ADVOCAY France
Paris 19e
The term "advocacy" refers to a means of helping people to express themselves when they consider themselves victims, feel they are not listened to properly or sufficiently respected by the institutions with which they have to deal, or encounter obstacles to the exercise of full citizenship. It is a social mediation practice that introduces a third party, giving more weight to the user patient's request without speaking on his or her behalf, and thus makes it possible for those with different points of view to reach a compromise through respectful dialogue.
The purpose of the association ADVOCACY France is to support all forms of appeal in situations where individuals are excluded, segregated or deprived of their freedom. It comprises users and mental health professionals and pursues collective action and fosters co-operation and solidarity among all the parties concerned, however different their status and experience (translation of excerpt from Usagers de la Psychiatrie: de la disqualification à la dignité, by Martine Dutoit and Claude Deutsch, Érès, 2001, 165 p.)
ADVOCACY France is a national network of five local associations, which was set up in 1996 by Martine Dutoit and Claude Deutsch. The Paris premises are located in Place des Fêtes in the 19th arrondissement.
Martine Dutoit, a psychiatric social worker at the Sainte-Anne Hospital, wanted to set up a body bringing together users, parents, committed members of the public, health professionals, sociologists, philosophers, and so on in order to change the way in which society viewed and treated patients and to promote their inclusion.
Inspired by British methods (she has spent some months in England), she uses participatory inclusion techniques, such as empowerment*.
*Empowerment means enabling individuals to take charge of their own lives in terms of finance, work, family and place in the community.
As its name indicates, empowerment is the process whereby people acquire power, in this case the power to work, earn their living and decide what place they want to have in the community, with due regard for the needs and terms of society. A person who is independent is able to exist in the community without being a burden on it: indeed, an independent person is an asset to the community.
Empowerment, according to Martine Dutoit, means establishing conditions that enable people to regain control over their lives, through individual and collective work; it involves social work techniques whereby the people concerned identify their own problems and find solutions to them.
When she first started trying to apply these techniques in the hospital where she worked, Martine came up against obstacles and, in particular, a reluctance to innovate. As she could go no further, she developed relations with other branches, such as institutional psychotherapy (working groups designed to encourage self-help, but which do not combat exclusion), and set up ADVOCACY France with Claude Deutsch (co-founder of the association), who wants to work towards the genuine social inclusion of users, on the basis of his experience of setting up an alternative hostel. (This hostel, using group work methods, concentrates on situations where people are excluded or are passive recipients of assistance, which leaves no scope for independence, and on fostering users' awareness of their power. It is still a special place to which users return regularly, despite opportunities to become integrated in the daily life of their town or neighbourhood.)
At ADVOCACY, the idea is to unite three groups: the social services, psychologists/the medical profession and users (users being persons who recognise themselves as being in a situation where they are receiving psychiatric care and who demand a place in society as credible citizens who can take on responsibilities).
Once the association was set up, it was found that there was very little participation on the part of hospital personnel: it was mainly users who were involved in the association, some with the support of their relatives.
In fact, ADVOCACY was gradually transformed from a body bringing together different parties into an association of users from throughout the Paris area (many of its members in the medical professions support its activities without actually taking part). It officially became an association in 2005 (further to the European Charter). The administrative council is composed primarily of users. The president of the association, for instance, who is schizophrenic, has a job, lives with a partner and recently had a baby. Having just become a mother, she decided to hand over her job to her partner, who suffers from a mental handicap (he can neither read nor write) but whose natural charisma won over the members, who help him to write when general meetings are held.
The association: how it operates, its activities, some examples and anecdotes
How it all started: protection and support/advocacy
The association's activities focus primarily on the protection of human rights.
Calls come from throughout France from users who have been denied recognition or credibility in various contexts. Without acting as an adviser or spokesperson, the association tries to make each person aware of his or her situation so that he or she can make the necessary choices. "We can't work miracles, but people know they have someone to whom they can turn."
Letters are sent by the users themselves. In many cases, a supporting letter drafted by Martine Dutoit lends credibility to requests submitted to institutions and government departments. In most cases, social workers and other people with whom users have to deal refuse to listen to them because of particular incidents in the past (verbal violence or too many demands), and this can lead to certain legitimate demands being rejected, in which case ADVOCACY supports and protects users.
A first development: mutual support
To prevent users from becoming passive recipients of assistance, the association trains them in pair advocacy: an "old" user lends support to a "new" user. A person who has experienced a similar situation supports and encourages the other user.
Becoming a pair advocate is not easy, as the fact of identifying with the problems of the other user may mean that the necessary objectivity is lacking, but the advice of a pair advocate carries more weight than advice from someone who works for an institution because the two partners have shared the same experience and are on an equal footing. "It's a bit like a new recruit working under the supervision of someone more experienced," says Martine Dutoit.
The relationships established made it necessary to regroup
Initially the association met once a month in a café. Then it was allocated a room in a community centre. It emerged, in the light of the relationships established in these informal settings, that there was a need for premises that bore some resemblance to the various "images" of traditional gathering places: the village square, the washhouse or (in an urban setting) a cafeteria.
With the support of the Fondation de France, the first Espace Convivial Citoyen (convivial community area) was opened in Caen. ADVOCACY's initial aim was to appropriate somewhere where people could gather in a town or neighbourhood and which would operate democratically.
