0113 2470449 Fax: 0113 2470448
Advocacy for Mental Health and Dementia
office@advocacy4mhd.org.uk
Mental health advocacy has a relatively brief history, having emerged in
the wake of growing social and health policy concerns about mental health
services in the second half of the last century.
The idea of providing citizen advocacy for people with learning
difficulties had been developed in America in the 1960s, the first such
scheme in this country having been established in London in 1979.
The 1983 Mental Health Act and Code of Practice reflected a new policy
emphasis on the legal and human rights of mental health patients and their
right to information and representation.
The 1985 World Congress for Mental Health, held in Britain, fostered an
awareness of new approaches in other countries. Holland, for example, had
developed Patients' Councils in most hospitals and had a national
organisation to lobby for policy changes.
The first Patients' Council in Britain was established in Nottingham in
1986 and the national self-advocacy network Survivors Speak Out was created
in the same year. By 1992 more than a hundred local survivor groups had come
into being, stimulated by the 1990 NHS and Community Care Act and the
introduction of Mental Illness Specific Grant (MISG) in 1991. These groups
became linked up through the creation in 1992 of the United Kingdom Advocacy
Network (UKAN).
LMHAG was started in 1993 with funding from Joint Finance - which enabled
social services departments and health authorities to co-fund independent
advocacy services - and MISG.
LMHAG'S initial role was to provide trained volunteer advocates for
citizens advocacy and Patients' Councils. One to one representational
advocacy requests were referred to two full time equivalent workers in the
Health Unit of Leeds City Council's Benefits and Rights Department.
The Health Unit was wound up early in 1998 and after six months it became
clear that this had created a serious gap in services. The City Council then
agreed to proposals from LMHAG that workers would provide direct paid
advocacy rather facilitate volunteer advocacy.
After the second world war, people began to question many aspects of our
culture. This included psychiatry. Numbers of patients, relative, friends
and service providers themselves were unhappy. They began to question
whether it was right to lock people away in large asylums for long periods
of time.
Writers such as Goffman (Asylums) and Foucault (Madness and Society)
challenged the idea that people with mental distress are different from
other people. They said that living in an asylum led to institutionalisation, loss of identity, social skills.
The idea grew that social factors not only created mental distress but
were also important in recovery. The idea of having a right to a normal life
took shape.
1950�s onwards successive governments promised to close the long stay
hospitals. Scandals around the large hospitals began to surface. The mental
health charity MIND, lobbied for change including more legal protection for
patients.
1983 Mental Health Act and Code of Practice brought in greater awareness
of legal and human rights of patients and rights to proper information and
representation.
Growing network of lawyers specialising in mental health law1990 NHS and
Community Care Act brought further changes.
1966 Wolf Wolfensberger (USA) developed idea of citizen advocacy for
people with learning difficulties. This was one to one volunteer advocacy.
The first scheme in this country was in 1979 in London.
In mental health informal advocacy was developing with friends and
families.
1985 the World Congress for Mental Health was held in Britain. Holland
had developed Patients Councils in most hospitals and had a national
organisation to lobby for change.
1986 the first Patients Council was set up in Nottingham and Survivors
Speak Out (a national self advocacy network) was established.
1991 MISG (mental health specific grant) came in and helped to fund the
development of many local groups. The 1990 NHS and Community Care Act also
acted as a catalyst.
1992 UKAN (United Kingdom Advocacy Network) was set up to bring together
these local groups.
1993 Advice on setting up advocacy projects and consulting with advocates
was given mainstream accept- ance by inclusion in the Key Area Handbook on
Mental Illness published by the Department of Health.
LMHAG was set up in 1993. From the beginning, the management committee
has had a majority of service users. The Constitution states that the
Chairperson must always be a service user though whenever possible the
Treasurer and the Secretary are also service users. The committee is elected
every year at an AGM by the membership on a rotating basis.
For the first 5 years, advocacy was provided by volunteers the majority
of whom were service users themselves or had been in the past.
Until 1998 LMHAG provided patients councils at both Roundhay Wing and
High Royds as well as citizen advocacy. There were two project co-ordinators
and a part-time admin worker.
Requests for immediate advocacy were referred to the Health Unit advocacy
workers based within the Benefits and Rights department of the local
Council.
In the spring of 1998 the council announced that the Health Unit would no
longer be funded. At first we continued to provide volunteer advocacy but
within 6 months it was clear that the need for instant advocacy support was
unmet and that this was the real priority for service users. The council
agreed to redirect the funding so we could provide direct paid advocacy.
Since this time we have grown in numbers and now provide: