IR5 — Services to People with Mental Illness:
An Overview of the Mental Illness Protection & Advocacy (MIP&A) Act
and the Protection & Advocacy for Individual Rights (PAIR) Program

What Is The Purpose Of The MIP&A Act?

ESTABLISH A MENTAL ILLNESS PROTECTION & ADVOCACY (MIP&A) SYSTEM TO:

  1. Protect Constitutional And Statutory Rights
  2. Investigate Complaints Of Abuse, Including
    1. rape or sexual assault;
    2. the striking of a mentally ill individual;
    3. use of excessive force when placing a mentally ill individual in bodily restraints; and
    4. the use of bodily or chemical restraints which is not in compliance with Federal and State laws and regulations.
  3. Investigate complaints of neglect, including an act or omission such as the failure to establish or carry out an appropriate individual program or treatment plan, the failure to provide adequate nutrition, clothing or health care, the failure to provide a safe environment, including the failure to maintain adequate numbers of appropriately trained staff.

Who Can The MIP&A System Serve?

  1. Persons with a serious mental illness who reside in facilities that provide care and treatment for mental illness which may include, but need not be limited to, hospitals, nursing homes, community facilities for individuals with mental illness, board and care homes, homeless shelters, and jails and prisons.
  2. Persons with a serious mental illness living in the community including their own homes;
  3. Persons with mental illness in the process of being admitted to a facility, including those being transported to a facility, if he or she qualifies for admission;
  4. Persons with mental illness who are placed in municipal jails for reasons other than conviction for a criminal offense;

When Can The MIP&A System Provide Services?

  1. When a complaint is received, or
  2. When there is probable cause to believe a violation occurred.

What Powers Does The MIP&A System Have?

  1. Authority to investigate.
  2. Access to public and private residential facilities providing care or treatment.
  3. Access to client records, including discharge planning records and all investigation reports on abuse, neglect, or injury.
  4. Authority to subcontract for services, in particular with groups run by persons who have or are receiving mental health services or their family members.
  5. Authority to receive and review annual title XIX compliance reports.

What Other Requirements Must The System Meet?

  1. Be independent from the mental health service delivery system;
  2. Have a staff trained to provide advocacy services to persons with mental illness;
  3. Establish an advisory council, one-half of the membership being individuals who have or are receiving mental health services or their family members;
  4. Submit an annual report to HHS;
  5. Provide public input in the setting of annual priorities;
  6. Keep client records confidential;
  7. Try to solve problems administratively before filing suit;
  8. Not duplicate actions taken by guardians or other legal representatives; and
  9. Establish a grievance procedure for clients.

The PAIR Prpgram

In October 1993, Advocacy, Inc. was awarded federal funds to operate the PAIR program in Texas. Advocacy, Inc. can use PAIR funds to serve persons with mental illness who do not meet the MIP&A eligibility criteria outlined above. That means that each regional Advocacy, Inc. office can represent a limited number of individuals who have mental illness on Advocacy, Inc.'s priority issues even though they are not complaining of an incident that occurred in a residential facility or within 90 days of discharge.

Advocacy, Incorporated's goal is to make each handout understandable by and useful to the general public. If you have suggestions on how this handout can be improved, please contact Advocacy, Inc. at the address and telephone number shown on Advocacy's home page or e-mail Advocacy, Inc. at infoai@advocacyinc.org. Thank you for your assistance. This handout is available in Braille and/or on audio tape upon request. Advocacy, Inc. strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate. The handout is not intended to and does not replace an attorney's advice or assistance based on your particular situation.