AS DDTF have highlighted with the work on MAT standards, at present, research reveals large health inequalities in society, with most recent statistics from 2019 highlighting Scotland as having the highest drug related deaths in Europe. This evidence shows that there is development needed in tackling these inequalities. It is heartening to see Scottish Government addressing these issues through the development of a Human Rights Based Approach in Social Security, Patient Bill of Rights and Rights, Respect and Recovery legislation and policy guidelines.
In their aims, DDTF state that through MAT standards they hope to create ‘no barrier’ medication assisted treatment (MAT Standards, 2020). DDTF have recognised the research from NHS health Scotland (2017), that medical treatment is often made inaccessible to those who need it due to: stigma, isolation, loneliness, social, and financial problems. MAT, like REACH recognise that drug related deaths is not a simple issue, such as lifestyle choice but rather an issue compounded by social complexities of deprivation, poverty, and exclusion. REACH and MAT share the belief that a holistic approach is required to address these underpinning factors leading to drug related deaths.
REACH Advocacy promote the use of a Human Rights-Based Approach (HRBA) which has the capacity to deal with these interrelated and interlinked issues across advocacy practice and health and social services. This approach is ensconced within the key messages from the NHS Scotland (2016) Human Rights and the Right to Health publication addressing health inequalities in Scotland. This shared emphasis on human rights is reflected in the Scottish government national taskforce for human rights leadership (2020) which has a key task of ensuring Scotland is a world leader in putting human rights into practice.
In response to underlying health inequalities and drug related deaths, we at REACH designed and deliver an SQA approved SCQF 7 (HNC level) qualification in Advocacy Practice promoting a HRBA. This training and qualification allow organizations and individuals to become synonymous with government legislation (Human Rights Act, 1998, Equalities Act, 2010 & Patient Bill of Rights, 2011) and current strategies such as Rights, Respect and Recovery (2018). Through this education and training candidates learn a human rights-based framework (FAIR model and PANEL principles) from which to advocate. In addition to the award, REACH deliver introductory workshops on a HRBA to all people including varying front line organisations. REACH HRBA qualification and workshops enables staff to understand human rights legislation and apply it within their engagements with patients, clients, peers, and employees. For staff this is a great opportunity for continuous personal and professional development through the SQA accredited framework. Subsequently, making rights accessible by the
way of accredited training utilises a national framework which unites all people and organizations in upholding and protecting the rights of every human despite their status.
MAT in their work principles state that families effected by substance use need to be reached at both local and national levels (MAT Standards, 2020). The REACH training directly tackles community absence in decisions about programs and policy by providing them with the educational tools underpinning a HRBA. Providing these skills and supporting communities to establish advocacy services in their local area empower people to have a voice in ensuring systems are non-discriminatory, putting user experience and participation at the heart of making service change.
REACH is an evidence-based organisation; we design, deliver, and evaluate on all our activities across client, candidate, and stakeholder participation. By adopting this approach, we always keep people’s experience central to our activity.
The data collection system we use for HRBA workshops and the Advocacy Practice Award, is a mixed methodology of qualitative and quantitative measures. The feedback we receive is collated from REACH pre and post questionnaires which is used to inform us of the content, delivery, and efficacy of the training. Information collected is from the (WHOQOL-bref) questionnaire which is a global measure of someone’s quality of life, which we use to measure the potential benefits of education across populations. An agreement to use this questionnaire was received from the World Health Organisation (WHO). As well as this, we use the Advocacy and Advocacy Problems Perception Questionnaire (Amended, McPhee, I. 2018: AAPPQ, Cartwright 1980), pre and post participation of the award. The evidence collected thus far highlights the positive gains in quality of life and has shown candidates increased confidence in delivering advocacy services.
The advantages of delivering a human rights based advocacy service based on our training and Advocacy Practice Award, for people living with Substance use Disorders (SUD) and co- morbid health issues, was reported as being a positive experience by people who attended our advocacy service. We were able to evidence the benefits of a HRBA approach which is more fully explained in the independent evaluation: McPhee, I., Sherridan, B. and O’Rawe, S. (2019) Rights Based Advocacy as Intervention.
From the points raised in this blog, we at REACH would recommend and support the MAT subgroup in adopting a Human Rights Based Approach to treatment, training, and advocacy. As illustrated, using a HRBA allows everybody to become informed, increases confidence and ensures people have their rights met. REACH believe and recommend establishing a Human Rights Based Approach provides the bridge between Medically Assisted Treatment and Advocacy Practice Standards.