Addendum

to

Advocacy in Birmingham

for those with Mental Health Issues.

{The above report was written for Birmingham LINk Mental Health Working Group. In this addendum, as in the report, all opinions expressed are my own, not those of Birmingham LINk}
I have not undertaken a systematic review of advocacy in Birmingham as I did in 2009.

This addendum updates changes that I have become aware of in the course of the various mental health activities I am involved in. It needs to be read in conjunction with the full report at:

http:// www.suresearch.org.uk/Advocacy_Revisionv1_Dec2010.pdf

I

The IMCA & RPR Services

The Second National Report of the IMCA (Independant Mental Capacity Advocates) Service: April 2008-March 2009 gave the following figures in relation to English referrals.

Year total: 8 327, of which 6 582 were eligible and 1 745 were ineligible.

For Birmingham a year total of 180 referrals were made, of which130 were eligible and 50 were not.

According to the “Nature of Client’s Impairment” breakdown, 858 or 13% of referrals had “mental health problems” while a further 2,382 or 36.2% had dementia. So presumably the former figure relates to so called “functional mental health problems”. This means that 49.2% of the eligible referrals had either “functional” or “organic” mental health issues. The comment in “Advocacy in Birmingham for people with Mental Health Issues” page 3, para 3: “Referrals for Birmingham from April 2008-March 2009 have almost tripled” relates to the year April 2009-March 2010.

RPR (Relevant Person’s Representative) only came into force with the Deprivation of Liberty Safeguards (DOLS) on April 1st 2009. I am not aware of any statistics that are currently available regarding this role.

I am pleased to say that the Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) Forensic Services now have an IMHA (Independant Mental Health Advocates)service, provided by Friendship Care and Housing Advocacy. This was put in place almost one year after it became a statutory duty (placed on Primary Care Trusts) to provide an IMHA service to qualifying patients.

 

General Mental Health Advocacy

There is one addition to the list of advocacy organisations in this section.

Birmingham Community Advocacy

[This paragraph has been removed for correction.]

North Birmingham Advocacy (Rethink)
The most recent Service Level Agreement with the PCT does not include the proviso that North Birmingham Advocacy works only with people aged under 65 years of age.
The advocacy post directly funded by the BSMHFT in the Mental Health Service for Older People mentioned in the final paragraph of page 5 of the Advocacy Report no longer exists.

II

Children and Adolescent Mental Health Service (CAMHS)

Following prolonged and unsuccessful negotiations with its commissioners the CAMHS has funded an IMHA services from its own budget. It plans to recharge the Primary Care Trust from which the qualifying patients come for this service. The IMHA is provided by the National Youth Advocacy Service (NYAS).

Learning Disability Service

Agreement has finally been reached by the commissioners and an IMHA is being provided by Friendship Care and Housing Advocacy. In fact it is one full-time post split between the Forensic Service and the Learning Disability Service.

III

{I am not aware of any changes to advocacy in non NHS establishments registered to take detained patients.}

Issues of Concern

I identified four issues of concern in the December 2009 report.

The first was the failure of the relevant commissioners to ensure that all qualifying patients in Birmingham could access an IMHA. This now seems to have been successfully tackled.

My ongoing communications with the Care Quality Commission (CQC) were difficult. I was informed that the CQC does not regulate commissioners. I stated that in not ensuring qualifying patients were able to access an IMHA, the CQC was manifestly failing in its duty to protect the interests of detained patients.

By way of written parliamentary questions, asked by Dr. Lynne Jones MP, of the Minister, Phil Hope, I was informed that from April 2010. “The availability and accessibility of advocacy will be a standard question asked on all their regular visits to hospital...A CQC report concerning initial findings on the implementation of Independent Mental Advocacy in 2009-2010 is planned for publication in October 2010.”

The second issue was age discrimination in the commissioning of general mental health advocacy. As mentioned on page two, Rethinks contract no longer excludes people over the age of 65 years of age. However the main provider of general mental health advocacy Voice still excludes people over 65 years.

The third issue was the lack of co-ordination/communication between the different sets of commissioners. I am not aware of any improvement in this area.

The fourth issue was the lack of a welfare rights and debt service to all service users. Again I am not aware of any improvement in this area.

 

Acknowledgements:
I would like to thank....

Dr. Lynne Jones MP and her parliamentary assistant Ingrid Davidson for their ongoing help with written parliamentary questions.

My Birmingham LINk colleague Paul B. Tovey for sharing his experience in getting answers through Freedom of Information requests and written parliamentary questions.

Mark Vaughn of Friendship Care and Housing Advocacy.

Caron Thompson and Nick Hay, of LINk, for their ongoing support.

Contact details for all advocacy organisations are in the December 2009 Report, which can be found here

Alex Davies. April 2010

DAB-P (21st April 2010)