"Thank you for my priceless support"

About: Advocacy Support Cymru Cefn Coed Hospital / Mental Illness

(as the patient),

My disillusionment with the games played by the ‘Doctor’ were drastically eased just by the presence and reassuring demeanour of my advocate (Dylan). It had only been thirteen days since my arrest. I had reached the end of my tether as the cyclical, egotistical nature of the ‘Doctor’s’ interrogative assessment of my section 2 status led me to conclude that proving my sanity to the ‘Doctor’ was futile. Uncomfortable with resigning myself to a life of incarceration and by this stage I had refused my medication, alienated my family and the authority of the establishment in which I found myself, I sat down and quietly prayed to the King of Kings. I was tapped on the shoulder and asked if I would like to talk to an Independent Advocate who I warmly could see respectfully standing behind the inquirer.

Making use of the art area for privacy my Advocate gave me an overview of my rights and explained the complexities of the mental health legal system in the simplest way he could. Overwhelming as the information was, I was so grateful to have been blessed with parents who taught me the use of the English language, supported my extended education, encouraged me to think for myself and instilled an ethical sense of personal responsibility. None of which could have been an easy task for them as I am dyslexic, dyspraxic and audio-logically deaf. Already during this experience I was compelled to go against my parents wishes in refusing the medication being prescribed and battled in my mind the situation of events, the prognosis, the judgement and from my perceptive a slanderous history of being a ‘wild child’. Blessedly thanks to my unconditionally loving parents and being educated to a high level I even surprised myself in having the confidence to challenge the advice, process and authority I was being presented with.

I was informed I was 10 days into the process and therefore only had 4 days left in which to challenge the doctor’s prognosis. I was given the ‘List of Solicitors Who Hold a Mental Health Contract for Patients in Wales’, assured it was a free government supported scheme and asked which one I would like to request help from. As solicitors were an unknown entity to me, I asked my Advocate for previous case results, specialism or any data that I could base my decision on. My Advocate due to restrictions of his role was unable to advise but did suggest that I could ask other patients who they used. The other patients from what I could gather had been in the system a long time, so I deduced that asking them would surely only identify those Solicitors (if on the list) I would probably want to avoid and all this would take more time that I did not have. I also realised that my presumptions of the other patients’ situations, coupled with the complexities of cases indicated any judgement on my part would be unsound; my only recourse was instinct and logistics. I was thinking of the salt of the earth and as I looked at the list I saw ‘Salter Kelly, Walters Road, Swansea’, this met logistical needs and instinct which I concluded was as good a decision as I could make given the information at hand. My Advocate completed a form, which via his office would go to my chosen solicitors thus commencing the challenge of the Doctor’s prognosis. How long this would take was unknown at the time, I could only hope they were not so swamped with work that action could be swift.

My Advocate was able to support me by being by my side at all further meetings with the ‘Doctor’, if his diary allowed, the first of which to my relief occurred quickly. If I recall figures accurately, we were invited into the room containing 3 members of the medical establishment and 1 member of the Crisis Resolution Team. The rhetoric and reality battle commenced and the authority that chaired the meeting continued to challenge the essence of my being, my state of mind and personal beliefs. I turned in despair to my Advocate, who supported my argument and reiterated the cyclical and contradictory nature of the doctors reasoning, in response to which the doctor resumed his game. To me it was evident that the attitude of the Authority Chair in the room was infectious and my plight futile. My only hopeful argument was to save Solicitor and tribunal time and quietly implying the doctors’ time in having to defend his prognosis and present his case via the impending tribunal. Noting my despair my Advocate diplomatically requested a break. I noted I had been helping other patients prior to my meeting and had failed to prepare myself with water or nicotine which quickly resulted in my stress. During this break the Advocate explained the extent to which his role is restricted included being unable to speak on my behalf or offer advise, yet thankfully in my stressed state pricelessly summarised what the doctor was offering. Authorised leave which would be assessed at another meeting on Monday, which if all going well would be with a view to my release on Monday. We resumed the meeting and agreed to the Doctors proposal of leave however negotiated 4 hours leave over the weekend rather than during the week when my husband would be in work.

I was informed a few days later by a member of the medical team that my case to challenge the doctors’ prognosis was going ahead, the solicitor would come and see me Tuesday and the tribunal was booked in for Thursday.

