“ Advocacy is taking action to help people say what they want, secure their rights, represent their interests and obtain services they need.”
“ Advocacy is … a deliberate process of speaking out on issues of concern in order to exert some influence on behalf of ideas or persons.”
"Advocacy is an ongoing process aiming at a change of attitudes, actions, policies and laws by influencing people and organisations with power, systems and structures at different levels for the betterment of people affected by the issue.“
Advocating with or on behalf of clients empowers the individual and can have a hugely beneficial effect on the improvement of mental health as their rights, opinions and ideas are taken seriously by those working with them.
Empowerment and advocacy can help reduce the duration of impatient treatment and the number of visits to health services.
Why do we advocate on behalf of our clients? Continued.
To build self-esteem
To enhance coping skills
To build social support networks
To improve family relationships
To improve mental health legislation
To improve public awareness and decrease stigma
To uphold human rights
Why do we advocate on behalf of our clients? Continued.
Recognition of an infringement on a human right: Human rights are based on a set of core values which directly relate to advocacy:
Professional duty of care
If we notice that a client is not being treated according to these values – we must advocate for change.
In profession groups, make a list of all the attributes that you have which other professions don’t have. Think of your professional skills; interaction with clients; interactions with other staff and departments etc.
Advocating on behalf of an individual or a group who has been able to present their concerns and issues to the advocate.
Advocating based on the knowledge of an injustice on behalf of an individual or a group who has not been able to present their concerns. This is only used when patients cannot vocalise their opinions as a result of their condition.
Advocating for issues that affect you personally. This can be difficult to achieve and many people find it is better to be supported by other people or groups in order to have a stronger message. This also helps give clarity to an issue where otherwise personal emotions could get involved. For some mental health clients, this will not be possible, which is why we need to work with them to advocate for their rights.
This is when someone who has a greater knowledge of the system or situation advocates alongside the client. They can draw on their own experiences to understand and empathise with the person you are working with. Former clients add a great insight into what the client is experiencing and can make suggestions for action based on this shared knowledge. As health workers you have an in-depth knowledge of the system in which you are working and can help to advocate for change more affectively than if the client was a solely a Self-Advocate.
This is where a group of people with similar experiences meet together to put forward shared views. Local mental health service-user groups, support groups and patient councils are all examples of group advocacy. As a health worker you can support the establishment of such Group Advocacy activities, by advocating for them!
This is when an individual or an organisation is professionally focused on advocacy. It may be an organisation that advocates on behalf of other like-minded organisations (i.e. Malawi Health Equity Network) or an outsourced service to others (i.e. like me!). In this case it primarily provides short-term work rather than long-term support.
People with specialist knowledge and training, such as lawyers and legislative specialists are sometimes called “legal advocates”. Legal advocates differ from other mental health advocates in that they represent people in formal settings, such as courts, tribunals or complaints procedures. A legal advocate will often given advice and express their opinion about the best course of action. You may wish to consult a legal advocate if there are continual human rights abuses that you are not able to address at an institutional level.
Also known as “best interests” advocacy, this is where an advocate represents what he or she feels a person’s wishes would be, if they were able to express them. Non-instructed advocacy is not appropriate in mental health advocacy if clients are able to express their needs and opinions. However if they have dementia or other severe mental disabilities which make it impossible to communicate feelings, then this would be an appropriate form of advocacy to use.
Advocacy and Related Concepts Advocacy Information, Education, Communication (IEC) Community Mobilisation Networks and Partnerships Fundraising and Resource Mobilisation Overcoming Stigma and Discrimination What can it change? Policy; Policy implementation; Law; Practices on Mental Health Awareness and behaviour of Mental Health issues Capacity of communities to identify and address Mental Health problems in their area Isolation and duplication Levels of resource available for mental health work Level of stigma and discrimination against people with mental health issues Target Group Decision-makers; Leaders; Policy-makers; People in Positions of Influence A specific group – age, gender, community etc Members of a community Individuals or groups who have a similar agenda Local government, donors, private sector, communities People who stigmatise or discriminate Does the target group have influence over others? Yes No No No No No Typical indicators of success Changes in policy; laws and practices Statistical change in condition (i.e. % of mental health patients in the community attending a support group); Changes in attitudes A community problem is solved; Higher participation in community meetings Members of the network/partnership achieve more than they could have done if working alone Government or donors increase funding; Private sector makes financial or resource donation; Local community members offer facilities to use for meetings etc Fewer mental health patients victimised in communities; Less cases of depression and anxiety as a result of discrimination; Increased community support for rehabilitation of clients etc
An objective is the specific task that you want achieved through your advocacy work.
For example: Caregivers with responsibility for bathing patients allocate additional time in their daily schedule to bathe difficult and disruptive clients, so that they receive the same standards as other clients.
This involves engaging with your client and their position – understanding their perspective and needs.
This is the stage where you must strongly draw on your professional expertise and that of appropriate colleagues.
This is establishing a programme of what needs to be done in order to achieve the objectives.
Forming an Activity Plan Objective: Caregivers with responsibility for bathing patients allocate additional time in their daily schedule to bathe difficult and disruptive clients, so that they receive the same standards as other clients. Activity Timeframe Lead Persons Co-Actors Status Communicate with client on their perspective on the issue; what has been done to address the issue to date and agree ways forward By 5 th November Myself Client Done Speak to caregivers to understand their reasons for spending less time with these clients By 30 th November Myself Caregivers Done Liaise with management responsible for timetabling activities to allocate more time for bathing By 5 th December Myself Management Due Draft a refined timetable based around bathing requirements and present to management for review By 15 th December Myself Admin staff; Management Due
Using your case study experience, plan your advocacy work.
Ask yourselves the Engagement and Planning Questions. What value do they contribute to your advocacy work?
Produce an Activity Plan for your objectives. Make it as specific as possible in order to ensure all aspects of the Engagement and Planning questions are answered and to make it easier when you come to implement the plan.
A good process of monitoring and evaluating your work will not only make sure that you achieve what you set out to, but will also develop you into an even better advocate in the future! You will learn from the challenges and adapt your approach the next time.