Brain Injury- Survivor/Family Advocacy

1. Brain Injury-Survivor/Family Advocacy Carmela Hutchison, President Alberta Network for Mental Health & DAWN-RAFH Canada BIAC, 11 July 2008

2. Goal To help survivors gain knowledge and skill to become self-advocates, advocate for other people, and advocate with agencies, policymakers and government leaders

3. Objective Learn basic principles of advocacy and practice skills that are important for effective advocacy efforts

4. Application • Group Activity – brainstorm with the group about what advocacy means to them

5. Advocacy To defend a right or ask a favor on behalf of yourself or others using: • Right language • Right time • Right place • Right person who can respect the right or grant the favor • Right method

6. An advocate is: • A self advocate is able to stand in support of their own need and/or right • An advocate is someone who is willing to stand beside someone in support of their need and/or right • An advocate speaks on behalf of: themselves; another person; or a group

7. An advocate is: • Directed by the consumer’s needs and begins by listening and understanding the person, the facts, and the need • Someone who has good listening skills, is accepting, has knowledge of what options are available, laws and procedure (or can find them), and be able to clearly state what you want in a positive way (assertive)

8. An advocate is: • Reasonably available to the survivor • Eager, enthusiastic, committed, energetic • Someone who knows when to “make peace”; mediate; or use other problem solving skills • Someone who also knows when to express opposition, be resistant, intense and passionate

9. An Advocate Is • Directed by the survivor • Someone who listens to what the survivor is actually asking for rather than what you think they need • Someone who follows the reasonable directions of the survivor • Someone who can deal with difficult situations or people in crisis

10. Application • Group Discussion of Different Types of Advocacy • Ask group members for and personal examples or experiences they want to share with the group

12. Preparing the Advocacy Plan • Define the issue – be sure you understand it well • Prepare a response instead of a reaction • Break the problem into small steps • Use problem solving skills to help • Concentrate on the things you can change • Determine the goals • Identify your resources

13. Preparing the Advocacy Plan • Know your allies and your opponents • Know your strengths and weaknesses • Plan your strategy • Forum, Timing • Tactics • educating, reminding, pressuring, complaining, negotiating, legal action, political action • Put the strategy into action • Evaluate and adjust as necessary • Keep accurate records

14. Application • Do the self-assessment tool on strengths and areas for development • Be honest here to get an accurate picture for how to improve your advocacy skills

15. Common Advocacy Issues • Promotion of rights, freedoms, dignity, safety (protection from financial, physical, emotional, and sexual abuse) • Ensuring protection of legal and human rights • Helping consumers receive health care, social service, private insurance benefits • Promoting independence • Assisting consumers to get the least intrusive methods of support • Protection from discrimination

16. Carrying Out Your Advocacy Plan • Using the following checklist, proceed from the most gentle to more persistent tactics • Follow the proper channels • Keep accurate records and confirm ALL verbal agreements IN WRITING • Build a resource list of people who have been helpful to you or share the same issue; identify people of influence

17. Carrying Out Your Advocacy Plan • Make the request and state why you want it and the reason it should be granted • Make the worker do the work as much as possible, government is there to provide service • Identify who is authorized to make decisions and ask to see them • Follow the chain of command one level at a time until you get help

18. Carrying Out Your Advocacy Plan • Insist on common sense. Refuse to let your issue be needlessly complicated or made overly complex • Find good examples of similar cases solved the way you want your case to go • Prepare your compromise points in advance (sometimes compromise is the only way)

19. Carrying Out Your Advocacy Plan • Discover areas where officials have some leeway that is not entirely limited by policy • Show that there are always exceptions to the rules • Cite the case law or policy, rule, or legislation (helps to have legal advice if you can get it or someone with the same experience). • Develop a good relationship with a “buddy” in the system who can help discretely

20. Carrying Out Your Advocacy Plan • Make it clear you are going to persist until a resolution is reached (preach, embarrass, go to the press) • Evaluate and adjust your plan if you are still not getting anywhere • Find the support of third parties and start carefully building coalitions (be careful, sometimes the more people you involve in a problem, the more complicated it becomes and their agendas can compete with yours)

21. Application - Using the scenario provided, create an advocacy plan in your group

22. Advocacy Skills • Assertiveness (verbal and non verbal) • Communication Skills • Attitude • Negotiation Skills • Problem Solving Skills

23. Assertiveness Assertive behavior enables a person to act in their own best interest and advocate for themselves with confidence; to express honesty comfortably; and exercise personal rights without denying the rights of others.

