Understanding Advocacy

What is Advocacy?

The word advocacy usually means different things to different people, ranging from holding a bake sale for a local school to helping a patient fight for their legal rights. Webster’s Dictionary defines advocate as both a noun and verb.

Advocate Definition

  1. (n) One who argues a cause or pleads the cause of another; a supporter or defender
  2. (v) Pleading on behalf of something

So you may have been an advocate and not even realized it! Being an advocate for an issue means making your voice heard and fighting for what you believe is right.

Types of Advocacy

  • Self-advocacy is the process that involves identifying the obstacles you face as a patient, developing the strategies to overcome them, and then putting your plan into action.
  • Public policy or legislative advocacy is the act of trying to influence public policy at the state and federal levels through a wide range of activities.

Keep in mind that the process of an ordinary citizen providing feedback to legislators and policymakers is the foundation of our democracy and it is often easy to do.

Advocacy is about making positive changes.

  • Help people get access to mental health services.
  • Enhance the quality or kind of mental health services people receive.
  • Protect patients' rights (protections under the Mental Health Act or other legislation, discrimination, etc.).
  • Change an unfair work situation (hiring and firing, being treated unfairly, etc.).
  • Help people get social assistance (eligibility, losing assistance, being assigned to the wrong kind of assistance, etc.).
  • Change any other situation that needs to be changed in order to enhance a person's quality of life. For example, you could create or promote public education to eliminate stigma about mental health or address issues surrounding social assistance and/or poverty and class.

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The Legislative Process

Prior to and during presidential elections, people across the country are involved in lively discussions on who would make the best president. And hopefully, before they cast their vote, they take the time to educate themselves about the candidates and their positions on important issues.

But what about the rest of the year? What about proposed legislation that could change laws that will affect you today and probably tomorrow? Are you informed? Are you involved? Do you follow important changes to healthcare, discrimination, disability, and other issues? Unless you belong to a political group or are closely following health in the news, by the time most people hear about a change, it’s more likely that it has already become a law and its too late for people to help make a change.

The legislative process can be very confusing. How does a bill become a law? How are officials elected? What does all of this legislative jargon mean?

This section will help answer all of those questions for you:

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Fighting Stigma

What is stigma?

Stigma is a negative view of a person based on something about him or her. Many illnesses get stigmatized—not just mental illness. People with cancer once had to cope with stigma. People with HIV or AIDS still cope with stigma, though there is less today than when the virus was first discovered. Stigma is unacceptable in any form. 

For the purposes of this page, stigma describes a negative view of depression, bipolar disorder, or people who have these illnesses.

DBSA educates the public to decrease this stigma and make it easier for people with mood disorders to ask for and receive the help they need. DBSA commissioned a survey of 1,200 American adults, a sample representative of the U.S. population in terms of gender, race, ethnicity, geography, and education, and found that many people still need to be educated about mood disorders, especially bipolar disorder. 

Stigmatizing attitudes were not held by the majority of people surveyed. However, approximately one in four people—which is one in four people too many—believed the following about people with mood disorders: they are not just like everyone else (18%); they should not have children (19%); they are easy to identify in the workplace (26%); and they do not live normal lives when treated (29%). Two-thirds of survey respondents also held the incorrect belief that mood disorder medications are habit forming.

Educating Others and Standing Up for Yourself

Even in casual conversation, people can be gently and quickly reminded that words like “psycho” are hurtful stereotypes, and that people with depression and bipolar disorder deserve understanding, not shame.

You do not necessarily have to identify yourself as mental health consumer to speak out against stigma, but your personal story may add credibility to your argument. It is your decision whether or not to tell others about your illness. In any event, you can always state the facts about depression and bipolar disorder and disagree with any myths about the illnesses that others believe. People may welcome the chance to learn about mood disorders.

Know that you deserve respect at all times. Gently but firmly let your friends and family know that depression and bipolar disorder should not be joked about or belittled. Answer questions to help people better understand the illnesses. Remind people (if they know your diagnosis) that you do not fit into the stereotype of a “crazy person.” 


Self-stigma (the belief that you are weak or damaged because of your own illness) can sometimes be the most difficult kind of stigma to fight. Self-stigma may cause people to stop their treatment, isolate themselves from loved ones, or give up on things they want to do.

How can you fight self-stigma?

