Independent Mental Capacity Advocacy
Independent Mental Capacity Advocates, or ‘IMCAs’, are trained professionals who support people who lack capacity, as outlined in the Mental Capacity Act, around certain decisions. Their role is to help ensure that the person’s views and wishes are respected and taken into consideration.
Independent Mental Capacity Advocacy (IMCA) is a statutory service under the Mental Capacity Act. Local authorities and NHS organisations have a duty to refer individuals who lack capacity and may benefit from the support of an IMCA in specific situations.
What is mental capacity?
The Mental Capacity Act applies to people who, due to an impairment or disturbance in the functioning of their mind or brain, are unable to make a specific decision at a particular time. This could be the result of a disability, injury, or illness, and may be temporary or long-term.
Lacking capacity means a person is unable to understand, retain, or weigh up the information relevant to a decision, or communicate their decision. This might affect everyday choices, such as when to have a bath, or more complex decisions, such as those about medical treatment or where to live.
A person’s capacity can fluctuate over time, and it is rare for someone to lack the capacity to make all decisions.
Who might need this service?
Local authorities and NHS organisations have a duty to (meaning they must) refer someone for the support of an IMCA if:
- The person is 16 or older.
- A decision needs to be made about a long-term change in accommodation (for example, moving into a care home) or serious medical treatment.
- The person has been assessed as lacking capacity in relation to that decision.
- The person has no-one else who is appropriate to consult about the decision, such as a family member or a friend. Someone who is paid (for example, a support worker or a social worker) cannot provide this support as they are not independent.
In addition, local authorities may (but do not have to) refer for an IMCA where a decision needs to be made about:
- Adult safeguarding cases (whether or not the person has family or friends involved)
- Care reviews for individuals lacking capacity regarding their ongoing care and accommodation
An Independent Mental Capacity Advocate can help by:
- Meeting with the person to try and gain their views, wishes and feelings.
- Supporting the person to be as involved as possible in the decision-making.
- Speaking to other people in the person’s life (e.g. care workers) to gather information.
- Deciding whether to ask for a second opinion (for serious medical treatment decisions).
- Writing a report for the person responsible for making the decision (usually a social worker or doctor).
- Attending best interest meetings about the decision.
- Accessing relevant care and health records.
- Looking at alternative options.
- Challenging decisions if it is appropriate (for example, if the principles of the Mental Capacity Act have not been followed).
If people can’t tell their advocate what they want, it’s not a problem. Our advocates will find different ways of working to help establish people’s views and wishes as far as possible so that their rights can be upheld. We call this ‘non-instructed’ advocacy.
Who can make a referral for an IMCA?
- The local authority or NHS
- The person responsible for making the decision (usually a doctor or social worker) or someone acting on their behalf (e.g. a secretary or member of nursing staff)
If you think someone should have the support of an IMCA, but you do not work for the local authority or NHS, you can still contact us and let us know. We can then get in touch with the person making the decision to discuss the referral with them.
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