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Rights of access to advocacy

 

Key message

The right of access to advocacy extends to everyone with a mental disorder, not just to those subject to compulsory treatment under the Mental Health (Care & Treatment)(Scotland) Act 2003.

 Why we are interested in advocacy

The Mental Health (Care and Treatment) (Scotland) Act 2003 introduced the right of access to independent advocacy services for all people with a mental disorder.We were interested to find out how easy it was for people to access independent advocacy and if advocacy was being used regularly in wards for older people.

What we would expect to find

All relevant staff should know about the right to independent advocacy and its role, the legal requirements relating to independent advocacy under the act.

We expect to find evidence that people have been informed of their right to an independent advocate and that people with impaired capacity are given help to engage with an advocate. This should happen for all people, not just people who are detained.

What we found

We found that just over half of people seen in functional assessment wards had been told about advocacy and this had been entered into their care file. This compares with just under half of those seen in dementia assessment wards and combined wards. We based our decision upon whether someone had been informed about advocacy by asking them and/or looking at care files to see if this had been recorded.

Circles Advocacy is on site.Response time is very good and there is a specialist older people advocacy worker, really helpful.
Quote from Commission visitor at Royal Edinburgh Hospital

We found that informal patients are much less likely to have been informed about advocacy than patients who are in hospital on a compulsory basis .We heard from staff that in some areas local advocacy services were only able to work with people who needed their help with mental health Act matters.

Most wards we visited had promotional materials for the local advocacy service displayed, but quite often individual patients and their relatives were unsure about what advocacy was. We feel it is important to supplement these general advertisements with specific information for individuals.

We also heard from staff who said they would only refer someone to the advocacy service if there were no involved relatives. This is not consistent with the right of individual access to advocacy

Action needed

  • All older people in assessment wards must be individually informed of their right to independent advocacy. Where people lack capacity, staff should do their best to help them exercise that right.
  • Advocacy services should be available to everyone with a mental disorder, not just those detained in hospital under the mental health Act.