Understanding Gillick Competence

Some young people prefer to manage their own medical care or speak to healthcare professionals on their own. This might be a personal preference or because of family circumstances.

When a young person wants to proceed with medical care without the involvement of their parents or guardians, clinicians must consider a concept referred to as Gillick Competence.

Gillick Competence is considered for all clients under 18, especially if they want to pursue their assessment journey without their parents or guardians involved. This article explores what Gillick Competence involves and how it applies to the assessment process.

What is Gillick Competence?

Gillick competency refers to a young person's capacity to make a particular healthcare decision for  themselves.

Gillick competence is usually presumed for young people who are 16 years old and over, as they can be expected to have capacity to consent to treatment. For children under 16, Gillick competence must be assessed to determine if they have enough understanding and maturity to make a particular healthcare decision themselves.

Medical professionals need to consider whether a young person is Gillick competent if they wish to access assessment or treatment for a condition without their parent's consent or knowledge, for example:

• If they seek a type of care they don't want their parent to know about, such as therapy
• If they seek support for a condition they want to keep confidential, such as substance abuse
• If they are worried about how their parent or guardian may respond to their decision to seek treatment

Gillick competency is important to people who work with children to balance their needs and wishes with the responsibility to keep them safe.

Assessing Gillick Competency

As a young person, if you want to pursue a neurodevelopmental assessment without your parents' knowledge, or without them playing a part in your journey, we would need to assess your Gillick competency.

There are no defined questions to this assessment, but several areas are considered, including:

• Your age, maturity, and mental capacity
• Your understanding of the condition and what the process involves
• Your understanding of potential outcomes that might arise from your decision
• Your understanding of alternative options and of what advice and information you have been given

The Assessment Process

Though the decision to proceed without your parents' knowledge or involvement is up to you, we would always encourage you to discuss your healthcare and education with them where possible.

The following areas of your assessment could be affected by the lack of involvement from a parent:

• Your Assessment

  • Your parent or guardian usually acts as an Informant for you and completes pre-assessment forms alongside your school or college. Their input provides essential background information, especially for your early years and development, and without it your assessment could be inconclusive

     

• Post-Diagnostic Care
  • Psychoeducation for Children and Young People has content which is tailored to the parents rather than to you. If you're proceeding without them, our team may be able to facilitate giving you alternative resources on request
  • ADHD medication may require additional considerations if you are proceeding without a parent or guardian involved. Our prescribing team will consider your individual circumstances and whether medication can be safely prescribed and monitored.