Ms Deirdre Lillis:

There is some discussion and debate about who would fulfil the role. There is a clear commitment to developing peer-led advocacy, but I am not sure how open the current peer-led advocacy service is to people with intellectual disabilities. There should be a breadth of capacity in respect of the independent advocacy resource in order that it will not restrict itself in regard to whom it might serve, including children and young people aged 16 to 18, who may also be in need of an independent advocate. There is scope for discussion. The National Advocacy Service for People with Disabilities is growing, strong and independent of the HSE but it is not necessarily a peer-led service. There has to be some scope for development and discussion in that regard, although I am just a small cog in a small organisation in this advocacy world. There needs to be space to discuss the issue, or else there will be only competition between forms of advocacy, which does not serve us well at all.

On when the advocacy might be triggered, we have heard during this meeting that it is no good giving the blue book, or whatever it is now called, to a person when he or she is in a state of extreme distress as he or she walks through the door.

An advocate should be available when a person walks in the door. If I am correct, advocacy is referred to in many places throughout the report Dr. Morrissey and Dr. O'Mahony have written with regard to the human rights approach in nearly every section, which talks about rights relating to consent, care planning, support in writing an advanced healthcare directive and mental health tribunals, and its recommendations. I hope Dr. Morrissey and Dr. O'Mahony will tell me if I am mistaken. It needs to be there from the beginning to the end and beyond. In Scotland, people may have access to independent advocacy support before they go into hospital so there is someone to support them and to speak for them in respect of what their advanced healthcare directive says regarding what does and does not help them. It may say that it helps to have somebody who is in the community, a person they can speak to. In the UK, this has been categorised as falling under involuntary detention. It is not sufficient because it happens at the last minute. It has to be across mental health service provision, just as it is in Scotland's legislation.