Carers identified?

Findings

Page last updated: 2010

  • All participants were of the view that identification and engagement of carers is crucial in any recovery based approach to care. This position is substantiated by the literature. They also agreed that change in clinical practice will only occur if it is mandated by legislation, well grounded in policy and protocols, compliance is audited on a regular basis and incentives are associated with positive changes in practice.
  • Research that recognises that carers play a critical role in the process of recovery and relapse prevention is continuing to be largely ignored by both public and private specialist mental health services.
  • The professional judgement of clinicians is recognised, however no single clinician or carer can meet all the needs of all consumers. A partnership and recovery approach to care will improve consumer outcomes and decrease the burden on services and carers.
  • The ideal process for identification is by the consumer. These discussions together with the degree of involvement should be negotiated, documented and regularly reviewed. The experience of staff currently working in a carer inclusive manner is that if approached in this manner then the majority of consumers recognise and welcome the involvement of their support network.
  • Some carers who self identify are not necessarily the best people to be involved in the ongoing care and recovery of consumers, either because of their past history with the consumer, or their own particular needs. However, these carers continue to have rights and mechanisms need to be developed to ensure their needs are met.
  • Some consumers will, from time–to–time, because of the nature of their illness, refuse to identify or to involve carers. All professional interactions with them and written information provided to them needs to reinforce the importance of their support network being actively involved in their care. Top of page
  • Consumer refusal to identify does not lesson the burden on carers. It may in some cases increase the burden of care.
  • Consumer refusal to identify carers and privacy legislation is not a basis for preventing clinical staff across a range of settings from having a working relationship with the family/carer. Carers still have a right to give information to clinical staff to assist in assessment, treatment and ongoing care.
  • Identification is not a one–off process. Service providers at all levels, on the basis of existing policies, Carer Recognition Legislation, mental health legislation and National Standards for Mental Health Services have a responsibility to identify and support carers. Cultural and organisational change, policies, protocols, education and support will be necessary to encourage changes in clinical practice.
  • Policies and protocols to identify carers are essential and will vary according to service setting. The following settings provide opportunities and "trigger points" for identification to occur.
    • Primary care – specifically GP practices.
    • Public and private assessment services.
    • Formal Admission to a specialist public or private mental health service.
    • Formal discharge from a service.
    • Continuing care in both the public and private sectors.
  • A nationally consistent information brochure for families and other carers is highly desirable as it will improve mental health carer literacy and opportunities for engagement. It was acknowledged that on first admission to a mental health services the information required needs to be simple, specific and practical however given that all carers are at different stages in their journey when the opportunity arises to obtain this information it was considered important to develop a brochure that was more comprehensive that could be referred to as carers were able to absorb the information. It was decided that this should be presented primarily in one booklet however should refer people to additional information related to specific diagnosed and medication once these were established. The brochure has been developed on the basis of information provided by carers, consumers and service providers, all of whom are participating in the varying stages that accompany in the treatment and recovery process.

    Top of pageThe brochure will:
    • Provide an introduction to the mental health service, explaining the processes that would be followed;
    • Provide some general information about what the symptoms of mental illness might be;
    • Outline in question and answer form some of the concerns they may have;
    • Provide examples using the stories of family members and friends to assist them to feel less alone;
    • Introduce the new language, e.g. 'consumer', 'carer';
    • Introduce the concept of carers rights and complaints processes;
    • Introduce the issues associated with the consumers rights to confidentiality and what this might mean for the sharing of information; and
    • Provide information on where to go for additional information and support.
  • This information brochure could be augmented by the diagnosis specific guidelines prepared by the RANZCP once a specific diagnosis is agreed and a treatment process implemented.
  • Carer identification and support will be enhanced by the appointment of a nominated person/Carer Consultant/Family Support Worker on staff, with whom they can personally interact, discuss and clarify information needs as required and generally use as a point of contact for future needs.