Ying  was a patient detained under section 3 of the Mental Health Act on a ward for older people. She did not speak English and so required an interpreter. She was originally referred to the IMHA service for support with appealing her section.

The advocate met Ying in a quiet room on the ward with an interpreter. Ying did not want to appeal her section at this time, but identified a number of other issues, including feelings of hopelessness; confusion about why she was in hospital; concerns about medication; wanting to visit family members; and problems with her room on the ward.

Ying had a ward round meeting that day, with an interpreter attending, so it was agreed that the advocate would attend. The advocate supported Ying to raise all of the issues identified above, in most cases giving a brief outline of the issue, following which Ying could add more detail and discuss the issue with her doctor and ward staff.  Some of the issues could be resolved straight away, but others continued over several weeks, so the advocate attended Ying’s ward rounds whenever possible. After each ward round, Ying and the advocate met briefly with the interpreter to make sure that Ying understood what had been said.

Early on, Ying felt hopeless about her situation, didn’t think that advocacy support could make any difference, and even expressed thoughts about harming herself. The advocate explained that it was entirely up to her whether she wanted to use the service or not, but suggested that it might be worth at least raising the issues with the hospital team and seeing what their response was. Following support at a meeting, Ying said she felt that she had been listened to, and she felt reassured that somebody was trying to help her. She said she felt more hopeful and didn’t feel like harming herself.

On one occasion, ward staff were unable to book an interpreter for Ying’s ward round. Ying became very anxious about this.  The advocate called Language Line and was able to talk to Ying through a telephone interpreter, identifying key issues that she wanted to raise at her meeting. The advocate then informed Ying’s doctor about these issues, and later on another professional was able to translate the doctor’s responses for Ying.

All of the issues raised by Ying were addressed: staff talked to her about her feelings of hopeless and she was offered medication to help her mood; she was given more information about reasons for her admission and plans for discharge; medication was adjusted in response to her concerns; section 17 leave was granted to visit her family; and changes were made to her room on the ward.

Later on, decisions about future accommodation were required and Ying’s capacity had to be assessed. The advocate, who had also worked as an IMCA, was able to advise Ying’s care coordinator about Mental Capacity Act issues including the role of Ying’s family and their concerns about being formally consulted.

On several occasions, Ying thanked the advocate for supporting her and making sure that people really listened to her. She said she felt reassured that somebody was supporting her to make her voice heard, and this made her feel more hopeful about the future.