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Advocacy > Be An Advocate
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Chapter Three
Creating An Agenda: Selecting Goals
It's Not As Easy As It Sounds
Since an advocacy agenda is fundamentally a list of your advocacy goals, it sounds like a pretty
simple thing to do. It turns out, however, that it's not as simple as it sounds.
The Eight P's
In general goals need to be carefully thought through and formulated in terms, which are clear to
potential members of your group, to people who have the power to change policy, and to those
who can influence the powers-that-be, such as the press.
To develop a thoughtful agenda I find it useful to consider each of the following “ eight P’s”.
- Population
Which population do you want to help? Suppose that your goal is to improve the quality
of life for people with mental illnesses. While this is a noble goal, it is vague. Do you
mean all people with mental illnesses? Children, adults, and geriatrics? In New York, in
the United States, in the world? All diagnostic categories or only those that suggest a
serious illness and ongoing disability?
Suppose that your concern is adults in New York State with long-term psychiatric
disabilities. In current policy jargon this population is known as "people with psychiatric
disabilities". Your goal then would be to improve the quality of life for people with
psychiatric disabilities in New York State.
- Problem
This is still a nebulous goal. What's wrong with the quality of life of people with
psychiatric disabilities? What's the problem? There are many possible answers. One is
that people with psychiatric disabilities are too frequently homeless or live in housing
which is shabby and dangerous. Another is that they cannot get jobs. Another is that
they frequently get no treatment or inadequate treatment. Another is that they are forced
to stay in hospitals too long. Or they are forced to leave hospitals before they are ready.
Different people have different views.
Suppose you think the major problems are lack of safe and decent housing, lack of access
to high quality treatment, and lack of access to work. Your goals then would be to make
more safe and decent housing available for people with psychiatric disabilities in New
York State, to assure access to high quality treatment, and to create greater access to
work for them. Such goals begin to be specific enough to mount a meaningful advocacy
effort.
The Choice of Language in Describing the Population and the Problem
Some people might find the use of the expression “people with psychiatric disabilities”
objectionable. They might want to overcome the same problems for the same people but would
use other expressions such as “people with severe and recurrent mental illnesses,” “people with
brain disorders,” or “psychiatric survivors.” Terminology is very important in formulating your
goals. You need to choose terminology that is acceptable to the people in your advocacy group.
But you also need to gear your language to the people who have the power to make changes in
public policy.
- Proposed Solution
In addition to specifying the population and describing the problem, it is useful to give
some idea of how the problem can be overcome. For example, you may believe that the
best way to make decent housing available is for The New York State Office of Mental
Health to build and fund community residences. Or you may think that rent subsidies are
the answer. With regard to work, you may think that it is important to provide job
coaches or that Medical insurance must be available. Again these are just examples.
You will also need to be more specific. For example, if you want more housing for
people with mental illnesses, you will need to say how much more.
- Policy
In addition to proposing a solution to the problem you have identified, it is very helpful if
you can specify how to change policy. What is the current policy? How should it be
changed? How much will it cost?
The amount of knowledge it takes to do this is daunting to many would-be advocates.
Don't hesitate to go to the powers-that-be just because you don't know everything you
need to know. They can help you learn, and they can actually help you refine your
agenda in ways that will make it more feasible. Besides, it is really the people in
government who have the responsibility to take your concerns and shape them into public
policy.
You can also recruit or hire policy experts.
- Possibility
Another consideration in developing an agenda is how idealistic or realistic you want it to
be. Politics is the art of the possible. Ultimately it takes compromise to get policy
changes that approximate your ideal goals. But advocates who insist on achieving certain
ideals serve a very useful function on the stage of advocacy. Players at the extreme edges
of an issue are necessary to define an acceptable middle ground. Some advocates,
therefore, must be stubborn extremists while others are more realistic negotiators.
Whether to tilt your agenda towards the extreme or the middle is up to you.
- Preservation and Development of Your Advocacy Group
In order to achieve your advocacy goals, you need a strong group. What will it take to
keep your group together and active? What will it take to make it stronger and more
effective? In addition to desired systems changes, your advocacy agenda may need to
include specific goals related to preserving the group, enlarging the group, or improving
the group’s public image and visibility.
- Priorities
How many issues should be on your advocacy agenda? Some advocates insist that it
must be a very few. Others argue that you should address the issues that are very
important to the population you are trying to help even if there are a great many issues.
There is no correct answer. The scope of your advocacy agenda should depend on:
- How much work can your organization take on? Don't bite off more than you can
chew.
- How many issues will the powers-that-be pay attention to at any given time?
- How many issues have to be on the agenda to hold the advocacy group together?
- The Process of Selecting Goals
A group's agenda usually arises from a group discussion and debate. The passions of the
members of the group and their relationships with each other will have a great impact on
the group process, whether agreement is achieved, and what is on the agenda. A good
chairperson is essential.
Some groups end up with long agendas to hold the group together. This is a perfectly
good reason to have a long agenda, though it sometimes leads to struggles about priorities
later in the process.
Some Current Policy Issues
In New York State, mental health policy issues, which are most mental health advocacy agendas,
include:
- Funding for community-based services for adults with serious and persistent mental
illnesses, especially housing, case management, employment, and "assertive" community
services.
- Funding for community-based services for children and adolescents with serious
emotional disturbances.
- A long-term plan to meet the mental health challenges of the elder boom.
- Improvement of quality of care and treatment, using state-of-the-art methods.
- Mental health insurance coverage equal to health insurance coverage ("parity").
- Access to psychiatric medications.
Obviously this way of describing the issues does not meet the test of clarity, which I have
emphasized. It is meant just to give you a taste of prominent mental health policy issues at the
moment.
(A statement of MHA's advocacy agenda is included in the Sample Advocacy Agenda)
The 8 Ps of Setting an Agenda
Population: Who needs help?
Problem: What’s wrong?
Proposed Solution: How do you think the problem can best be overcome?
Policy: What policies need to change? How should they be changed? How much will it cost?
Possibility: What’s achievable? Are you willing to compromise?
Preservation and Development of Your Advocacy Group: What is needed to preserve
your group? What is needed to make your group stronger?
Priorities: What’s most important?
Process: Who needs to agree? How will you get an agreement?
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