Skip to main content

Disability Rights: Not for Service - Report: Part 8_7

Not for Service: Experiences of injustice and despair in mental health care in Australia

PART EIGHT: APPENDICES

8.7 NATIONAL STANDARDS FOR MENTAL HEALTH SERVICES

Standard 1 - Rights

The rights of people affected by mental disorders and/or mental health problems are upheld by the MHS.

Criteria

1.1 Staff of the MHS comply with relevant legislation, regulations and instruments protecting the rights of people affected by mental disorders and/or mental health problems.

1.2 Consumers and their carers are provided with a written and verbal statement of their rights and responsibilities as soon as possible after entering the MHS.

1.3 The written and verbal statement of rights and responsibilities is provided in a way that is understandable to the consumer and their carers.

1.4 The statement of rights includes the principles contained in the Australian Health Ministers Mental Health Statement of Rights and Responsibilities (1991) and the United Nations General Assembly Resolution on the Protection of Persons with Mental Illness and the Improvement of Mental Health Care (1992).

1.5 The right of the consumer not to have others involved in their care is recognised and upheld to the extent that it does not impose imminent serious risk to the consumer or other person(s).

1.6 Independent advocacy services and support persons are actively promoted by the MHS and consumers are made aware of their right to have an independent advocate or support person with them at any time during their involvement with the MHS.

1.7 The MHS upholds the right of the consumer and their carers to have access to accredited interpreters.

1.8 The MHS provides consumers and their carers with information about available mental health services, mental disorders, mental health problems and available treatments and support services.

1.9 The MHS recognises the rights of people with mental disorders and/or mental health problems in their service goals and staff job descriptions.

1.10 The MHS has an easily accessed, responsive and fair complaints procedure for consumers and carers and the MHS informs consumers and carers about this procedure.

1.11 Documented policies and procedures exist and are used to achieve the above criteria.

1.12 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 2 - Safety

The activities and environment of the MHS are safe for consumers, carers, families, staff and the community.

Criteria

2.1 The MHS and its staff comply with relevant legislation, regulations and other instruments.

2.2 Treatment and support offered by the MHS ensure that the consumer is protected from abuse and exploitation.

2.3 Policies, procedures and resources are available to promote the safety of consumers, carers, staff and the community.

2.4 Staff are regularly trained to understand and appropriately and safely respond to aggressive and other difficult behaviours.

2.5 A staff member working alone / solo has the opportunity to access another staff member at all times in their work settings.

2.6 A consumer has the opportunity to access a staff member of their own gender.

2.7 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 3 - Consumer and Carer Participation

Consumers and carers are involved in the planning, implementation and evaluation of the MHS.

Criteria

3.1 The MHS has policies and procedures related to consumer and carer participation which are used to maximise their roles and involvement in the MHS.

3.2 The MHS undertakes and supports a range of activities which maximise both consumer and carer participation in the service.

3.3 The MHS assists with training and support for consumers, carers and staff which maximise consumer and carer participation in the service.

3.4 A process and methods exist for consumers and carers to be reimbursed for expenses and/or paid for their time and expertise where appropriate.

3.5 The MHS has a written statement of roles and responsibilities (code of conduct) for consumers and carers participating in the service which is developed and reviewed with consumers and carers.

3.6 Consumer and carers are supported to independently and individually determine who will represent the views of each group to the MHS.

3.7 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 4 - Promoting Community Acceptance

The MHS promotes community acceptance and the reduction of stigma for people affected by mental disorders and/or mental health problems.

Criteria

4.1 The MHS works collaboratively with the defined community to initiate and participate in a range of activities designed to promote acceptance of people with mental disorders and/or mental health problems by reducing stigma in the community.

4.2 The MHS provides understandable information to mainstream workers and the defined community about mental disorders and mental health problems.

4.3 Documented policies and procedures exist and are used to achieve the above criteria.

4.4 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 5 - Privacy and Confidentiality

The MHS ensures the privacy and confidentiality of consumers and carers.

Criteria

5.1 Staff of the MHS comply with relevant legislation, regulations and instruments in relation to the privacy and confidentiality of consumers and carers.

5.2 The MHS has documented policies and procedures which ensure the protection of confidentiality and privacy for consumers and carers and these are available to consumers and carers in an understandable language and format.

