Therapeutic Confidentiality and the Provision of Psychological ...

More documents

Recommendations

Info

healthcare practitioners working with under 16's (DoH, 2000; Ford and Kessel, 2001) 7 . Instead, the preferred policy focus will be on developing age-appropriate psychiatric accommodation for young people, especially for the seriously under-resourced 16-18 age group. This latter issue has been correctly highlighted by successive Mental Health Act Commission Reports as requiring urgent attention. The contradictions in wider Government policy, however, remain unresolved on the contentious issue of Gillick and young people's rights to confidential therapy. The Government has a clearly stated public commitment to the 1989 UN Convention on the Rights of the Child, with the appointment of a Minister for Children in England. However it seems that, in the present dash to construct an over-arching strategic reform of psychiatric care, a decisive opportunity for introducing some joined up policy on the Gillick principle is all too likely to be overlooked. Northern Ireland Review of Mental Health Provision for Children and Adolescents In the specific context of the current review of mental healthcare provision, there are a number of suggested developments which could be considered, based on the model of children’s rights described above, in terms of their rights respectively to welfare, participation and independence. These suggestions could be linked to the detailed and comprehensive survey of current provision in Northern Ireland undertaken for the Children’s Law Centre (O’Rawe, 2003) 10 . The following fairly modest proposals are all drawn from recent reviews or reports on this issue in England and Wales, and are set out as potential aims for the future service. (Specific sources are numbered, and appear as a separate section in the references at the end of the article.) Proposals for Northern Ireland Review of Mental Health Provision for Children and Adolescents Welfare: 43
• to identify the mental healthcare needs of children and adolescents and plan appropriate provision (1) • to set standards and protocols for mentally ill minors detained in adult wards (1) • to establish agreed working and referral arrangements with CAMHS (1) Participation • to make patient information available in formats accessible to children (2) • to set a duty to provide advocacy services (2) Autonomy • to bring selected parts of case law into statute (3) - to assume a threshold of 16 for presumption of capacity (4) - to assume a rebuttable presumption of capacity for the 10 – 16 age group (4) Confidentiality These proposals for change need to be underpinned by a reappraisal of the status of confidentiality in providing mental healthcare for children and young people, based on the Gillick principle, and the similar themes contained within Scottish statute. Confidentiality for young people is recognised and protected by both common law and statute, notably via s.60 of the Data Protection Act 1998 and Article 8 of the Human Rights Act 1998. The right of the child to confidentiality is logically distinct from their capacity to consent to treatment if seen to be of ‘sufficient understanding’. This means that confidentiality needs to be maintained, 44
Page 1 and 2: Therapeutic Confidentiality and the
Page 3 and 4: will prevail. It simply requires th
Page 5: duties and responsibilities involve
Page 9 and 10: of counsellors both a sound underst

Therapeutic Confidentiality and the Provision of Psychological ...

Create successful ePaper yourself

Delete template?

Save as template?