Search results

Advocacy is an important tool for translating population health objectives and research findings into policy and practice, as well as for enhancing stakeholder support for programmes and activities with a potential to improve the health of populations. At the inception of modern prisons, health advocacy approaches focused on appealing to humanitarian and religious sentiments of stakeholders to improve the well‐being of prisoners. This approach achieved limited results, not least because of persistent apathy of custodial authorities and the public to prisoners’ wellbeing. From the mid twentieth century onwards, a constitutional and human rights approach evolved, with courts becoming actively involved in mandating minimum health standards in prisons. Penal populism eroded public support for a judicial recourse to improving prison health services, and encouraged governments to institute procedural barriers to prisoner‐initiated litigation. The author proposes an approach premised on public health principles as an appropriate platform to advocate for improvements in prison health services in this era. Such an advocacy platform combines the altruistic goals of the humanitarian and constitutional rights approaches with an appeal to community’s self‐interest by alerting the public to the social, financial and health implications inherent in released prisoners suffering from major communicable and chronic diseases re‐entering the community.

The purpose of this paper is to address a knowledge gap on advocacy outcomes from mental health service users’ perspective, and the implications for evaluating advocacy impact. The studies discussed highlight challenges for measuring the outcomes of advocacy, but underline the importance of doing so, and of involving service users alongside other stakeholders in co-designing evaluation systems.

The paper uses findings from three qualitative studies of independent advocacy involving focus groups and interviews with: 30 African and African Caribbean men who were mental health service users; 90 “qualifying patients” in a study of Independent Mental Health Advocate services; and nine young women in children and adolescent mental health services (CAMHS).

A comparative analysis and synthesis of findings from three studies identifies four common dimensions: how mental health advocacy is conceptualised and understood; how service users define advocacy outcomes; wider impacts; and, user involvement in evaluating advocacy outcomes. Advocacy outcomes were conceptualised as increasing involvement, changing care and treatment and supporting personal development. There was evidence of advocacy acting to empower mental health service users, and of broader impacts on service regimes and policies. However, there was limited evidence of transformational impact. Evaluating advocacy outcomes is increasingly seen as important.

Few researchers have focused primarily on the perspectives of people using independent mental health advocacy, or on the experience of “advocacy as empowerment”, and none have done so across diverse groups. This analysis adds insight into the impact of independent advocacy. Data from empirical studies attest to the important role independent advocacy plays in modern mental health systems.

This paper aims to show the particular difference Independent Mental Capacity Advocates (IMCA) can make towards specific decisions which some acquired brain injury clients, who are eligible for the IMCA service, experience.

A case study is highlighted in which the role of the IMCA is described against the background of a selective literature review on the history of advocacy in relation to its emergence as a profession. This analysis references issues of spirituality and culture.

Themes raised in the case are discussed with reference to ongoing research and these are related to the best interests of clients, and to reflexivity as a basis for the professionalisation of advocacy.

IMCA practitioners are instructed in well‐defined “best interests” situations, where an individual has no capacity, support or representation, or requires safeguarding measures in relation to certain decisions. In these cases, social, cultural, emotional, religious or spiritual factors can contribute to the decisions which need to be made.

The emerging role of the IMCA in the “best interests” process is outlined, including how health and social care professionals, or decision‐makers, may relate to, benefit from, or respond to challenges by the IMCA in supporting clients in decisions made on their behalf.

Healthcare professionals and those advocating, including IMCA, could more intentionally weigh up the values and beliefs of clients using, for example, the “best interests checklist” or by referring to “spiritual assessment”, as used increasingly by mental health ward staff and chaplains.

This chapter discusses challenges faced by older adult health-care consumers in obtaining access to responsive care from physicians relevant to a broad spectrum of health issues ranging from prevention to chronic illness and end-of-life care. Based on our prior research with community-dwelling elders (E. Kahana & B. Kahana, 2003, 2010), we propose a conceptual model of consumer self-advocacy for better access to effective health care in late life. We argue that older adults who are well informed and confident health-care partners and who involve their physicians in active dialogue will experience better care, and will be more satisfied with their health care. We present findings from our studies of cancer prevention and from our research focused on end-of-life care relevant to patient self-advocacy. We also discuss the role of educational interventions and of patient empowerment in facilitating greater access to responsive health communication and health care, particularly among elders who are disadvantaged and who have low health literacy.

