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Chapter Six
Persistence: The Key to Effective Advocacy
- Advocacy for changes in public policy is inherently frustrating. Changes usually take
place slowly. Occasionally there are dramatic successes, but usually you win some and
lose some. Sometimes it seems that you are not getting anyplace.
- It is critical to be persistent despite feeling frustrated.
- Remember that mental health policy has improved a great deal since the mid-20th century.
- For example, I originally became a mental health advocate in 1978, when I was working
in a rehabilitation program for people who had been in psychiatric hospitals for long
periods of time. They generally lived in shabby and dangerous places. There were
virtually no community residences or supported housing programs. Few people had
access to high quality mental health treatment. Most went to State aftercare clinics,
which had poor psychiatric staff and outrageously high caseloads. There were only a
handful of community-based rehabilitation programs. When people were in crisis,
usually they were either hospitalized in poor hospitals for excessively long periods or
they were turned away without the services they needed. Many State hospitals at that
time were dangerous. People with mental illnesses also had very limited access to health
care. They generally did not have enough money to get through a month with enough to
eat. Frequently they had only worn out, dirty clothing to wear. Often they had nothing
better to do during the day than to wander the streets or to sit on park benches.
- In order to change these conditions, many people fought for specialized housing and
community-based treatment and supports.
- Advocacy worked. In 1978, NYS introduced the community residence program and the
community support system program. Now there are about 27,500 housing units in New
York State. And there has been great growth of rehabilitation programs, outpatient
services, local hospital programs, crisis services, and peer support programs. In addition
the quality of care in state hospital in-patient and outpatient programs is vastly improved.
The mental health system is far better today than it was twenty-five years ago.
- This success reflects the work of coalitions of providers, of family members, and of
recipients of services, all of whom consistently spoke to the need for more and better
community services.
- Obviously much more needs to be done to create a comprehensive and responsive mental
health system. And each year that passes without great improvement creates a sense of
disappointment and frustration.
- But, over time, persistent and aggressive advocacy in coalitions works.
- You have a critical role to play. Your experiences, insights, and hard work are vital to
effective mental health advocacy in the future. Hang in!
Basic Rules of Advocacy
Work in Groups
Plan Carefully
Take Action
Build Relationships
Be Persistent
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