Advocacy processes in mental health: a qualitative study

ABSTRACT

Advocates perform an important role in representing the rights of mental health consumers, especially since mental health consumers are often marginalized. Little is known about the processes advocates use to assist mental health consumers in navigating the health care system. This study details the manner in which advocates work together with mental health consumers and health professionals through presenting a qualitative synthesis of 60 case records. Four main themes emerged: negotiating on behalf of consumers during meetings with health professionals; liaising between consumers and health professionals outside of meetings; supporting consumer decision making without the involvement of health professionals; and involvement in legal processes. The findings of this study demonstrated that advocates were primarily oriented toward the protection of negative rights, but they also promoted positive rights.

KEYWORDS:

• Advocacy
• consumer
• mental health
• participation

Additional information

Notes on contributors

Norman Stomski

Norman Stomski holds a PhD in the health sciences and works as a postdoctoral researcher at Murdoch University. Norman has undertaken research across a broad range of areas, including mental health, chronic pain, and Indigenous health. He has a particular interest in understanding how the interactions between health professionals and consumers influence health outcomes.

Paul Morrison

Paul Morrison is the Dean of Health Professions at Murdoch University. He has experience in health care and university settings in Ireland, the United Kingdom, and Australia. He worked as a mental health nurse and general nurse before completing tertiary studies in psychology (BA, PhD), education (PGCE), and counseling (GradDip). Paul is an experienced teacher, researcher, and writer. He is also a registered psychologist, a member of the Australian Psychological Society (MAPS), a Chartered Psychologist (CPsychol), and an Associate Fellow of the British Psychological Society (AFBPsS).

Martin Whitely

Dr. Martin Whitely is a mental health advocate, researcher, author and former politician. While a Member of the Western Australia Legislative Assembly (2001–2013) he influenced Attention Deficit/Hyperactivity Disorder prescribing practices within Western Australia, contributing to a 50% fall in child prescribing rates between 2002 and 2010. A focus of Martin’s advocacy has been exposing and reducing what he asserts is “regulatory capture,” primarily by the pharmaceutical industry, of research, treatment guidelines, and prescription drug licensing and safety monitoring processes. He has also been prominent in highlighting concerns about “diagnostic creep”—the loosening of the diagnostic criteria of psychiatric disorders, potentially leading to inappropriate labelling and harmful over-medication. His book Speed Up and Sit Still—The Controversies of ADHD Diagnosis and Treatment was published in 2010 (UWA Publishing). He has also written numerous shorter items on ADHD and mental health. He completed his PhD thesis ADHD Policy, Practice and Regulatory Capture in Australia 1992–2012 at Curtin University in 2014.

Pip Brennan

Pip Brennan has worked in the community sector for the last 15 years. Inspired by her own experiences of the confusing maternity care system, Pip initially volunteered as a maternity consumer representative in a range of roles. She began her paid health career as an Advocate working at the Health Consumers’ Council (HCC) from 2006. She then moved to the Office of Health Review (now the Health and Disability Services Complaints Office) in 2007 and took up a position as a Conciliator of Health Complaints. In 2009 she began working at Community Midwifery WA (Now The Bump WA), while also working on a pilot project in the victim support services sector, Reclaiming Voices. In 2010 she took on the role of Manager of CWMA until 2013. She spent 2014 working at WACOSS on outcomes based contracting in the health not for profit sector project before returning to HCC to take on the role of Executive Director. Pip sits on the Executive Board of the WA Health Translation Network and works closely with the Consumer and Community Engagement Network. This has evolved from the Involving People in Research Project, for which Pip is an Ambassador.