This article reports the outcomes of a study on communication support, commissioned to develop a borough‐wide strategy in 2003 by the London Borough of Tower Hamlets.The research stems from a recognition of communication as a key to successful delivery of public services and enhancement of a multicultural community.The focus is on ‘communication’ (rather than ‘language’), since it captures issues beyond the exchange of information through words: interpersonal interactions and relationships, techniques and modes of organising information exchange. Language is a key component within the broad ambit of communication mechanism and skills. Hence interpretation and translation are perceived as models of communications support alongside advocacy, integrated team, multilingual professional team, family/friends and minors, supported language, symbols and signs, and Plain English.While engaging in the debate and highlighting some of the broader issues concerning communication support services, the focus is on the following main issues:• policy frameworks and guiding principles in communication support• methods and techniques for needs assessment, monitoring and evaluation of communication support• communication support provision in Tower Hamlets including quantifying need, actual state of provision and users' perceptions.Probably among the first of its kind, the strategy draws on existing knowledge and good practice to develop a common framework for public services in Tower Hamlets. It is believed that it will serve a pioneering role in co‐ordinated existing and developing coherent approaches to communication support.

Although medical schools do well in preparing the next generation of practitioners to diagnose and clinically treat illness, they struggle in preparing them with capabilities in the areas of health promotion and disease prevention. Similarly, health promoting schools (HPS) face challenges in working to enhance the health and educational outcomes of children. The paper aims to discuss these issues.

The authors draw from their local and international collaborative work as practitioners and medical educators to examine how health professions schools can work in partnership with HPS for mutual benefit.

Health advocacy is a core competency in medical education. A primary focus is on health promotion and disease prevention. However, providing practical, experiential opportunities – “learning-by-doing” – is a challenge. To overcome this difficulty, medical schools may be well served by partnering with HPS. This can provide mutually beneficial learning opportunities that will enable emerging physicians to develop health promotion-related knowledge and advocacy skills while the emerging generation of citizens (the children) are enabled to live healthier and more productive lives.

The parallel development of Health Promoting Schools and the teaching of health advocacy to health professionals has proceeded to the point where convergence of the gathered knowledge and experience can provide a powerful and synergistic model to advance both initiatives. This conceptual paper focuses outlines the actions that might achieve this.

This article looks at the legal and policy context for the development of advocacy services and considers the legal issues which arise when developing standards and codes of practice for advocacy services, in particular capacity, consent and confidentiality.

The creation of the Patient Advice and Liaison Service (PALS) was part of a range of measures to make the NHS more patient‐centred. The purpose of this paper is to present a critical analysis of PALS through examining the impact on major stakeholder groups.

The paper starts by examining the drivers for reform and the significance of PALS in the wider policy context. Key issues for implementation are then discussed including access to information, independence, cultural change in the health service and relationships with the voluntary sector. Research literature on the provision of advice in health care settings is drawn on.

Taking a critical perspective, the paper argues that the current model of PALS can never succeed in bridging the gap between users and the health service and will end up merely defending service interests. It concludes by arguing for an alternative model of development based on fostering strong partnerships with the community and voluntary sector.

This paper highlights critical issues for service development and delivery, including examining the impact on service users and the voluntary sector.

PALS is a very significant development in the health care provision, operating at the interface between the service and the public and yet its development has attracted little critical comment. This paper provides a comprehensive analysis of the new service and proposes an alternative model of development.

Health science librarians occupy a unique place in librarianship, guiding healthcare professionals and the public to quality sources of medical research and consumer health information in order to improve patient outcomes and quality of life. A broader impact of health sciences librarianship is its advocacy for improvements in public health. In recent years, health science librarians have been actively involved in advocating for adequate, responsive, and culturally competent health care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals. Health sciences librarians have advocated for LGBTQ+ individuals through a variety of specialized outreach projects to address health disparities found in the LGBTQ+ community such as HIV/AIDS, women’s health, or substance abuse, have collaborated with public health agencies and community-based organizations to identify health disparities and needs, and have implemented outreach to address these needs.

This chapter maps the landscape of health sciences librarian outreach to LGBTQ+ people. The authors develop this theme through case studies of health science librarians providing health information to the LGBTQ+ community and healthcare professionals. Following an overview of advocacy for LGBTQ+ health by the US National Network of Libraries of Medicine and professional information organizations, they conclude the chapter by discussing the “pioneering” nature of these projects and the common threads uniting them, and by identifying the next steps for continued successful outreach through the development of an evidence base and tailoring of outreach and resources to address other demographic aspects of the members of the LGBTQ+ community.