Table of Contents. I. General Information pg. 2 II. Effective Advocacy pg. 3 III. The Medical System pg. 5. IV. The Legal System pg.

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This manual is designed to assist mental health consumers understand how to self-advocate for change in their lives. The information provided has been compiled from general knowledge on self-advocacy. The information in this manual does not constitute financial or legal advice. Consumers are encouraged to access appropriate information from qualified professionals to ensure that consumers are taking all necessary steps and understand the consequences of problem solving through self-advocacy.

Self-advocacy allows people to make a difference in their

own lives and leads to personal empowerment.

ACKNOWLEDGMENT

CMHA would like to thank and acknowledge the MS Society of Canada, Alberta Division, for permission to adapt the MS Society of Canada Self Advocacy Guide. The original information has been adapted to focus on the needs of mental health consumers. Self-advocacy issues touch all persons with disabilities, and it is hoped that providing information on the skills and

knowledge needed to effectively self-advocate will assist consumers with empowerment and increase their engagement in their communities.

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I. General Information What is advocacy?

There are different definitions of advocacy, depending on the context in which you are using the word. For example, advocacy in a legal context has a different meaning from advocacy in a political context. We are using a broad definition that applies in all situations.

For the purposes of this booklet, advocacy means standing up for the things in which you believe. Advocacy is sometimes divided into two types: systemic advocacy and individual advocacy.

Systemic Advocacy

Systemic advocacy, also referred to as social action, includes efforts aimed at changing

legislation, policies, practices, opportunities or attitudes It is directed at making changes in the system that will have an affect on the lives of a group of people.

Individual Advocacy

Individual advocacy includes efforts aimed at supporting, empowering or acting on behalf of an individual. Sometimes viewed as “going to bat” for a person, individual advocacy helps where one feels he/she has not been treated as he/she should have been.

What is an advocate?

An advocate is someone who speaks up for others. In the case of both systemic and individual advocacy, it is the person assisting another person with a concern. The assistance may be as simple as finding information or it may be as involved as attending a hearing with the person.

What is a self-advocate?

A self-advocate is someone who speaks up for him/herself. You take the steps needed to achieve your goal, whether it is to get information, obtain a service or change a policy. You may not necessarily be acting alone, but you have an active role in initiating and moving along the process.

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II. Effective Advocacy

Keep the following suggestions in mind throughout the advocacy process:

Know Your Rights

To be able to speak up for yourself, you must first be aware of your rights. You can find out what your rights are by talking to others, such as a representative of a disability or mental health organization, or by reading materials such as government publications.

How you decide to learn about your rights is up to you as there are many sources available. Be sure that the source you use is credible - that is, it is giving you trustworthy information. Sources that may seem to be aimed at providing information are sometimes aimed at a different purpose and you may end up with misinformation. It is a good idea to confirm information that comes from a questionable source. It is a good idea to get a second opinion from a reputable source.

Rights are described both as human rights and legal rights. Most human rights are basic rights that belong to every living person and are also legal rights – rights guaranteed through the law. For example, the basic human right to equality is a legal right in Canada.

Be Assertive

To be most effective, you will need to be assertive when dealing with others and speaking up for yourself. Being assertive means standing up for what you feel and believe, without being passive (letting things happen without saying anything) or being aggressive (being too forceful or

demanding). You need to not let others push you around, but you need to be open to compromise and reason. If you are too passive nothing will change. If you are too aggressive, you will have trouble getting the information and assistance you need.

Focus on What You CAN Do

You know yourself and your abilities best. Where you have been negatively labeled or treated unfairly, you may start doubting yourself. It is important for you to focus on your strengths, abilities and your rights. Think positively!

Negative thinking will prevent you from achieving your goals and can negatively impact your mental health.

Know Your Goals

If you know your rights, you should be able to know what you want to achieve. Whether you are seeking to obtain a benefit, educate others, or solve a problem, you should know your goal before you begin. If you are advocating without a goal in mind, you won’t know where to go or what to do. As well, you won’t know when you’ve reached your goal and you may end up wasting valuable time and resources.

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Work with Others

Don’t think that you need to advocate on your own. Others not only support you - they will want to help you. Family, friends, other advocates and other consumers of mental health services will be able to provide you with resources and support that can be invaluable. Depending on your goal and the extent of your abilities, you may not need the help of anyone, or you may require extensive assistance.

Be Organized

Being organized involves a practical approach. For example, when you are applying for

something (e.g. a social benefit), you will have to fill out numerous forms. Make sure you have photocopies of everything you submit. If you talk to someone from a program, write down the name of the person and the date that you spoke to him/her. Keep all your information in one place. Being organized in this sense is critical to being able to advocate for yourself effectively.

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III. Medical System

Advocating for yourself within the medical system will involve being aware of how the system is structured and what kinds of problems you will encounter. Waiting lists, referral rules and

changes to the healthcare system may be frustrating, but you will need to be patient and

informed.