5.3 The MHS encourages, and provides opportunities for, the consumer to involve others in their care.

5.4 Consumers give informed consent before their personal information is communicated to health professionals outside the MHS, to carers or other agencies or people.

5.5 Consumers have the opportunity to communicate with others in privacy unless contraindicated on safety or clinical grounds.

5.6 The location used for the delivery of mental health care provides an opportunity for sight and sound privacy.

5.7 Consumers have adequate personal space in regard to indoor and outdoor physical care environments.

5.8 Consumers are supported in exercising control over their personal space and personal effects in residential and inpatient settings.

5.9 Confidential processes exist by which consumers and carers can regularly feedback their perception of the care environment to the MHS.

5.10 Consumers have appropriate space and privacy in order to practice their cultural, religious and spiritual beliefs.

5.11 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 6 - Prevention and Mental Health Promotion

The MHS works with the defined community in prevention, early detection, early intervention and mental health promotion.

Criteria

6.1 The MHS has policy, resources and plans that support mental health promotion, prevention of mental disorders and mental health problems, early detection and intervention.

Promotion of Mental Health

6.2 The MHS works collaboratively with health promotion units and other organisations to conduct and manage activities which promote mental health and prevent the onset of mental disorders and/or mental health problems across the lifespan.

6.3 The MHS provides information to mainstream workers and the defined community about mental disorders and mental health problems as well as information about factors that prevent mental disorders and/or mental heath problems.

Prevention of Mental Disorders and Psychiatric Disability

6.4 The MHS has the capacity to identify and appropriately respond to the most vulnerable consumers and carers in the defined community.

6.5 The MHS has the capacity to identify and respond to people with mental disorders and/or mental health problems as early as possible.

6.6 Treatment and support offered by the MHS occur in a community setting in preference to an institutional setting unless there is a justifiable reason consistent with the best outcome for the consumer.

6.7 Each consumer receives assistance to develop a plan which identifies early warning signs of relapse and appropriate action.

6.8 The MHS ensures that the consumer has access to rehabilitation programs which aim to minimise psychiatric disability and prevent relapse.

6.9 Wherever possible and appropriate, vocational and social needs are met through the use of mainstream agencies with support from the MHS.

6.10 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 7 - Cultural Awareness

The MHS delivers non-discriminatory treatment and support which are sensitive to the social and cultural values of the consumer and the consumer's family and community.

Criteria

7.1 Staff of the MHS have knowledge of the social and cultural groups represented in the defined community and an understanding of those social and historical factors relevant to their current circumstances.

7.2 The MHS considers the needs and unique factors of social and cultural groups represented in the defined community and involves these groups in the planning and implementation of services.

7.3 The MHS delivers treatment and support in a manner which is sensitive to the social and cultural beliefs, values and cultural practices of the consumer and their carers.

7.4 The MHS employs staff or develops links with other service providers/organisations with relevant experience in the provision of treatment and support to the specific social and cultural groups represented in the defined community.

7.5 The MHS monitors and addresses issues associated with social and cultural prejudice in regard to its own staff.

7.6 Documented policies and procedures exist and are used to achieve the above criteria.

7.7 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 8 - Integration

Standard 8.1 - Service Integration

The MHS is integrated and coordinated to provide a balanced mix of services which ensure continuity of care for the consumer.

Criteria

8.1.1 There is an integrated MHS available to serve each defined community.

8.1.2 The consumer's transition between components of the MHS is facilitated by a designated staff member and a single individual care plan known to all involved.

8.1.3 There are regular meetings between staff of each of the MHS programs and sites in order to promote integration and continuity.

8.1.4 Opportunity exists for the rotation of staff between settings and programs within the MHS, and which maintains continuity of care for the consumer.

8.1.5 The MHS has documented policies and procedures which are used to promote continuity of care across programs, sites, other services and lifespan.

8.1.6 The MHS has specified procedures to facilitate and review internal and external referral processes within the programs of the MHS.

8.1.7 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 8.2 - Integration within the Health System

The MHS develops and maintains links with other health service providers at local, state and national levels to ensure specialised coordinated care and promote community integration for people with mental disorders and/or mental health problems.

Criteria

8.2.1 The MHS is part of the general health care system and promotes comprehensive health care for consumers, including access to specialist medical resources.

