News & events

01 Aug 2017

Advocacy Needs of Mental Health Service Users Living in the Community

Mental Health Reform launched a report last week entitled The Advocacy Needs of Mental Health Service Users Living in the Community: A Pilot Study. It focuses on advocacy for servce users and you can read the highlights below.

The report examines the need for independent, one-to-one advocacy supports for people who use mental health services and who need help to make decisions or access their rights and entitlements. The study surveyed 76 people who use mental health services in a major urban area.

It is very significant that two-thirds of participants in this study did not know how to make a complaint about the HSE mental health services. The HSE mental health services should be proactive in explaining to service users how they can make a complaint and encourage both negative and positive feedback. Overall, the Minister of Social Protection, the Minister of State for Mental Health and the relevant agencies (Citizens Information Board and HSE) should review the findings of this report and consider how they can ensure that the scope and capacity of publicly-funded advocacy services are adequate to meet the needs of people with long-term mental health difficulties living in the community.”

Launching the report, the Ombudsman, Peter Tyndall said, “I greatly welcome the publication of this report.  Often, people receiving treatment for mental health difficulties will greatly benefit from the support of an independent advocate to guide them through the system, help them to understand their condition and treatment, and to get answers to questions that are troubling them. Of equal importance from my perspective is that an independent advocate can help a service user to complain when they’re not happy.  The high percentage of people who don’t know how to complain revealed by the survey is sadly not a surprise to me, but it is essential that we learn from people’s experience of their services, and especially any mistakes, if we are to improve services for the future.”

Key findings:

Satisfaction with involvement in the community: One third of participants were not at all happy with their involvement in the community, while 61% were either not at all or only slightly happy with their involvement in the community.

Sense of control over own life: More than a third of participants felt that they had little control to lead their own lives as they wanted.

Satisfaction with support from mental health team: 20% of participants were very satisfied and 38% mostly satisfied with the support they receive from their mental health team. A further 28% were a little satisfied and 9% were not satisfied with the support they receive from their mental health team.

Involvement in planning their own mental health treatment: 34% of participants said they were very involved in planning their own mental health treatment, 34% were involved a little, over a fifth (21%) selected that they were not involved at all, while only 4% selected that they were involved as full partners.

Confidence in advocating for themselves: Participants had a relatively low level of confidence in their own ability to advocate for themselves. When asked about their confidence in raising issues within a variety of services, on average participants said they were only ‘a little confident’ compared to the other options of ‘not confident at all’, ‘mostly confident’ or ‘fully confident’.

Confidence in raising an issue with their psychiatrist: Participants’ confidence in raising an issue with their psychiatrist was relatively low, with only 9% of participants being ‘fully confident’, while 18% were mostly confident, 43% were ‘a little confident’ and 17% were ‘not confident at all’.


In A Vision for Change, the Expert Group on mental health policy recommended that “advocacy should be available as a right to all service users in all mental health services, i.e. including hospitals, day centres, training centres, clinics, or elsewhere in all parts of the country.” The Community Advocacy Needs (CAN) survey was developed to investigate the level and nature of mental health service users’ need for independent, one-to-one advocacy support. Mental Health Reform (MHR) is aware that there may be a gap in independent advocacy services for people with a mental health difficulty living in the community

MHR receives enquiries from individuals who are seeking information on how they can access better mental health services or how they can obtain redress for poor treatment received within mental health services. These individuals are often unaware of the advocacy services available. MHR has also heard about difficulties that individuals experience in trying to make a complaint about mental health services.

No research has ever been undertaken to specifically explore the advocacy needs of people with mental health difficulties living in the community. However, previous research has identified low levels of community participation among people living in HSE community residences. Research was therefore needed into this group’s potential need for independent advocacy services and their preferences for advocacy supports. Drawing upon some questions from previous surveys as well as developing new questions, the CAN survey focussed on the following questions about people who use secondary mental health services:

  • The level and nature of their need for representative advocacy
  • The level of their need for support for self-advocacy
  • The level of awareness of their rights
  • The level of their awareness of existing advocacy services
  • The level of their awareness of existing complaints and redress mechanisms
  • Who they would turn to for support

The aim of the CAN survey pilot was two-fold: firstly, to determine if the CAN survey instrument was user friendly and capable of capturing levels of need for advocacy services; and secondly, to describe the need for advocacy services in one mental health service area.

The survey was conducted among 76 mental health service users in one urban mental health catchment area.

For further information contact:

Ray Burke Communications and Campaigns Officer, Mental Health Reform

Tel: (01) 8749468 / Mob: 086 171 1920



Recent News & events / Archive

Recent News & events / Archive