Home chevron_right Health and wellbeing chevron_right Mental health chevron_right Advocacy services

Advocacy services

Independent advocacy is supports people to have their feelings and wishes heard, and their rights and choices respected.

Independent advocacy is free, and advocates work for organisations which are independent of health and social care services.

There are different types of independent advocacy, some are informal and other are defined by legislation.

Types of advocacy

Care Act Advocacy


Independent Care Act Advocacy (ICAA) is statutory advocacy defined by the Care Act 2014. Professionals must refer a person for this kind of advocacy when they're going through a local authority social care process, including:

  • needs assessment (adult, child in transition carer, or young carer for an adult)
  • developing a care and support plan (or a support plan if they're a carer)
  • reviewing a care and support plan (support plan if they're a carer)
  • Safeguarding Adults Enquiry or Safeguarding Adults Review


the person has substantial difficulty engaging in the process in one or more of the following areas:

  • understanding information
  • remembering information
  • weighing up their options
  • communicating their feelings, wishes, and decisions


the person has no one who is appropriate to help them engage in the process, for example:

  • the person may choose to have an independent advocate support them
  • their family member has strong views and is not listening to the person
  • the person only has paid staff around them

Independent Mental Health Advocacy


The Mental Health Act 2007 sets out the rules about when it's necessary to compulsorily admit someone who is having a severe mental ill health episode to hospital.

The Act is used when someone needs to be admitted to hospital to protect their own health and safety, or to protect other people. Being admitted to hospital under the Mental Health Act is sometimes called being 'sectioned'. This is because the Act is split into sections, each saying when and for how long someone can be admitted, depending on how unwell they are.

People who are admitted to hospital under the Mental Health Act are entitled to help from an Independent Mental Health Advocate (IMHA).

An IMHA will support people to:

  • understand their rights and choices under the Mental Health Act
  • understand their treatment and discharge options in hospital and in the community
  • ask for a review and challenge their section

Independent Mental Capacity Advocates


Independent Mental Capacity Advocacy (IMCA) is statutory advocacy defined by the Mental Capacity Act 2005. Professionals must refer someone for this kind of advocacy if the person has been formally assessed as lacking the capacity to make decisions about:

  • serious medical treatment
  • a local authority change of accommodation for 4 weeks or more
  • an NHS change of accommodation for 28 days or more
  • being under continuous supervision, where they are not free to leave, and they are being assessed for a Deprivation of Liberty Safeguard (DoLS)

Anyone who is making a life-changing decision on behalf of a person who is unable to make that decision for themselves, and has no family or friends willing to be involved in that decision, has a statutory duty under the Mental Capacity Act 2005 to make sure the case is referred to the IMCA service.

IMCA services also provide advocacy in adult safeguarding cases.

General advocacy


Generic advocacy support is also available for people who have an issue which doesn’t fall into one of the statutory categories of advocacy above. The advocacy service can help you contact services, explain decisions, and help you to put your views across.

Advocacy referrals

All advocacy referrals for people who live in Middlesbrough are managed by the People First Independent Advocacy Hub.

Visit the People First website to get:

  • an Independent Mental Health Advocate (IMHA)
  • an Independent Mental Capacity Advocate (IMCA)
  • a Care Act Advocate
  • a Non-Statutory (General) Advocate

People First can offer further support by calling 03003 038 037 or by emailing bestlife@wearepeoplefirst.co.uk.