8.2.2 Mental health staff know about the range of other health resources available to the consumer and can provide information on how to access other relevant services.

8.2.3 The MHS supports the staff, consumers and carers in their involvement with other health service providers.

8.2.4 The MHS has formal processes to promote inter-agency collaboration.

8.2.5 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 8.3 - Integration with Other Sectors

The MHS develops and maintains links with other sectors at local, state and national levels to ensure specialised coordinated care and promote community integration for people with mental disorders and/or mental health problems.

Criteria

8.3.1 Mental health staff know about the range of other agencies available to the consumer and carers.

8.3.2 The MHS supports its staff, consumers and carers in their involvement with other agencies wherever possible and appropriate.

8.3.3 The MHS has formal processes to develop intersectoral links and collaboration.

8.3.4 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 9 - Service Development

The MHS is managed effectively and efficiently to facilitate the delivery of coordinated and integrated services.

Criteria

Organisational Structure

9.1 The MHS is managed by an appropriately qualified and experienced person with authority over, and accountability for, mental health service resources and planning.

9.2 There is single point accountability for the MHS across all settings, programs and age groups.

9.3 The MHS has an organisational structure which identifies it as a discrete entity within the larger organisation.

9.4 The organisational structure of the MHS ensures continuity of care for consumers across all settings, programs and age groups.

9.5 The organisational structure of the MHS reflects a multidisciplinary approach to planning, implementing and evaluating care.

9.6 A system exists which ensures that staff are aware of their roles and responsibilities within the MHS.

Planning

9.7 The MHS produces and regularly reviews a strategic plan which is made available to the defined community.

9.8 The strategic plan is developed and reviewed through a process of consultation with staff, consumers, carers, other appropriate service providers and the defined community.

9.9 The strategic plan includes:

  • consumer and community needs analysis
  • quality improvement plan
  • service evaluation plan including the measurement of health outcomes for individual consumers
  • plan for maximising consumer and carer participation in the MHS
  • plan for improving the skills of staff, and
  • relevant financial information.

9.10 The strategic plan is consistent with national mental health policies and legislative requirements.

9.11 The MHS has operational plans based on the strategic plan, which establish time frames, responsibilities of organisations and/or individuals and targets for implementation.

Funding

9.12 The MHS manages a dedicated budget using nationally accepted accounting practices.

9.13 The MHS allocates a portion of its budget for the provision of staff development and, in the public sector, for the promotion of consumer and family / carer participation in the MHS.

Resource allocation

9.14 Resources are allocated according to the documented priorities of the MHS and reflect national mental health policies.

9.15 Resources are allocated in a manner which follow the consumer' and allows the MHS to respond promptly to the changing needs of the defined community.

9.16 Where the MHS has redeployed staff according to demand, it ensures that staff are a dequately trained for new and/or changing roles and ensures that continuity of care for consumers is maintained.

Staff training and development

9.17 The MHS regularly identifies training and development needs of its staff.

9.18 The MHS ensures that staff participate in education and professional development programs.

9.19 New staff are provided with an orientation program to the MHS.

9.20 The MHS ensures that staff have access to formal and informal supervision.

9.21 The MHS has a system for supporting staff during and after critical incidents.

Information systems

9.22 The MHS collects and aggregates data which promote effective care for consumers and their family/carer, assist with the management and evaluation of the MHS, and promote staff training and research.

9.23 Data are collected in a manner which ensures reliability, validity and timeliness of reporting.

9.24 Data collected are analysed and used to promote continuous quality improvement within the MHS.

9.25 Information is made available to funders, staff and the defined community in an understandable format within the bounds of confidentiality requirements.

9.26 Data collection is consistent with statutory requirements and State/Territory/ National requirements for mental health services.

9.27 Data collected are stored and reported in a manner which ensures confidentiality and complies with relevant legislation.

Service evaluation, outcome measurement, research and quality improvement

9.28 There is documented accountability and responsibility for the evaluation of the MHS.

9.29 The MHS has a service evaluation strategy which promotes participation by staff, consumers, carers, other service providers and the defined community.

9.30 The MHS routinely monitors health outcomes for individual consumers using a combination of accepted quantitative and qualitative methods.

9.31 The MHS conducts or participates in appropriate research activities.

9.32 Research proposals are reviewed by an ethics committee constituted and functioning in accordance with the National Health and Research Medical Council Statement on Human Experimentation and Explanatory Notes.

