Previous Client Comment
Previous Client Comment
Advocacy in Somerset came into being three years ago. In its first two years it was jointly funded by the Health Authority and Social Service, and it was very much a pilot service, with a part time advocate and a couple of volunteer office helpers. It was managed by Taunton CVS, with a steering committee of interested people, most of whom had experienced mental health difficulties. We are limited in the geographical area that we cover, principally due to resources, so the area that in practice we cover Taunton and West Somerset. This represents only about a quarter of the County, and at present we are the only mental health advocacy service in Somerset, but more of that later.
We offer a free independent casework advocacy service to anyone experiencing mental health difficulties. By mental health difficulties we do not limit that to people who have been diagnosed as suffering mental health problems, nor to people who are users of the statutory mental health services. Our service is open to anyone who considers that they are suffering mental health problems. This reflects our feeling that there are other views concerning mental health other than those defined by the medical model.
In theory, we offer short-term advocacy, concentrating on the presenting problem or issue. In practice, this becomes more problematical, how long is short term? Some of my cases have lasted nearly a year. Some because the issues are very complex and time consuming, others because the client has multiple issues, and regularly a client with mental health problems will experience serial problems. This naturally raises issues surrounding disempowerment and dependency, and if I had more time I would gladly debate these issues with you, however, can I leave it that one of our prime aims is to empower our clients to self advocate. I am most happy supporting clients to speak for themselves rather than having to speak for them.
The types of issue/problem we will help with are very wide. There is obviously issues around the provision of mental health services, whether that be assisting a client to appeal against being sectioned, attending ward round meetings, to attempting to get appropriate help. We help with benefit tribunals, complaints, housing issues, in fact any thing where a person feels unable to represent himself or herself, or represent themselves without support.
A good example of where an advocate can make a great deal of difference is ward round meetings. There will probably be the consultant psychiatrist, a number of his or her junior doctors, a psychologist, a social worker, a CPN, the patients nursing key worker, and Uncle Tom Cobbley and all, on one side of the room, with the patient sitting in splendid isolation on the other side. I often think of the picture .when was the last time you saw your father.. The patient often knows exactly what they want to say, or the questions they want to ask, but feels totally intimidated. The presence of an independent advocate, who has talked through what the person wants to say before the meeting, can enable them to feel able to participate fully in the meeting. If not, the advocate is there to speak on their behalf. This has to have advantages for everyone engaged in this type of meeting, not just the client.
Last year saw major changes within our organisation. We became a self-managing, with the steering committee taking over management control, and achieved independent charitable status. We also secured matched funding from Comic Relief, which enabled us to employ a full time advocate and a half time admin assistant.
In the last year I have worked with nearly one hundred clients. I have also achieved a measure of acceptance from those working in the statutory mental health field, as they have come to realise that I do not represent a threat to them, unless they are not doing their job properly, and my involvement can, at the very least, often aid communication.
For us, additional money is being found from the NHS Trust to extend the provision of mental health advocacy to cover the whole county. So we look forward to many more people being helped.
More generally in the mental health field, you may have noticed that central government has put mental health issues on the national agenda. I have to say I"m not sure I like some of the assumptions that underpin many of the proposed changes. Locking up people with personality disorders, assertive outreach to make people take medication, community care has failed, etc.
However, it"s not all bad. The draft report from the group reviewing the 1983 Mental Health Act recommended that there should be a requirement on the Secretary of State to make sure that patients have access to independent advocacy. If this is adopted then, there will not only have be many more advocacy services come into being, but it will in effect validate the practice of advocacy.
