Assuring accountability for the poor: patient advocates

The three patient advocate groups that existed in this particular state hospital and differing structures, functions and degrees of effectiveness. However, all three seemed necessary to assure that the serving institution and its professionals would become accountable for the success or failure of their methods and performance. Two of the groups (relatives group and legal aid group) seemed to be functioning effectively within certain limits which each thought to be appropriate in advocating patient causes. Thus, they were providing the countervailing force that is a necessary component of accountability when the persons to be served are a powerless group. The consumer group being the powerless group was not effective in advocating its own cause. It would have been very beneficial to this group had they succeeded. There is a therapeutic effect of having control over one's own life that fosters independence and decreases withdrawal and feelings of alienation from the social order. Certainly these are the goals of the mental health professionals for their patients. In order to realize these goals certain changes would have to be made in the mental health code would have to be changed to include formalized grievance procedures and the desirability of consumer groups would have to be formally established. If this were so, consumers of mental health services might be more effective in advocating their own causes and would be more able to hold the serving institution accountable