Over the weekend my leave went well. I shared my time between my own home with my husband and the cat and my parents and family which left little time to completely relax. I was elated regardless, as I was so sure of my imminent release.

Mondays meeting arrived if I recall figures accurately, we were invited into the room containing 5 members of the medical establishment and 1 member of the Crisis Resolution Team. I reported back the weekend’s events to the Doctor who was still adamant in my detention. My Advocate highlighted to me the only other recourse was to ask my husband if he would consider instigating his right as Nearest Relative to obtain my release. He explained these rights to my husband over the phone. My advocate had to travel to another appointment so was unable to be there when my husband came in, however this was done and the doctor accepted the request and was not going to challenge it thereby releasing me. In hindsight the speed in which Salter Kelly instigated my request and my subsequent release I can only presume also applied the pressure necessary. Later on that day my Advocate called to confirm he had e-mailed confirmation information regarding my status in still being able to drive which the doctor had implied was not the case which caused needless worry. My Advocate also confessed to noting the doctor saying certain things in the meeting, which he wanted to check before sharing with me. I had not even registered the information so was grateful for his knowledge and commitment to my case. He confirmed the doctor had said something that should by rights have enabled my release without the need for my husband to take time from work to attend the hospital and secure my release.

I am ever thankful for the unconditional love of my parents that continues to be the foundation of my strength. I am grateful for my education, which enabled me to challenge the doctors’ psychoanalysis. I am ever grateful to the Ward Manager who took time to listen to me and respected my decision to stop taking the medication prescribed for me and assured me they would not force it upon me in the Doctors absence. I believe I would not have been able to cope with this level of psycho analysis had my brain been impaired any further by the medication or the stress already inflicted upon me.

I am very thankful for the support and priceless time of my Advocate and the services you offer appreciating any silent partners that have enabled this resolution. As such with my training and experience within the field of Human Resources I would like to offer you some points of feedback with regard my perception of the role of ‘Independent Mental Health Advocate’ and hope it is received with the good intentions it is intended.

I noted that contrary to the nature and demands of the role they are unable to advise or speak on behalf of the patient. In my mind role responsibility with no authority to change anything causes stress. Being able to advise, have data they need at hand or speak on the patients behalf would have been great yet thankfully was not critical to my case. In my minimal experience with mental health patients I would conclude most patients are initially not equipped with psycho analysis skills, they are heavily medicated, they are ill and far more vulnerable than I was.

I appreciate the spontaneous nature of my initial situation, however my advocate seemed to have additional adhoc workload demands on his time and seemed not to have control over his own diary that prevented him following my case fully.

The priceless support I received from your service has enabled my health, happiness and freedom. I hope the role of ‘Independent Mental Health Advocate’ is allowed to flourish to enable them the tools and reduced restrictions to successfully fulfil their role with the pride and honour they so deserve. They undertake a role in an already stress fuelled environment. Their success is ultimately the patients and our communities also, in the swift economical use of time and resources.

Thank you for my priceless support, freedom and this feedback opportunity.

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Response from Advocacy Support Cymru

We apologise for the delay in responding, but have very much appreciated reading your story. We have ensured that Dylan has seen it.

We have looked especially at your feedback on the advocacy role. We do understand that there are times when people would like to be advised as to what course of action to take. However, it is a core principle of Independent Advocacy that we do not give advice, as we are obliged to offer non-judgmental support and advice by necessity requires a judgement to be made. We work with people to ensure that they have information and can understand their options, in order that they can make their own best choice.

As advocates we are able to speak on behalf of people in almost all situations, and this is a substantial part of our advocacy work. An exception to this is normally at Mental Health Review Tribunal, where for the most part people are represented by Solicitors. Although on rare occasions the tribunal may ask for a contribution from the advocate, the role of the advocate in this circumstance is to help people prepare for the hearing and provide emotional support in the hearing itself.

It is true that our advocates cannot always be available for people, and this is something that we try to limit as much as possible. The demands on our service are high and our advocates all work with a number of people at any one time. Sometimes, we do not get much notice of meetings and have competing appointments. Having said that, we do take this very seriously and your comments underline that we must continue to have a weather eye to time and workload management, in order to be able to support our clients in the way that is most useful to them.

Thank you again for you story, which raises interesting points and also demonstrates well the benefits and limits of advocacy.

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