- Applies to teens who seek sexual health advice for STI, abortion, contraception, drug misuse and aren’t comfortable to share it with the parents.
- These guidelines help understand when we need to report to police/ involve social services/ can treat w/o letting parents know
Assessing Gillick Competence (Mental Capacity)
- The child’s age, maturity, and mental capacity.
- Their understanding of the issue and what it involves, including the advantages, disadvantages, and potential long-term impact.
- Their understanding of the risks, implications, and consequences that may arise from their decision.
- How well they understand any advice or information they have been given.
- Their understanding of any alternative options, if available.
- Their ability to explain the rationale behind their reasoning and decision-making.
Fraser Guidelines
- The young person cannot be persuaded to inform their parents or carers that they are seeking advice or treatment (or to allow the practitioner to inform their parents or carers).
- The young person understands the advice being given.
- The young person’s physical or mental health, or both, are likely to suffer unless they receive the advice or treatment.
- It is in the young person’s best interests to receive the advice, treatment, or both without their parents’ or carers’ consent.
- The young person is very likely to continue having sex with or without contraceptive treatment.
Involve safeguarding (child protection referral) if:
- Sexual activity in child less than 13 years old and age doesn’t matter
- Difference in age
- Position of trust
- She is not giving information regarding partner
- Age 13 - 18 years old can be sexually active but with people of same age group (age 13 - 16 years old)
- No need to ask for partner age if 18 years old.
Approach
- D: Why do u want this pill? When did this happen? Is it first time (if not then when was first time?)
- D: I understand you are sexually active, may I ask if you are In a relationship? since when? may I know where did you meet your boyfriend? Is he you classmate? (If doesn’t tell then say we ask these questions to all teens just to make sure they are safe, so how old is he?) (if tells 30 then case is regarding safeguarding and not the pill.)
- D: Does anyone else know about it, friends, parents? How is he as a person? Any long standing medical condition?
- D: First of all I will give you morning after pill you should take it right away as soon as possible however I also need to talk to my senior and social service because you told me that you are in a relationship with the 30 year old, with your teacher and I’m a bit concerned about you.
- P: He is a good guy, etc
- D: I understand that it’s really not your fault and you like him but he is an adult, teacher and he should know better. He should know that it’s unacceptable to have relationship with his students. It’s something which should be reported. I have to do this for your safety. You are just a victim here but you are a child and he is an adult. Please don’t stay in touch with him anymore after this. Avoid him.
- P: But I like him, etc
- D: Actually there might be other children at risk as well and this is a crime.
- P: Are u going to let my parents know?
- D: I’m not going to let you parents know by myself but we will involve social services with help of my senior as it seems like you need some protection. Social services might involve your parents. Police might be involved as well, as this is a crime.