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Effective Interventions Unit: Advocacy for Drug Users: A Guide

Chapter 3: Provision of advocacy services to drug users

Many drug users receive advocacy without being aware that this is the term for the service they are receiving. Drug users receive advocacy from a range of sources and consider knowledge of the subject and good people skills to be key qualities of an effective advocate.

Who provides advocacy to drug users?

Our evidence suggests that the majority of drug users receive advocacy from service providers with whom they are in contact, e.g. staff within treatment and care services, not from specialist advocacy services. Many drug users (especially those who are not in touch with services) receive advocacy from family members and friends. However, some reported not to have a lot of contact with their families. Some reported that when they make contact with services, staff within these services tend to replace family and friends in providing advocacy. According to our evidence, only a minority of service users currently receive advocacy from independent advocacy agencies.

Both service users and providers felt that, in the case of drug users, staff from treatment and care services were well placed to provide advocacy. Reasons given included:

• advocacy provided by a drugs worker would maximise a client's potential of 'staying clean'

• staff within treatment and care services have the best knowledge of drug users

• service users are often not in a position, and may be reluctant, to approach another service. Getting to know and learning to trust new staff can be a real challenge.

Who should provide advocacy to drug users?

The majority of service providers (EIU Advocacy Survey 2003) believed independent advocacy to be the most appropriate source of advocacy. However, when asked to comment further, many highlighted a range of potential difficulties with relying on independent agencies to provide advocacy for their clients. They felt that independent advocacy services are often not very well informed about drug misuse issues. They also had concerns that separate independent advocacy services designed specifically for drug users may have a stigma attached to them. There was also a view that, despite the value of independent advocacy services, drug users often feel unable to access them.

Some respondents thought advocacy should be a specialist role carried out by formally trained individuals working within treatment and care agencies. Some felt it was not always appropriate for family and friends to provide advocacy because often they were too involved, they may be part of the problem or may promote their own agenda rather than that of their drug-using relative.

When considering the most appropriate providers of advocacy to drug users in their local area, DAATs and their partners may wish to consider the strengths and weaknesses of different types of advocacy. From the research and consultation evidence we have put together the following table:

Note: EIU has produced this table from the research and consultation evidence.

The impact of advocacy

Service users felt that the key quality of an advocate is their knowledge about the subject on which they were advocating. Whether the advocate was independent or a member of their family did not seem to matter to them (EIU focus groups 2004).

Impact on service users

The majority of service users felt that the advocacy they received had a positive impact on their lives. The key factor they highlighted in determining the success of advocacy was the level of competence and knowledge of the person advocating for them. Service users also felt that good advocacy services depended on advocates having 'good people skills'. These include someone who is:

• Trustworthy - "someone you can trust and isn't going to tell people"

• Non judgemental - "someone that wouldn't judge you"

• Good listener - "good at listening and putting it back a better way"

• Honest - "they have to be honest and open with you, giving you good advice telling you when you won't get something so as not to build up your hopes"

Focus group participants also thought that, providing they have the above qualities, ex-service users could have a role in providing advocacy.

Confusion over the term 'advocacy'

Service users who participated in the EIU focus groups found the term advocacy confusing. Some participants did not understand the term at all and others had a vague idea of what the term meant. Yet others were confused because they connected the term advocacy with the legal system and the position of an advocate. All participants felt that the confusion over the term advocacy means that drug users would be unlikely to approach services that are advertised as 'advocacy services'. Participants felt that drug users will not know what type of interventions such services provide.

Anticipating this confusion, Principles and standards in Independent Advocacy (Advocacy 2000, January 2002) suggests that, when explaining the concept of advocacy to people who might use it, it is important to:

• not use jargon.

• use a range of communication techniques (i.e. don't just rely on leaflets).

• instead of using the word advocacy, say it is about help to talk to people about health issues, money, housing etc. and that it is about having someone on your side.

• explain the difference between an advocate and other service providers (e.g. drug worker, nurse, GP).

• explain what advocacy cannot do or cannot help with.

• use examples that clearly demonstrate how advocacy helped individuals in similar situations.

Impact on professionals and service providers

Health and social care professionals and service providers may have some concerns about the role of the advocate in relation to their own role. It may be helpful for DAATs/local partners to consider how to realise awareness of the benefits of advocacy both for the individual and the care provider.

Effective advocacy can assist with the identification of the individual's needs and inform the care planning process.

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