24. Assertiveness • Is an important skill because the lack of it is the chief barrier to getting your needs met • Lack of assertiveness is one of the key issues during times of mental illness; even if you have the skill, you may not be able to use it

25. Assertive People • are brave • respect self and others • own their own feelings, thoughts, and ideas • openly and honesty state their feelings • understand the possible consequences of assertiveness • know when and how to be assertive

26. Tips For Assertiveness • Choose the right time • Choose the right place • Be direct • Use “I” statements • Content: be specific, spontaneous, genuine, direct • Use body language to back up your words • Confirm your request • Practice the skill in safe situations

27. Non Verbal Assertive Skills • 90% of our message is delivered through nonverbal communication (http://web.cba.neu.edu/~ewertheim/interper/commun.htm) • Eye contact • Body posture, body space • Gestures • Voice, tone, volume

28. Application • Review and role play some assertiveness techniques

29. Communication Skills • Communication skills allow for good relationships with many people • Means you are understood and you understand the other person • Be an active listener • Ask questions to show you are listening and check understanding • Summarize what the other person has said

30. Communication Skills • Body language • Space • Personal appearance • Hygiene • Attitude

31. Negotiation Skills • Negotiation is a discussion intended to produce an agreement • Lead with the strongest part of your argument • Be brief and relevant • Focus on solutions instead of complaints • Control your emotions

32. Negotiation Skills • Have a minimum in mind in advance that you are willing to accept • Show you understand the other person’s position • Be persistent, use “I” statements • Be non threatening • Point out faulty logic or weak points

33. Negotiation Skills • Ask for the chance to present more information or follow-up • Restate any actions agreed upon • Set a timeline for action • Be prepared to walk out without resolving the issue • Follow-up

34. Application • To practice verbal communication, have participants form Groups of two and role pay a face to face meeting or telephone call addressing an advocacy situation • Have one person be the advocate and another person being approached to solve the problem

35. Application • While doing the communication exercise focus on: • Using I statements • Listen actively • Plan and practice what you will say • Negotiate for what you want • Be considerate • Keep records and follow up

36. Problem Solving Skills • Are the most important skill to avoid conflict • Define the problem • Break down complex problems • Set priorities • Look at causes and who is affected by a problem

37. Problem Solving Skills • Identify solutions • Select a solution • Plan your action • Take action • Evaluate and adjust

38. Application • Problem Solving Skills – In groups of three, identify a problem using the problem solving process, and how to formulate a solution to the problem using the consumer’s decision about what they want to happen, assist the group to break the problem down into manageable parts to come up with a resolution

39. Application • Problem Solving Process • What do you want to happen? • Who will you approach? • What are the strengths of your case? • What does the other side have to gain? • What is the action plan? • Select an approach?

41. Selecting an Approach • Consider the following: • Which approach will most likely solve the problem for the long term? • Which approach is the most realistic to accomplish for now? • Do you have the resources? • Do you have enough time to implement the approach? • Are there any risks to taking the chosen approach?

42. Individual Rights and Responsibilities • Natural rights may not be expressed under a particular law (the right to be heard, for example) • Citizen rights are legislated rights that are protected under federal and provincial law • Health/Mental health legislation may affect our ability to exercise our rights in some situations

43. Canadian Charter of Rights and Freedoms • Equality rights – equal treatment before and under the law, equal protection and benefit of the law without discrimination on the basis of: in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age or mental or physical disability.

44. Canadian Charter of Rights and Freedoms • Democratic rights – every citizen of Canada has the right to vote in an election of members of the House of Commons or of a legislative assembly and participate in political activities • Mobility rights - Every citizen of Canada has the right to enter, remain in and leave Canada, to move take up residence and gain livelihood in any province; these are limited by a) laws of a province except for those that discriminate on the basis of area of residence (ie professional acts); and b) any laws providing for reasonable residency requirements as a qualification for the receipt of publicly provided social services.

45. Canadian Charter of Rights and Freedoms • Legal Rights- the right to be presumed innocent until proven guilty; the right to retain and instruct counsel without delay; the right to an interpreter for the language in which the court proceeding takes place or the right to an interpreter if deaf; and against unreasonable search and seizure or cruel and unusual treatment

46. Canadian Charter of Rights and Freedoms • Language rights -The right to use either English or French languages in communications with Federal and certain Provincial Governments • Minority language education rights- in general French and English Minorities in every Province and Territory have the right to be educated in their own language

47. Canadian Charter of Rights and Freedoms • Everyone has the following fundamental freedoms: • a) freedom of conscience and religion; • b) freedom of thought, belief, opinion and expression, including freedom of the press and other media of communication; • c) freedom of peaceful assembly; and • d) freedom of association.

48. Individual Responsibilities as a Canadian • Understand and obey Canadian Laws • Participate in Canada’s democratic political system • Vote in Elections • Allow other Canadians to enjoy their rights and freedoms • Appreciate and help and to preserve Canada’s multicultural heritage

49. Enforcing your rights • If your rights have been violated by Federal or Provincial Government, you have the right to appeal • This right is usually stated on the forms or a poster or you are informed of it; IF IT IS NOT VISIBLE ASK; there are usually appeal bodies in each agency; ultimately once these levels of appeal are exhausted you can go to Court and may proceed all the way up to the Supreme Court of Canada if your motions of appeal are granted by the courts

50. Enforcing your rights • If your rights have been violated by a private individual you may seek justice from Federal or Provincial Human Rights Commissions, Privacy Commission, Office of the Ombudsman, Community advocacy organizations • If you require legal assistance, you may be eligible for free or low cost legal assistance