In 1986, following public hearings, the United States Congress enacted a
federal grant program to enable the states and territories to create
independent protection and advocacy programs to investigate reports of
abuse and neglect of persons with mental illness in residential facilities
and to pursue legal, administrative, and other remedies on behalf of those
persons. The author discusses implementation of the law and performance of
the protection and advocacy agencies in the program's first six years.
About 20,000 individuals were served by the program in 1991 and in 1992.
The largest category of complaints in those years concerned access to
services. Besides representing individuals, protection and advocacy
agencies provide referral and information services, public education,
outreach, training, and class- action representation. As mental health
systems change and fewer persons live in residential facilities, access to
protection and advocacy services for persons with mental illness living in
the community will become increasingly important. Advocacy will also be
important in ensuring enforcement of new laws and policies affecting care