Protect rights; protect IMHA
I am circulating my views on the current discussion paper on the Mental Health and Wellbeing Act (MHWA). I am keen for your engagement and to hear your views.
With previous non-legal advocacy experience at IMHA and VMIAC, I was warmed by the Royal Commission’s recommendation for state-wide non-legal advocacy for people on, or at-risk of, compulsory treatment. However, I have become increasingly concerned that IMHA has not been confirmed as the state-wide provider of non-legal advocacy. I focus on this issue here.
The Royal Commission recommended a general scheme of non-legal advocacy. The Royal Commission not specifically identify IMHA as the state-wide service, but this does not preclude the Victorian Government from making such a decision.
IMHA was identified as immensely valuable within the Royal Commission’s final report,[i] is an independent evaluation of the service,[ii] and has support from other agencies such as the VMIAC. Very few, if any, other services in Victoria’s mental health system have been independently evaluated.
Having worked in other advocacy roles, and at several regulators and legal organisations across the mental health system, I can speak from deep practice experience that IMHA provides a unique service that should remain state-wide. IMHA is independent of the mental health system, while other models (and commissioning by the Regional Boards) becomes part of the mental health system, which risks capture. It has a specialised workforce and good internal governance and workforce infrastructure to ensure that advocates adhere to representational (rather than best interests) advocacy models.[iii] These models of advocacy were co-designed with consumers, and their self-advocacy resources were co-produced with consumers over 2 years.[iv] IMHA also has long-standing relationships and memorandums of understanding with every designated mental health service. In addition to this, there is consumer leadership built into the foundations of IMHA, both in its establishment and through its ongoing leadership from the Senior Consumer Consultant. Finally, IMHA is a recognised service for consumers, with that trust and brand recognition taking years to establish, maintain and strengthen.
Each of these things are threatened if IMHA is fractured or is commissioned by the Regional Boards separately (rather than the Department of Health). Trust will be lost, consumer leadership will be undermined, quality of service delivery will be threatened, and the risk of capture will loom large in different regions. There will also be increased and duplicated regulatory burdens on the Victorian Government, the Ombudsman, the Regional Boards, and the MHWC to ensure the quality-of-service delivery amongst the separate IMHAs. Importantly, IMHA is not a mental health service, so it should not be based or funded out of those services. IMHA also benefits from the close working relationship with Victoria Legal Aid, meaning intra-agency referrals for consumers with mental health and disability law issues, as well as other broad legal needs that consumers confront, are easily addressed. Other regions will not be able to provide this level of service for a lack of similar legal services. They may create referral pathways between their agency and Victoria Legal Aid, however deep connections and institutional learning – such as the role that IMHA’s Senior Consumer Consultant has had in promoting consumer leadership – are undermined by this fracturing.
While there are supposed benefits of a locally-commissioned IMHA, such as localising service delivery to each community’s needs, this hasn’t been identified by consumers or other stakeholders as an issue needing resolution. Therefore, the risks of fracturing, increasing regulatory burden, siloing of systemic advocacy and a lowering of holistic legal service provision are far greater. IMHA should be explicitly named within the legislation to meet the spirit of the Royal Commission’s vision, and to act on the views of people who called for non-legal advocacy.
[i] RCVMHS, Royal Commission into Victoria’s Mental Health System, Volume 4: The Fundamentals for Enduring Reform (State of Victoria, 2021) <https://finalreport.rcvmhs.vic.gov.au/download-report/>.
[ii] Chris Maylea et al, Evaluation of the Independent Mental Health Advocacy Service (IMHA) (RMIT University, 2019).
[iii] Wanda Bennetts et al, ‘The’Tricky Dance’of Advocacy: A Study of Non-Legal Mental Health Advocacy’ [2018] (24) International Journal of Mental Health and Capacity Law 12.
[iv] Daniel Van der Pluym, ‘Consultation Report - Supported Decision Making under the Mental Health Act 2014 - What Consumers Want’ (Consultation Report, Independent Mental Health Advocacy, Victoria Legal Aid, 2016); Alma Mistry, ‘New Resources Help Consumers Speak up and Protect Their Rights’ (Text, 3 April 2019) <https://www.imha.vic.gov.au/about-us/news/new-resources-help-consumers-speak-up-and-protect-their-rights>.