9.33 The MHS is able to demonstrate a process of continuous quality improvement.

9.34 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 10 - Documentation

Clinical activities and service development activities are documented to assist in the delivery of care and in the management of services.

Criteria

10.1 The MHS complies with relevant legislation and regulations protecting consumer confidentiality and ensures that documentation processes are such that confidentiality is protected.

10.2 Treatment and support provided by the MHS are recorded in an individual clinical record which is accessible throughout the components of the MHS.

10.3 Documentation in the individual clinical record is dated, signed (with designation), shows the time of each intervention and is legible.

10.4 A system exists by which the MHS uses the individual clinical record to promote continuity of care across settings, programs and time.

10.5 Documentation is a comprehensive, factual and sequential record of the consumer's condition and the treatment and support offered.

10.6 Each consumer has an individual care plan within their individual clinical record which documents the consumer's relevant history, assessment, investigations, diagnosis, treatment and support services required, other service providers, progress, follow-up details and outcomes.

10.7 The MHS ensures that only authorised persons have access to information about the consumer.

10.8 Documented policies and procedures exist and are used to achieve the above criteria.

10.9 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11 - Delivery of Care

Principles guiding the delivery of care

The care, treatment and support delivered by the mental health service is guided by:

Choice: Access to a range of specialised mental health treatment and support options and information to assist in the selection of the most appropriate option(s) in the setting most empowering for the consumer.

Social, cultural and developmental context: Specialised mental health treatment and support which respect and utilise for optimal benefit, the consumer's social and cultural values, beliefs, practices and stage of development.

Continuous and coordinated care: Specialised mental health treatment and support are provided in a continuous and coordinated manner by a range of service providers in and between a range of settings.

Comprehensive care: Access to specialised mental health treatment and support services is available throughout the consumer's lifespan and is able to meet their specific needs during the onset, acute, rehabilitation, consolidation and recovery phases of their mental disorder and/or mental health. Each component of the mental health service, such as the psychiatric unit and the community mental health team, is equally valued by the organisation.

Individual care: Specialised mental health treatment and support are tailor-made for each individual.

Least restriction: Specialised mental health treatment and support which impose the least personal restriction of rights and choice in balance with the need for treatment.

Standard 11.1 - Access

The MHS is accessible to the defined community.

Criteria

11.1.1 The MHS ensures equality in the delivery of treatment and support regardless of consumer's age, gender, culture, sexual orientation, socio-economic status, religious beliefs, previous psychiatric diagnosis, past forensic status and physical or other disability.

11.1.2 The community to be served is defined, its needs regularly identified and services are planned and delivered to meet those needs.

11.1.3 Mental health services are provided in a convenient and local manner and linked to the consumer's nominated primary care provider.

11.1.4 The MHS is available on a 24 hour basis, 7 days per week.

11.1.5 The MHS ensures effective equitable access to services for each person in the defined community.

11.1.6 The MHS informs the defined community of its availability, range of services and the method for establishing contact.

11.1.7 The MHS, wherever possible, is located to promote ease of physical access with special attention being given to those people with physical disabilities and/or reliance on public transport.

11.1.8 Documented policies and procedures exist and are used to achieve the above criteria.

11.1.9 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.2 - Entry

The process of entry to the MHS meets the needs of the defined community and facilitates timely and ongoing assessment.

Criteria

11.2.1 The process of entry to the MHS is made known to the defined community.

11.2.2 The MHS has documented policies and procedures describing its entry process, inclusion and exclusion criteria and means of promoting and facilitating access to appropriate ongoing care for people not accepted by the service.

11.2.3 The MHS can be entered at multiple sites which are coordinated through a single entry process.

11.2.4 The entry process to the MHS can be undertaken in a variety of ways which are sensitive to the needs of the consumer, their carers and the defined community.

11.2.5 The entry process to the MHS is specialised and complementary to any existing generic health or welfare intake systems.

11.2.6 An appropriately qualified and experienced mental health professional is available at all times to assist consumers to enter into mental health care.

11.2.7 The process of entry to the MHS minimises the need for duplication in assessment, care planning and care delivery.

11.2.8 The MHS ensures that a consumer and their carers are able to, from the time of their first contact with the MHS, identify and contact a single mental health professional responsible for coordinating their care.

