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This commentary reflects on peer advocacy in relation to citizen advocacy in the context of the vital need for advocacy in all its different forms.

The authors reflect from the standpoint of developing peer advocacy in secure mental health settings as an organisation based on self-advocacy and co-production.

By reflecting on peer advocacy and citizen advocacy side by side, the authors affirm both and all kinds of advocacy as being vital to people with learning disabilities living full and free lives as citizens.

The authors hope this commentary will enrich people’s understandings of the essential role of peer advocacy within different kinds of advocacy, and the need to enlarge the range of possibilities and choices open to a person.

The purpose of this paper is to critically examine the current state of literature on peer parental advocacy, offering practical insights and ideas for researchers and practitioners interested in this evolving field.

This narrative review is a comprehensive, critical and objective analysis of the current knowledge on peer parental advocacy.

Parental peer advocacy (PPA) has seen growing interest, with increasing research detailing the benefits and challenges. It is now being considered within children’s services across the UK, drawing upon the success of similar initiatives, especially in the USA. There is a compelling case for PPA, not least as it may contribute to resolving the longstanding challenges within children services of families having the opportunity to meaningfully participate in decision-making (Corby et al., 1996; Muench et al., 2017; Bekaert et al., 2021).

Parental advocacy (PA) continues to be an evolving area of academic research and policy development both in the United Kingdom and internationally. Emerging research suggests a compelling case for an expansion in PPA within child welfare and protection systems, specifically in case, program and policy advocacy.

PA continues to be an evolving area of academic research and policy development both in the United Kingdom and internationally. Emerging research suggests a compelling case for an expansion in PPA within child welfare and protection systems, specifically in case, program and policy advocacy.

To the best of the authors’ knowledge, this is one of the first UK-based narrative reviews that critically analyses the research, highlighting the limitations and strengths of adopting PPA as an approach.

Parental advocacy is an emerging area of research and policy interest in Wales and across the UK. Although there is little research in the UK context to date, international research has indicated that parental advocacy can improve the relationship between parent and professional in the field of child protection social work. This paper aims to ascertain how the implementation of a parental advocacy programme supports parents to play a meaningful role in decision-making when children’s services are working with them and their families.

This study used interviews, surveys and focus groups to obtain qualitative data from 18 parents, seven parent advocates, two advocacy managers and four social workers, to explore the potential impact of parental advocacy on decision-making. The study identified challenges in implementing parental advocacy, particularly relating to awareness of the service. Participants also discussed experiences of the child protection system and how parents are supported by advocates.

Despite challenges surrounding implementation, initial findings were encouraging, and generated examples of how parental advocacy services have helped parents to understand children’s services and develop relationships of trust with social care professionals. In doing so, this study identified potential mechanisms that may be useful to support future service delivery.

This paper and research is novel as it explores parental advocacy within the Welsh context. Although there has been research conducted into parental advocacy, this has largely come from the USA. This research comes from the evaluation of an innovative and promising parental advocacy scheme in Wales.

“Inclusivity” and “empowerment” are central concepts in the philosophy of nursing practice and education. Recent professional concern has focused on the need to embed compassion in healthcare cultures where practice contributes to learning. The purpose of this paper is to explore an innovative partnership approach to undergraduate placement provision for adult-general nursing students in the context of learning disability and mental health.

Critical discussion focuses on evaluation of a non-clinical placement centred on the health and social care of individuals with a learning disability or mental health needs. Two projects from practice around healthy living and hate crime illustrated the value of transformative learning as a pedagogic philosophy.

Student feedback offered insight into social and cultural processes that impact on practice-based learning, and factors promoting inclusive engagement. Such included the context of identity formation, narrative as an evidence-base for caring, and personal/emotional growth through critical reflection.

Evaluation provided a platform to re-think model(s) of clinical practice learning in healthcare education derived from a non-clinical placement. There are tangible benefits for sustaining value-led practice at a time of political change in the way health services are configured and delivered.

