Access to advocacy
The UN Convention on the Rights of the Child requires that children and young people must be given an opportunity to express views on all matters affecting them. The 2003 Act gives every person with a mental illness or learning disability, including children and young people, the right to access independent advocacy. The act also requires that local authorities and NHS Boards make sure that independent advocacy services are available locally and that information about services is provided so that the services can be readily accessed. The code of practice also notes that the right of access to independent advocacy is for every patient and is not limited to those who are best able to articulate their needs. People may need support and advice from staff to encourage them to access advocacy. We regard independent advocacy as vitally important, particularly in relation to children and young people in hospital who are potentially vulnerable to having their views ignored.
During these visits the availability of independent advocacy services was discussed at each of the meetings with CAMH services. Advocacy services appear to be readily available within the specialist in-patient units, and we were pleased to see that several NHS Board and local authority areas have specialist advocacy services for young people in place, or in the process of being developed. We would expect that where a specialist service is in place an advocacy worker would be more familiar with specific issues about children's rights and have particular skills and experience in relation to engaging with young people. In one area the development of collective advocacy for young people has been tried, although it has proved to be difficult to engage young people with this provision. In most other areas children and young people access generic advocacy services. In one local authority area we were told that there is no independent advocacy service for young people, but that children's' rights officers who are employed by the local authority provide advocacy support.This does raise an issue about whether there is a conflict of interest in such a situation, even if structurally a children's' rights service is not part of the operational service system in a local authority.
With regard to what young people told us themselves, four people confirmed that they had accessed advocacy services.Others mentioned seeing leaflets, one person said that they had heard of it but did not really understand what this service provided and others had "never heard of it".One understood about advocacy and how to access it, but said he had not felt the need to use the service.
Recommendation
NHS Boards and local authorities should review the provision of independent advocacy services and the format of information about advocacy services available to children and young people. As part of this review, consideration should be given as as to whether a specialist service may be appropriate in their area.