11.2.9 The MHS has a system for prioritising referrals according to risk, urgency, distress, dysfunction and disability.

11.2.10 The MHS has a system that enables separate assessment of more than one consumer at a time.

11.2.11 The MHS has a policy which acknowledges that assessment and the entry process to the service are linked.

11.2.12 The MHS has a system which ensures that the initial assessment of an urgent referral is commenced within one hour of initial contact and the initial assessment of a non-urgent referral is commenced within 24 hours of initial contact.

11.2.13 Documented policies and procedures exist and are used to achieve the above criteria.

11.2.14 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.3 - Assessment and Review

Consumers and their carers receive a comprehensive, timely and accurate assessment and a regular review of progress.

ASSESSMENT

Criteria

11.3.1 Assessments are conducted by appropriately qualified and experienced mental health professionals.

11.3.2 Wherever possible, the assessment is conducted in a setting chosen by the consumer. The choice of setting is negotiated by the consumer and the MHS and considers the safety of those people involved.

11.3.3 The MHS has a procedure for appropriately following up people who decline to participate in an assessment.

11.3.4 The MHS has a system for commencing and recording assessment during the consumer's first contact with the service.

11.3.5 The assessment process is comprehensive and, with the consumer's informed consent, includes the consumer's carers (including children), other service providers and other people nominated by the consumer.

11.3.6 The assessment is conducted using accepted methods and tools.

11.3.7 The MHS has documented protocols and procedures describing the assessment process.

11.3.8 The assessment is recorded in an individualised clinical record in a timely and accurate manner.

11.3.9 There is opportunity for the assessment to be conducted in the preferred language of the consumer and their carers.

11.3.10 Staff are aware of, and sensitive to, cultural and language issues which may affect the assessment.

11.3.11 Diagnosis is made using internationally accepted medical standards by an appropriately qualified and experienced mental health professional.

11.3.12 Where a diagnosis is made, the consumer and carers (with the consumer's informed consent) are provided with information on the diagnosis, options for treatment and possible prognoses.

11.3.13 Wherever possible, the MHS conducts face-to-face assessments but may use telephone and video technologies where this is not possible due to distance or the consumer's preference.

REVIEW

11.3.14 The MHS ensures that the assessment is continually reviewed throughout the consumer's contact with the service.

11.3.15 Staff of the MHS involved in providing assessment undergo specific training in assessment and receive supervision from a more experienced colleague.

11.3.16 New assessments are subjected to a clinical review process by the MHS.

11.3.17 All active consumers, whether voluntary or involuntary, are reviewed at least every three months. The review should be multidisciplinary, conducted with peers and more experienced colleagues and recorded in the individual clinical record.

11.3.18 A review of the consumer is additionally conducted when:

  • the consumer declines treatment and support
  • the consumer requests a review
  • the consumer is injures themself or another person
  • the consumer receives involuntary treatment
  • there has been no contact between the consumer and the MHS for three months
  • the consumer is going to exit the MHS
  • monitoring of consumer outcomes (satisfaction with service, measure of quality of life, measure of functioning) indicates a sustained decline.

11.3.19 The MHS has a system for the routine monitoring of staff case loads in terms of number and mix of cases, frequency of contact and outcomes of care.

11.3.20 Documented policies and procedures exist and are used to achieve the above criteria.

11.3.21 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.4 - Treatment and Support

The defined community has access to a range of high quality mental health treatment and support services.

Criteria

11.4.1 Treatment and support provided by the MHS reflect best available evidence and emphasise positive outcomes for consumers.

11.4.2 Treatment and support provided by the MHS, including any participation of the consumer in clinical trials and experimental treatments, are subject to the informed consent of the consumer.

11.4.3 The MHS ensures access to a comprehensive range of treatment and support services which are, wherever possible, specialised in regard to a person's age and stage of development.

11.4.4 The MHS ensures access to a comprehensive range of treatment and support services which are specialised in regard to a consumer's stage in the recovery process.

11.4.5 The MHS provides access to a comprehensive range of treatment and support services which cater for the needs of people compelled to receive treatment involuntarily, whether in an inpatient or community setting.

11.4.6 The MHS ensures access to a comprehensive range of treatment and support services which address physical, social, cultural, emotional, spiritual, gender and lifestyle aspects of the consumer.

