Carers identified?

6.3 Good practice protocols

Page last updated: 2010

Research demonstrates that better outcomes are achieved for consumers, carers and mental health clinicians by informing and engaging carers early in the planning and on-going delivery of service. It is increasingly recognised that carers play a critical role in the process of recovery and relapse prevention.

Identification is not a 'one off' process. The relationship between consumers and carers is frequently complex, and likely to change over time. Identification and level of participation will need to be continuously re-negotiated in a positive and inclusive manner at all stages and in all settings during the diagnosis, treatment and recovery of the person with a mental illness.

6.3.1 General points regarding identification of carers

  • Staff in all service settings should be trained and encouraged to avoid stereotypes. Carers come from a variety of social, financial, religious, racial and cultural backgrounds. The people they are caring for may be of any age and may or may not live with the person they are caring for.
  • Carers can be young people caring for parents, brothers, sisters, parents, partners, including same sex partners, or whole communities in the case of Indigenous people. Most frequently carers define themselves by their relationship to the person with the illness rather than their role in supporting that person.
  • There may be more than one carer involved with a particular person with a mental illness. Those carers may have very different needs and views. They may even be in conflict with each other.
  • The main, or only, carer may not necessarily be the next of kin.
  • The carer may also be receiving treatment themselves for a mental or physical illness. This, of course, does not stop them being identified as a carer and this information being communicated to other services with their permission.
  • Sometimes the person with the mental illness may not be keen on their carer being identified and classified as such, for various reasons. Consumer identification of carers will remain the preferred option however staff need to be aware of their role in the implementation of carer recognition and mental health legislation.
Carers need to be seen as individuals with different problems, different needs and different ways of coping. Some groups of carers are more difficult to reach, and others have particular needs, so specific strategies to identify and engage with carers may vary according to service settings and level of consent by the consumer.

The following charts (chart 1 and chart 2), adapted from some developed in Townsville are presented to provide guidance to clinicians in situations where consent for sharing information is given, or withheld. Top of page

Chart 1: family/carer participation guidelines, where consent is given but concerns exist in regards carer role/motivation and/or consumer capacity


Text equivalent below for Chart 1: family/carer participation guidelines

Top of page

Text version of chart 1

  1. Discussion with consumer. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken.
  2. Does consumer give consent? If yes, go to next step. If no, see separate pathway for process when no consent.
  3. Is the consent informed? If no, go to next step. If yes, give information. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken.
  4. Are there concerns held regarding the role/motivation of carer? If yes, go to next step. If no, give information. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken.
  5. Examples of concerns include: disclosure may place consumer at risk; information may be damaging while consumer unwell; motives in question regarding well being of consumer. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken. Go to next step.
  6. Is there an advance directive? If yes, go to next step. If no, make an MDT decision (notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken) and refer consumer and/or family to advocacy service.
  7. Action as per directive. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken. Go to next step.
  8. Review at regular intervals as per guidelines. Go to step 1.
Note: Please see carer standards document for definition of carer/family member.

Queensland Government (Queensland Health), You are not alone (ARMI), Carers Queensland. Top of page

Chart 2: family/carer practice standards guidelines, where the consumer does not consent to information sharing


Text equivalent below for chart 2: family/carer practice standards guidelines

Top of page

Text version of chart 2

  1. Discussion with consumer. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken.
  2. Consumer does not give consent. If the decision is not informed, go to next step. If the decision is informed, the carer/family have right to information. Discuss information with family/carer in general terms: information pertaining to risk, well being, relapse prevention plans; general information regarding mental illness, side effects, family supports. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken. Then go to step 7.
  3. Is there an issue of safety for client, family, community? If no, go to next step. If yes, disclose all relevant information (notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken).
  4. Is there an advance directive (should be noted in ISP)? If no, go to next step. If yes, action as per directive and go to step 7.
  5. Multidisciplinary team decision. Notation in clinical file should include: who was involved; what the decision/judgment was; what the rationale for the decision was; what action was taken. Go to next step.
  6. Discuss information with family/carer in general terms: information pertaining to risk, well being, relapse prevention plans; general information regarding mental illness, side effects, family supports. Refer family and/or consumer to advocacy service. Go to next step.
  7. Review at regular intervals as per guidelines. Go to step 1.
Note: Please see standards document for definition of carer/family member.

Queensland Government (Queensland Health), You are not alone (ARMI), Carers Queensland.