As with any long term illness or disability, there are long term legal, financial and systems issues. There may be times when you will have to advocate for your family member to help her get the services she needs. Issues such as applying for benefits or dealing with insurance companies may be too complicated for her, so you will have to be her representative.

Knowing that you are going to have to play this role some day can help you prepare for the inevitable. You also need to have a basic understanding of the systems she may be involved in. There may be financial implications – who will be responsible for her bills; who will take care of her in case of your death. Know what you can do to protect yourself, your family and your finances.

You need to understand the systems if you intend to be an effective advocate for your family member. Some basic people skills and a good record-keeping system can also help you navigate the complicated health care system. We have compiled a list of basic techniques to help you be a more effective advocate.

• Keep a record of everything. List names, addresses, phone numbers, dates of crisis events, admission and discharge dates for hospitalization. Make notes of conversations and conferences. Make copies of everything you mail. Keep all notices and letters. Spend some time organizing them so you know where everything is when you need it. A file system that organizes documents by event (hospitalization, applying for SSI benefits, etc.) is one way to organize files. Other families have kept a journal, where they document and file everything on a day-to-day basis.
• When talking to therapists, agency staff, receptionists, doctors or others, who are involved in your family member’s life, be polite and keep conversations to the point. Simple courtesy can get you a long way. By the same token, don’t allow yourself to be intimidated; do not try to intimidate the professionals and care givers.
• Write letters of appreciation when they are deserved; write letters of criticism when necessary. Send these to the hospital or agency director. Send copies to anyone else who may be involved. Also, send copies to your legislator or other state official if necessary.
• Don’t accept vague answers or statements that are confusing. When a clinician says something like, "We are observing your daughter carefully" this statement doesn’t give you any real information. Ask for specifics about behavior, discharge dates, visiting hours, etc.
• Let your relative know what you plan to do. He might disapprove of your action or may wish to handle it differently.
• Don’t be afraid or ashamed to admit that you are the relative of a person who has a mental illness. This is the first step in removing stigma.
• Don’t let yourself be patronized, put down or blamed for your family member’s illness. Old theories about dysfunctional families don’t do anyone any good. They hinder your ability to cope and undermine your efforts to support your family member.
• Finally, be assertive! You are paying, either directly or through taxes. You are entitled to information, respect and courtesy. You are not asking for favors; you are simply helping to get the job done.