Tuesday, 21 August 2012

the cost of redefining independence to mental health advocacy

Where I live they have been debating the meaning of independence, in respect of advocacy.  And after much discussion and rhetoric there is still no consensus about what independent advocacy amounts to in Fife.  (I'm talking about others as for me there is no doubt)

In the rest of Scotland there doesn't seem to be a problem.  The Scottish Independent Advocacy Alliance (SIAA), devoted to the promotion, support and defence of Independent Advocacy in Scotland, tells us:

"Independent Advocacy is a way to help people have a stronger voice and to have as much control as possible over their own lives. Independent Advocacy organisations are separate from organisations that provide other types of services."

But Fife decided to do their own thing and had to cut their coat according to their cloth.  Because in 2009 the Fife statutory agencies awarded the mental health advocacy contract to a (learning disability) service provider, Circles Network.  Taking the contracts away from the grassroots user led historical mental health advocacy groups.  And ever since then in Fife the meaning and practice of independent advocacy has been diluted.  

With the result that people with a mental disorder, locked up and at risk of restraint, seclusion and forced treatment, are disadvantaged.  What they need is consistent, strong and independent advocacy.  To have a voice and take back control of their lives.  Advocacy that is prepared to take a stand with the person/patient against the psychiatric system, if necessary.  This is independent advocacy.

Because of the local situation I found myself advocating for a relative in a locked ward recently.  It meant that, at the clinical meetings, I set aside the carer role and took up the independent advocacy position.  Standing with him throughout.  Helping him to have a voice and to take back control.  It wasn't easy.  The powers that be don't like to be challenged.  But it was necessary and the right thing to do.

What about the people and patients in Fife, locked up and/or under compulsory treatment, who don't have access to independent advocacy?  It looks like they'll just have to put up with the situation.  Do what they're told, be compliant, take the pills, accept the diagnosis, agree with the experts and wait until you're out of the system to take back control.  That's what I did in 2002 as a psychiatric inpatient.  But it took much longer to recover than it should have, had I been able to access advocacy, which I wasn't offered.  

Advocacy is one of the safeguards in the Mental Health Act Scotland 2003.  Protecting the rights of people under the act and with a mental disorder.  It's one of the balances that are important in a psychiatric system where the power firmly rests with the professionals.  Power that is liable to misuse and abuse.  Where incapacity can be a reason for denying freedom of speech and basic human rights.  

Therefore the cost of redefining independence is far too great, in terms of mental health advocacy and human rights.  And Fife statutory agencies have to consider the consequences of their actions.  And I would like to see support from Scottish Government in the upholding of the advocacy safeguard and its independence.  For the sake of all of us who may have to engage with the psychiatric system involuntarily.

1 comment:

  1. PS I've just been tasked by a paid Fife Council Social Worker to try and raise interest from user/survivor/carer colleagues in mental health, to the advocacy developments - it seems that Fife Council staff want carers to do their work for them, unpaid