You will encounter a number of different health care professionals and you should be aware of what services they can offer you.

Family Doctor

Your family doctor is a general practitioner - that is, he/she is able to look after your general medical problems. He/she takes care of and often has the best understanding of your overall health. Usually, the doctor is someone you have been with a long time. He/she also usually treats other members of your family. For these reasons, your family doctor plays a significant role in your health care.

If you do not have a family doctor, you should find out which doctors in your area are taking new patients and you should schedule an appointment to see one. To obtain a list of doctors

that are taking patients in your area, contact the Calgary Health Region Health Link (403-943-5465) or the College of Physicians and Surgeons of Alberta Website (www.cpsa.ab.ca).

You may use a walk-in clinic for access to a doctor. In this case, try to see the same doctor at the clinic each time you visit for consistency. If you have general health problems or need regular check-ups, you should see your family doctor. It is important that you are comfortable with the doctor so that you can avoid switching later. Consistency is an important factor in getting proper health care. When looking for a new doctor, consider talking to other people for their

suggestions. If you do switch doctors, you will need to make sure your medical history is forwarded to your new doctor.

Many family doctors prescribe psychiatric medications. It is important that you follow up with your doctor when taking psychiatric medications and attend all required blood tests or other regular check ups. This is to ensure that your medications are working and that you are not having problems with medication side effects.

Your family doctor is also your first contact when you require special treatment or information for a specific disability or illness. In order to see a specialist you will need a referral from your family doctor.

Your family doctor can also fill out forms for you, write letters and advocate on your behalf when necessary.

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Specialist

A specialist is a doctor who has a specific area of medical expertise. For example, a psychiatrist has specialized medical knowledge in regards to mental health issues and medications. It is unlikely that a doctor will be a specialist in more than one area because of the education and training that is involved in acquiring a specialty. You may have to see more than one specialist depending on your condition.

To see a specialist, you will require a referral from your family doctor. Examples of specialists that require referrals include:

• psychiatrists • neurologists • oncologists • cardiologists

The role of a specialist is to treat you in relation to a specific illness or disability. Only specialists can prescribe some medications. For example, if you have a mental health condition, your

psychiatrist will be the individual with whom you would discuss drug therapies, and he/she will be the doctor who can prescribe them. He/she does not become your family doctor and you should not see a specialist for general health concerns.

The challenge with seeing a specialist is that because he/she does not know your overall health, you may need to spend time discussing other aspects of your life and your health with the specialist. It is important that the specialist understands how your disability affects your life. Another challenge with specialists is that it will take much longer to get appointments with them. It can take as long as several months to see a specialist.

Your specialist may also fill out forms or writer letters for you. You will need to decide which doctor can give the best information about you and your disability in this case.

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Knowing What to Do

In recent years there have been many changes to the medical system and such changes will continue to occur. In order to make your visit to the doctor as productive as possible, you have a responsibility to be proactive; that is, you must deal with issues as soon as they come up.

Sometimes it can be very helpful to have a trusted friend or family member come with you to the doctor. A friend can help you remember the doctor’s advice later, or help with asking questions. The following suggestions should help you make the most out of the medical services provided: When you need to see a doctor or specialist:

• Make an appointment as soon as possible. Some clinics have a walk-in option.

• Try to schedule your appointment to allow for waiting time, especially if it takes a while to get an appointment with the doctor.

• State the reasons for your visit and if you need more time than usual to discuss a problem. If you prefer not to give the reason for your visit say “it’s personal” but indicate if it’s a new or an old problem.

• Let them know if you expect the doctor to see more than one family member (to better schedule the time).

Before your visit:

• Check to see if the doctor is on time, especially if you are on a tight schedule.

• If you will be delayed or need to cancel, you should call beforehand. Some offices will charge you a fee if you do not call ahead to cancel an appointment within a certain amount of time.

• Have someone go with you if you need assistance or support during the visit. Write down specific points or questions that you want to discuss.

During your visit:

• Ask the receptionist if your appointment will be delayed. If you are unable to wait, reschedule another visit.

• Inform the receptionist of changes in your personal information (e.g. address, phone number, next of kin, and marital status).

• At the beginning of your appointment, briefly list all your health concerns. Be aware doctors can only cover one or two health issues per appointment. You may need to schedule another appointment or book two back to back to discuss multiple issues. • Describe your symptoms, whom you’ve seen about them and any treatment or tests taken

as a result.

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• If you are feeling rushed, uncomfortable or if you don’t know or understand something, SPEAK UP and ask your doctor to explain it again. It may be helpful to repeat in your own words what you think he/she said.

• If you don’t think you can follow your doctor’s advice you need to say so and explain why (e.g. personal beliefs, lack of money). Your doctor may have to check the Alberta Blue Cross Drug Benefit List (see Appendix 2 for the internet connection to this information) before prescribing a new medication to ensure that the costs are covered under AISH, or Alberta Works.

