# Associate hospital managers and IMHA

**URL:** <https://forum.mentalhealthlaw.co.uk/t/associate-hospital-managers-and-imha/6158>\
**Category:** Mental Health Act\
**Created:** [24 September 2026 16:00 UTC](https://forum.mentalhealthlaw.co.uk/t/associate-hospital-managers-and-imha/6158 "2026-09-24T16:00:41Z")\
**Posts on this page:** 3\
**Page:** 1

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**Author:** ![wellsj](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/w/67e7ee/32.png) [@wellsj](https://forum.mentalhealthlaw.co.uk/u/wellsj)\
**Post date:** [24 September 2026 16:00 UTC](https://forum.mentalhealthlaw.co.uk/t/associate-hospital-managers-and-imha/6158/1 "2026-09-24T16:00:41Z")

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A detained patient is due her Associate Hospital Managers hearing. She is said to lack capacity and to have refused to use an IMHA in the past. A referral has been made to the IMHA service, but they are questioning whether it makes sense for them to attend as they are uninstructed. Should the meeting go ahead without patient and IMHA present, or should an IMHA still be expected to attend?

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**Author:** ![Santino](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/s/d26b3c/32.png) [@Santino](https://forum.mentalhealthlaw.co.uk/u/Santino)\
**Post date:** [24 September 2026 16:33 UTC](https://forum.mentalhealthlaw.co.uk/t/associate-hospital-managers-and-imha/6158/2 "2026-09-24T16:33:20Z")

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The first principle to Mental Capacity is to presume that the person has Mental Capacity, you state that ‘She is said to lack capacity’ who has determined this? Does the patient have a Nearest/Nominated Relative if so great if not ask the patient if they wish to nominate family/friend to act as nominated person/relative.

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**Author:** ![Ptr23](https://forum.mentalhealthlaw.co.uk/letter_avatar_proxy/v4/letter/p/bc8723/32.png) [@Ptr23](https://forum.mentalhealthlaw.co.uk/u/Ptr23)\
**Post date:** [24 September 2026 18:32 UTC](https://forum.mentalhealthlaw.co.uk/t/associate-hospital-managers-and-imha/6158/3 "2026-09-24T18:32:39Z")

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It straight forward really. If the imha agrees that the service user lacks capacity to instruct ( with all the caveats, assessments and evidence ) , they can attend and offer rights based non instructed advocacy. But proceed with caution.