Independent Advocacy

1

• Independent Advocacy
• Ryan ONeill Project Manger
• Circles Community Advocacy Project
• Royal Edinburgh Hospital

2

• Circles Network Scotland
• Scottish Independent Advocacy Alliance
• What is Independent Advocacy
• Instructed Advocacy
• Non-Instructed Advocacy
• Advocacy Acquired Brain Injury
• Questions

3

• Voluntary organisation formed in 1994
• Educational objective to build inclusive
  communities
• Upon the foundations of justice, advocacy,
  relationships and empowerment
• Remit of organisation is both national and
  international
• Circles Advocacy Projects are a core element in
  their overall ground breaking work.

4

• Glasgow Advocacy Project has been operational
  since 2001.The project supports people across 3
  hospital sites for Low to Medium Secure care
  additional persons living in the community.
• The Circles Community Advocacy Project has been
  operational since 2005 provides independent
  advocacy to people who have dementia and live in
  their own homes in the City of Edinburgh. 
• Edinburgh Advocacy Project based at the Royal
  Edinburgh Hospital has been operational since
  2004

5

• Circles Network offers Advocacy to
  individuals who use a wide range of services
  including
• Adult psychiatry
• Child Adolescent mental health services
• Dementia
• Early onset dementia
• Forensic
• Old peoples services continuing care
• Ritson Clinic
• Robert Ferguson Unit (ABI)

6

• Direct result of the Mental Health (Care and
  Treatment) (Scotland) Act 2003. The Act gives
  everyone with a mental health difference,
  learning difficulty or personality disorder the
  right to access an independent advocate
• Circles Advocacy is a joint commissioned project
  between NHS Lothian Primary and Community
  Division and the City of Edinburgh Council.

7

• History and content of Independent Advocacy In
  Scotland

8

• Advocacy projects in Scotland have been funded
  for over 15 years.
• Advocacy as a movement has grown, developed and
  professionalized
• Over 100 Independent advocacy organisations in
  Scotland (SIAA 2008)
• Advocacy is increasingly referred to in
  Government legislation and policy
• The Mental Health (Care Treatment) (Scotland)
  Act 2003 first piece of legislation that gave
  people the right to access independent advocacy
• Under the terms of the Act a duty is placed on
  NHS Boards Local authorities to secure the
  availability of advocacy

9

• Scottish Independent Advocacy Alliance (SIAA)
  www.siaa.org.uk
• Set up a Good Practice Working Group
• April 2008 introduced 2 documents
• Principles Standards outlines the philosophy
  that influences the Advocacy movement in Scotland
  
• Code of Practice explains in detail what advocacy
  is about and what advocates do
• As well as being bound by law Advocacy is
  accountable through Code of Practice, Principles
  and Standards

10

• Models of Advocacy
• Self-Advocacy
• Citizen Advocacy
• Collective Advocacy
• Peer Advocacy
• Professional Advocacy

11

• What Is Independent Advocacy?
• Independent advocacy is a way to help make an
  individuals voice stronger and for them to have
  as much control as possible over your own life.
• It is called "independent" because it is not
  tied to the people who provide other types of
  services.
• It helps an individual to get the information
  they need to make real informed choices and to
  help the individual decide what they want to say
  and then help them say it.

12

• The main themes of advocacy are
• Safeguarding people who are vulnerable and
  discriminated against or whom services find
  difficult to serve.
• Empowering people who need a stronger voice by
  enabling them to express their own needs and make
  their own decisions.
• Enabling people to gain access to information,
  explore and understand their options, and to make
  their views and wishes known.
• Speaking on behalf of people who are unable to do
  so for themselves.

13

• TYPES OF ADVOCACY ISSUES
• Assessments
• Benefits
• Pass
• Tribunals
• Medication
• Ward Rounds
• Home/Housing
• Transition
• Family
• Detention
• Staff
• Advance Statements
• Safeguarding/Guardianship
• Employment
• CPA/Review
• Named Persons
• Criminal Justice system
• Child Protection

14

• Non-Instructed Advocacy

15

• People who lack capacity or have such profound
  communication difficulties that they cannot
  instruct an advocate are additionally
  marginalised and therefore have a greater need
  for Independent Advocacy
• A persons views and opinions can be dismissed as
  they are judged not to have insight or
  understanding
• In such circumstances the assistance of an
  advocate can be invaluable in helping to widen a
  persons horizons and promote inclusive
  opportunities

16

• Is taking affirmative action with or on behalf
  of a person who is unable to give clear
  indication of their views wishes in a specific
  situation.
• The non-instructive advocate seeks to uphold the
  persons rights , ensure fair and equal treatment
  and access to services and make certain that
  decisions are taken with due consideration for
  the unique preferences and perspectives.
  (Henderson 2006)

17

• The role of the non-instructed advocate
• Gathering information about the individual
  through a variety of measures. This may include
  identifying past and present wishes or any
  Advance Statement made.
• Ensuring that individual rights are respected
• Speaking to significant others in that persons
  life
• Trying different methods of communication
• Being aware that a persons capacity can change
• Undertake Safeguarding Role

18

• The advocate should have good working knowledge
  of relevant legislation.
• The Mental Health (Care Treatment) (Scotland)
  Act 2003
• Adults with Incapacity (Scotland) Act 2000
• The Human Rights Act 1998
• SIAA Code of Practice and Principle Standards
  for independent Advocacy.

19

• Mental Health (Care Treatment) (Scotland)
  Act 2003 Code of Practice Volume 1- Chapter 6
• Best practice guidelines in relation to the role
  of Independent Advocacy.
• Section 139 What happens when a patient is
  unable to communicate whether or not they would
  like an advocate
• Section 140 particular attention to past
  wishes, views and prior use of advocacy.

20

• How can we best advocate for individuals who
  can not clearly tell us what they want?
• There are a number of questions that the
  non-instructed Advocate should consider?

21

• What is life like for this person?
• What is important to them?
• What might their wishes, feelings and desires be?
• What are there rights?
• What do other people who know this person well
  think?
• What responsibility do other people or
  organisations have towards this person?
• Is this person being treated fairly?
• How can we increase this persons involvement in
  decision made about them and their life?

22

• The issue of judgement is a key factor in
  defining non-instructed advocacy.
• Places a degree of responsibility on the
  advocate.
• Implications for accountability of actions and
  greater scrutiny of practice.

23

• Advocacy and
• Acquired Brain Injury

24

• Since December 2006, Circles Network has been
  providing Independent Advocacy to people living
  on the Robert Ferguson Unit.
• This is a specialised unit with the Royal
  Edinburgh Hospital.
• Scottish Neurological Rehabilitation Service
  provides services for patients with ABI and
  associated severe behavioural disturbance

25

• Presents a number of challenges to the advocate
• High level of skill required in non-instructed
  advocacy
• Must have an understanding of cognitive
  impairments in relation to ABI
• Important to understand how a person process
  information
• Must work closely with multi-disciplinary team to
  draw on their knowledge and expertise.

26

• Questions