11.4.7 The MHS ensures access to a comprehensive range of treatment and support services which are, wherever possible, specialised in regard to dual diagnosis, other disability and consumers who are subject to the criminal justice system.

11.4.8 The MHS ensures access to a comprehensive range of treatment and support services which are, wherever possible, specialised in addressing the particular needs of people of ethnic backgrounds.
11.4.9 There is a current individual care plan for each consumer, which is constructed and regularly reviewed with the consumer and, with the consumer's informed consent, their carers and is available to them.

11.4.10 The MHS provides the least restrictive and least intrusive treatment and support possible in the environment and manner most helpful to, and most respectful to, the consumer.

11.4.11 The treatment and support provided by the MHS is developed collaboratively with the consumer and other persons nominated by the consumer.

11.4.12 Documented policies and procedures exist and are used to achieve the above criteria.

11.4.13 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.4.A - Community Living

The MHS provides consumers with access to a range of treatment and support programs which maximise the consumer's quality of community living.

Criteria

Self Care

11.4.A.1 The setting for the learning or the re-learning of self care activities is the most familiar and/or the most appropriate for the generalisation of skills acquired.

11.4.A.2 Self care programs or interventions provide sufficient scope and balance so that consumers develop or redevelop the necessary competence to meet their own everyday community living needs.

Leisure, Recreation, Education, Training, Work and Employment

11.4.A.3 The MHS ensures that settings for day programs provide adequate indoor and outdoor space for consumers.

11.4.A.4 The MHS ensures that the consumer has access to an appropriate range of agencies, programs and/or interventions to meet their needs for leisure, recreation, education, training, work, accommodation and employment.

11.4.A.5 The MHS supports the consumer's access to education, leisure and recreation activities in the community.

11.4.A.6 The MHS provides access to, and/or support for consumers in employment and work.

11.4.A.7 The MHS supports the consumer's access to vocational training opportunities in appropriate community settings and facilities.

11.4.A.8 The MHS promotes access to vocational support systems which ensure the consumer's right to fair pay and conditions, award (or above) payment for work and opportunities for union membership.

11.4.A.9 The MHS supports the consumer's desire to participate in Further or Continuing Education.

11.4.A.10 The MHS provides or ensures that consumers have access to drop-in facilities for leisure and recreation as well as opportunities to participate in leisure and recreation activities individually and/or in groups.

Family, Relationships, Social and Cultural System

11.4.A.11 The consumer has the opportunity to strengthen their valued relationships through the treatment and support effected by the MHS.

11.4.A.12 The MHS ensures that the consumer and their family have access to a range of family-centred approaches to treatment and support.

11.4.A.13 The MHS provides a range of treatments and support which maximise opportunities for the consumer to live independently in their own accommodation.

11.4.A.14 Documented policies and procedures exist and are used to achieve the above criteria.

11.4.A.15 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.4.B - Supported Accommodation

Supported accommodation* is provided and/or supported in a manner which promotes choice, safety and maximum possible quality of life for the consumer.

* Psychiatric inpatient accommodation is addressed under Inpatient Care (Standard 11.4.E)

SUPPORTED ACCOMMODATION PROVIDED BY THE MHS

Criteria

11.4.B.1 The MHS has guidelines for the provision of accommodation which are adhered to.

11.4.B.2 Consumers and carers have the opportunity to be involved in the management and evaluation of the facility.

11.4.B.3 The accommodation program is fully integrated into other treatment and support programs.

11.4.B.4 Accommodation is clean, safe and reflects as much as possible the preferences of the consumers living there.

11.4.B.5 Access to the accommodation is non-discriminatory and determined on priority of need alone.

11.4.B.6 A range of treatment and support services is delivered to the consumers living in the accommodation according to individual need.

11.4.B.7 Consumers living in the accommodation are offered maximum opportunity to participate in decision making with regard to the degree of supervision in the facility, decor, visitors, potential residents and house rules.
11.4.B.8 There is a range of accommodation options available and consumers have the opportunity to choose and move between options if needed.

11.4.B.9 Where desired, consumers are accommodated in the proximity of their social and cultural supports.

11.4.B.10 The accommodation maximises opportunities for the consumer to participate in the local community.

11.4.B.11 The accommodation maximises opportunities for the consumer to exercise control over their personal space.