Focus on your strengths, not your limitations. Know the facts about your biological illness, and keep reminding yourself of them. Spend time with others who have mood disorders at a DBSA support group; discuss feelings of self-stigma with others who can understand. Volunteer with your DBSA group or with other organizations where people need help. Find out what brings you joy and go after it. Stick with your treatment. If you aren’t satisfied with your treatment, talk to your health care providers about making changes.

Write letters to fight stigma.

Letter-writing can be an effective way to fight stigma and inform a large number of newspaper readers, radio listeners, or policy makers. You might also write a letter to a business you feel is discriminatory.  Any time you see stigma, writing a letter can help to educate and empower.

Writing Tips

  • State the facts about depression and bipolar disorder.
  • State your argument clearly let the reader know what was offensive, why, and how it could be made less offensive.
  • Don’t resort to accusations or name-calling.
  • Support your argument with clear examples that people with different opinions can relate to.
  • Keep your argument concise (short, organized, to the point) to hold people’s attention.
  • Offer help for people who want to know more about mood disorder facts.

Example Letters

The following are a few sample letters that are targeted to specific audiences.

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Advocacy Is Important

Advocacy is especially important now because of the many legislative changes made to mental health services, social assistance, and other areas that impact the lives of people who use the mental health system. You don’t need special training to be an advocate. Anyone can do it. All you need is a passion for DBSA’s mission—to improve the lives of people living with mood disorders. Most of what a good advocate does is intuitive and grows out of a few basic principles. You just need to make the commitment.

Your voice makes a difference.

Decision-making centers around you, the voters. At some point in the legislative process, there will be one letter or one call that breaks the camel’s back and affects change. And while your letter may not be the straw that breaks the camel's back, it may make the last straw possible.

Think about it as if you were a legislator who just won an election.

  • You leave your home state, go to Washington, and suddenly find yourself voting on issues a range of issues, including taxation, trade, defense, housing, education, highway construction, healthcare, and pension benefits, all while hearing absolutely nothing from your constituents who are entrusting you to represent them.
  • You are overwhelmed by the amount of issues, by advocates lobbying for issues you have never heard of, and by groups working their own agenda. You are trying to figure out where you stand. 
  • You quickly realize you can’t cover everything by yourself. The only way to stay on top of the things that are important to your constituents is for them to tell you what's important.

If we don’t speak up and communicate with our legislators, we won’t get what we need out of the policymaking process.

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Advocacy Myths

I just don’t have the time.

Most of us don’t have a lot of extra time. But if we, as patients, don’t speak out for our own rights on issues such as insurance discrimination, who will speak for us? On some issues, it takes as little as five letters or phone calls to tilt a representative’s decision making process one way or the other. 

I won't make a difference.

Every voice makes a difference. Look at recent presidential elections. The decision sometimes comes down to a few votes in a few states. Your opinion matters, but it only does good if you make it known. The assumption that your voice won’t make a difference is what makes bad public policy possible. 

Someone else will do it.

It is probably true that someone else will contact your legislator, but how do you know they are working for the same cause? There are many groups trying to get their voices heard. If they are talking and you are silent, how will anyone know the patient’s point of view? Your silence makes your opponents' voices even louder.

Absolutely no one is going to advocate for our illnesses—except us. And in many cases others may be fighting against us. There are millions of Americans with depression and bipolar disorder. Think how easy it would be to change things if each person took only five minutes out of their day to make that phone call or write that letter.

Nothing ever changes.

How often have you heard this? Sometimes, it seems like glaciers move faster than the legislative process. Let’s look at the numbers. During the 108th session of Congress in 2003, 3,700 bills were introduced in the House and 2,004 of them made it to the Senate. Legislative change happens slowly; the system is engineered this way on purpose. If laws were easy to change, then every swing of public opinion could change laws that would swiftly effect citizens. Though the system is slow, change does happen and you can affect change.

I don't know enough.

You don’t have to know all the details of a bill. Legislators don’t expect you to. All you have to know is why the bill is important. Members of Congress put a high value on input from the people they represent. 

Make your voice heard

Become an Advocate

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Learn more about the Affordable Health Care Act

The Patient Protection and Affordable Care Act is a statute that was signed into law in 2010. The act aims to increase the number of Americans covered by health insurance and secure coverage for those with pre-existing conditions. 

Essential Health Care Benefits Standards

The Center for Consumer Information & Insurance Oversight (CCIIO) was created to oversee the implementation of several pieces of the Patient Protection and Affordable Health Care Act. Learn more about the CCIIO.

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Advocacy Center

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Advocacy Policies | Understanding Advocacy | Become a Legislative Advocate | Advocacy Toolkit