An advocacy service for people who have been involuntarily detained in mental health wards should be expanded to an opt-out model so patients do not slip through the cracks, an independent evaluation has found.

The Independent Mental Health Advocacy service (IMHA) was established in 2015 to support people receiving compulsory mental health treatment in Victoria and ensure they are aware of their right to object to treatment.

But an independent evaluation conducted by RMIT University found that the service was only reaching a fraction of those who had been forced to undergo compulsory treatment and that many were not even aware the service existed.

It recommended that hospitals be required to notify IMHA whenever a new patient is put on a compulsory treatment order, similar to a system that operates in Western Australia.

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Victoria does not provide data on the number of people involuntarily detained for treatment, so the report was unable to say how many people did not receive any advocacy support. According to IMHA’s own data it had 26,000 interactions with clients in 2017-18, of which 8,500 involved high-intensity coaching or support.

Among those clients was Barbara Russell, a 47-year-old Melbourne woman who was involuntarily admitted to mental health wards on two occasions in January 2018.

Russell has never received a mental health diagnosis. She said the experience was “very scary” and would have been “much worse” without IMHA’s support.

She was held in The Alfred hospital for three days after a friend called an ambulance to help her escape an abusive partner. Two weeks later she was detained for five days in the psychiatric ward of Casey hospital when police detained her on an order from medical staff that she had stopped taking her medication.

“I wasn’t on any medication,” Russell told Guardian Australia. “I felt like I was totally on my own until I had spoken to someone from IMHA because they are actually on your side.

Russell, who is now training to be a community support worker, said she was scared and distrustful of nursing staff on the psych ward because they ignored her request to contact her GP, who she said would have been able to explain the situation.

“[The hospital staff] are questioning your state of mind, they are questioning who you are and you feel like you have no rights for anything and if you step out of line you are going to be medicated or you are going to be made to stay longer,” she said.

Dr Chris Maylea, the lead evaluator on the report, said the current system relied on staff within the mental health system to refer patients to IMHA or for patients to see an IMHA advocate on one of the advocate’s regular visits to the hospital. That meant many patients were left uninformed about their rights.

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“I think the general public would be very shocked if they were aware of the human rights abuses that are going on in mental health wards,” Maylea said. “We have a lot more oversight in the prison system than we do in the mental health system.”

The Andrews government announced a royal commission into the state’s mental health system last year, focusing on early intervention and prevention.

Maylea said he hoped the terms of reference would be interpreted to include a focus on treatment of involuntary inpatients.

Advocates from the service currently visit every mental health intake facility in the state at least once a fortnight, as well as responding to referrals.

The IMHA manager Helen Makregiorgos said advocates help people assert their rights around treatment options, type of medication, rights of appeal, right to see their full treatment order and right to keep their mobile phone, which is often removed as a matter of course by hospitals.

“People often say that we have saved their life,” she said.