where there are family or friends) and care reviews.

The Mental Health Act 2007 (3) includes the statutory duty to provide advocacy for those people subject to compulsory powers. This applies to England and Wales.

• Independence means that advocacy should, so far as is practicable, be provided by a person who is independent of any person who is professionally concerned with the patient’s medical treatment.
• The function of the IMHA will include helping patients in obtaining information about and understanding:
  • the provisions of the legislation which he/she is subject to
  • any conditions or restrictions he/she is subject to
  • the medical treatment being given, proposed or being discussed, the authority under which this would be given and the requirement that would apply.

The Department of Health is planning to publish detailed commissioning guidance for Independent Mental Health Advocacy during 2008.

Our health, our care, our say

This Department of Health White Paper sets out a vision to provide people with good quality social care and NHS services in the area where they live. The emphasis is on social care services promoting independence and giving service users more choice and control. For health services, the aim is to develop more responsive services and prevent ill health by the promotion of healthy lifestyles.

Link: Department of Health: Our health, our care, our say

Commissioning Framework

• 'Our health, our care, our say' aims to support the shift towards services that are personal and sensitive to the needs of the individual.
• Stronger focus on commissioning for outcomes across health and local government, working together to reduce health inequalities and promote equality.
• Places a duty on the local authority to undertake a Joint Strategic Needs Assessment, which has to be focused on outcomes.

Link: Department of Health: Commissioning framework for health and well-being

Next in this section: Mental health policy