8(H). Lay and legal advocacy
There is evidence that the provision of independent lay (non-legal) advocacy, often through independent non-governmental organisations part-funded by the state can lead to greater empowerment of patients including those in community settings. It can allow people to become more involved in their care and treatment decisions.91 The beneficial effect of advocacy goes beyond positive clinical outcomes, and includes reductions in frustration and fear which are often used to justify coercive measures. Numerous models have been developed internationally, including services which can be provided at a relatively low cost.
Under Czech law, the possibility for informal advocacy through a representative or ‘confidante’ is possible.92 The confidante can receive information about the person being supported, and can exercise all of the rights connected to the hospitalisation of the person concerned, including the right to appeal against particular decisions. The Code also provides that the patient can meet with their representative or confidante in private.
It is advisable for patients in psychiatric hospitals to have the opportunity to seek legal representation in proceedings to challenge their detention and treatment. Without a system where lawyers are involved, abusive practices continue to be carried out with impunity: clinical standards do not get developed, victims are not provided with legal remedies, and perpetrators go unpunished.
91 H. P. Lefley, H. P., Advocacy, Self-Help, and Consumer- Operated Services, in Psychiatry (3 rd edn.), (Chichester, UK: John Wiley & Sons, Ltd.)
92 Article 106 of the Civil Code, Law No. 89/2012 Coll.