When engagement with the principles of inclusivity and empowerment become part of the lived-experience of the nursing student, longer-term recognition and retention of caring, and enabling values are more likely to endure.

The emotional development and skills acquired by nursing students transfer to all branches of the profession by revitalising core conditions of compassion, respect, dignity, and humanity.

This paper aims to show the particular difference Independent Mental Capacity Advocates (IMCA) can make towards specific decisions which some acquired brain injury clients, who are eligible for the IMCA service, experience.

A case study is highlighted in which the role of the IMCA is described against the background of a selective literature review on the history of advocacy in relation to its emergence as a profession. This analysis references issues of spirituality and culture.

Themes raised in the case are discussed with reference to ongoing research and these are related to the best interests of clients, and to reflexivity as a basis for the professionalisation of advocacy.

IMCA practitioners are instructed in well‐defined “best interests” situations, where an individual has no capacity, support or representation, or requires safeguarding measures in relation to certain decisions. In these cases, social, cultural, emotional, religious or spiritual factors can contribute to the decisions which need to be made.

The emerging role of the IMCA in the “best interests” process is outlined, including how health and social care professionals, or decision‐makers, may relate to, benefit from, or respond to challenges by the IMCA in supporting clients in decisions made on their behalf.

Healthcare professionals and those advocating, including IMCA, could more intentionally weigh up the values and beliefs of clients using, for example, the “best interests checklist” or by referring to “spiritual assessment”, as used increasingly by mental health ward staff and chaplains.

The need for advocacy for autistic adults is emphasised in many government policy and good practice guidelines. The purpose of this paper is to investigate legislation and policy relevant to advocacy for autistic adults in England and explore whether this translates into practice. It also seeks to clarify which policies can be enforced under current legislation and highlight the gaps in legislative power to ensure implementation of good practice.

This paper aims to define what is meant by autism advocacy. Relevant legislation, including human rights, disability and autism-specific guidelines, are discussed in respect to autistic adults in England.

Implementation of autism advocacy policy appears to vary greatly according to local and individual resources.

Autistic adults, and services that support them, may be unaware of the policies and guidelines relevant to advocacy, they may also be confused by the plethora of different guidelines or unsure how to implement these. Further research is needed to review obstacles to the practical application of autism advocacy policy.

As self-advocate leaders, the authors aim to present the perspective of people with learning disabilities on “Behaviour that Challenges: A Unified Approach”. Building on firsthand accounts which reveal compassion and cruelty in the health-care system, the authors propose ways of working, which confirm and add to the thinking in “A Unified Approach”, especially “Capable Environments”.

To ensure integrity, the authors engaged contributors with lived experience of admission to secure care after acting in ways that put themselves or others at risk. The authors included the perspective of people whose severe learning disabilities limit them to few or no words as best they could by interviewing their parents. The authors were supported and advised in the writing of this commentary while retaining full control throughout.

While recognising compassionate care, the authors suggest the provider’s power over a person’s life is a central reason for the care system’s vulnerability to the cruelty evident in firsthand accounts. The authors propose practical ways to offset this power. Firsthand accounts suggest the key features of capable environments are communication, valuing families and developing a valued, caring, well-trained workforce. Lived experience in workforce training and peer-support to individuals offer great potential to transform outcomes.

The perspectives of diverse contributors with learning disabilities bring lived experience insight to the challenges of “behaviour that challenges”. The authors aim to add value by blending lived experience viewpoints with the emotion of firsthand accounts of care. The insights of lived experience – too often a marginal consideration in health-care design – are presented here as central to care that fully achieves what people want and need.

Fig. 1 illustrates the current level of the integration of three sectors, and Table 1 shows the strategic entry points for the integration.

This article looks at the legal and policy context for the development of advocacy services and considers the legal issues which arise when developing standards and codes of practice for advocacy services, in particular capacity, consent and confidentiality.