At Benedictine Hospital in Kingston, N.Y., P.E.O.P.L.e.’s advocates work a total of 50 hours a week on the psychiatric emergency service and 15 hours a week on two psychiatric units.

The advocates who work on the psychiatric emergency service explain emergency department procedures to patients, accompany them during the admissions process, and help in other ways, said Thomas Dowling, R.N., M.S.N., coordinator of the psychiatric emergency service.

"Overall, the advocates are very helpful," explained Dowling. "There have not been any problems. They do not approach patients who are acting out or who are intoxicated. The advocates have different priorities and offer a different perspective" than would a physician or other professional, he added.

Dowling said that these advocates have helped him "be more aware of what it would be like to be a patient in the ER, and their reassurance to patients has enabled patients to work with us with less resistance." He described the example of one advocate who calmed a fearful patient by saying, "I know this guy [Dowling]; you really can trust him."

The most important service the advocates provide, Dowling emphasized, is that "they offer the patients hope and help them see that they can take an active role in their recovery."

John Mitchell, M.D., a psychiatrist on Benedictine’s two psychiatric units, has worked with advocates about 30 times in the last two years. With rare exceptions, he thought the advocates were "objective, professional, and very helpful."

"They remind me and others on the treatment team about patients’ fears and concerns. . . . And their presence in treatment-team meetings lets patients see that we really are listening to them and we do really respect their concerns," Mitchell noted.

Mitchell said the advocates often help improve communication between patients and the treatment team. For example, on a few occasions, the advocates have told the treatment team that patients would like information about medication explained more clearly, a step that is likely to facilitate treatment for both patients and caregivers.