mental Health - January 2010
MCA advocacy: the second year
The Department of Health has just
reported on the second year of Independent Mental Capacity Act
activity.
There have been increases across the board,
with women more likely than men to have an Independent Mental
Capacity Advocate (IMCA), and those over 80 years-of-age the
likeliest of all. Because of some schoolboy errors, however, the
report’s conclusions about adult protection work are too
pessimistic.
The largest rises were in the use of IMCAs in
care reviews and with serious medical treatment, where the first
year’s figures had been troublingly low. Decisions about a change
in accommodation were also more likely to involve IMCAs, but
overall, the Department doesn’t think that the service is reaching
all the people it needs to.
When it comes to adult protection work where
the new report is equally downbeat, the picture is a little more
complicated. This is for two reasons:
- The report mis-states the rate of increase in
IMCA referrals. There were 681 in 2007/08 and 960 in 2008/09, a
rise of 41 per cent (not the 29 per cent claimed).
- And the report has an exaggerated view of the
powers of local authorities. It says an IMCA may be appointed even
where there is only an allegation of abuse. In fact, that step can
be taken only where adult protection proceedings have already been
commenced or are at least in prospect. (That state-of-affairs was
the subject of adverse comment last autumn, following research into
the use of IMCAs in adult protection proceedings.)
These reservations notwithstanding, the latest
figures are troubling. They show, for example, that while Cornwall
made 50 adult protection referrals to IMCAs in 2008/09, and Devon
made 43 and Birmingham 33, only 20 local authorities made more than
ten referrals, and ten local authorities made no referrals at
all.