• If you are uncomfortable making a decision about treatment, ask for more information or discuss the benefits of a second opinion.

• Be clear about instructions before leaving. Understand your test results, recommended follow-up and who to contact if you have questions.

Following your visit:

• Book tests or follow-up appointments right away.

• If you need a prescription, ask your pharmacist for advice and information on the drug and its side-effects.

• If you feel your doctor acted inappropriately and you’d like to file a complaint, you can contact the College of Physicians and Surgeons of Alberta (see Appendix 2). Remember that filing a complaint is a serious matter.

During your visit, you may feel anxious or sick and it may be difficult to remember details.

Appendix 1 contains a list of questions you may want to ask your doctor. There is also an example of a reminder sheet you or your doctor can fill out to help you remember what was said during your visit.

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Mental Health Workers

Persons dealing with mental health issues often access support through mental health therapists and mental health support workers (e.g. Independent Living Support Programs). Understanding how to get the most out of meetings with mental health workers will allow you to increase your knowledge of how to deal with mental health symptom management. It has become more common for psychiatrists to focus on medication management, leaving the “talk therapy” to counsellors and mental health workers. The success of your relationship with your mental

health worker will depend on your ability to provide accurate information and work cooperatively with the person.

Skills discussed in the previous section about meeting with doctors are important to keep in mind when meeting with your mental health worker (e.g. ensure that you discuss important issues during your visit, make notes, and follow up on suggestions or referrals). Remember, your working relationship with mental health workers will depend on developing respect and a common understanding of how to move forward. In the case of a dispute with a mental health worker, seek out mediation assistance from a supervisor to try to work out the issue. If this is not successful, you may have to look at what other support options are available to you; a consumer advocate can assist you with understanding your options.

Health Care Insurance

Part of understanding how to make the most out of the medical services available to you, is to understand your health care insurance. When you have a disability, different provisions will apply to you and your family. You may be able to obtain coverage for aids and assistive devices (e.g. Alberta Aids to Daily Living Program) but you will have to apply and provide medical proof of your disability.

Co-ordination and Consistency

When you are seeing multiple doctors and other mental health service providers, it will be a challenge to co-ordinate all the information you get. However, it is important that each of your service providers understands what the others are doing. It will be up to you to make sure they are informed, as these service providers are very busy people. You have the responsibility to ensure you are receiving the best health care possible by ensuring all your supports understand your needs and how they can best support you.

Where you require assistance in filling out forms (e.g. AISH applications) you will need to make sure the doctors are consistent in the information they provide. They need to be consistent not only among themselves but with you as well. Often, when a patient has not conveyed the functional limitations of their disability to their doctor, the doctor cannot provide the medical support required for successful applications. The person with a disability may describe a problem or limitation on their application but the medical information does not indicate the same

problems or limitations. It is important your doctor knows how your disability is affecting

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you know what your doctor has written on your forms before it is submitted to the agency it is intended for. This will help you avoid any issues over inaccuracies, or a lack of necessary information being provided to the agency you are requesting support from.

Be Organized

When you need to submit medical information and other documentation to apply for programs and services, you will need to keep your information organized. It is very important that you

• answer all questions;

• keep copies of all the information you submit;

• write down information given to you by phone or in person;

• make note of when you speak to people, their names and their position; • make note of when you submit your application;

• make note of the date you receive any correspondence/documentation; • know the timelines and follow-up if processing is overly delayed.

Often, when in a hurry to get applications in, people forget to do these small things. However, taking a little extra time to make sure your application is complete, and that you have

documented everything, can make the difference in a successful application/appeal. If your application is not properly filled out, then this will delay processing and may reflect poorly on you. If you cannot fill out an application, you can always request assistance (e.g. seek

assistance from your mental health worker, or a consumer advocate). If you do use help, be

sure to make note of this on your application.

Complaints about treatment from a doctor can be addressed to:

College of Physicians and Surgeons of Alberta 2700 Telus Plaza South,

10020 100 St NW, Edmonton, AB T5J 0N3 www.cpsa.ab.ca

Confidential complaints: 1-800-661-4689

Telephone (general inquiries toll free): 1-800-561-3899 Fax: 780-420-0651

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IV. The Legal System

Because people have legal rights that may be infringed, they may find themselves within the legal system. The legal system is a complicated environment for many reasons. Legal language is difficult to understand, especially if you are not trained in the legal field. As well, the legal system is full of procedures and rules that must be followed in order to make some progress. Not knowing these rules can be very frustrating, especially if the various procedures and rules have not been explained to you. Added to all this is the anxiety that is generally associated with the legal system.

Many people believe that if you need the help of a lawyer or are involved in a legal issue, you have done something wrong. That is often not the case. Where you are trying to have your rights upheld, you have done nothing wrong. You are using the justice system for the purpose it was intended.

When Would I Be Involved with the Legal System?

