A judge has fiercely criticised the quality of advocacy in mental health review tribunals (MHRT) as calls intensify across the profession for the compulsory accreditation of practitioners appearing for mentally ill clients.

The judiciary, regulators and bodies representing mental health lawyers are all calling for membership of the Law Society MHRT Panel to be a mandatory requirement for appearing before the tribunal.

However, it is feared that cuts to legal aid may put the cost of accreditation beyond the reach of sole practitioners and smaller firms.

Tribunal judge Carolyn Taylor said: ‘My heart bleeds when I see vulnerable patients being represented very badly. They would often be better off not represented at all.’

While the cost of accreditation – likely to be around £800 – would pose difficulties for some firms, compulsion would be a ‘huge incentive to find the money somehow’, she said.

Practitioners say some firms are cutting costs by instructing trainees to take clients’ statements, with the result that cases are poorly prepared. Patients have also told the Care Quality Commission that they have been left ‘in a state of despair’ by lawyers leaving them ‘to advocate on [their] own account’.

Practitioners claim that police have been called to hospital wards because law firm representatives were pressuring patients to sign contracts and refusing to leave until they had done so. Some firms even stand accused of forging patients’ signatures.

Richard Charlton, chair of the Mental Health Lawyers Association (MHLA) said the association backs attempts to make Law Society panel membership mandatory. ‘The MHRT is a closed jurisdiction without the open scrutiny of other lawyers judging how well or otherwise a representative is handling the case,’ he said. ‘There is an urgent need for effective monitoring.’

Law Society mental health and disability committee chair Susan Thompson said: ‘We have been looking at ways of ensuring higher standards in the MHRT, including requiring panel members to supervise the work of non-members. We have also been tasked with improving the accreditation process for lawyers and are in discussion with the Legal Services Commission.’

Mandatory accreditation would involve the LSC giving contracts to accredited firms only. The LSC said it is committed to mandatory accreditation but does not have regulatory powers. ‘We encourage practitioners, the judiciary, clients and hospitals to report instances of poor representation to the appropriate regulator,’ a spokesman said.