Wise Up! survey of Brook clients

Introduction

Brook carried out this survey to find out more about young people’s views on and experiences of the sexual health advice and services available to them and their knowledge and views of their rights on sexual health, particularly in relation to confidentiality.

Survey distribution

Surveys were distributed to clients at ten Brook Centres in different parts of the country (Birkenhead, Birmingham, Blackburn, Eccles, Jersey, Liverpool, London, Milton Keynes, Oldham and Wigan) during August and September. A total of 729 surveys were completed.

The sample

• 10% of people who completed the survey were male and 90% were female. (For the purposes of comparison, in 2004-2005 17% of Brook’s clients were male and 83% were female.)
• 71% of respondents described themselves as White, 12% as Black, 9% as Mixed race and 6% as Asian.
• 16% were aged 12-15, 53% were aged 16-19, and 31% were aged 20-25.

Important characteristics of sexual health services

53% of respondents who gave a single answer as requested said that confidentiality was the single most important thing for them when they were seeking sexual health advice. The next most popular answer was ‘not being judged by anyone’, accounting for 19% of responses, closely followed by ‘that it is free’, which was the answer chosen by 18% of respondents.

The findings suggest that confidentiality is particularly important for young people under the age of 16. 62% of this age group said that confidentiality was the single most important thing for them. 18% said not being judged was the most important thing for them, and 14% said that the fact the services were free was most important.

Knowledge and views of rights in relation to confidentiality

Confidentiality of visit
61% of respondents believed that health professionals are not allowed to tell anyone else that young people under 16 had been to see them. 17% thought that health professionals could tell others about visits from under-16s, while 19% did not know and 2% did not answer the question.

A similar proportion of under-16s (62%) believed that health professionals are not allowed to tell anyone that young people under 16 had been to see them, and a slightly lower proportion thought that health professionals could tell others about their visit (13%), while 20% did not know.

When asked if they thought health professionals should be allowed to tell others about visits from under-16s, 78% said no, 14% said yes and 7% said they did not know, or did not answer the question. In the under-16 age group an even higher proportion - 91% - of respondents said that health professionals should not be allowed to tell others about their visits. Only 3% of under-16s said that health professionals should be able to breach their confidentiality.

Confidentiality of contraceptive services
80% of respondents said that young people under 16 could get contraception without their parents being told. 6% said they could not, 12% did not know and 2% did not answer. Young people under the age of 16 were clearer on this question, with 91% saying that under-16s could get contraception without their parents involvement, and only 4% saying they could not.

These results suggest Brook clients have a relatively high level of knowledge of their rights on confidentiality, particularly those under 16. This reflects the fact that all Brook clients are reassured about confidentiality when they register and that Brook Centres display publicity materials reinforcing this message. They are more confident when asked about a specific situation – in this case the right to confidential contraceptive services – than when asked in general about the principle of confidentiality.

Likely impact of referral of underage sexual activity to social workers

When we asked whether their decision to seek sexual health advice would be affected if they knew health workers could pass details of sexually active under-16s to social workers, 64% said they would be less likely to seek advice. 18% said they would be no less likely to seek advice, 14% said they did not know, and 5% did not provide an answer. An even more significant proportion (74%) of under-16s said they would be less likely to seek advice in these circumstances, while 10% said they didn’t know, and 4% did not respond. Only 13% said they would be no less likely to seek advice.

In response to our question on whether there were any situations in which it might be acceptable for a doctor or clinic to breach confidentiality by telling social workers about a young person, 42% of all respondents (62% of under 16s) said no. 35% (18% of under-16s) said it would be acceptable in some circumstances. 18% did not know and 5% did not answer this question.

Of those who said it would be acceptable in some situations two thirds (66%) specified circumstances such as abuse, rape or other situations where a young person was at serious risk of harm. Only 1% said the fact that someone under 16 was having sex was a good reason to breach their confidentiality, and only 6% said that pregnancy or an STI would be an adequate reason for breaching confidentiality.

This indicates that many young people do understand that there might be exceptional circumstances in which confidentiality needs to be breached but feel strongly that information about them should not be routinely shared.

Experiences of sexual health services

81% said they were happy with the way they had been treated when seeking sexual health advice. Only 2% said they were not happy, and 16% did not answer.

This reflects very well on Brook Centres, since all respondents were users of Brook’s services. A small number of people referred to bad experiences elsewhere and a similarly small number said they were not happy with treatment they had received without specifying whether or not they were referring to Brook’s services.

Willingness to complain

36% said they would complain if they were not happy with the way they had been treated. However, 25% said they would not, and 20% said they did not know whether or not they would complain. A further 19% did not respond to this question. Young people under 16 were less likely to say they would complain – 31% said yes, they would, 29% said no, they would not, 27% did not know, and 13% did not answer.

Those who said they would not complain were asked why not. Examples of the reasons give for not complaining include: ‘lack of confidence’, ‘too much hassle’, ‘embarrassing’, ‘waste of time’ ‘wouldn’t know who to complain to’.

Information about rights

When asked if they thought it would be useful for young people to be given information about their rights 90% (654) said yes; 1% said no; and 8% did not answer or said they didn’t know.

We also asked what they thought the best way was to make sure young people had this information. Of those who provided suggestions, 32% suggested that information should be disseminated via advertising, leaflets, posters or the media (TV, radio and magazines were all mentioned). 31% said that information should be made available through schools. Some specified that it should be taught about in sex and relationships education classes; others suggested posters, leaflets and talks from organisations such as Brook.

(NB Because this was an open question some respondents gave several suggestions in response and may have been included in both of the major categories above.)