E1142Mental Health7 Recovery and self advocacy7.2 Self-advocacy7.2.2 Providing self-advocacy supportOnce both the consumer and the worker have identified that self-advocacy is the “way to go”, it isimportant to provide support to the person to achieve their desired outcome. What form thesupport can take is very varied, but it is crucial that every step along is done in line with bestpractice.The approaches discussed in the first part of this module can be helpful in facilitating the supportprocess, especially when it comes to exploring the consumer’s world and overcoming potentialconceptual barriers, as many of these approaches allow for a challenge of pre-conceived notions,such as low self-esteem which is often the result of stigma and discrimination experienced byconsumers.Workers should follow the below steps when providing support:assessment of needs and capabilitiesdevelop a self-advocacy strategyreflection and follow-up.AssessmentAssessment is the first step when providing advocacy support, this process should determine1 2 3which type of advocacy is best suited to the consumer. As mentioned already, workers can usestrategic questioning to clarify issues and might have to assist the person (or group) to identifytheir own needs and rights before exploring whether their rights are being infringed or not met.The next step is to evaluate the advocacy options available and to document these optionsaccording to policy and procedures.It is also important to understand that there are different approaches to advocacy which can beundertaken with individuals or groups and it is up to the professional to work with the consumerto identify which type of types of advocacy are best suited for the case in question.Health and Disability Advocacy NZ mentions the following types of advocacy:| Topic – 2 / 13© Open Colleges Pty Ltd, 2020.peer advocacy – takes place when the individual providing the help has been through, or isgoing through, a similar experience. This is also known as support advocacy and is oftenused by support groupsbest interest advocacy – decisions are made by someone considered to have the bestinterests of the consumer in mind and/or who is considered to have the knowledgeneeded to make an informed decision – often on behalf of the consumer. The consumermay not be part of the decision making process.statutory advocacy – is where someone is appointed with legal responsibility to representanother such as a welfare guardian.crisis advocacy – uses a one-to-one relationship between a paid or unpaid advocate andsomeone who is at risk of being mistreated or excluded. This is usually a short-term oneoff arrangement organised to deal with the crisis.professional/specialist advocacy – is most widely recognised as ‘legal advocacy’, but mayalso be provided by others who provide specialist advocacy services such as HDCadvocates specialising in advocacy under the Health and Disability Commissioner Act.political advocacy – can include lobbying and is the advancement of particular viewpoints ata political level on behalf of a group of people.self-advocacy – This is standing up for one’s self. Anyone can act as his or her ownadvocate. It is when a person makes an informed decision about a matter of importanceand then takes responsibility for bringing about the change necessary to make that choicea reality”.Source:dss.gov.au[https://www.dss.gov.au/our-responsibilities/disability-and-carers/publications-articles/policy-research/research-of-the-models-of-advocacy-funded-under-the-national-disability-advocacy-program?HTML], viewed 31/3/2016.Depending on the circumstances of the consumer, any of these types could be appropriate forthe situation. It might also be in the best interest of consumers to use a combination of differentadvocacy types, some of which might require a referral. In order to manage this selectionprocess in the most cooperative way possible, workers not only need to be aware of advocacyoptions and referral pathways, they must also be able to review and provide information on self-| Topic – 3 / 13© Open Colleges Pty Ltd, 2020.advocacy in relation to individual or group issues.Another helpful consideration towards a shared understanding of advocacy issues and choicesavailable can be for the worker to assess how empowered the consumer is to make choices andstand up for their own rights. In order to successfully navigate the self-advocacy process, theperson needs to have the required ability, motivation and knowledge to work towards their goals.If consumers do not have these required skills, workers need to be more involved by doingthings for and with consumers. As these skills increase, workers can step back and step into acoaching or mentoring role (Health and Disability Advocacy NZ, 2015).Source:dss.gov.au, 2015. Accessed 01/02/2016.There are many areas where consumers living with mental illness might experience aninfringement of their rights and/or not have their needs met. This makes it important for workersto assess advocacy needs in a holistic and thorough manner, including the following aspects:| Topic – 4 / 13© Open Colleges Pty Ltd, 2020.choice regarding mental health treatmentaccess to appropriate housing optionsaccess to recovery-oriented service provisionaccess to meaningful work and employmentaccess to training and educationaccess to meaningful engagement with communities of choiceopportunity to take risks and to