Implementation and activities of protection and advocacy programs for persons with mental illness

In 1986, following public hearings, the United States Congress enacted a federal grant program to enable the states and territories to create independent protection and advocacy programs to investigate reports of abuse and neglect of persons with mental illness in residential facilities and to pursue legal, administrative, and other remedies on behalf of those persons. The author discusses implementation of the law and performance of the protection and advocacy agencies in the program's first six years. About 20,000 individuals were served by the program in 1991 and in 1992. The largest category of complaints in those years concerned access to services. Besides representing individuals, protection and advocacy agencies provide referral and information services, public education, outreach, training, and class-action representation. As mental health systems change and fewer persons live in residential facilities, access to protection and advocacy services for persons with mental illness living in the community will become increasingly important. Advocacy will also be important in ensuring enforcement of new laws and policies affecting care and treatment.