Abstract
<p>The need, in mental health care, for advocacy which is independent of the health care provider is clear and acknowledged but the existence of the schemes which provide it might be seriously threatened by PALS. Principles of independent advocacy have been developed over the last twenty five years. Unfortunately many advocates are unfamiliar with the law affecting their practice and its impact upon those principles, especially in respect of confidentiality. The advocate is the client’s agent, owing a duty of care but unable to guarantee confidentiality. It is likely that most independent advocacy schemes have wholly inaccurate and inadequate confidentiality policies and guidelines. If these inadequacies are not addressed independent advocacy will not be able to compete with rival systems and it will be in danger of disappearing.</p>
Highlights
Sinead Dalton and Peter Carlin*Summary: The need, in mental health care, for advocacy which is independent of the health care provider is clear and acknowledged but the existence of the schemes which provide it might be seriously threatened by Patient Advocacy and Liaison Service (PALS)
Advocacy in the context of mental health is a manichean concept labouring under two very different principles, the one being independent “client led” advocacy which adopts as its final position the principle that “the service user must be heard”; the other being “profession led” advocacy which adopts as its final position the principle that “the medical profession and the service provider know best”
If independent advocacy does survive and prosper alongside Patient Advocacy and Liaison Service (PALS) it will be because its practitioners understand both the principles governing their practice and the legal context within which they work
Summary
Summary: The need, in mental health care, for advocacy which is independent of the health care provider is clear and acknowledged but the existence of the schemes which provide it might be seriously threatened by PALS. It is likely that most independent advocacy schemes have wholly inaccurate and inadequate confidentiality policies and guidelines If these inadequacies are not addressed independent advocacy will not be able to compete with rival systems and it will be in danger of disappearing. Psychiatric nurses are taught to regard advocacy for their patients as part of their role[1] but there is an obvious likelihood of conflict between what the client wants and what the mental health team thinks is best for them. In such a situation the “nurse advocate” will almost inevitably bow to the weight of medical opinion and say that the patient must do likewise. Advocacy in the context of mental health is a manichean concept labouring under two very different principles, the one being independent “client led” advocacy which adopts as its final position the principle that “the service user must be heard”; the other being “profession led” advocacy which adopts as its final position the principle that “the medical profession and the service provider know best”
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