You may be involved in the legal system or need a lawyer where

• you have been discriminated against on the basis of your mental health concern; • you are appealing the decision of a government program;

• you have been denied long term disability from your insurance provider;

• You may also be involved in the legal system for reasons unrelated to your disability.

Human Rights Complaints:

The Human Rights, Citizenship and Multiculturalism Act is the legislation that protects

Albertans from discrimination. The Alberta Human Rights and Citizenship Commission is an independent commission of the Government of Alberta. The mandate is to foster equality and reduce discrimination. The commission provides public information and education programs, and helps Albertans resolve human rights complaints.

The Act does not allow a person to make a frivolous or vexatious complaint with malicious intent. This means that people should not make human rights complaints that are not serious. They should not make complaints just to cause trouble for someone. If people make such complaints, a complaint can be made against them.

The Commission does not take sides. It works with both the complainant and the respondent in a dispute to settle a complaint.

Making a complaint to the Commission is an orderly process—one step follows another. This helps to make sure the process is fair for everyone.

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Resolving a complaint takes time. At every step, the parties are encouraged to find a resolution that is fair and in keeping with the law.

The Human Rights, Citizenship and Multiculturalism Act prohibits discrimination on the following grounds, whether real or perceived:

Race, gender, ancestry, place of origin, religious beliefs, age, physical disability, mental disability, marital status, family status, source of income, and sexual orientation.

(Excerpt from Alberta Human Rights Commission website www.albertahumanrights.ab.ca) Complaints must be filled within 12 months of the date of the incident in questions for the Commission to initiate an investigation.

Discrimination on the Basis of Disability

As used in human rights law, discrimination means making a distinction between certain

individuals or groups based on a prohibited (expressly forbidden) ground. Under the Canadian

Human Rights Act, one of these prohibited grounds is mental or physical disability, which includes previous or present drug or alcohol dependence. Under the Human Rights,

Citizenship and Multiculturalism Act (Alberta), discrimination on the basis of mental or physical disability is also prohibited.

For Albertans, both these acts apply. The Canadian Human Rights Act applies to areas for which the federal government has responsibility and the Act applies throughout Canada. In Alberta, the Human Rights, Citizenship and Multiculturalism Act applies to areas for which the Alberta government has responsibility and the Act applies only in Alberta. Other provinces have similar legislation that applies to that province only.

Example:

If you are asked to give information about whether or not you have a disability on a job application for an Alberta company and there is no reason why the job would require such information, then you could file a complaint under the Human Rights, Citizenship and Multiculturalism Act. This issue falls under the responsibility of the provincial government.

Should I File a Complaint?

In many cases, you may be able to resolve a situation by speaking to the people involved. What might seem at first to be discrimination may be a misunderstanding. In the case of workplace discrimination, many employers have policies against discrimination and a specific person should be contacted if it occurs. Or there may be a union or company grievance procedure you can follow. In situations where you have been refused a service, you could complain to the manager.

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If these steps don’t get results, you can contact the Canadian Human Rights Commission or the Alberta Human Rights Commission. Sometimes they are able to resolve a situation simply by talking to the people involved. If this doesn’t work, you can file a complaint. Filing a complaint

is a serious matter and should not be taken lightly. If you do file a complaint that is

considered frivolous or is intended only to cause trouble, you may face charges. The further along in the process you get, the more likely it is that you will require legal assistance. You should also be aware that the process could be very lengthy.

Both Human Rights Acts give protection to people who file complaints and those who may give information in the process of investigating a complaint. Anyone who intimidates threatens or discriminates against someone or who interferes with an investigation, can face criminal charges.

Duty to Accommodate

One of the most frustrating forms of discrimination against people with disabilities is the failure to accommodate disability in the workplace. Because people with disabilities may require a workplace modification, employers may not want to retain or hire them. However, that person may not only be productive but also the best person for the job. Under human rights legislation, employers have a legal obligation to take appropriate steps to get rid of discrimination against employees, prospective employees or clients in the workplace. This is referred to as the “duty to accommodate”. This duty does not apply where it can be shown that the discriminatory practice/ condition is a bona fide occupational requirement (BFOR) or there is a bona fide justification. To prove that a practice/condition is a BFOR or is a bona fide justification, an employer would have to prove there would be “undue hardship” if made to accommodate.

* Bona fide means that the practice/condition is proper considering the circumstances.

Undue hardship on an employer is measured in part by costs. Health and safety are also factors considered. Basically, the law requires all reasonable accommodation.

Even where a reasonable accommodation is contrary to a collective agreement (in a unionized setting), an employer is required to implement it. The duty to accommodate, where reasonable, overrides a collective agreement. If an employer fails to reasonably accommodate your

disability, you can file a complaint with a human rights commission. If you are successful, the result could be reinstatement, compensation for lost wages and other expenses, letters of apology, an order to issue an anti-harassment policy, and/or other orders the human rights commission sees fit to issue.

