A rod for our own back – Professionalisation of Advocacy
A rod for our own back – Professionalisation of Advocacy
I write this blog as a Free Our People Advocate, supporting disabled inpatients detained under the Mental Health Act 1983 or Mental Capacity Act who want to live in their communities.
Over the years disabled people, families and organisations have campaigned for advocacy to be placed on a statutory footing. We can see why, many disabled people find themselves in a powerless position when dealing with statutory authorities that have a great deal of power over their lives, regardless whether detained in an institution of some sort or living with their families or elsewhere within the community. The Mental Capacity, Mental Health and Care Acts are required to arrange independent advocacy services that will provide independent mental health advocates, independent mental capacity advocates and care act advocates for disabled people lacking capacity, detained under certain Mental Health 1983 sections or will have difficulty engaging in the care assessment and planning processes. These statutory advocates are usually required to undertake the Independent Advocate’s Qualification including appropriate specialism. So far so good, no one would be arguing against the provision of advocacy services with advocates who know the law, know the system and understand their roles and boundaries.
As a disabled activist campaigning to end institutionalisation of disabled people, I see myself as a peer-advocate or an advocate partner. Over the past 12 months I have been asked by an inpatient with learning difficulties and autism detained under the Mental Health Act whether I could be her advocate – reason given because I promote disabled peoples’ rights. Knowing naught about the Mental Health and Care Act did not seem to worry the patient, probably because she knew I would find out what I need to know to help her secure a good discharge package which we are well on the way to do – just got the care plan to do with her now accommodation and provider has been identified. So what have I learnt over the past year!
Increasingly it’s the state rather than individuals using advocates who are controlling the area of issues that can be addressed. For instance IMHA are only funded to work with detained patients who have an issue about their section, medication or care whilst in hospital; they are not supposed to deal with other issues such as community care and housing alike even though the goal of patients challenging a section is to get discharged from hospital and live within the community again.
There is a stranglehold of LAs and care institutions commissioning over their own advocacy services even though they are provided by an independent organisation. I have received emails and have spoken to disabled people who tell me that their advocates do not challenge decisions made by an institution’s staff. One institution thought nothing of telling the commissioned advocacy service that they could not speak to anyone outside the institution. Clearly, there is a conflict of interest and even bigger one when the disabled person wants to secure release!
Whilst the training is useful, what is covered is very narrow and I do not think it prepares the advocate for their role. I looked to see that the IMHA and IMCA training covers Mental Health and Mental Capacity Act – what appears to be missing is other relevant legislation required to get the job done, the use of Equality, Autism and Human Rights Act alongside the European Convention on Human Rights and indeed our very own UN Convention Rights of Persons with Disabilities. – Particularly handy when challenging discriminate and oppressive practises within psychiatric settings for disabled people with autism and learning difficulties who are on anti-psychotic medication.
Apart from narrowness of the training and permitted issues, more worrying is that statutory advocacy has created a two tier system. It’s written in law that statutory advocates have legal entitlement to meet their “clients” in private, accompany them on ward rounds and other meetings and access their medical records with consent. As I am not a statutory registered advocate I have no legal entitlement to meet my advocacy partners in private and access their medical records even through the patient has CHOSEN me to be their advocate. Before such legislation was in place I would have had the same “privileges” as any other advocate (other than a legal one). As local authorities and inpatient hospitals are responsible for providing the independent advocacy services, disabled people no longer have a choice over who will be their advocate. Too often disabled people are left years and years in hospital or within poor circumstances because of the ineffectiveness of the statutory commissioned advocacy services.
The commissioning of advocacy services on a case-by-case basis where advocates are paid for set hours of work, between eight to fifteen hours per client limits on what can be achieved. All I know is that it can take more than 8 hours to get to know your advocate partner and to address one issue. Too often the time is taken up with working with advocate partner to help write the correspondence, prepare before meetings and alike.
Advocacy is more than providing a service; advocacy is part of our grassroots work sitting in the heart of a thriving disabled people’s organisation and independent living movement those campaigns for our rights at a personal and collective level. It’s through 1-1 advocacy work that the politicalization of disabled people who have not engaged in rights-based work begins; it’s our chance to share our history, social model of disability and indeed where needed social construction of mental illness so that our partners begin to see their barriers are the ones created by society.
Because of efficiencies and statutory requirements imposed by legislation, the awarding of statutory advocacy services are mainly given to national organisations which means that very few if any disabled peoples lead organisations are providing IMHA, IMCA or Care Act advocates; we are therefore excluded and prevented from doing vital work, freeing our brothers and sisters out of institutions. Due to budget cuts, non-statutory advocacy services once provided by DPOs have either been reduced substantially or are no longer in existence. It’s the loss to disabled peoples and independent living movement if we cannot go into institutions and make friends with those who are most disempowered and abused by our “care” system.
The big see change over the past five years of so is the decline of peer and self-advocacy; People First and self-advocacy groups are closing down whilst DPOs are losing funding for their peer advocacy services. The move is on increasing professionalised advocacy of both statutory and non-statutory advocacy support that is provided as a service rather than a core activity of empowerment of our brothers and sisters to achieve equality and inclusion in their lives and support their leadership in the continued struggle for our human rights to independent living.