Sunday, 3 March 2013

independent advocacy - been there, done that, got the straitjacket?

I remember working in advocacy from 2000-02, at the time of the Same as You Review for people with learning disabilities, one of the aims being that people would have more say and control over their lives.  I also worked in mental health, helping a patient in a locked forensic ward have a voice.  He eventually was discharged and came to volunteer in the organisation I worked in.

I remember attending Allies in Change, weekend courses in 2001, led by the Scottish Human Services Trust:

ALLIES IN CHANGE is a programme to promote the involvement of people with mental health problems and their families and friends.  The programme was developed by a consortium that brought together people who use services, carers and the organisations that provide services. It has been funded by the Scottish Executive from 1999-2002.  The main elements of the programme are:
• information packs, to give practical advice to people involved in formal meetings
• a series of newsletters, showing examples of different types of involvement
• the User and Carer Participation Route Map, to identify the strengths and limitations of current arrangements
• leadership development training for user and carer activists and staff who work in services
• events organised in partnership with local networks.
[from Partners in Change Newsletter 2001]

Then in 2002 I had another engagement with psychiatry, recovered in 2004 and got back on with my life for a few years until getting back into mental health matters through the peer support movement, and the SRN conference in December 2005.  It seems that in the intervening years something happened to the user/survivor voices in Scotland.  As in, they were assimilated or co-opted.

I remember the human rights movement aspect of advocacy, the expectation of mental health service and psychiatric system transformation.  Advocacy a powerful tool in the hands of ordinary people who stood up with others for the right to be heard, to be included.  Peer support following on from advocacy in standing with the person in and out of the psychiatric system. 

Now it seems that advocacy in Scotland is losing its place and has been superceded by the establishment.  Funding to Scottish Independent Advocacy Alliance is being reduced, 10% a year.  Meanwhile the Mental Welfare Commission is employing people with 'lived experience' of mental ill health, to do visits.  

Independent advocacy is one of the safeguards under the Scottish Mental Health Act:
    "The new Act gives every person with a mental disorder a right of access to independent advocacy and puts duties on Health Boards and local authorities to ensure that independent advocacy services are available. This right to access advocacy applies to all mental health service users, not just to people who are subject to powers under the new Act."

The tendering of advocacy services in health board areas in my opinion has weakened the position of independent advocacy and its effectiveness as a safeguard.  (Fife now has Circles Network managing)  If jobs and management are under threat then the resulting insecurity will mean that advocacy workers will be less inclined to risk their position by speaking out on behalf of the person with a 'mental disorder'.  It's obvious.

There appears to be no system of quality and improvement in advocacy services apart from in the localities where it's more like an add-on or afterthought to the main business of social work service delivery.  Advocacy workers are on low pay scales compared to the other mental health 'professionals'.  But not as poorly paid as peer support workers.  

The discrepancies in pay and position undermines the voices of experience who are coming to the table with cap in hand.  Grateful for the crumbs or so it seems.  Rather than having pride of place which they deserve, as survivors of the system.  For we have something important to bring to the conversation and should be encouraged to speak out with a critical voice.

I want to see independent advocacy restored as a strong safeguard and rewarded with the proper remuneration and support.  Otherwise human rights issues in psychiatric treatment will persist and power imbalance continue.  We've come too far to let ourselves be taken over and subsumed.  Resist the pressure, stand up and speak out.  You know it makes sense.

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