For more information on the duty to accommodate, contact your nearest office of the Alberta Human Rights Commission or Canadian Human Rights Commission

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To contact the Alberta Human rights Commission confidential inquiry line call:

Calgary Office: 403-297-6571 Edmonton Office: 780-427-7661

Canadian Human Rights Commission:

The Canadian Human Rights Commission tries to resolve complaints of discrimination filed against federally regulated employers, unions and service providers. If a complaint cannot be resolved, the Commission may investigate the case further, and may ultimately request that the Canadian Human Rights Tribunal hear the case.

(Excerpt from the Canadian Human Rights Commission website www.chrc-ccdp.ca)

To contact the Canadian Human rights Commission:

National Office

344 Slater Street, 8th Floor Ottawa, Ontario K1A 1E1 Phone: 613-995-1151 Toll Free: 1-888-214-1090 TTY: 1-888-643-3304 Fax: 613-996-9661 E-mail: info.com@chrc-ccdp.ca Regional Offices

Alberta, Prairies and Northwest Territories

308 – 10010 106 Street Edmonton, Alberta T5J 3L8 Phone: 780-495-4040 Toll Free: 1-800-999-6899 TTY: 1-888-643-3304 Fax: 780-495-4044

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Appealing the Decision of a Government Program

When you require income support or any other form of assistance through a government

program, you will have to fulfill different eligibility requirements. Within government programs, different criteria will apply. What is considered to be a disability in one program may not be considered a disability in another.

You will have to be familiar with the various requirements of each individual program.

If you feel you do meet the requirements and you have gone through the process of filling out the appropriate applications but you have been denied, or you disagree with the amount given or the date your payment begins, you may appeal. To appeal, you must follow the appeal procedures outlined in the appropriate legislation or regulations. For example, for Canada Pension Plan disability benefits, appeals must first go to Reconsideration, then to a Review Tribunal and then, if leave is granted, to the Pension Appeals Board. These steps must be followed in this order - you cannot just go to court. AISH has a different appeal process, and again, the proper steps must be followed to access the appeal process.

In the more preliminary stages of an appeal you often won’t require legal help. The assistance of family, friends, or another advocate who is familiar with the program will be sufficient. If the appeal continues on to more formal stages with more formal panels, boards, tribunals, or commissions, you may require legal assistance.

Denial of Long-Term Disability

Again, in this situation you may not need the assistance of a lawyer in the initial stages of applying for long term disability. Union representatives or benefits workers are there to provide you with assistance.

It is important that you have read and understand your insurance plan. For example, you will need to know whether there is a statement on “pre-existing condition” as this may affect your eligibility. As well, there may be a clause stating that the insurance provider has a “right to refuse” or that there can be “non-compliance with recommended protocols”. As well, your plan may state that to be eligible you must be unable to do “any” as opposed to “some” work. Various conditions may be placed on eligibility.

Once you know what your plan says, you need to provide the right documentation. Getting the right reports and other documents will allow you to avoid delays and frustration. If you are denied, you should request written reasons for denial, although unless the plan says so, the insurance provider is not required to give them.

If you have been denied but you feel you qualify, the assistance of a lawyer may be your best option. A simple letter from a lawyer to the insurance company may be sufficient but in some cases it may require more involvement.

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At this stage you need to weigh the benefits of obtaining the long-term disability coverage with the costs of continuing legal help.

Other

In addition to the above situations, you may find you need legal help for issues unrelated to your disability. For example, you may need to make a will or want to buy/sell property.

Where do I find help?

If you have never needed a lawyer before or do not know a lawyer, you may not know where to get the legal help you need. You should actually speak to some lawyers before choosing which one to hire. There are a number of options for finding a lawyer

Lawyer Referral Service

Another source of legal help that is available in Alberta is the Lawyer Referral Service. This program is offered by the Law Society of Alberta to help people find a lawyer who will provide them with the legal services they need. You can call toll free 1-800-661-1095 (or 228-1722 in Calgary) and a Lawyer Referral Operator will answer. After describing the nature of your problem the operator will give you the names and phone numbers of three lawyers practicing in the appropriate field.

You can make an appointment with any one or all of the lawyers, making sure to tell them you were referred to them by the service. There is no charge for the first half-hour. Afterward, you can decide whether you would like one of those lawyers to represent you at full fee rates and the lawyer can decide whether to take your case.

Legal Aid Society

Legal Aid services are provided by lawyers who are willing to act for legal aid clients. Lawyers willing to act are on a list and are issued certificates for individual cases. Participation by lawyers is voluntary. Before one of these lawyers can assist a client, he/she must first have a certificate from a Legal Aid office.

Eligibility for legal aid services depends on the nature of your problem and your income. You will be required to pay costs reasonable to your financial situation. To find out whether you qualify and the costs you can expect, you should contact your local legal aid office.

Access to Legal Aid Services (ATLAS) can be also be contacted for connection to Legal Aid lawyers for consultation by contacting 1-866-845-3425.

