No abstract

Purpose -The paper is a commentary (an outline or explanation) about the theme of this edition (supporting independence) from the point of view of people with learning difficulties. The paper has been cowritten by people with and without learning difficulties. Design/methodology/approach -The paper is based on discussions using several open prompt questions around what people understand by independence and why it is important to them. Findings -The team found that being listened to and taken seriously, having real involvement in the community, good support that is personalised and co-produced services are all key to ensuring people can be as independent as possible. Originality/value -The paper is uniquely co-written by people with and without learning difficulties and provides an insight into why independence is so important for people with learning difficulties.

Purpose 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”. Design/methodology/approach 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. Findings 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. Originality/value 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.

No abstract

Purpose 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. Design/methodology/approach 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. Findings 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. Originality/value 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.