SIAA Roundtable – Scottish Mental Health Law Review Consultation: Additional Proposals

SIAA held a roundtable on Monday 27 June to gather members views and comments, as the Executive team of the Scottish Mental Health Law Review (SMHLR) provided Additional Proposals around independent advocacy in the Mental Health Law Review Consultation.

The roundtable was attended by independent advocacy organisations and members from the SMHLR Secretariat. Shaben Begum & Kirsty McGrath (SMHLR Secretariat) provided background on the new proposals and participants shared their views on independent advocacy elements. SIAA will submit a response to the consultation based on our members’ comments around the recommendations.

SIAA’s Director, Suzanne Swinton, highlighted the need of strengthening independent advocacy and making it more effective in terms of helping others to know and understand their rights and pursue their human rights in the context of mental health legislation.

We encourage our members to share further views and comments on these Additional Proposals by filling in this form, the link will be open until Friday 15 July.


Scottish Mental Health Law Review Consultation – Additional Proposals key discussion points

Here is a summary of the key points that were discussed at the roundtable:

Independent advocacy definition, right of access, commissioning, and funding 

  • The Scottish Government should consolidate and align all the different pieces of legislation and policy to ensure consistency regarding the definition of independent advocacy, the right to access it and how it is commissioned and funded.

See Additional Proposals Paper, page 17.

SIAA member views and comments

  • Currently, different legislation and policy documents define independent advocacy in different ways. For example, the definition of independent advocacy in children’s hearings is slightly broader than that under Social Security legislation.
  • Members agreed with the principle of having one definition of independent advocacy and another for collective advocacy.
  • It is important that the definition of Independent Advocacy incorporates a human rights-based approach.
  • Some members highlighted that the ‘opt out’ system should consider all the models of Independent Advocacy as not one specific model will suit everyone.  


Improving access to independent advocacy 

If there is to be an opt out system the SMHLR team thinks the following things need to happen:

  • The Scottish Government needs to set out in law what the role of an independent advocate is and the duties required to effectively commission and fund independent advocacy organisations (IAOs).
  • IAOs need to be resourced to explain what they do and how they can help people help themselves.
  • Training need to help practitioners across health and social care to understand what IAOs can do and how IA can help improve communication, relationships with patients and unpaid carers and can help secure better outcomes for patients.
  • There should be a public awareness raising about independent advocacy.
  • A wider right to independent advocacy in law.
  • Strong right to access independent advocacy in human rights legislation.

See Additional Proposals Paper, page 17-18.

SIAA member views and comments

  • Members agreed to the proposal in principle and liked the idea of an opt-out pilot scheme to test out some of the reasons people choose to opt out of advocacy support.
  • Most members expressed concern about the anticipated increase in demand and whether this would be matched by an increase in local authority funding.
  • It was discussed that the Scottish Government needs to invest resources to realise the proposal. As this is about changing the human rights landscape in the context of mental health, it cannot happen on the current modest levels of funding organisations are receiving.
  • Local authorities need to be on board to agree to increased funding.


Evaluation and quality assurance of independent advocacy organisations 

  • The SMHLR team thinks that an independent body should be created by the Scottish Government with a specific remit to evaluate independent advocacy organisations, or responsibility be given to an existing organisation to do this.
  • Resource should be given to independent advocacy organisations to collect data in a uniform way across Scotland, so issues can be tracked at structural and strategic level.

See Additional Proposals Paper, page 19-20.

SIAA member views and comments

  • Evaluation of independent advocacy is a key line of work as it provides an opportunity to bring in quality assurance work.
  • Members welcomed the proposal but wish to know who the appointed evaluating body would be and how their remit is defined.


Who can be an independent advocate? 

  • Introduce a Scotland wide qualification for paid and voluntary Independent Advocacy Workers
  • Create a national register for Independent Advocacy Workers.

See Additional Proposals Paper, page 20.