11.4.B.12 Wherever possible and appropriate, the cultural, language, gender and preferred lifestyle requirements of the consumer are met.

11.4.B.13 Consumers with physical disabilities have their needs met.

ACCOMMODATION PROVIDED BY AGENCIES OTHER THAN THE MHS </ h4>

11.4.B.14 The MHS supports consumers in their own accommodation and supports accommodation providers in order to promote the criteria above.

11.4.B.15 The MHS provides treatment and support to consumers regardless of their type of accommodation.

11.4.B.16 The MHS does not refer a consumer to accommodation where he / she is likely to be exploited and/or abused.

11.4.B.17 Documented policies exist and are used to achieve the above criteria.

11.4.B.18 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.4.C - Medication and Other Medical Technologies

Medication and other medical technologies are provided in a manner which promotes choice, safety and maximum possible quality of life for the consumer.

Criteria

11.4.C.1 Medication and other technologies used are evidence-based and reflect internationally accepted medical standards.

11.4.C.2 Medication and other technologies are prescribed, stored, transported, administered and reviewed by authorised persons in a manner consistent with legislation, regulations and professional guidelines.

11.4.C.3 The MHS obtains the informed consent of the consumer prior to the administration of medication or use of other medical technologies such as Electro Convulsive Therapy.

11.4.C.4 The consumer and their carers are provided with understandable written and verbal information on the potential benefits, adverse effects, costs and choices with regard to the use of medication and other technologies.
11.4.C.5 Wherever possible and appropriate, the MHS provides the option of medication being prescribed and administered in a setting of the consumer's choice.

11.4.C.6 The MHS ensures that a system exists which monitors to prevent - and promptly provides the consumer with appropriate treatment for any adverse effects of medication.

11.4.C.7 Where the consumer's medication is administered by the MHS, it is administered in a manner which protects the consumer's dignity and privacy.

11.4.C.8 "Medication when required" (PRN) is only used as a part of a documented continuum of strategies for safely alleviating the consumer's distress and/or risk.

11.4.C.9 The use of medication and other technologies is monitored and reported utilising nationally accepted clinical indicators and other benchmarks.

11.4.C.10 The MHS ensures access for the consumer to the safest, most effective and most appropriate medication and/or other technology.

11.4.C.11 The MHS promotes continuity of care by ensuring that, wherever possible, the views of the consumer and, with the consumer's informed consent, their carers and other relevant service providers are considered and documented prior to administration of new medication and/or other technologies.

11.4.C.12 The consumer's right to seek an opinion and/or treatment from another qualified person is acknowledged and facilitated and the MHS promotes continuity of care by working effectively with other service providers.

11.4.C.13 Where appropriate, the MHS actively promotes adherence to medication through negotiation and the provision of understandable information to the consumer and, with the consumer's informed consent, their carers.

11.4.C.14 Wherever possible, the MHS does not withdraw support or deny access to other treatment and support programs on the basis of a consumer's decision not to take medication.

11.4.C.15 Documented policies and procedures exist and are used to achieve the above criteria.

11.4.C.16 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.4.D - Therapies

The consumer and the consumer's family/carer have access to a range of safe and effective therapies.

Criteria

11.4.D.1 Therapies offered or recommended by the MHS reflect best available evidence and are conducted by appropriately qualified and experienced mental health professionals.

11.4.D.2 The MHS provides access to a range of accepted therapies according to the needs of the consumer and their carers.

11.4.D.3 The extent to which therapies are directly provided by the MHS is determined according to the assessed need of the defined community and the documented priorities of the MHS.

11.4.D.4 The consumer is supported to make an informed choice on the most acceptable form of therapy from the range available.

11.4.D.5 The consumer is informed by the MHS of the potential benefits, potential adverse effects, financial costs and any other foreseeable inconvenience associated with the provision of a particular therapy.

11.4.D.6 The MHS promotes continuity of care for consumers referred outside the MHS for a particular therapy.

11.4.D.7 Therapies provided by the MHS are provided in an environment which is safe, private, comfortable and affords minimal disruption.

11.4.D.8 Documented policies and procedures exist and are used to achieve the above criteria.

11.4.D.9 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.4.E - Inpatient Care

The MHS ensures access to high quality, safe and comfortable inpatient care for consumers.

