Helping Kim

What was the person’s situation before working with Advocacy Focus?

Kim* was admitted to hospital under a Section 2 of the Mental Health Act and was referred into our service by the Mental Health Act Administrator, as there was concern that Kim did not understand her rights and was presenting as very confused and requiring support to express her views. Kim, who has a mild learning disability, had previously lived with her grandmother due to losing her previous accommodation, but was unable to return here upon discharge due to her Grandmother’s health concerns. Due to this Kim was being seen by the Patient FLOW Coordinator to investigate alternative accommodation and had an Adult Social Worker and a Family Social Worker supporting her, due to the recent removal of her child after child protection issues had arisen.

When Kim’s Independent Advocate first met with her, she presented as very confused and stated that she did not understand why she was in hospital and could not recall where she was living before she came to hospital. Kim’s Independent Advocate spent time with her offering reassurance, explaining her rights whilst under a section in hospital, and supported her to understand who the different professionals were that were involved in her life and what their roles were. Kim’s Independent Advocate made simplified notes that Kim could refer to at a later date if she forgot or became confused.

What did you do to help the person?

Over time, and as Kim’s mental health improved, Kim’s Independent Advocate supported her to speak to the ward staff about several issues, such as leave, and Kim wanting to attend some external medical appointments. Kim’s advocate was able to build a relationship with her to ascertain where she may wish to live upon discharge and what kind of setting. With Kim’s consent, the Independent Advocate shared this information at professionals’ meetings with both the FLOW Coordinator and her Social Worker and fed back to Kim at every step, as to what work was being completed around this. Kim’s wish was to live in supported living, but with a view to getting her own flat in the future.

Towards the end of Kim’s stay in hospital it became apparent that her care and treatment was completed and yet she remained on a Section. Professionals involved felt that should Kim become an informal patient she would leave the hospital before accommodation was sourced and that she was ‘too vulnerable to do this’. Kim’s Independent Advocate supported her to challenge this, as she no longer met the criteria for detention under the Mental Health Act and supported Kim raise that she would consent to stay in the hospital informally until suitable accommodation was sourced.

What was the outcome?

Kim’s Independent Advocate was able to support Kim to understand her rights whilst in hospital and to understand who each professional was that was involved in her life, as there were many, and what role each person played and why. This greatly relieved Kim’s anxieties and increased her engagement, particularly with her new social worker. Kim’s advocate was also able to ascertain Kim’s wishes in regard to her future accommodation and make sure these were raised in professional’s meetings. This resulted in Kim being offered a flat in a supported living placement for a period of 2 years, with a view to building up her daily living skills and securing her own independent flat after this period.

During the time Kim spent in hospital, her advocate supported her to obtain leave and speak to the staff to explain her wishes regarding medical appointments outside the hospital, which she was then supported to attend.

Towards the end of her stay, Kim’s advocate supported her to challenge her Section via a tribunal application, as well as raising this with the Responsible Clinician and through the Mental Health Act Administrator. This resulted in Kim being made an informal patient, as she consented to stay within the hospital setting whilst suitable accommodation was found, lessening the level of restriction placed upon Kim.

Kim was able to understand who the multiple professionals were in her life and why she was in hospital, this in turn increased her engagement with professionals and her understanding and engagement with her care and treatment. Kim was able to express her views through the representation from an Independent Advocate, as she felt too anxious to speak at the MDT Meetings, and this in turn ensured that accommodation was sought in line with her views and wishes. Kim was also able to attend previously arranged medical appointments outside of the hospital, causing no delay in her medical treatment. Additionally, as Kim was made an informal patient towards the end of her stay, she was under less restriction, could enjoy extended leave, and was able to build her confidence in the community prior to discharge.

Why was advocacy support so effective?

Kim was confused and described feeling scared when she was admitted to hospital and stated she “did not understand what was going on”. Kim’s Independent Advocate was able to spend time with her to explain her rights and to ascertain who the professionals were in her life and support her to make notes to remind herself of this information. This increased Kim’s engagement with the professionals involved as she then understood what their roles were. The Independent Advocate facilitated an environment where Kim was able to speak freely about her feelings and explore where she may like to live moving forward, building Kim’s confidence in speaking to staff, which resulted in her communicating her wishes independently towards the end of her stay.  Having the support of an advocate gave Kim confidence in expressing her views and realising that she has a voice and has a right to ask for help.