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Strengthening consumer voices to have their say on mental health treatment

Independent Mental Health Advocacy has been named Victoria’s first-ever primary provider of non-legal mental health advocacy services.

Published:
Wednesday 5 July 2023 at 12:53 am

Key points

  • Independent Mental Health Advocacy (IMHA) will provide support to every person receiving compulsory treatment from September
  • IMHA helps people understand their rights and have as much say as possible about their assessment, treatment and recovery

‘I ended up calling them many times. They were always there, they gave me information, they told me I had rights and I felt empowered by that.’ – Simona

All people receiving compulsory mental health treatment in Victoria will get access to non-legal advocacy support – if they want it – to help them understand their rights and have as much say as possible about their assessment, treatment and recovery.

IMHA has been named Victoria’s first-ever primary provider of non-legal mental health advocacy services.

The change, which commences in line with the Mental Health and Wellbeing Act 2022 (Vic) later this year, means IMHA will be notified at key points whenever people are subject to compulsory treatment, including when being placed on an order or when an order is varied.

All mental health consumers then have the option of deciding they want IMHA support which can include being provided with information about their rights, help making an advance statement of preferences, seeking legal advice or referrals, as well as direct support from an advocate.

Consumers will be able to opt out at any time.

It is the first time non-legal advocacy support will be made available to all people receiving compulsory treatment in Victoria and was a key recommendation of the Royal Commission into Victoria’s Mental Health System in 2021.

‘This is a significant investment in reform by the Victorian Government that supports a culture shift within our mental health system to consumer rights and recovery by ensuring they get a say in decisions that can often have life-altering consequences,’ IMHA Program Manager Helen Makregiorgos said.

‘Consumers often tell us IMHA is “someone in their corner” and it’s gratifying to know that we can now reach more people who weren’t already aware of our service or have been unable to access it.’

Involving consumers in decision-making

Established and run by Victoria Legal Aid, IMHA is a free and confidential non-legal advocacy service that has operated since 2015, with teams currently based in Geelong, Melbourne, Bendigo and Dandenong.

Each year, IMHA provides thousands of information and referral services, and directly advocates on behalf of consumers or supports their self-advocacy to ensure their voices are heard.

In 2021-22, that included more than 25,000 information and referral sessions and more than 13,000 instances of advocacy or self-advocacy support.

Simona was placed on compulsory treatment twice.

My two experiences were like night and day.

The first time I was hospitalised, two strangers took me away. At first, I thought it was a hotel but later it felt more like a prison. There was no privacy, I couldn’t make phone calls to my family without permission and multiple times a night, every night, I’d be woken up by a flashlight in my face. I was given medication with no information. Non-compliance was answered with force and a trip to a seclusion room no bigger than two bathtubs, with a glorified gym mat for a bed and a cardboard contraption for a toilet.

It seems strange to me that mental care experts would choose to lock someone up in a claustrophobic environment at the height of their distress and need for empathy. It felt like I was being punished for having emotions, having questions. Worst of all there was no clock, which was absolute torture. I felt judged and voiceless, like I was an inconvenient human being. It appeared irrelevant that I was a survivor of multiple forms of trauma including family violence and a recent sexual assault. Certainly, no one ever asked.

The effects of those months were devastating. I suffered from side-effects from the drugs, like feeling sedated and trapped in my body. I gained 30kg and had frequent night terrors.

I rebuilt my life. Ten years later, my trauma revisited. Instead of a slow, gentle wave, it impacted like a tsunami of emotion that I couldn’t hold back. I was taken to a different mental health hospital this time, but it felt strangely familiar. The flashlights were back, along with the lack of communication, the random assortments of pills, and the confusion.

I saw a poster on the wall that read: ‘Know your rights’. It confused me more – I wasn’t aware I had any. I called the number, which was for a non-legal advocacy service. They hadn’t been around 10 years before. I ended up calling them many times. They were always there, they gave me information, they told me I had rights and I felt empowered by that.

Instead of feeling captive, I had the tools that ensured my voice was heard.

I ended up discharged within a week. My psychiatrist told me I was very intelligent that it had surprised him I knew about my rights. If I was a mental health consumer that didn’t know about my rights, I might’ve been judged as still not having ‘capacity’. They were going to discharge me on a compulsory treatment basis, but another phone call to IMHA and I was able to leave with only a voluntary order.

Embedding consumer leadership

As well as studying a Bachelor of Psychological Science, Simona is now a member of Speaking from Experience, IMHA’s consumer advisory group.

Simona said it was vital that the rebuild of Victoria’s mental health system was centred around consumer experience.

‘Voices like mine need to be heard,’ she said.

‘We need to have an allyship with those with lived experiences so that therapeutic, trauma-informed care is more than just an ambition, it’s embedded into future design and practice.’

From the royal commission to the passing of the new Act, our advocacy has been, and will continue to be, led by consumer voices.

We continue to advocate for a mental health system that centres consumers’ rights, respects consumer will and preferences and supports personal recovery.

‘It is so exciting to finally get the go-ahead to expand IMHA to be an opt-out service,’ said IMHA Senior Consumer Consultant Wanda Bennetts.

‘This is great recognition that IMHA is an amazing service that really works.

‘I believe that is because it was designed with the people who were expecting to use it and also because of the dedicated IMHA team who work their supported-decision-making magic every day to make the world better for people using IMHA.’

Victoria Legal Aid is also currently working with the Victorian Aboriginal Legal Service and the Mental Health Legal Centre to develop a new legal service model to support more consumers appearing before the Mental Health Tribunal.

Increasing access to legal representation formed part of the royal commission’s Recommendation 56 to support consumers in exercising their rights.

Victoria Legal Aid is the largest provider of legal and non-legal advocacy services for people with mental health issues in the state.

More information

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