Criteria

11.4.E.1 The MHS offers less restrictive alternatives to inpatient treatment and support provided that it adds value to the consumer's life and with consideration being given to the consumer's preference, demands on carers, availability of support and safety of those involved.

11.4.E.2 Where admission to an inpatient psychiatric facility is required, the MHS makes every attempt to promote voluntary admission for the consumer.

11.4.E.3 The MHS ensures that a consumer who requires involuntary admission is conveyed to hospital in the safest and most respectful manner possible.

11.4.E.4 The MHS ensures that the admission assessment includes the views of other current service providers and the consumer's carers.

11.4.E.5 The MHS ensures that there is continuity of care between inpatient and community settings.

11.4.E.6 As soon as possible after admission, the MHS ensures that consumers receive an orientation to the ward environment, are informed of their rights in a way that is understood by the consumer and are able to access appropriate advocates.

11.4.E.7 The MHS assists in minimising the impact of admission on the consumer's family and significant others.

11.4.E.8 The MHS ensures that the consumer's visitors are encouraged.

11.4.E.9 The MHS ensures that there is a range of age appropriate day and evening activities available to consumers within the inpatient facility.

11.4.E.10 The MHS provides opportunities for choice for consumers in regard to activities and environment during inpatient care.

11.4.E.11 The MHS seeks regular feedback from consumers on the activities and environment associated with inpatient care.

11.4.E.12 The MHS, where appropriate, enables consumers to participate in their usual religious and/or cultural practices during inpatient care.

11.4.E.13 Consumers and their carers have the opportunity to communicate in their preferred language.

11.4.E.14 The MHS provides a physical environment for inpatient care that ensures protection from harm, adequate indoor and outdoor space, privacy, and choice.

11.4.E.15 Documented policies and procedures exist and are used to achieve the above criteria.

11.4.E.16 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement performance as part of a quality improvement process.

Standard 11.5 - Planning for Exit

Consumers are assisted to plan for their exit from the MHS to ensure that ongoing follow-up is available if required.

Criteria

11.5.1 Each consumer's documented individual care plan includes an exit plan which is begun during entry to the MHS to ensure ongoing continuity of care once the consumer has exited from the MHS.

11.5.2 The exit plan is reviewed in collaboration with the consumer and, with the consumer's informed consent, their carers at each contact and as part of each review of the individual care plan.

11.5.3 The exit plan is made available to consumers and, with the consumer's informed consent, their carers and other nominated service providers.

11.5.4 The consumer and their carers are provided with understandable information on the range of relevant services and supports available in the community.

11.5.5 A process exists for the earliest appropriate involvement of the consumer's nominated service provider.

11.5.6 The MHS ensures that consumers referred to other service providers have established contact and that the arrangements made for ongoing follow-up are satisfactory to the consumer, their carers and other service provider prior to exiting the MHS.

11.5.7 All services provided by the MHS are planned and delivered on the basis of the briefest appropriate duration of contact consistent with best outcomes for the consumer.
11.5.8 Documented policies and procedures exist and are used to achieve the above criteria.

11.5.9 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

Standard 11.6 - Exit and Re-entry

The MHS assists consumers to exit the service and ensures re-entry according to the consumer's needs.

Criteria

11.6.1 Staff review the outcomes of treatment and support as well as ongoing follow-up arrangements for each consumer prior to their exit from the MHS.

11.6.2 The MHS ensures that the consumer, their carers and other service providers and agencies involved in follow-up are aware of how to gain entry to the MHS at a later date.

11.6.3 The MHS ensures that the consumer, their carers and other agencies involved in follow-up, can identify an individual in the MHS, by name or title, who has knowledge of the most recent episode of treatment and/or support.

11.6.4 The MHS attempts to re-engage with consumers who do not keep the planned follow-up arrangements.

11.6.5 The MHS assists consumers, carers and other agencies involved in follow-up to identify the early warning signs which indicate the MHS should be contacted.

11.6.6 The MHS ensures that the individual clinical record for the consumer is available for use in any potential future contact with the MHS.

11.6.7 Documented policies and procedures exist and are used to achieve the above criteria.

11.6.8 The MHS monitors its performance in regard to the above criteria and utilises data collected to improve performance as part of a quality improvement process.

© Mental Health Council of Australia 2005. Last updated 29 August 2005.
Email: admin@mhca.com.au