Mental Illness: Advocacy

by Rethink

What Is Advocacy?

Advocacy is a means of supporting and helping people to speak up or act for themselves. The key aims of mental health advocacy are to empower people who use mental health services and to protect their rights as citizens by helping them to get their views across. Empowerment is an essential aspect of advocacy. It supports and promotes people's rights to speak and act for themselves and to regain some control over their lives. Advocacy is different from advice in that advice work is concerned with information and advocacy is concerned essentially with support although clearly advocacy will involve some information and advice will involve some element of support.

Advocates do not take a deliberate adversarial stance, but neither do they seek to avoid confrontation and challenges where they are necessary. They seek to practice reasoned negotiation.

Advocacy support is needed in the mental health services because people who use them can feel and can be dis-empowered by the rules, procedures and people providing the services. Decisions are taken that affect their daily lives and well-being, for example:

• being detained in hospital under a section of the Mental Health Act
• being prescribed medication which has adverse physical side effects
• how much money they have to live on through the welfare benefits system
• provision of suitable accommodation

What Do Advocates Do?

Advocacy can involve

• listening and giving information
• encouraging the client to speak on their own behalf
• liaison with different agencies
• mediating so people understand each other
• representing or acting on behalf of someone

What Sort Of Problems Can Advocates Help With?

Within hospital:

• difficulties in communicating
• feelings of loss of respect and dignity
• sense of being powerless
• lack of information about medication, side-effects and entitlements
• lack of support when feeling confused, frightened or intimidated
• difficulties getting a diagnosis
• supporting at CPA's, Mangers Hearings, Mental Health Review Tribunals

Within the community:

• practical problems in accessing benefits, accommodation and other services
• lack of understanding of severe mental illness
• discriminatory attitudes and fear
• pressures at work, college and other environments
• strain within the family
• difficulty getting a second opinion or a medical review
• problems with police and courts

What Advocates Don't Do

• offer counselling
• advise clients on which choice to make
• make decisions for people
• offer legal representation (unless they are legal advocates - see below)

What Are The Different Forms Of Advocacy?

There are a number of ways of delivering advocacy services. The main ones are:

• legal advocacy, which is provided by legally qualified advocates, usually solicitors
• citizen advocacy, which involves long-term, one-to-one partnership between user and advocate. This kind of advocacy tends to be more common in the learning disability field that in mental health, but may have some role to play in the latter, particularly for people with both kinds of problems or organic difficulties.
• formal advocacy usually refers to schemes run by groups which are not, by and large, user-led. Co-ordinators are salaried and often advocates are paid. They usually are prepared to act for both carers and service users. They are sometimes involved in giving informed choices and mediating for clients.
• peer advocacy, where advocates are themselves mental health service users.
• self-advocacy, which involves people speaking out for themselves

Within the NSF there are advocacy services around the country. These usually employ a paid advocacy manager who may be responsible for a number of volunteer advocates, who may themselves be mental health service users.

How to Find an Advocate

You may be able to find an advocate by :

• enquiring at a local psychiatric hospital
• contacting a local Rethink or MIND group
• contacting the Rethink National Advice Service - 020 8974 6814 (Mon-Fri 10-3)
• contacting a local Citizens Advice Bureau
• contacting UKAN, United Kingdom Advocacy Network (Premier House, 14 Cross Burgess Street, Sheffield, tel [phone]

About the Author

www.rethink.org
Rethink is the largest severe mental illness charity in the UK. We are dedicated to improving the lives of everyone affected by severe mental illness, whether they have a condition themselves, care for others who do, or are professionals or volunteers working in the mental health field.