Kris is in his early twenties and was born in Thailand but has lived in the UK for many years now. He has a mental health diagnosis and was detained in hospital under the Mental Health Act, Section 2. The ward manager made a referral for an Independent Mental Health Advocate (IMHA) to support Kris with communication as he was not engaging with his Multidisciplinary Team (MDT) and was refusing to sign his section papers, care plan and the paperwork for one of his medications.

Brian, a POhWER IMHA, met with Kris and explained his role and remit and how he could support Kris while he was detained in hospital.

Kris spoke very good English but explained to Brian that he could not read English and therefore was not willing to sign the paperwork. He explained that he needed the paperwork in his first language, Thai, so that he could read it. Kris said he had not explained this to ward staff because he felt they had not given him the chance to do so, instead they just kept "hassling" him to sign many different papers. He told Brian that he was very confused and anxious. 

Kris told Brian that he was not sleeping very well. Brian asked if he had discussed this with the staff but Kris said he had not. Kris also explained that he has taken the same medication for his mental health for some time and did not understand why staff were asking him to take another medication at night. 

Brian gave Kris a leaflet about the IMHA service in Thai and Kris provided verbal consent for Brian to speak with the ward manager about his concerns.

Brian met with the ward manager and gave her the contact details for a translation and interpreting company. The ward manager contacted them and arranged for an interpreter to attend Kris’s next ward round. 

Brian also contacted the Mental Health Act administrator to explain that Kris needed the Section 2 papers to be translated into Thai, they agreed to organise this.

A translator was also booked to transcribe Kris’s care plan for him. The ward manager explained that every time the care plan is updated it is printed off for Kris to sign. It was agreed that this will not happen going forward until it has been translated. The ward manager apologised to Kris that they did not know he could not read English.

Kris asked Brian to come to his ward round with him. Brian and an interpreter attended the ward round with Kris and his mother. Brian supported Kris to ask questions about his medication. The ward doctor explained that Kris had been prescribed Zopiclone as a PRN. Kris asked what the Zopiclone was for and the doctor explained that it is a type of sleeping pill used to treat insomnia which helps you fall asleep more quickly, and also helps stop you waking up during the night. Kris said he did not understand what PRN meant. Brian explained that PRN means ‘when required’ and refers to medication which is usually prescribed to treat short-term or intermittent medical conditions and is not to be taken regularly. Kris was satisfied with this and said he was happy to take this medication.

Kris and his mother were grateful for Brian’s support and that he had taken the time to understand his communication needs. 

The ward manager thanked Brian for supporting Kris and helping her and the MDT to improve communication with him.

Brian supported Kris to have his healthcare right to information about his treatment and his human right to protection from discrimination in respect of his rights and freedoms upheld.