failmeaningful engagement with loved ones, including children.It might be helpful for workers to have a checklist so any potential areas of advocacy can beexplored in a collaborative manner which will then allow the building of a shared understandingregarding advocacy issues.Many consumers may not even be aware of any potential advocacy issues that are present andmight need information and input from workers to identify issues and potential infringements ofrights. This means that workers need to have an awareness of resources where they can accessand review information about consumer needs and rights and they need to develop skills on howbest communicate information to consumers. It might be helpful for workers to create an‘advocacy toolkit’ which includes relevant information, resources and contacts for the provision ofadvocacy or support with self-advocacy. Consumer groups and peer services usually provideexcellent options for referral and it can be helpful to seek the support of peer workers to furtherenhance the effectiveness of the care network and increase positive outcomes for consumers.Once an assessment has been completed, it is important to discuss any options for advocacyidentify possible strategies for advocacy and self-advocacy. The assessment outcome shouldlead towards the development of a self-advocacy strategy which is based on a sharedunderstanding of advocacy issues and the choices available. This strategy can be documented aspart of the individual treatment plan or as part of case notes, depending on the policies andprocedures of the organisation.| Topic – 5 / 13© Open Colleges Pty Ltd, 2020.Activity 44589Rights and mental healthThese resources provide an overview of rights associated with service provision regardingmental health.Mental health statement of rights and responsibilities[https://www.health.gov.au/internet/main/publishing.nsf/Content/E39137B3C170F93ECA257CBC007CFC8C/$File/rights2.pdf]Mental health declaration of human rights[http://www.cchr.org/about-us/mental-health-declaration-of-human-rights.html]ACTIVITY 44589 TYPE ResourceSCENARIO Rights and mental health Activity 44590Self-advocacy toolkitThis Self-advocacy Toolkit for Mental Health Services Users[https://opencolleges.sharepoint.com/:b:/s/OS/EYz-73z8YepJrx-tiULHv8MBsnOq8AEn85quRmrsl6BFUA?e=pe8UuX]developed provides an excellent resource for workers and consumers alike.We suggest that you start building your resource toolbox now. Think about which pieces ofinformation from this course could you use to start gathering useful information and resources.ACTIVITY 44590 TYPE ResourceSCENARIO Self-advocacy toolkit Developing a self-advocacy strategy| Topic – 6 / 13© Open Colleges Pty Ltd, 2020.A self-advocacy strategy should be the basis of any advocacy work undertaken together andinclude goals as well as practical ways how to achieve advocacy goals. Workers should also openup discussion about what might get in the way of achieving the desired outcomes, including anypersonal barriers, and support consumers in planning for relevant strategies to overcome them.When faced with situations where rights are infringed upon, workers can encourage consumers todocument the circumstances and events relevant to the advocacy situation. For example, if aconsumer has difficulties with a specific service provider, it might be important for consumers tocreate a written record of the engagement with the service. This is especially helpful if theadvocacy issue cannot be resolved in a simple manner ( talking to a specific person in the service)and needs to be addressed at a higher level within the service or with outside support such asombudsman services or the Healthcare complaints commission.In order to document events and circumstances, consumers need adequate information aboutwhich events constitute infringements of rights. Identifying needs and providing information aboutrights and responsibilities are important parts of this process and are very much in line with theoverall aim of any advocacy work which to enable the person to gain self-advocacy skills.Workers should be open to providing consumers with opportunities to practice self-advocacywhenever possible, including with any issues pertaining to the support and engagement with theservice itself. Workers also need to allow for openness in the helping relationship for consumersto grow their sense of power. This can be a challenging process for both consumers andworkers, and it is essential for workers to have supervision and professional support in place tomanage this challenge appropriately and in line with best practice.