Advocacy and Participation in Mental Health Cases: Realisable Rights or Pipe-Dreams?
This article discusses Australian experiences of mental health clients, legal advocates and other stakeholders in the mental health review system. We review forms of advocacy, the reactions to these, and the contribution lawyers make to protecting rights within this field. Based on our fieldwork we suggest a mixed model of advocacy, one that includes legal representation that goes beyond simple 'following instructions', but also self-advocacy, systemic advocacy and mobilisation of support networks. We suggest that Jan Brakel was right to recently call for a re-conceptualisation of mental health advocacy, and indicate ways this might be achieved.
‘Odyssey of Hope’: The role of carers in mental health tribunal processes and systems of mental health care
This article examines carers' involvement in the interconnected processes of mental health care planning and mental health tribunal hearings, decision-making processes which often dramatically impact on carer–service-user relationships and effectively impose obligations on some carers to assist in implementing legally binding orders. It explores concerns expressed by carers about difficulties accessing information about, and contributing to, these processes, and identifies associated dilemmas and conflicts. Whilst carer involvement may not be appropriate in all cases, the article concludes that carers should be better engaged at the service delivery level from the first point of contact and on an ongoing basis. It argues that a more consistent approach which assists and encourages carer participation in tribunal processes should be adopted. It also suggests that there is a need for additional processes and efforts to deal with conflicts arising between service-users, carers, and health services in the mental health context.
Emergency commitment and legislative reform in New Jersey.
The effects of a state commitment law that combines use of the dangerousness criterion, screening for less restrictive alternatives, and a new mental health structure were investigated. A time-series analysis of the number of commitments in a 12-year period at one screening center revealed that the expected outcome of the legislation--a decrease in state-hospital commitments--was not realized.