Max E. Guttman, LCSW

We Need More Advocacy Work Within Mental Health

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Max E. Guttman, LCSW, (2022, June 1). We Need More Advocacy Work Within Mental Health. Psychreg on Mental Health & Well-Being. https://www.psychreg.org/we-need-more-advocacy-work-within-mental-health/
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Advocates, human rights experts, and people who support and ‘ally’ with the victimised people are such great people, aren’t they? Since I moved into advocacy for people with mental health disorders, I have met some wonderful folks, caring, unassailable, and selfless.

I have also met some nasty, mean-spirited, and hateful advocates. Advocates are just angry sometimes, and this isn’t helpful. Advocates are so self-involved in their trauma that they moved into advocacy for the wrong reasons.

The reason I suspect is to feel a sense of satisfaction and power of people like me and many others, just there to help for the sake of helping and not some self-serving physiological bent.

I have been the victim of trauma too. But, I spent many complicated, labored hours unpacking my ‘stuff’ and reflecting on how I could better understand and relate with others more pro-socially. Again, in graduate school, I did the same thing with my peers to prepare myself for professional help as a social worker.

So, when I am the victim of another advocate hell-bent on telling me, “I am a danger to people with disabilities” because I am not in line with the newest most PC rhetoric, I have to question the integrity and ethics of the accuser and intention. I genuinely apologize if the purpose is cheerful and good-natured and further educates me. I am fearful that I am correct, and the intent is malicious.

Advocates prepare other people to understand better their rights as mental health patients in treatment settings like hospitals and other spaces where they can be vulnerable to abuse and other trauma from workers who are there not to help but to terrorise. As an advocate, I provide this information and other skills and services I can offer vulnerable people.

I have to pause and ask: ‘Why do I need more education? Why am I the other end of the finger-pointing, suggesting I am hurting the people I am serving?’

So, why are other advocates on the sidelines so critical of other advocates? And what is this teaching anyone or modeling about behavior? It’s not, and even worse, the behaviour can set people up for failure in a world that can be unforgiving at times.

When I prepare folks for the hospital, I arm them with a vast, deep, and eclectic language and skill-set that spans many perspectives and theories within the mental health dogma that is accepted, contested, and still up for debate.

I prepare people for dark times. I don’t sugarcoat everything. And when one of my clients is in a tough spot, empowering them with the correct information is more critical than most PC information. So, listen when the nurse speaks and be cooperative because your rights are in their hands. Your rights may be in someone else’s hands that may not care about the law, and you might get very hurt if you start quoting Mindfreedom or some other organization’s mantra against Forced Treatment. Sometimes, people, including advocates, need to stop being so hypercritical and less dismissive.

I spoke with an older peer recanting about one of her hospitalizations years ago. The staff needed her to move rooms for whatever reason. She didn’t want to go. and asked the nurse in charge, “What if I don’t go?” she asked the nurse.

The nurse said: ‘I’ll drag your legs across the floor if I have to get you out of here.’

The next time a PC advocate wants to talk about the ‘worthiness’ of fellow advocates, remember, your safety comes first. Because last time I checked, it’s much easier to be loud on the internet than walk back lousy advice to people trapped in terrible situations.

At the root of it, pathologizing advocates also believe people with schizophrenia and the more severe diagnoses are less likely to heal and recover. Some feel sure about people with similar diagnoses like mine, who are ‘less than, sicker, and less trustworthy to adhere to our treatment.’

I’ve heard advocates say downright mean-spirited and malicious things about people with schizophrenia. Some might seem like they are even cheering you on, albeit condescending. Others will be openly critical and negative towards people with more severe and complex clinical pictures.

Advocates will gaslight people. Given bias, discrimination, and diagnosis, stigmatising other advocates is the very thing we were supposed to fight against as advocates in the public mental health system. 

Advocates, even peer advocates, can be stigmatising. The impact is catastrophic for people expecting direct and non-judgemental support in.


Max E. Guttman, LCSW  is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.

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