What does a good IMHA service look like?

Introduction

Independent Mental Health Advocacy (IMHA) is an important source of independent support and information for people subject to compulsion under the Mental Health Act 1983. Since it was introduced in 2009, the quality of IMHA provision has been measured in a number of ways: the Quality Performance Mark ⁽¹⁾ and ‘The right to be heard: Review of Mental Health Advocate (IMHA) services in England’ ⁽²⁾ both highlight factors which influence the quality of IMHA.

This self-assessment tool has been created to help IMHA providers and commissioners understand what a good IMHA service looks like. It enables IMHA providers to self-assess their service within a clear quality framework.

Ten key messages for quality IMHA services

• IMHA services must clearly define their role to ensure it is understood by people who use services, carers and mental health service staff.
• IMHA services should adopt an approach which emphasises recovery, selfdetermination and is person-centered.
• Demonstrable independence of the IMHA service from mental health services is essential.
• IMHA services should be co-produced; people who use services should be involved in all aspects of IMHA service design, implementation and monitoring.
• IMHA services should ensure they can meet diverse needs.
• IMHA staff should have relevant training and operate within a clear policy, management and accountability framework.
• IMHA services should have good links to other forms of advocacy provision and clear transition pathways.
• IMHA services should be accessible to all qualifying patients and monitor the service accordingly.
• An engagement protocol between the IMHA service and the mental health provider should:
  • include a clear process for mental health staff to support people who use services to access IMHA
  • provide a positive context for IMHAs to operate independently
  • enable the IMHA service to raise common themes and concerns
• IMHA services must measure and record outcomes.

Quality indicators

The following ten indicators can be used as a guiding framework to promote quality IMHA services. Each indicator is set out below with suggested evidence sources for self-assessment. IMHA providers can use the third column to rate themselves using red, amber and green traffic lights. (Red means the service is not meeting the indicator, amber means attention required, green means all is well.)

Completing the self-assessment

• Score yourself green, amber or red under each commissioning area.
• For each area you score green, record your key strengths in this area in the box provided.
• For each area you score amber or red, identify areas for development.
• Once you have completed the self-assessment, identify actions to address areas for development. Prioritise areas you have scored red.
• If you identify an area in which you think your authority is particularly strong, please share it with SCIE.