An Independent Mental Capacity Advocate (IMCA) is a statutory role under the Mental Capacity Act (2005) that supports a person who lacks capacity to express their wishes around a particular decision.
Criteria for receiving an IMCA
Anyone aged 16 or over who has been assessed to lack capacity is entitled to the support of an IMCA for specific decisions and processes. These include:
- Safeguarding
- Serious medical treatment
- Accommodation or care review
- DoLS authorisation
If the individual has a Lasting Power of Attorney (LPA) in place that covers the specific area of decision-making – or if they have a suitable family member/friend who can support – then they would not qualify for an IMCA.
How is an IMCA appointed?
In England, the role of IMCA is assigned by the Local Authority. In Wales, the role is assigned either through the local Health Board or NHS body. It is then the responsibility of a clinician under these authorities to refer for an IMCA.
What can an IMCA do?
Under the Mental Capacity Act (2005), an IMCA can support in a number of ways:
- Establish information by meeting with the individual, examining relevant records and consulting relevant parties.
- Evaluate information around the decision(s) being addressed, to confirm that the five principles of the Act have been upheld. They can further request a second opinion, if deemed necessary, regarding serious medical treatments.
- Promote and aid inclusion of the individual, wherever possible.
- Represent the individual’s established views and wishes to the decision-maker, which must include a written report to the referrer who has instructed them.
- If a decision has been made and all possible resolutions prior to this have occurred, then the IMCA can formally challenge the outcome, through either complaint procedures or the Court of Protection.
As such, an IMCA can play a pivotal role in upholding an individual’s voice, promoting person-centred care, and ultimately, protect their rights.