SIAA member views and comments

  • It was discussed that a qualification provides another mechanism for ensuring that the people who have access to vulnerable people are suitably qualified.
  • The majority of members agreed to a formal qualification and favoured a vocational qualification, CPD approach, or City and Guilds course which would fit around work.
  • There were some questions around who will provide the qualification, how it will be developed and how it will be funded.
  • With reference to a proposed national register, some members mentioned that people using advocacy services should be able to evidence that their appointed independent advocate is registered and has the relevant qualification, just as you can with any other professional.
  • The group had no valid argument against a register and would fully support it provided standards and quality assurance are met and it is on a human rights basis.


Diversity, equality, and inclusion 

  • Those commissioning independent advocacy services to require collection and sharing of monitoring data.
  • Resource provided for diversity and equality training for all independent advocacy workers.
  • Support for independent advocacy organisations to have dedicated staff to work with specific groups they share a background with, and to work with groups facing particular barriers in Scottish society.

See Additional Proposals Paper, page 21.

SIAA member views and comments

  • The proposal aims to ensure independent advocacy organisations work with a cross-section of the community in terms of monitoring conflicting data and looking at diversity within the movement i.e. how many minority groups are employed within the sector, volunteering for advocacy organisations or use the services provided.
  • The members in attendance agreed that we should be thinking about these things and improving access by minority groups.


Funding and commissioning of independent advocacy 

  • The SMHLR team suggests the following should be considered around funding and commissioning
  • A national fund to be created for the provision of independent advocacy which would cover the different areas of work –e.g. mental health, children’s advocacy, social security and remove unequal levels of access across.

See Additional Proposals Paper, page 22.

SIAA member views and comments

  • Members discussed about the importance of a national fund and the conflict of interest in challenging funders directly if there is a human rights breach.
  • The group expressed concern that if there was one national model, the Scottish Government would give the contract to one large contractor thereby undermining local connectivity.
  • Members highlighted that if there was to be a national fund how would this integrate with local Strategic Independent Advocacy Planning as outlined in The Mental Health (Scotland) Act 2015. Members also raised the concern that this could adversely affect small grass root community-based groups in favour of national Independent Advocacy groups and the potential that Independent Advocacy would not respond to local need.
  • One member suggested that the national fund is allocated to localities and the Mental Welfare Commission still have a scrutiny role over Independent Advocacy Planning. SIAA would like to see the Mental Welfare Commission have more power to ensure Strategic Independent Advocacy Planning are in place as outlined in The Mental Health (Scotland) Act 2015.


The role of independent advocacy in supported decision making 

The Scottish Government should:

  • commission a training programme on Human Rights and SDM to all independent advocacy organisations and :
  • commission a training programme and awareness raising for the public and other relevant groups on SDM.

See Additional Proposals Paper, page 23-24.

SIAA member views and comments

  • Members were generally supportive of the proposals for training.
  • The REH Patients’ Council Mind Our Rights Education Programme was mentioned along with the possibility of training advocacy workers on human rights awareness from a lived experience point of view. This initiative was partnered with CAPS and Mental Health Patients Council.
  • A member also referred to a recovery college which opened up in North Ayrshire offering community-based classes, workshops and learning opportunities for people. The IA organisation also delivered sessions on self-advocacy work which paid dividends for those who attended and they are seeing less of those people as they are now more able to self-advocate themselves.


Scrutiny and accountability of independent advocacy organisations 

  • Scottish Government should appoint an agency to scrutinise independent advocacy organisations regularly. Such an agency might need to be overtly human-rights based. For independent advocacy to promote and protect human rights effectively, the scrutinising agency would have to have a
    thorough understanding of human rights law and its application in practice.

See Additional Proposals Paper, page 24-25.

SIAA member views and comments

  • Members addressed this point when discussing the ‘Who can be an independent advocate’ and ‘Evaluation and quality assurance of independent advocacy organisations’ sections.  


Independent advocacy for carers 

  • Independent advocacy organisations are resourced by the Scottish Government to recruit dedicated staff and volunteers specifically to support unpaid carers.

See Additional Proposals Paper, page 25.

SIAA member views and comments

  • The group discussed the important of unpaid carers accessing independent advocacy.
  • The Carers Act is one of the things that did not clarify the importance of independent advocacy for unpaid carers. We now have a situation where some independent advocacy is available for some carers in some parts of Scotland but there are also carer centres that claim to provide independent advocacy.
  • There was strong support from members for this proposal.
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