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Advocacy provocateur – a challenge and a call to advocates

Given the range of advocacy on offer, things have never looked better. However, Kate Mercer Training highlights three areas where improvements could be made

The right to receive advocacy support has never been stronger: a statutory advocacy now includes Independent Mental Health Advocacy (IMHA) for people subject to the compulsory powers of the Mental Health Act, Independent Mental Capacity Advocacy (IMCA) for people who lack capacity to make certain decisions; advocacy for people assessing NHS complaints processes; advocacy for children and young people receiving services under the Children Act and now the Care Act introduces the right of advocacy for people who face difficulty in being involved in assessment planning, review and safeguarding decisions and have no-one else to support their involvement.

Only around 50% of people entitled to receive IMHA actually do so, with fewer than 1 in 10 people accessing NHS complaints procedures were provided with advocacy support. A freedom of information request made by Community Care found that independent advocates were provided to just 2.1% of 253,000 people assessed under the Care Act between April and September in 2015.

A lack of decision making support

Most of us, at varying times in our lives, need help to make decisions. This could be a non-judgemental face across the table listening to our aspirations or concern, or it could be much more involved – particularly if we are facing challenging times, or have a condition or impairment that means we face difficulty or lack the capacity to make certain decisions.

A huge part of the advocacy role is to help people make decisions and the Mental Capacity Act (MCA) produced the best guidance a person needs to follow when they are going to make a decision on behalf of an incapacitated person. This process is called Substituted Decision-Making, but does the Act do enough to support this? Kate Mercer Training asks if there are ways to improve three areas of advocacy: the lack of referrals, lack of supported decision making and the lack of challenging decisions.