Self-advocacy

How can you advocate for yourself in the mental health system?

You may encounter a problem with the mental health system and may need to advocate for yourself. Here are some examples of problems that other people reported: "I was on an endless list to see an individual counselor." "I wanted to get a job. I couldn't find out how to get help with this." "I was ready to leave the day treatment program, but people kept telling me there was no alternative."

When problems come up, the following guidelines may be helpful:

• Keep a record of the details of the problem and what you have tried to do about it.
• Seek out the person on your treatment team who has the most experience in the type of problem you are having.
• Talk about your concerns calmly and clearly.
• If you are not satisfied after speaking with the appropriate person, take additional action.
• Follow through on actions that are your responsibility.
• Let people know that you appreciate their efforts.
• If at first you don't succeed, try, try again.

Who can you ask for help if you have a problem with the mental health system?

Mental health systems can seem huge and overwhelming. Even when you speak up for yourself, there may be times when it's helpful to have someone to help you advocate for yourself.

In King County, there is a Mental Health Ombudsperson who is designated to be an advocate and to investigate if there are complaints or grievances.

The King County Mental Health Plan also has a Client Services Specialist. The Client Services Specialist can assist you if you are having difficulties accessing services or if you have a complaint about the services you receive. Call 1-800-790-8049, press "2" and ask for Client Services. Click here for more information on advocacy.

Some of the mental health agencies have a Client Advocate available within the agency to help clients advocate for themselves.

Another resource is the National Alliance on Mental Illness (NAMI). All of the NAMI groups are organizations including people who have mental illnesses, family members, friends and professionals, all working to ensure everyone gets the best services possible to help them recover. There are three NAMI groups in King County. They have information and referrals, support groups and other information on their websites. They will also help you advocate for yourself if you need help. There is a NAMI in greater Seattle, called NAMI Greater Seattle and one on the eastside of King County, called NAMI Eastside and also a NAMI in the south end of King County, called NAMI SouthKing.

Sometimes people feel that they "get lost in the system." To avoid that experience, it usually helps to find someone on your treatment team whom you feel comfortable talking to and whom you could turn to for help if you are having problems.

People usually feel most comfortable talking to someone who listens to their problems, asks questions, remembers what was said in past conversations, offers suggestions, and avoids critical or judgmental comments. Most people look for someone who seems to take an active interest in their well being.

The job title of the person with whom you feel comfortable will vary. Some people feel most comfortable talking with their case manager or their social worker or their psychiatrist. Other people feel most comfortable with their nurse or their psychologist or some other mental health worker. Some mental health agencies have Peer Counselors, who are people who have had training to be helpful and who have also been clients themselves.

Once you identify the person you feel comfortable with, it helps to keep him or her informed about how things are going with you. Let the person know both when things are going well and when things are not going well. Maintaining good communication will help the person be more effective if a problem comes up for you.

Summary of the main points about getting your needs met in the mental health system

Community mental health centers are the main source of public outpatient mental health services.

• Mental health centers usually offer a wide range of services.
• Individuals vary widely in the mental health services they use.
• Depending on your work history and financial need, you may be eligible for financial benefits from Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), or Public Assistance.
• Depending on your work history and financial need, you may be eligible for health insurance benefits from Medicare or Medicaid.
• Speak up for yourself if you encounter a problem in the mental health system.
• Get to know the consumer advocate at your mental health center.
• Identify someone on your treatment team to help you advocate for yourself if you encounter a problem with the mental health system.

This article is adapted from the Illness Management and Recovery Workbook, an Evidence-Based Practice, available on the Substance Abuse, Mental Health Services Administration (SAMHSA) website, a branch of the United States Department of Health and Human Services.