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Internet

If you have access and you are familiar with the Internet, it could be very helpful to you. Many law firms have web pages, as do other organizations that provide legal assistance and they will tell you what type of work they do. Here are two helpful websites:

http://www.acjnet.org/naabout/default.aspx

(Access to Justice Network for legal information and research)

http://www.albertacourts.ab.ca/familylaw/

(Alberta Family Law Information Centre Site) Phone Listings

You can also look in the phone book under Lawyers. You will have to call those lawyers who you think may be suitable.

When looking for a lawyer, you should find one that makes you comfortable and who

understands your issue. Some lawyers are very specialized and others are not. While you can talk to as many lawyers as you want before choosing, be reasonable. Talking to too many lawyers

may confuse you and take up valuable time.

How much will legal help cost?

Lawyers have different ways of setting the fees they charge. A lawyer may • charge a fixed fee (for example, to write your will);

• charge a fee according to the amount of money or the value of property involved in your case (for example, according to the value of the house you are buying/selling);

• charge you according to the amount of time spent on your case, according to what type of work it is (for example, an hour in court may cost the same as several hours of research), and according to how complex the work required is;

• charge you on a contingency basis (for example, in a personal injury case it may be based on a percentage of how much you receive).

Lawyers often cannot predict exactly what their costs will be as each case is different. Some lawyers do what is called “pro bono” work where they will provide their services for free.

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What will happen when I first visit a lawyer?

After you have contacted some lawyers and chosen which one(s) you want to meet with, you will arrange a first visit. When you first visit a lawyer, you should

• bring any papers or documents that have anything to do with your problem;

• be prepared for many questions - the lawyer is trying to see whether he or she can help you and will need many details;

• be completely honest - the lawyer is not there to judge you and you need not feel uncomfortable;

• know what you want to achieve - if the lawyer knows exactly what you expect, he/she will be able to help you better;

• ask any questions you may have (e.g. about costs, timelines, whether or not he/she thinks you have a good case) and write down the answers;

• discuss the next steps (e.g. arrange next appointment) if you have decided you would like to hire this lawyer.

What should I expect from my lawyer?

The lawyer should explain the laws that apply to your legal problem. He/she should be able to tell you what your rights are, what you can expect from him/her and the process you are involved in, what costs you can reasonably expect and about how long it will take. It will be difficult to accurately predict exactly what will happen but you should have some idea.

Your lawyer may not always tell you what you want to hear or be able to do everything you want. The legal system places restrictions and timelines that lawyers must follow and he/she knows that.

What should my lawyer expect from me?

Your co-operation is essential. You must be honest at all times. You should also be aware that lawyers have other clients and other commitments too. You need a lawyer to help you with a legal problem and he/she may not be able to assist you with other problems you may have. Your expectations should be realistic. For example, he/she cannot provide you with family

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V. The Political System

Many programs and services that people with disabilities require are funded and run by

government departments. To advocate for yourself in this context, you will need to know how to find help using the political system. Where it is appropriate to contact your MLA (Member of the Legislative Assembly) or MP (Member of Parliament), there are certain steps that should be followed.

Before you take any steps at all, you should be informed about the program/service with which you are experiencing problems. Be familiar with the various people that you will need to

communicate with. Read all the information you are given on a program, and call the program or another advocate if you have questions. The key to success is being informed.

Before You Contact Your MLA or MP

Make sure you have gone through all the proper channels before contacting your political representative. For example, where you are experiencing problems with your AISH (Assured Income for the Severely Handicapped) benefits, you should speak to your financial benefits worker first. If you are unhappy with how someone has treated you, speak to his or her

supervisor. If there are procedures that you are supposed to follow, you must do so. Whether you are appealing a decision to deny you benefits, or you are experiencing problems with a program worker, go through the appropriate people first to try to resolve the issue.

There are many levels to the government and this is often frustrating. But if you write a letter to your MLA or MP without first going through the right channels, this may only lengthen the process of getting the assistance you need, as you will be referred back to the proper officials.

Contacting Your MLA or MP

When you have gone through the appropriate channels and are still dissatisfied, then consider contacting your MLA or MP. MLAs and MPs are elected first and foremost to serve their constituents (the people in a specific electoral riding). Those who become Cabinet Ministers or who sit on committees take on additional duties, but they do not give up their responsibility to represent those who elected them. No representative can agree with all constituents however - opinions are never unanimous. They often have to take sides depending on the platform/positions of their political party, the constituents’ points of view and the MLA/MP’s personal beliefs. You are not limited to the MLA/MP for your constituency. You can contact the Cabinet Minister responsible for a specific department, although they will be more difficult to contact and meet with. You can also contact an MLA from an opposition party, but their ability to help you may be limited.

You may wish to meet with your MLA/MP as a group or individually. Because political representatives are concerned about keeping their position, where people begin to express their concerns as a group, this has a greater effect.

