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What is an advocate?

An advocacy service is provided by an advocate who is independent of social services and the NHS, and who isn't part of your family or one of your friends.

An advocate's role includes arguing your case when you need them to, and making sure the correct procedures are followed by your health and social care services.

Being independent means they are there to represent your wishes without giving their personal opinion and without representing the views of the NHS or the local authority.

An advocate might help you access information you need or go with you to meetings or interviews in a supportive role. You may want your advocate to write letters on your behalf, or speak for you in situations where you don't feel able to speak for yourself.

Local authorities fund advocacy services in their area. To find an advocacy service, contact your local council or check its website.

If you have a care co-ordinator from your local social services or healthcare team, they will liaise with other agencies for you.

Advocacy and disability organisations

People with learning or physical disabilities can often struggle to be listened to and have their wishes understood. SEAP is an organisation that provides advocacy support, and wants everyone to "have their voice heard on issues that are important to them within health and social care services".

It also provides training for advocates, volunteers and professionals who need to understand the role of advocacy in health and social care services.

The British Institute of Learning Disabilities (BILD) works with people with learning disabilities and their families to make sure they have the right support to make choices and decisions about their own lives.

Mencap's advocacy service enables people with a learning disability to speak up and make decisions about things that are important to them, while their Empower Me service provides personalised advocacy support for people with a learning disability. It aims to help people develop the skills, confidence and knowledge needed to voice concerns and secure rights.

Other advocacy organisations

Some advocacy services help people with a specific condition. For example, Diabetes UK offers an advocacy service for vulnerable people with diabetes, and is available in many areas of England and Wales. Email the Diabetes UK advocacy service or visit the Diabetes UK website.

Age UK gives advice and information to older people and their carers, family, friends and other people involved in their care. Some branches offer advocacy services.

Carers UK has a free advice line for carers – call 0808 808 7777 or visit the Carers UK website for advice on many aspects of caring. It doesn't provide an advocacy service, but can give you information on where to go for help.

Advocates from the charity VoiceAbility can help you get your voice heard and involved in making key decisions about your care and health needs.

Voiceability specialises in working with vulnerable people, such as those who have a disability, communication difficulties, mental health needs, and those who lack capacity, or those who have no one else to support them.

Advocacy and mental capacity

The Mental Capacity Act 2005 introduced Independent Mental Capacity Advocates (IMCAs). An IMCA supports people who can't make or understand decisions by stating their views and wishes or securing their rights.

This is a statutory advocacy service, which means in certain situations people who lack capacity must be referred to an advocate.

An IMCA is not the decision-maker (such as the person's doctor or care manager), but the decision-maker has a duty to take into account the information given by the IMCA.

The Independent Mental Capacity Advocate (IMCA) service aims to help particularly vulnerable people who otherwise have no family or friends consult about those decisions.

IMCAs are independent people who work with and support people who lack capacity, and represent their views to those who are working out their best interests.

An IMCA must be instructed, and then consulted, for people who lack capacity and have nobody else to support them (other than paid staff) whenever:

  • an NHS body is proposing serious medical treatment

  • an NHS body or local authority is proposing to arrange accommodation (or a change of accommodation) in hospital or a care home and (a) the person will stay in hospital longer than 28 days or (b) they will stay in the care home for more than eight weeks

An IMCA may be instructed to support someone who lacks capacity to make decisions concerning:

  • care reviews, when nobody else is available to be consulted

  • adult protection cases, whether or not family, friends or others are involved

GOV.UK has more information on what it means to have an IMCA.

Independent advocates under the Care Act

The IMCA service is not the only form of independent advocacy available to support individuals. New advocacy provision is being introduced as part of the Care Act 2014.

The Care Act introduces new statutory advocacy from April 2015. This is for people who have substantial difficulty in being involved with the assessment of their needs, or with their care planning or care reviews, if they have nobody appropriate to help them be engaged. Your local authority can provide more information.

Advocacy and mental health

The Mental Health Act introduced statutory advocacy for people who are detained under the Mental Health Act or who are under a Community Treatment Order (CTO). This form of advocacy is provided by advocates called Independent Mental Health Advocates (IMHAs). Care Programme Approach The Care Programme Approach (CPA) is a way that services are assessed, planned, coordinated and reviewed for someone with mental health problems or a range of related complex needs.

You might be offered CPA support if you:

  • are diagnosed as having a severe mental disorder

  • are at risk of suicide, self-harm, or harm to others

  • tend to neglect yourself and don't take treatment regularly

  • are vulnerable; this could be for various reasons, such as physical or emotional abuse, financial difficulties because of mental illness or cognitive impairment

  • have misused drugs or alcohol

  • have learning disabilities

  • rely significantly on the support of a carer, or have your own caring responsibilities

  • have recently been detained under the Mental Health Act

  • have parenting responsibilities

  • have a history of violence or self-harm

Anyone experiencing mental health problems is entitled to an assessment of their needs with a mental healthcare professional, and to have a care plan that's regularly reviewed by that professional. You should also be able to get an assessment of your care and support needs from your local authority to look at your social care needs.

How the CPA can help you

If you need CPA support, you should be involved in the assessment of your needs and in the development of the plan to meet those needs.

You’ll be told about your different choices for care and support services. As a result of the CPA, you should get a formal written care plan that outlines any risks – including details of what should happen in an emergency or crisis.

You will have a CPA care co-ordinator (usually a nurse, social worker or occupational therapist) to manage your care plan, and you’ll be given their name and contact details.

The care co-ordinator will make sure that the CPA care plan is reviewed regularly. A formal review is made at least once a year, and this will look at your circumstances, including whether CPA support is still needed.

If you aren't eligible for CPA help

If you don't meet the criteria for CPA support, you should still expect assessment of your needs, care planning and reviews of care plans to proceed as normal. These assessments and reviews should also consider whether you should be transferred to CPA support if your needs or condition changes. Other Advocate Services.. Mind for Mental health ALL TYPES..


seAp is an independent charity that provides free independent and confidential advocacy services for all

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