Carers and families

The Act recognises and supports the important role of carers and other key support people in the assessment, treatment and recovery of people with mental illness.

Who is a carer and what is a care relationship?

The Mental Health Act 2014 uses the following definitions from the Carers Recognition Act 2012 (Vic):

• care: means the provision of ongoing support, assistance or personal care to another person
• carer: means a person, including a person under the age of 18 years, who provides care to another person with whom he or she is in a care relationship (but does not include a parent if person to whom care is provided is less than 16 years of age)
• care relationship: a person is in a care relationship if he or she provides another person, or receives from another person, care because one of the persons in the relationship has a disability, is older, has a mental illness or has an ongoing medical condition (including a terminal or chronic illness or dementia) .

When are the views of a carer considered?

If the carer and the care relationship will be affected, the views of a carer will be considered when:

• the authorised psychiatrist or Mental Health Tribunal (Tribunal) considers whether to make a Temporary Treatment Order or Treatment Order, including determining the setting and duration of the Order. The authorised psychiatrist determines the treatment to be provided to a patient
• the authorised psychiatrist determines whether to vary an Order to change the setting in which treatment is provided(either inpatient or community)
• the authorised psychiatrist determines whether to vary an Order to transfer responsibility for providing assessment or treatment to another designated mental health service.
• the authorised psychiatrist consents to medical treatment for a patient who does not have capacity to give informed consent to that medical treatment
• the authorised psychiatrist determines whether to grant a leave of absence to a compulsory patient or security patient
• a psychiatrist is giving a second psychiatric opinion
• the Chief Psychiatrist reviews a patient’s treatment following a second psychiatric opinion report
• the authorised psychiatrist makes an application to the Tribunal for electroconvulsive treatment (ECT) to be performed on a patient or young person
• the Tribunal determines whether to transfer a person to an interstate mental health facility
• the Secretary of the Department of Justice is deciding whether to grant monitored leave to a security patient.

Parents

Parents of children under 16 years of age must also be consulted at the same key points in the child’s treatment.

The Secretary to the Department of Human Services must also be consulted and notified at specified points if a young person is the subject of custody to Secretary or guardianship to Secretary order.

When are carers notified?

If the carer and the caring relationship will be affected, carers must be notified when:

• an Assessment Order, Temporary Treatment Order or Treatment Order is made, varied, revoked or expires
• a leave of absence for a compulsory patient or security patient is granted, varied or revoked
• the authorised psychiatrist determines to vary an Order to change the setting in which treatment is provided (either inpatient or community)
• the authorised psychiatrist determines to vary an Order to transfer responsibility for providing assessment or treatment to another designated mental health service
• an inpatient’s right to communicate is restricted (inpatient means a compulsory, forensic or security patient detained at a designated mental health service)
• a second opinion report has been completed (carers must also be given a copy of the second opinion report)
• the chief psychiatrist completes a review of a patient’s treatment following a second psychiatric opinion report
• the Tribunal approves the performance of ECT on a patient or young person
• a restrictive intervention is used on a person
• the chief psychiatrist makes a written direction to a mental health service provider in respect of a person for whom the carer provides care
• the Tribunal lists a matter for hearing
• a security patient or forensic patient is received at a designated mental health service
• a Court Assessment Order is made, varied and the assessment of a person subject to a Court Assessment Order is complete
• the Secretary of the Department of Justice decided to grant monitored leave to a security patient
• an authorised psychiatrist discharges a person as a security patient
• a patient is absent without leave from a designated mental health service.

Carers will also be given copies of any Orders made and relevant statements of rights.

Parents of children under 16 years of age must also be informed at these points in the child’s treatment.

The Secretary to the Department of Human Services must also be consulted and notified at specified points if a young person is the subject of custody to Secretary or guardianship to Secretary order.

How does the role of a carer relate to the role of a nominated person?

A person can nominate another person to receive information and provide support in the event that they become unwell and require compulsory treatment. In most cases, the nominated person is a carer or family member. However, where a person nominates someone other than a carer to be their nominated person, a carer must still receive information and have their views considered as described above.

Information disclosure to carers and families

Clinicians should always seek a person’s consent to sharing information with their carer or family member.

The provisions requiring that carers be consulted and notified about key events means that information about the patient’s treatment will necessarily be given to the carer so that they can effectively participate in a consultation or so that they can take action in response to being notified about an event.

Separate to information being disclosed under the consultation and notification provisions, if a patient is unable to consent or refuses to consent to sharing information, carers can be given information if they need the information to provide care to a patient and to prepare for their caring role. A person disclosing information in these circumstances must have regard to the patient’s views and preferences, including any preferences expressed in an advance statement.

This information may be about the treatment and management of mental illness, how to respond to disturbing behaviours and how to access practical assistance. It may also include information to generally assist carers to better support the person with mental illness.

Where a family member or friend is not directly responsible for providing care, the Act permits a mental health service provider to disclose a person’s health information in ‘general terms’, for example,advising whether an inpatient is well enough to receive visitors.

For more information about information sharing, see disclosure of health information.

How are complaints handled?

The Mental Health Complaints Commissioner receives, manages and resolves complaints about mental health services provided to consumers.

The Commissioner can receive complaints from carers and family members on behalf of a consumer or where they satisfy the Commissioner that they have a genuine interest in the wellbeing of a consumer. This ensures all consumers can have their complaints heard and addressed and be supported to participate in the complaints process bycarers or family members.