I thank the joint committee for giving us the opportunity to appear before it today to outline the origins, ethos and day-to-day work of the Irish Advocacy Network. In my short opening statement I will outline the origins of the network, provide an overview of the concept of peer advocacy, a concept that is central to our work; explain the values and principles that guide our work and give information on our day-to-day work, funding sources and budget. If the committee requires any additional or supplementary information, we will be happy to oblige.
The Irish Advocacy Network is a peer-led, island-wide organisation which, in partnership with other organisations, promotes equal citizenship for people with mental health difficulties through advocacy, information and support. We work with people with mental health difficulties in every county in Ireland, except Donegal. Our staff and volunteers all have experience of mental-emotional health issues which they use to assist people using mental health services to speak up, speak out and regain control of their lives.We had more than 25,000 contacts last year
The Irish Advocacy Network grew from a grassroots identification of the need for peer advocacy. Our purpose is to champion the voice of the service user and offer peer support and advocacy. The network was established following a conference that took place in Derry. In 1999 approximately 270 individuals from all over Ireland who had mental health difficulties came together with the purpose of creating a representative voice for service users.
Several key individuals presented this vision to health boards across the Republic of Ireland. They also went on to engage with other service users, health board staff and mental health employees. Subsequently, an elected management committee, composed of people from the island of Ireland, all of whom had experience of mental health issues, was charged with establishing the Irish Advocacy Network, IAN. In 1999, with support from a number of key people within the HSE, the Irish Advocacy Network was constituted and officially formed.
Advocacy is commonly understood in terms of arguing in favour of someone or something, such as a cause, idea, or policy. This involves active support usually provided by legal, professional or public representatives. Legal and professional representatives offer expert knowledge as a means of addressing issues clients present to them. The representative is therefore requested to speak on behalf of the client. Peer advocacy is different. The style of advocacy adapted by IAN was influenced by successful models previously developed by peer-led mental health interest groups and organisations, such as the United Kingdom Advocacy Network and the National Empowerment Centre in the US.
A core belief, as set out by these models, is that personal experience of mental health difficulties and using mental health services are essential and invaluable to understanding and supporting people with mental health problems in negotiating services and recovering from emotional distress. Any other form of knowledge is secondary to personal experience as a route to empathy and trust building between peers. Peers who have achieved a significant level of recovery provide support and in doing so act as inspirational figures to Irish citizens in the throes of emotional or mental distress.
An ethos of empowerment is at the centre of advocacy services provided by IAN. The ultimate goal is to enable the individual to advocate for themselves, building confidence through the provision of information and one-to-one peer support. Peer-led organisations by their very definition prefer this self-style advocacy and see it as potentially more empowering for the individual. The danger of paternalistic representation has been addressed by Dorethea Buck-Zerchin, a self proclaimed victim of forced sterilisation, honorary chair and co-founder of the Federal Association of (Ex) Users and Survivors of Psychiatry. She states "A person cannot be more devalued than to be considered unworthy or incapable of conversation." In other words, the voice of the client is in danger of being silenced as the potential for taking responsibility for one's own recovery through the promotion of choice and provision of information is overlooked, such as when a dependency on professional and legal experts sets in.
The Irish Advocacy Network acknowledges the value and utility of professional and legal advocacy but recognises its limitations. However, we strongly believe that peer advocacy, informed by a collective "expertise by experience" has an essential role in helping Irish citizens with mental health problems achieve maximum recovery and take back control of their lives. To ensure there is no interference with the message a client brings to us, a strong commitment is made that confidentiality is protected and that the IAN advocate would never act on a client's behalf unless asked to do so. We offer our services and never impose ourselves on any one. We work on the assumption that everyone with a mental health problem has the capacity to speak up for themselves and has an inherent ability to understand and make informed choices. Hope, opportunity and agency through choice is what peer advocacy could offer as means to empowerment.
IAN developed the concept of peer advocacy across Ireland and fostered the concept of recovery. For the first few years, a handful of IAN peer advocates worked on a voluntary basis. There began a growing expectation and need for our services from mental health service users and professionals. IAN now has 16 full-time staff, seven part-time staff, four trainees, five volunteers in the South and two full-time staff and one part-time staff in the North. IAN provides careers, volunteer work and training opportunities to people with experience of mental health problems. This is something IAN is proud of and continues to promote. In providing these opportunities, IAN helps people with mental health problems from the entire island of Ireland to reduce the effects of social exclusion.
