Tag: Independent mental health advocates

Advocacy services for children and young people must be strengthened – Children’s Commissioner

The Children’s Commissioner has today (13 June) published her review of independent advocacy services in England. This shows that 29% of local authorities do not know how advocacy services are provided to children in respect of health complaints – despite them having a legal duty to make such arrangements since 2012. Nine local authorities were unable to say what advocacy arrangements are in place for social care complaints, even though this has been a statutory duty for 30 years.

A survey of managers of advocacy services found majority support (68%) for moving towards ‘one-stop’, local advocacy services – working across services and systems.

Advocacy services provide independent information and help to ensure children and young people are heard and their rights protected. The first service was set up by Leicestershire County Council in 1987. This was for children in care and care leavers. Now local authorities have myriad duties to arrange for independent advocacy for children and young people, including:

  • When they receive (or are entitled to) social care services
  • When they wish to make a complaint about a health service
  • When they are detained in a mental health unit
  • Young people who are homeless
  • Children who run away or go missing.

Independent advocates also visit and help children in young offender institutions and secure training centres, though there is no statutory duty for this. Many children’s homes and mental health hospitals have ‘visiting advocates’ who regularly spend time with children, gaining their trust and being there to help them be heard as individuals or collectively.

The Children’s Commissioner makes 10 recommendations for strengthening and improving children and young people’s advocacy, including a consolidation of the law so that entitlements to advocacy are clear and the revision of national standards (statutory guidance). She urges advocacy providers to publish an ‘independence statement’ which sets out to children and young people how the advocacy service is separate from health, social care and other services. Continuing revelations of human rights abuses in prisons and mental health units underline the importance of advocates being able to act robustly and independently for children.

Article 39’s Director, Carolyne Willow, was a member of the Commissioner’s working group for this review. She said:

“Advocates are vitally important for children and young people living in institutional settings, whether this be children’s homes, mental health units or prisons. They give strength and power to children’s voices and make sure their rights are upheld. For a child who feels alone and unheard, having a person who respects them and takes the time to listen – and makes others listen – can be truly revolutionary.

Advocates are also a lifeline for young people struggling in the community trying to access support and services.

We hope the government, local authorities and advocacy providers will quickly accept and implement the Commissioner’s important recommendations. As we celebrate 30 years of the Convention on the Rights of the Child this year, this report shows how to practically implement the treaty’s obligations. Advocates empower children who are often in extremely powerless situations; they are not an optional extra but a crucial mechanism for making sure all children enjoy their rights.

Article 39’s work with the Children’s Commissioner was instigated by the late John Kemmis, a brilliant champion for children and young people’s rights and advocacy services. We pay tribute to him.

The Commissioner’s report and recommendations can be found here.

Review of Mental Health Act – new protections proposed for children

The final report of the Independent Review of the Mental Health Act 1983, published today (6 December), makes several very welcome proposals for strengthening the care and protection of children, including:

  • That children’s capacity to consent to admission to a mental health unit, and to treatment for a mental disorder, be based on their understanding and communication, rather than strictly tied to age. The review recommends the Government undertake a consultation on whether parents should continue to be allowed to have children (aged under 16) admitted to mental health units against the child’s wishes. Currently domestic law gives children aged 16 and 17 the right to consent to medical treatment; below this age, consent is dependent upon the child’s understanding. (See a summary of the legal position on our rights4children website).
  • That every child receiving in-patient care should have a care and treatment plan which clearly sets out their views and wishes.
  • That the Government should consider introducing a duty on health providers to support families to stay in touch when a child is placed out of their home area; this could include financial support.
  • That children’s right to independent mental health advocacy be extended to include care planning and making advance choices about care (this would include use of restraint). Very positively, the review recommends that advocacy be opt-out (taking the onus away from patients to seek support) and that children (and adults) in prison awaiting transfer to a mental health unit should have the right to an independent mental health advocate. Independent mental health advocates working with children and young people must be trained for this and providers should be required to produce quarterly reports, incorporating the views of those who have used their services, the review says.
  • Greater attention should be given to meeting the health needs of African and Caribbean children at a much earlier stage, particularly those at risk of school exclusion.
  • That children admitted to a mental health unit be legally defined as a child in need, thus entitling their parents to support from councils under Section 17 of the Children Act 1989.
  • That the Care Quality Commission makes special efforts to obtain the views of children and young people when it inspects and reviews mental health services. It should be notified within 24 hours of every child placed out of their home area.

Read the full report here. Recommendations relating to children and young people, and parents, appear throughout the report and in a dedicated section on pages 167-177.