Evaluation of the Independent Mental Health Advocacy Service (IMHA)

IMHA has proven to be very successful in a challenging context. After three years in operation, it has become an established part of the broader mental health service system. Consumers highly valued IMHA because it maintained their rights and because advocates treated them with dignity and respect. Irrespective of whether IMHA advocates achieved the outcome the consumer identified, consumers appreciated an advocate being present. Professionals who had worked with IMHA generally held it in high regard. To successfully maintain the rights of people subject to compulsory mental health treatment IMHA must be accessible to everyone who is eligible for it. This requires the adoption of an opt-out system where every person made subject to compulsory treatment is offered advocacy. This will require increased resourcing for IMHA to be able to respond to increased demand. With or without an opt-out system IMHA will require significantly more resourcing to ensure equitable access to advocacy via service promotion, and ensure referral pathways. Across the sector, but particularly in community mental health services, awareness of IMHA and understanding of the IMHA model is low. An opt- out system will reduce the need to address this and enable IMHA to focus on providing advocacy services instead of promoting the service. Achieving IMHA's key objective of maintaining the rights of consumers will require a whole of system approach with political and public sector leadership. Oversight and funding bodies, led by DHHS and including VLA, the Office of the Public Advocate, the Second Psychiatric Opinion Service, the Mental Health Complaints Commissioner, the Mental Health Legal Centre, the Victorian Mental Illness Awareness Council, Tandem, the Office of the Chief Psychiatrist and the Mental Health Tribunal, must invest and coordinate with mental health services to ensure that services comply with legislation, are recovery-oriented and least- restrictive in practice, and people are provided with the support they need to make decisions. The evaluation identified an enormous amount of goodwill in the sector, but little in terms of tangible outcomes or improved experiences for consumers. IMHA is working towards this goal but is hindered by inaction and resistance in some parts of the sector. Sector leadership will be required to address these systemic issues going forward. The 2019 review of the Mental Health Act 2014 and the proposed Royal Commission into Mental Health in Victoria provides an ideal opportunity for this.