The Separation of the Mental Health Act Commission’s Functions: Inspectors, Visitors and Advocacy

Abstract

This article is written in the week in which both the draft Mental Health Bill1 and the Durham University Report on Independent Specialist Advocacy have been published for consultation. All Commissioners are being consulted about both documents and it would clearly be premature to express any Commission views until we have all been able to digest their contents. We shall naturally have strong views on a number of issues, particularly the expressed intention to replace
the White Paper’s proposed Commission for Mental Health3 by a division of the new Commission for Health Inspection and Audit which will be responsible for scrutinising the proper application of the new Mental Health Act.

My intention here is not to attempt to anticipate our considered response but instead to put the spotlight on a critical strategic issue which is not raised in either document and may otherwise be overlooked. This is the relationship between the concept of independent specialist advocacy services as set out in the Durham papers, the statutory functions of mental health advocates as described in the draft bill, and the amalgam of functions involved in the current visiting functions
of the Mental Health Act Commission (MHAC). There is no intention of suggesting answers to the questions raised. These will depend on consultation and consideration over time. The first part of the article, which is my sole responsibility, raises the general question. The second part describes, on behalf of the MHAC, how it has evolved since 1983 in a way which highlights the need for a close relationship between personal meetings with patients and a high level monitoring
function. This combination may not be wholly compatible with an advocacy role.