How advocacy makes a difference.
I feel stronger and more able to cope
Claire was leading a busy life in Bradford, running her business with her husband and looking after her 8-year-old son. But she was feeling isolated and lonely. Her relationship was abusive and she was struggling with mental ill health.
When she was admitted to hospital for a mental health assessment, Claire met advocate Teresa, who was running a regular advocacy drop-in. Teresa explained that advocacy was about supporting Claire to understand her rights and have her voice heard. She gave Claire time to consider whether she would like advocacy support. She gave Claire her phone number and invited her to chat during the next drop-in if she wanted to. Teresa earnt Claire’s trust by chatting with her at the weekly drop-ins and Claire decided she wanted to be formally referred for advocacy.
Claire and Teresa discussed what Claire wanted. Teresa helped Claire understand her rights and options not only about her care and treatment in hospital but also about being able to see her son, her housing, and information about domestic violence support and divorce. She gave Claire a list of local solicitors, community support groups and organisations who could help her. She offered to explain more about Claire’s options, and to help Claire contact the people on the list.
After four months of weekly advocacy support, alongside care and treatment, Claire grew in self-confidence and started to make decisions about what she wanted to do next. She got support in her local community, using the information Teresa gave her. Claire was eventually discharged from hospital and is now in her own flat.
Claire said: “Teresa helped me make sense of what was happening to me and broke it down into more manageable chunks I could deal with. I feel stronger and more able to cope.”
Thank you for being a great support and help
Heather is in her 50s and lives in south-west London. She asked for an advocate when she was sectioned and in hospital, because she was frustrated with her care and treatment and wanted to challenge some of the decisions being made.
Heather had already been sectioned in hospital before. That time, she had been discharged under a Community Treatment Order (CTO) which gave rules about where she could live and get treatment. Heather had disagreed with the rules, which meant she was now back in hospital again. She was told she was not allowed to spend any time away from the hospital until she was discharged, and that when she was discharged it would be under another CTO.
Heather told her advocate Maryam that she was frustrated and upset because she didn’t want to be under another CTO. She also said she wanted to spend some time outside of hospital while she was getting treatment for her mental health problems, and that she wanted to change her medication.
Maryam explained Heather’s rights and options to her. She explained that Heather had the right to be involved in planning her care and treatment, and to challenge decisions around her freedom to leave hospital. Heather asked Maryam to write a letter to her doctor on her behalf. In the letter, Maryam highlighted Heather’s rights, asked about Heather’s admission and treatment plan, and asked for her to be allowed to spend time outside the hospital.
Heather asked Maryam to come with her to the discharge meeting. At the meeting, they told the clinical team that Heather disagreed with the changes that had been made to her treatment plan. They also told the team that Heather didn’t want to be placed under a CTO when she was discharged. Because Maryam had explained to Heather her rights and options, Heather felt confident to put her own views forward in the meeting, and to get involved in planning next steps.
Together, Heather and the clinical team set out a treatment plan that she was happy with. After fewer than two months working with Maryam, Heather got the changes she wanted to her medication. Heather left hospital without being put under a CTO. Maryam made sure Heather knew how to get advocacy support in future if she needed it, and Heather thanked her for being a ‘great support and help’.
I told him that it was his right to stay at home, and his face and eyes lit up
Jake lived with his best friend, in a house where they enjoyed gardening and listening to music together. The new flat didn’t look safe, and he didn’t understand why he had to move. Jake wanted someone separate from his social work team and support workers to help him find out what was happening, to help him decide what to do, and to get his voice heard. The manager at Jake’s day centre asked an advocate, Louise, to help Jake.
Louise met Jake and his social work team. They didn’t know anything about the plans for Jake to move out of his home. Because Jake and his friend had a learning disability, support workers from a care agency were helping them to live independently. Jake and his friend had told their support workers that they wanted to stay living together, but the care agency wouldn’t respect their wishes.
Although Jake found it difficult to talk, he could use single words, Makaton and pictures to explain his thoughts and feelings. Louise talked to Jake on his own so that he could have private conversations about his wishes and feelings. She made sure that the social work team and care agency started listening to Jake, and explaining what was happening. Louise helped Jake tell his social work team and the care agency that he didn’t want to move into the new flat.
The care agency told Louise that they wanted Jake and his friend to move out so that someone else could live in their house. But the person in charge of the flat told Louise that Jake would not be happy and safe there. There was no garden, and someone else with support needs, who had lived in the same building before, had trouble from drug dealers. Louise told Jake that the care agency wasn’t allowed to move him to an unsafe flat.
Louise helped Jake understand that he had the right to choose where he lived. “I found a lovely new bungalow with a garden, and we visited it together but I could tell from his body language that he still wasn’t happy,” says Louise. “I said, ‘do you like this place?’ and he said ‘No’, and then said his friend’s name.” Later on, using pictures and Makaton, Jake explained again to Louise and his social worker that he definitely wanted to stay in his home with his friend. “I told him that it was his right to stay at home, and his whole body relaxed. His face and eyes lit up. He put his thumb up to sign ‘OK’, and smiled.”
The care agency agreed that Jake had the right to stay at home. Jake and his friend are now living happily together in the home they love, and feeling more independent than ever.
I felt confident telling doctors what I needed, because you helped me prepare
17-year-old A-level student Tori was detained in hospital under the Mental Health Act for her own safety, when her self-harm became a threat to her life. She asked for advocate Eve’s help, because she was worried that the hospital would discharge her before she felt safe and ready. With Eve’s help, she was able to understand her rights and have her wishes respected in decisions around her discharge.
Tori’s previous discharge arrangements had come at a very difficult time for her, and before she was due to be sent home, she had attempted to take her own life. Since then, she didn’t feel she had been given any meaningful help at hospital to improve her mental health. She told Eve that she didn’t know how she would cope if she left hospital, and that she was terrified of going home. She was also concerned about the worry she would cause to her parents and young siblings if she went home while feeling so unwell.
Eve agreed to support Tori to raise her concerns with staff, and to ask for a plan which included therapeutic sessions at home once she’d left hospital. Eve accompanied Tori to her discharge meeting, where she helped her to feel confident in expressing her own views and to feel listened to by the medical team.
After the meeting, Tori felt positive about her discharge. She was excited to be going home, and looking forward to restarting her studies. Thanks to support from her advocate, Tori now understood her rights, knew how to get involved with decisions about her care and treatment, and had regained the confidence and self-esteem she needed for a successful return home to her family.
We can’t thank Krish enough for the help he gave Tommy
Tommy was due to have a cataract operation and an advocate called Krish came to support him as an IMCA.
Tommy’s carer said: “I was delighted to see how Krish worked with Tommy. Tommy is 78 and Krish put Tommy at ease almost immediately, not an easy task as Tommy has a great distrust of strangers.
Tommy went into hospital completely relaxed and the operation was a total success. This was definitely due to Krish’s input and Tommy still talks about Krish and asks, even now, if Krish is coming back to see him.
We were originally told Tommy could only have his right eye operated on and that he couldn’t have any further surgery, but we were truly grateful it restored Tommy’s sight. Last week, the consultant told us that Tommy can now have his left eye operated on in March and this will totally restore his sight. Tommy is thrilled and he’s really excited about going in for his operation because he hasn’t any fear of the hospital and he understands how much difference it’s going to make to his life.
We can’t thank Krish enough for the help he gave Tommy, it’s obvious to us that Tommy benefited greatly from Krish’s visit.”