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Access to advocacy

Under section 259 of the Mental Health (Care & Treatment)(Scotland) Act 2003 all individuals with a mental disorder have a right of access to advocacy. There is a duty on health boards and local authorities to ensure that independent advocacy services are available. It would not be acceptable to meet the access requirement simply by putting up a poster on the ward and expecting individuals to read and understand it. Information about advocacy services should be provided, both in writing and verbally, at different times during an admission to encourage uptake where appropriate.

We assessed access to advocacy by asking individuals and nursing staff whether advocacy services were readily available in the hospital and by reviewing case notes for evidence that people had been informed of advocacy or used their services during this detention period.

We were pleased therefore to find that in the majority of care settings visited (85%) there was evidence that independent advocacy services were available, and that 21% of people reported that they had already accessed independent advocacy services.

We found that many of the people we saw were not ready, at this stage of their illness, to consider whether they would benefit from advocacy. We recognise that services generally have responded well to the change in the legislation and whilst advocacy is now widely available in most areas we will continue to monitor this important new requirement.

We found some variations in the ability to access independent advocacy for certain groups of individuals. We found that access was more difficult for people with dementia and acquired brain injury. Services need to ensure that advocacy is accessible in a meaningful way for people with all diagnoses, specialist skills may be needed to work with particular client groups.

We have produced guidance on Working with independent advocacy which may be helpful for practitioners.