In tracing the history of advocacy in mental health from the days of the lunatic asylums, David and Toby Brandon warn that unless accurate and valid measuring tools are developed to assess the service, advocacy will not be allowed to reach maturity

Mental health advocacy has a very long history, contrary to what some recent publications claim (MACA 1999). In 1620, a pamphlet titled The Petition of the Poor Distracted People in the House of Bedlamwas published (Brandon 1991). John Monro, an 18th century Bethlem physician attacked the whipping of lunatics as ‘unnecessary, cruel, and pernicious’ (Monro 1758). John Haslam, an early ‘alienist’ at the same asylum, published a rebuttal of the alleged lunatic James Tilly Mathew’s self-advocacy in the courts. Mathew claimed to be sane in seeking his discharge and Haslam diagnosed insanity. The professional won the battle but later lost the war – dismissed in 1816 without post or pension (Haslam 1810).