On the strength of this experiment, a similar gathering place was opened in Paris, first in a small, ill-kept shop and subsequently in the current premises at 5 Place des Fêtes.
What goes on in these Espaces Conviviaux Citoyens?
What are they like, what activities take place there and what impact do they have on users?
1. The workshops
The distinguishing feature of the Espaces Conviviaux Citoyens is that they are run and organised by users. Every Monday a large meeting takes place for organisational purposes, to decide on the week's schedule. Some of the activities are regular ones, for example the philosophical discussion and a workshop where people learn how to put forward coherent arguments and take part harmoniously in a discussion.
The activities are open to everyone: local inhabitants and anyone else interested. The discussion workshop attracts members of some associations, for example the association La ligne d'horizon.
Taking over responsibility as a result of the transmission of know-how: one of ADVOCACY's key working methods
An important principle of the Espaces Conviviaux Citoyens is that users are responsible for upkeep and organisation: the idea is that they should not be consumers but be actively involved. The workshops, which are initially often organised by professionals, are subsequently run by users to whom the necessary know-how has been passed on. The philosophical discussion workshop, initially led by a psychologist working with ADVOCACY, is now run by user volunteers.
The art workshop, first run by a painter, made it possible to discover the artistic talent of one of the users, and this led to his social rehabilitation: Éric Colas, who had been in hospital for many years, arrived in the association in a very vulnerable state (he had difficulty in mixing with the others and was living in wretched conditions). Gradually his talent emerged and enabled him to obtain a subsidised job with the association and run his own workshop. Other contributors enabled Éric to discover new techniques (previously he had painted exclusively with oils).
Éric is delighted to have contact with children on the occasion of open-air events in the neighbourhood, having been deprived of contact with his nieces and nephews by members of his family.
Interestingly, he has been a member of the association since it was first set up in the shop in Rue de Nantes, where he turned up one day when the walls were being washed down. Picking up a sponge and setting to work, he turned to his neighbour, who also had a sponge in her hand, and asked whether she too had been in hospital. She replied that she was a psychologist.
"Roles are not defined in the association; it's the quality of the relationships that counts," says Martine.
The computer workshop enables people learn from one another, without there being a specific leader. Two computers are permanently available to everyone. All the users are now at ease using the Internet.
The association's activities change regularly. A new workshop, the women's club, was recently set up in response to a need that emerged at meetings when representatives of the association were called on to take part in external events: the volunteers were always men. The proposal that each delegation should include a man and a woman sparked off the debate. The women's club provides an ideal opportunity for women to express themselves freely, become aware of their position, talk about what they want and make plans for the future.
2. The importance of external events
External events make for contact with society and prevent ADVOCACY's premises from becoming a kind of ghetto. They also allow members of the association to make use of their skills.
A video and graphic design workshop has been set up, and two users produce posters and other information material. It has allowed some members to discover a talent for the management of sound, for video production, and so on, in response to the association's specific needs.
In the early years, for want of money, the association latched on to existing events, offering to help out. It now organises its own events with the support of the town hall for the 19th arrondissement of Paris and other associations, with the help of local inhabitants.
On 29 December 2006 ADVOCACY organised a number of activities in the town hall serving the 19th arrondissement of Paris, in conjunction with all the associations with which it is involved.
150 people joined forces to organise a philosophical discussion workshop, put on a play, show films, arrange African dancing, work with homeless people and present various associations. One woman living locally arrived speaking nothing Russian: one of the members who spoke the language was able to make contact and welcome her, in a fine tribute to diversity.
In June 2007 ADVOCACY occupied the Place des Fêtes for a whole month. Theatre, dancing, debates in various workshops and even an art market contributed to the life of the neighbourhood, bringing the inhabitants into contact with members of the association. All the workshops that normally take place in the Espace Convivial Citoyen were held in the square. The inhabitants were in contact with users of the mental health services. The event led to numerous encounters and ended with a meal in the club for local inhabitants, who were invited to come and fetch photos.
Future plans, obstacles, potential
In future, ADVOCACY wants to consolidate the principle of passing on know-how and involve the members of the association even more in running the workshops and in pair advocacy, the ultimate aim being that the association should be run entirely by users. Another constant concern is to retain the flexible and non-institutional nature of the place.
Recently, a new subsidy enabled ADVOCACY to recruit a full-time qualified social worker trained in working with groups by Martine Dutoit. This employee is considered as someone to whom it is possible to turn for help and who supports the members' projects, without acting as a supervisor or social worker. The association has also been able to recruit two members to subsidised jobs in order to enable them to devise plans for their future employment.
Martine Dutoit's great fear, of course, is that the Association will lose the subsidies that have made this possible. For this reason, the members have set up budget workshop to deal with money matters: they manage a separate account earmarked for projects and are also beginning to concern themselves with applications for subsidies.
The dynamics of the group are essential to ADVOCACY: the most vulnerable people rely for their integration on the energy of the group as a whole, which is genuinely self-managing, thanks in part to rules of procedure (which it took six months to draft). ADVOCACY would like to train other people in order to disseminate the method, but the task is a difficult one: an experiment in Créteil was not a great success. The association does, however, carry out a regular self-appraisal in order to introduce changes and to progress. No fewer than a hundred people a month come to the association's premises, and there is a constant stream of new arrivals.
- : Advocacy Paris Ile-de-France
- : 5 place des Fêtes 75019 PARIS
- : +33 (0) 1 46 07
- :
