Wednesday, 12 September 2012

why is independent advocacy not in the new mental health strategy?

I've been wondering why there is no mention of independent advocacy in the new mental health strategy.  Having done a word search and finding nothing.  I'm reading through the Scottish Independent Advocacy Alliance response to the strategy which, along with over 340 responses, was submitted by the end of January.  It gives a comprehensive underpinning of the importance of independent advocacy for safeguarding people's rights.  Collectively and individually.  Under the mental health act and in helping people generally to manage their own mental health.

Is it that the new strategy takes advocacy for granted?  In that we've got it, it's sorted and doesn't need to be mentioned?  Recent experiences of engagement with the psychiatric system disabuses me of that notion.  When independent advocacy was difficult if not impossible to access.  When I had to advocate for the person I care for.  Because the alternative was either unavailable or not independent.  A dire state of affairs for anyone in a locked ward where basic human rights are in danger of being ignored or worse.

Independent advocacy is one of the safeguards in the mental health act.  It should be in place to protect the rights of people with a mental disorder and under the act.  This is particularly important when a person/patient is at risk of being forcibly treated.  When their advance statement could be disregarded and overruled.  In February of this year I met with an RMO (responsible medical officer) of a locked ward who told me that people without capacity do not require advocacy.  I remember being incredulous at his statement and corrected him without delay.

Meanwhile in the locked ward the person I care for was asking for an independent advocate to be present, and not being able to access one when required.  And there were initial attempts to discourage me from advocating for him.  I was told to go away and come back another day, and leave the care up to them.  By 5 nurses who surrounded me in the visiting dining room, while I sat at a table.  Four of them standing, a very intimidating experience.  I came back that evening and managed to advocate for him.  To get a doctor in to look at his injuries and bruising.  But I wasn't allowed to photograph them.

So much for independent advocacy being a safeguard and available under the mental health act.  And what about advocacy for carers and family members?  Who is there for us when we are being told to go away and leave our family in the locked ward?  Out of sight and out of mind.  Fortunately for the person I care for I was not going to be intimidated.  I persisted in standing with him and helping him to have a voice.  But this is not good enough.  Independent advocacy can't be just an assumption for then it is in danger of being eroded and of disappearing altogether.  For some unfortunate people.


  1. I've heard f similar problems with photographs. They claimed the person was not able to give consent as they were mentally ill and open to abuse. 'So they see it as protecting the patient but really they are protecting themselves. The abuse is so often by the staff or the situation itself

  2. Good point Anonymous. Thing is that in the notes from back then there is nothing about the injury and almost a denial by staff about any bruising which was witnessed by many. Notes that often read like a work of fiction. To justify the force used and lack of accountability. One wonders about matters of conscience and truth in certain psychiatric situations.