Registration of mental health clients in CMI/ODS - October 2006 (Program management circular)

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Purpose

To provide advice about when to register in CMI/ODS a person making contact with public mental health services.

Key message

When a referral is made to a public mental health service, a clinician will make an assessment of the most appropriate service response for the person who is the subject of that referral.

When a referral has been accepted for further service delivery or intervention by the public mental health service, the client should be registered on the CMI/ODS system.

Where a person is assessed as not requiring public mental health services, that person must not be registered on CMI/ODS.

Background

CMI/ODS is the Victorian public mental health client information management system and comprises:

• Client Management Interface (CMI). The CMI is the local client information system used by each public mental health service
• Operational Data Store (ODS). The ODS manages a set of select data items from each CMI. The ODS is used to:
  • allocate a unique (mental health) registration number for each client, known as the statewide unit record (UR) number
  • share select client level data between Victorian public Area Mental Health Services (AMHS) to support continuity of treatment and care
  • ensure the legal basis for providing treatment is evident to all public mental health service providers where a client may be unable or unwilling to consent to treatment
  • meet the various reporting requirements of the Department of Human Services
  • support the statutory functions of the Chief Psychiatrist and the Mental Health Review Board.

The registration process

Registration is a process involving the recording of patient level data, both demographic and clinical, for each client of a Victorian public mental health service.

At the point of first registration, a client is allocated a statewide UR number. Upon subsequent registration at another public mental health service, the same UR number is used to register the patient.

When to register

A client must be registered on CMI/ODS in the following circumstances:

• a person not registered at this health service is admitted
• a decision is made following triage or assessment to provide further clinically significant mental health service(s). Registration is not mandatory if a clinical decision is made that registration is inappropriate or is contraindicated. Such a decision must be made by a clinician on a case-by-case basis.

A client must be informed of their registration under the provisions of HPP 1.4 of the Health Records Act 2001, but does not need to provide consent to registration. Authority to register is expressly permitted under the provisions of s.120A (3)(e)(ii) of the Mental Health Act 1986.

When not to register

• at any of the initial steps in determining the nature of service to be provided, including:
  • initial referral
  • duty clinician/triage receives and accepts referral
  • assessment of service needs/response
• if assessed as suitable for referral to another service, public or private
• where a clinician determines that specialist public mental health care is not required.

Further information
Further information about privacy laws are available on the Department of Human Services website at www.dhs.vic.gov.au/privacy (External site) or the Health Services Commissioner's website

Further information about mental health triage is also available.

About program management circulars
The information provided in this circular is intended as general information and not as legal advice. Mental health service management should ensure that policies and procedures are developed and implemented to enable staff to collect and use health information.