IAN has established its services within all HSE areas, excluding Donegal, as well as the Belfast Health Trust in Northern Ireland, developing strategic partnerships and alliances in cross-Border health services. IAN carried out surveys and was heavily involved in research projects to inform the future of services and professional practice. It developed the capacity and expertise to provide training and information to a number of audiences and partner organisations. IAN was also commissioned to carry out an in-depth survey in order to inform the current mental health policy for the Republic of Ireland, A Vision for Change.
The set of values and principles which IAN is committed to have been informed by models of peer advocacy outlined earlier and developed by a group of Irish citizens who have experienced mental health problems and mental health services. The following values and principles provide an ethical framework and guide our conduct. Principles that the IAN upholds include autonomy, empowerment, choice, individual rights and client-directed representation. Values that guide the network include living examples of recovery, recognition of each individual situation, equality and citizenship, independent voice, peer-to-peer relationships, collaboration, listening, non-judgment, reduction of stigma, independent voice, and adaptation.
The Irish Advocacy Network has always valued best practice and professional standards in its important work. Mind Yourself, a peer-led advocacy organisation from Derry, developed an Open College Network accredited training programme to empower service users to speak up for themselves or for those in recovery to become qualified to support other service users. IAN has partnered with Mind Yourself to provide this training for all of its staff and volunteers. Topics and themes presented and explored within the course include confidentiality, the Mental Health Act, different types of advocacy, why peer advocacy differs from other types of advocacy, alternative therapies and understanding medication.
As with our values and principles, IAN's code of practice was adapted from successful models and developed by a group of Irish citizens with experience of mental health services. We believe this code of practice has served us well in maintaining a consistent, professional and ethically sound service, steeped in the consciousness of the mental health community. The code of practice addresses the following in considerable detail: how the relationship between advocates and service users should be conducted; how advocates deal with the information shared by service users and the circumstances in which such information can be disclosed to others; advocates' obligations, including to act within the law, IAN's health and safety policy and our commitment to only make commitments to service users that they can fulfil; and the requirements on advocates to avail of the supports and supervision provided to them in their work.
Before concluding I would like to illustrate the impact of the Irish Advocacy Network by giving some practical examples of the work that our peer advocates undertake every day. As members will see, our work is comprised of continuous support for individuals as they address the medical, social and personal aspects of their condition. This support only succeeds through the establishment and development of trust between a peer advocate and a client.
For example, we would support clients who appear before a mental health tribunal. This work may include supporting the client in clarifying what they want to communicate to the tribunal, ensuring that the client is fully aware of the procedures of the tribunal and accompanying them to the tribunal for the hearing and staying with them for a period afterwards to discuss the proceedings. Peer advocates also support clients in their dealings with case conferences. Again, this often involves substantial preparatory work with the client to ensure that his or her opinions and questions are communicated clearly and that the responses are clear and address the issues of concern to the client. It is our experience that this important work ensures that clients are more aware of their diagnosis, treatment options and care plan and as a result can continue to make informed choices about their treatment.
Our peer advocates support clients in both a community and institutional setting. We often work closely with clients on proposed changes in their care plan or medication. Changes of this nature are often an issue of concern and we ensure that the views of the client are clearly communicated. We find that this type of support often has long-term benefits in that it empowers the client in their dealings with a range of mental health professionals and they know that at any stage they can call on the support and understanding that a peer advocate can provide.
The IAN is a company limited by guarantee. We provide our services by agreeing transparent, practical service level agreements with a number of health and social care agencies.
In 2011 our total income arising from 13 service level agreements was €884,816, with the highest amount just over €300,000. Our SLAs are with the HSE and individual institutions. We also receive some minor funding amounts from the national lottery. The income funds all our work and we are careful to ensure we deliver value for money to our partners. As such, our overheads are purposely kept as low as possible.
I again thank the committee for the invitation to attend this meeting to explain the origins, ethos and daily work of the Irish Advocacy Network. I also thank the committee staff who guided us through what is a new experience for us. Our total focus is on our fellow citizens with mental or emotional health issues. As an organisation composed of individuals who have also experienced mental health issues, our driving goal is to ensure these citizens are given the confidence, information and support needed to speak out for themselves and influence their own care and path to recovery.
We appreciate the opportunity to appear before the committee. We also appreciate the attention the committee has already given to the issue of mental health recovery, as well as the time the Oireachtas has invested in the issue, including the recent debate on mental health services, the maturity and tone of which were a credit to all concerned. Ours is not an organisation which actively seeks publicity and we are not experts at the public relations game. However, we strongly welcome external interest in and oversight and discussion of our goals, work and procedures. We will try to answer the questions of members of the committee.
