Patients' advocacy: The development of a service at the State Hospital, Carstairs, Scotland

Abstract

Advocacy is part of the process of empowering patients and involving them in the development of services. This paper describes the development of an advocacy service in the State Hospital at Carstairs and explores the issues involved in advocacy in a maximum secure environment. Using a model of citizen advocacy the service was started in September 1997. Patient involvement throughout the hospital was high with approximately 88% of patients having some contact with the service by January 2000. Most of the issues raised by patients are similar to those in any mental health advocacy project. Entrapment is a particular issue for some patients. Safety and security issues influence every aspect of the service. This ranges from advocates having to do more for patients rather than enable them to do things for themselves (e.g. make telephone calls) to the principle of the patients' wishes being paramount being tempered by security demands.