| Topic – 7 / 13© Open Colleges Pty Ltd, 2020.Activity 44591Resources for self-advocacyThe following websites to get an overview of external resources available to consumers:Health Care Complaints Commission[http://www.hccc.nsw.gov.au/]Mental Health Coordinating Council[http://mhrm.mhcc.org.au/home/]The Official Visitors Program[https://www.mentalhealthcarersnsw.org/wp-content/uploads/2016/01/Primary-Carers-to-DC-and-PCPs-RightsBrochure-2015.pdf]Support for people experiencing abuse[https://www.1800respect.org.au/]The Human Rights Commission[http://www.humanrights.gov.au/]National Mental Health Consumer and Carer Advocacy Service[http://nmhccf.org.au/]Start building your resource toolbox now.What other services and resources are available online?ACTIVITY 44591 TYPE ContributeSCENARIO Resources for self-advocacy Empowering consumers towards self-advocacy can be a long process, it is important to breakthings down into smaller steps and to set goals along the way. Any goals should be explored anddecided on in a collaborative process, allowing the consumer to lead where at all possible.Once goals and strategies have been decided, workers should document the process inaccordance with organisational requirements. It might also be helpful to create a second| Topic – 8 / 13© Open Colleges Pty Ltd, 2020.document which is the property of the consumer. Workers should be very clear on whose needsare reflected in the document, it can be helpful to completely separate the needs of the serviceand the needs of the consumer by creating a document that is entirely reflective of theconsumer’s needs. The advocacy strategy should definitely have the consumer at the centre andit is the task of workers to manage any relevant organisational requirements.Reflection and follow-upCollaborative reflection is a key ingredient of a successful self-advocacy process. Once a strategyhas been developed and goals have been set, it is important for workers to negotiate how thefollow-up will happen. Monitoring the process and outcomes is vital and it would be helpful to havescheduled ‘reviews’ of the process to make sure that the process is ‘on track’. Whereas workersare responsible to organize the framework for reflection, it is up to the consumer to givefeedback about outcomes.Depending on circumstances, it is then important to identify further strategies and next stepsaccording to the needs of the consumer. It is often necessary to provide additional advocacysupport to the person to further enhance their efforts.Often, the road to self-advocacy can be fraught with challenges and frustrations, it is important forworkers to support consumers in this process. Raising awareness about barriers to selfadvocacy can be helpful as this can allow the consumer to perceive their situation as part of an ongoing process.Workers should also become role models when it comes to self-advocacy skills which mean thatthey need to be able to embody self-advocacy skills such as assertive communication.One example of assertive communication skills are I-statements which can be successfully usedwhen trying to resolve conflict with other people around us.| Topic – 9 / 13© Open Colleges Pty Ltd, 2020.Adapted from:communicationandconflict.com, 2014.As you have learnt, recovery-orientation is the theoretical framework of mental health, but is notalways applied in day-to-day practice. This may mean that workers need to promote selfadvocacy, not only to consumers but possibly also to other service providers, including their ownorganisation.On a practical level, workers could develop and resource promotional materials about selfadvocacy, such as brochures, posters or leaflets based on best practice, consumer rights and thestrength-based approach.Assertive communicationWould you invite this neighbour to your party?| Topic – 10 / 13© Open Colleges Pty Ltd, 2020.[https://youtube.com/watch?v=VYht-guymF4]Activity 44592Assertive communicationThiswebsite[http://www.skillsyouneed.com/ps/assertiveness.html]provides you with an excellent overview of assertive communication skills to deepen yourunderstanding of this skill related to self-advocacy.HintsIt might be helpful to practice ‘I Statements’ as part of assertive communication.ACTIVITY 44592 TYPE ConsumeSCENARIO Assertive communication ACTIVITY 44593 TYPE Contribute| Topic – 11 / 13© Open Colleges Pty Ltd, 2020.SCENARIO Remember Jacob?Activity 44594History and definition of self-advocacyWhat is the key slogan used by the self-advocacy movement?When and where did the self-advocacy movement originate?What are the key values of the self-advocacy movement?What are the key phases in the self-advocacy process?What is a self-advocacy strategy?How might you reflect on the self-advocacy process?Choose a question above and share your answer with others.HintsAcquiring all the skills to use the different approaches can take time. It is OK to seek support inthe meantime!ACTIVITY 44594 TYPE ContributeSCENARIO History and definition of self-advocacy SummarySelf-advocacy is one of the key pillars of recovery-orientation. It is essential for workers to beaware of the history and context of the self-advocacy model. Depending on the needs andcapabilities of the consumer or the consumer group, workers might have to first start in the roleof advocate before being able to support the consumers to be an advocate for their own needsand rights. Assessment needs to incorporate an understanding of self-advocacy needs, asconsumers might not be aware of their needs or their rights being infringed upon. An advocacy1 2 3 4 5 6| Topic – 12 / 13© Open Colleges Pty Ltd, 2020.strategy should support the overall movement of the consumer towards increased self-advocacyskills and include small steps towards a bigger goal. Constant review and follow-up will allow forreflective practice throughout the process and should form the basis for the development offurther strategies towards the meeting of needs and rights. Workers also might have to take therole of advocate for advocacy as the mental health sector catches up with the ethos of recoveryorientation and dignity of risk.| Topic – 13 / 13© Open Colleges Pty Ltd, 2020.
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