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Requesting a meeting

• Find out who the MLA is. You can contact the Public Information Branch of the

Legislative Assembly Office at (780) 427-2826 or call the Alberta Government toll-free line at 310-0000. The Government of Alberta pages in your phone book will also be able to provide you with information. If you have access to the Internet you can visit the Alberta Government’s website at www.gov.ab.ca.

• Find out who the MP is. You can call Elections Canada toll free at 1-800-463-6868 and by giving your postal code or address they can give you information on the MP in your area. Information can also be found in your phone book in the Government of Canada pages. The Internet address for the Government of Canada is www.gc.ca.

• Call or write a letter expressing your situation and your concerns. Make sure to state that you have gone through the appropriate channels already. Request a meeting so that you can discuss your concerns.

• Where you receive a response asking you to call and make an appointment, be aware that it may be awhile before the MLA/MP is able to meet with you.

• If you do not receive a reply within three weeks, telephone or write again.

Meeting

• Arm yourself with information. Have all documents that relate to your issue, including letters from the department, doctors’ reports and articles.

• Explain how the situation is impacting you and others.

• Don’t assume the MLA/MP has any knowledge of the issue, because he/she may not. Technical language may have to be explained.

• Try not to get angry and don’t make accusations that are unfounded. This may be an emotional situation for you but you should stay calm.

• If the MLA/MP supports you, ask how he/she could assist you. • Don’t overstay the scheduled length of the meeting.

After the meeting

• Make notes and follow up on any steps you should be taking.

• Send a letter thanking the MLA/MP. It may also be a good idea to summarize your discussions and any actions or commitments.

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Tips on Writing to Your MLA/MP

A personal letter is a great tool for communicating with your representative. You can send an e-mail if you have e-e-mail access, but it is less formal, not entirely secure and easily forwarded to others. If you have ongoing contact with the MLA/MP, this may be a good way to communicate, as it is quicker. A personal letter is the best way to start communication with your representative.

Other suggestions

• Make sure to address your letter properly, using the proper titles. • Check the spelling and address before sending your letter. • Keep your letter short. One to two pages is ideal.

• If you required assistance in writing your letter, indicate so and who the person is. • Ask the member to reply to your letter.

• Copy/send the letter to another representative or organization.

The Ombudsman

In Alberta, as in other provinces, there is an Office of the Ombudsman. The Ombudsman conducts impartial investigations of written complaints by people who believe they have been treated unfairly by the provincial government. This office is independent of government and has broad powers to investigate actions, decisions, practices and procedures of Alberta government departments, boards, agencies and commissions (including Health Regions).

The Office of the Ombudsman is a last resort. All formal and informal appeals must have been completed. This does not include contacting your MLA, which can be done at the same time. If you have gone through all the appeal options available to you and you are still dissatisfied, you can write to the Ombudsman.

How Do I File a Complaint?

In order for an investigation to be conducted, your complaint must be in writing and signed by you (the person affected by the decision). If someone assisted you, indicate so and describe your relationship to that person. Your complaint should contain

• name, address, phone number(s) and any file numbers relating to your complaint; • name of the department/board/agency/commission being complained about; • details outlining the complaint;

• steps that have been taken to resolve the complaint (e.g., contact with manager/supervisor, formal appeal hearing);

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How much will it Cost?

The investigation is provided at no cost to you.

What Does an Investigation Involve?

The Ombudsman, if he approves your complaint for investigation, sends a letter to the appropriate Deputy Minister, President or Chairman of the government body you are complaining about. It includes information outlining your complaint and requests a detailed response. The Ombudsman then gathers additional information that helps him determine if the claim has merit. If the complaint is justified, the objective then is to resolve the issue in a fair and reasonable manner.

What Will the Result Be?

In most cases, government representatives are receptive and will try to correct the action. However, the Ombudsman does not have the power to change the decision. He makes

recommendations. If negotiations with a department are unsuccessful, the Ombudsman may take the recommendations to the appropriate Minister. If still not resolved, the complaint can be presented to the Lieutenant Governor in Council (the Cabinet) and ultimately to the entire Alberta Legislative Assembly. The Ombudsman will also make public any matter considered to be of public interest.

Even if the Ombudsman is unable to support the complaint, an investigator will review the findings with the complainant. As well, the Ombudsman writes each complainant advising him/her of the outcome of the investigation.

What Can the Ombudsman Investigate?

The Ombudsman cannot investigate the actions or decisions of the courts, the Legislature, the Mental Health Patient Advocate or government lawyers who act for the Government in a proceeding. The Ombudsman also cannot investigate hospitals, universities, schools and technical institutes. The Ombudsman does not investigate complaints between private individuals. However, the Office of the Ombudsman can direct you to the appropriate

resources where these complaints can be dealt with.

To contact the Office of the Ombudsman: Website: www.ombudsman.ab.ca

Calgary Office: 403-297-6185 Edmonton Office: 780-427-2756

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Contacting your Municipal Government Representative

Programs and services, such as subsidized housing, are also funded and run by city/town governments. If you experience problems with these services, you will still go through the appropriate steps (e.g. all appeal procedures, talking to the supervisors, etc.) before contacting your mayor, councillor or alderman. The same suggestions and tips on writing and meeting will apply. Your local municipal government information services leg. (e.g. City of Calgary is 311) can connect you with your alderman and/or the Mayor’s Office.

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VI. Conclusion

It is hoped that this guide will allow individuals to develop an understanding of the process required to become more self-sufficient in dealing with challenges they may face when working with different systems. Consumers of any type of health service are frequently challenged to have their voices heard when receiving services, and often do not understand their rights and responsibilities when dealing with health care providers. Self-education is a key to developing

the knowledge and skills necessary to become more effective in managing issues related to health care needs.

Mental Health consumers in particular face stigma from many areas of our society,

including health care providers. The impact of stigma on individuals can often cause a lack of

faith in support systems that are designed to assist the individual. Unfortunately, many

individuals develop the belief that they are powerless, and their quality of life suffers from not accessing the necessary supports. One of the purposes of developing self-advocacy skills is to

help individuals overcome the sense of helplessness that can be created by negative interactions with systems that are intended to help.

One of the key elements in developing self-advocacy skills is accessing help when you do not understand how to proceed. Self-advocacy skills will assist you in understanding the process in solving problems; however, there may be occasion to connect with supports to assist you to avoid getting stuck and not being able to move forward with resolving the problem. Asking for

help is OK. Remember, the point of getting help is to assist you in dealing with challenges, and

to hopefully help you understand how to be more independent in dealing with issues in the future.

Canadian Mental Health Association is pleased to have provided the information about self-advocacy. It is hoped that it will assist persons to become more effective in their participation in society and lead more fulfilling lives. Thank you for taking the time to use the information.

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VII. Appendix 1

Basic Questions to Ask During a Visit to the Doctor • What is my specific condition?

• Why do I need a test or need to see another doctor or health care professional? • What are my treatment options?

• How may the treatment affect me?

• What medication side effects should I expect? • What will happen once I begin treatment? • How will the doctor and I follow up?

• What should I do if there are treatment complications or if I have questions? • Who should I call if there are treatment complications or if I have questions? • Where can I get more information to help me understand my issues?

NOTE: Sometimes it can be very helpful to have a trusted friend or family member come with you to the doctor. A friend can help you remember the doctor’s advice later, or help with asking questions.

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Reminder Sheet to use during Visit to the Doctor

Date: Symptoms:

Condition(s):

Recommended Treatment/Tests:

Expected changes/improvements/side effects:

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VIII. Appendix 2

Resource Links (please note that this list is not exhaustive and should assist with basic links)

Advocacy Services:

Alberta Mental Health Patient Advocate Office Ph: 310-0000 then dial 780-422-1812 Calgary Health Region Patient Representative

Ph. 994-2080

Calgary Legal Guidance Social Benefits Advocate Ph: 716-6479

Canadian Mental Health Association – Calgary Region Advocate Ph: 297-1402

Mental Health Information Services

Canadian Mental Health Association – Calgary Region Advocate Ph: 297-1402

ACCESS Mental Health (Calgary Health Region) Ph: 943-1500

Alberta Mental Health Board Help Line (24 hours across Alberta) Ph: 1-877-303-2642

Crisis Services/Phone Support

Distress Centre (24 hours, Calgary) Ph: 266-1605

Mobile Response Team (Calgary) Ph: 266-1605

Alberta Mental Health Board Help Line (24 hours across Alberta) Ph: 1-877-303-2642

Parent Help Line

Ph: 1-888-603-9100 Kids Help Phone

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Internet Links

Alberta Alcohol and Drug Abuse Commission (AADAC)

www.aadac.com

Alberta Health Drug Benefit List www.health.gov.ab.ca/ahcip_list.html Alberta Mental Health Board www.amhb.ab.ca

Assured Income for the Severely Handicapped (AISH)

www.seniors.gov.ab.ca Calgary and Area Child and Family Services

Authority

www.calgaryandareacfsa.gov.ab.ca Calgary Health Region www.calgaryhealthregion.ca

Calgary Legal guidance www.clg.ab.ca

Canadian Mental Health Association – Calgary Region

www.cmha.calgary.ab.ca Centre for Addiction and Mental Health www.camh.net

City of Calgary www.calgary.ca

Family Law Information Centre www.albertacourts.ab.ca Credit Counselling Services of Alberta www.creditcounselling.com

Government of Alberta www.gov.ab.ca

Government of Canada www.canada.gc.ca

Inform Alberta (search engine programs in Alberta)

www.informalberta.ca

Internet Mental Health www.mentalhealth.com

Mental Health Works (Canada) www.mentalhealthworks.ca Office of the Superintendent of Bankruptcy

Canada

www.strategis.ic.gc.ca National Mental Health Consumers’ Self Help

Clearinghouse (USA)

www.mhselfhelp.org National Empowerment Centre (USA) www.power2u.org