Update to the Chief Psychiatrist’s Frequently Asked Questions resource

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The Chief Psychiatrist is pleased to present an update to the Chief Psychiatrist’s Frequently Asked Questions (FAQs) resource. This resource will continue to be updated, and further FAQs added over time. These FAQs are intended to assist clinicians with clinical translation of the complex aspects of the Mental Health Act 2014. They aim to assist with some of the frequent areas of query which clinicians address to the Office of the Chief Psychiatrist’s Clinical Helpdesk.

The FAQs should not be considered legal advice either for clinicians or the general public. These FAQs do not override the need for services to seek legal or other advice about individual clinical situations when appropriate.

The FAQs are available online at the Chief Psychiatrist’s Frequently Asked Questions page.

Clinicians may direct any queries regarding this through the Office of the Chief Psychiatrist.

Enquiries from the general public regarding the Mental Health Act 2014, may be directed to the Mental Health Commission (legislation@mhc.wa.gov.au), as the overarching agency responsible for that legislation and associated public information.

Dr Nathan Gibson
Chief Psychiatrist of Western Australia

New Guideline on the Use of Detention and Restraint in Non-Authorised Healthcare Settings

The Chief Psychiatrist is pleased to present the Chief Psychiatrist’s Guideline on the Use of Detention and Restraint in Non-Authorised Healthcare Settings.

The Guideline sets out the requirements for the use of detention and restraint in a non-authorised healthcare setting, within a human rights and best practice-based framework. It aims to help service managers, clinical leaders, clinical staff, and support staff such as security officers understand and manage their obligations in providing a safe, therapeutic culture and environment for consumers, carers, and staff.

Services may use this Guideline as the basis on which to develop local procedures and training on the lawful use of detention and restraint in non-authorised healthcare settings, and should ensure these documents and training are consistent with the policy framework and training template being developed by the Department of Health.

The Chief Psychiatrist is very grateful to the lived experience consultants, carers, mental health advocates, clinicians, security staff, other stakeholders and colleagues from the Office of the Chief Psychiatrist whose expertise has been instrumental in the development of this Guideline.

Please note, this Guideline is not to be considered legal advice. It is a tool to assist clinical governance, clinical decision-making and practice.

Dr Nathan Gibson
Chief Psychiatrist of Western Australia

Closure of Bethesda Clinic

The Chief Psychiatrist is saddened to learn of the impending closure of Bethesda Clinic in Cockburn later this month.

While the facility’s closure will affect health consumers, clinicians and other staff, there remain several private mental health inpatient and day therapy services which continue to operate throughout the Perth area. In addition, there is a range of private psychiatrists, psychologists and therapists continuing to provide private outpatient mental health clinical care in Perth’s southern suburbs, as well as in other areas.

WA’s public inpatient and community mental health services across Perth also remain open.

The Chief Psychiatrist encourages the patients affected by the Bethesda closure to consult with their General Practitioners on alternatives for care.

New Restrictive Practices Factsheet

I am pleased to present this new factsheet on restrictive practices, restraint and detention. This factsheet is for clinicians contemplating the use of detention and restraint in non-authorised healthcare settings.

It has been collaboratively developed by the Department of Health WA, and the Office of the Chief Psychiatrist. It contains up-to-date information on patient rights, duty of care and the application of the Mental Health Act 2014, if necessary.

Importantly, it details the circumstances under which the use of restraint may be contemplated, and the conditions under which its use may be unlawful.

The Chief Psychiatrist is developing an associated statutory Guideline to be released shortly.

Dr Nathan Gibson
Chief Psychiatrist of Western Australia

The Chief Psychiatrist’s Annual Report 2022-23

The Chief Psychiatrist’s Annual Report 2022-23 has been tabled in WA Parliament.

The Chief Psychiatrist issues an Annual Report on the functions and statutory requirements under the requirements of the Mental Health Act 2014. The Office of the Chief Psychiatrist (OCP) is the agency that supports the Chief Psychiatrist. This report highlights the key achievements of the Chief Psychiatrist and the Office for the year ending 30 June 2023.

The Chief Psychiatrist, through the OCP, actively monitors the standards of treatment and care in mental health services.  The Annual Report, through the data and narrative, makes transparent the progress and the ongoing challenges of the provision of mental health services in a complex environment. The significant majority of care in the sector is very good. There are important ongoing areas of focus for development.  The Chief Psychiatrist requires all services to be constantly learning and improving.

The Independent Governance Review, which included the mental health, during this reporting period  has offered the opportunity for enhancement of leadership and oversight in the mental health sector.  As the current state plan enters its final years, it will be timely to begin to consider the development of the next iteration of the state mental health, alcohol and other drug and suicide prevention plan, and this offers the opportunity to reclarify the direction of service development.

The Annual Report captures a period of significant development at our Office, including the establishment of our Kaatadjiny Walbraaniny Danjoo – Learning to Heal Together project. I’m grateful to the Noongar Elders and young people who’ve participated in this ongoing process to deepen our connection to and understanding of the Aboriginal community so that we can work to provide better mental health outcomes for the Aboriginal peoples in Western Australia. I extend that gratitude to the OCP team who have committed to embedding Aboriginal ways of working into what we do at the OCP and to the Curtin University research team who have helped facilitate this process.

Significantly, during the period of the Annual Report, the OCP undertook an extensive series of reviews of the state’s psychiatric hostels, which provide accommodation and supports for some of our most vulnerable consumers. This important piece of work will be completed in 2023.

This reporting period also saw the OCP develop and operationalise its own Strategic Plan 2023-25. Built on the values of Leadership, Integrity, Respect, Accountability and Commitment, this Strategic Plan will guide our work for the coming years, enabling us to facilitate the uptake of best practice in standards of mental health care, address priority issues and gaps in the mental health sector, increase our impact through productive relationships and continue to build the foundations of a strong and sustainable Office.

Lastly, I’d like to thank the team at the OCP who make this work possible. The work presented in this annual report is only made possible through the dedication, commitment and passion for improving the standards of mental health care in Western Australia.

Dr. Nathan Gibson,
Chief Psychiatrist

Chief Psychiatrist’s Forum

I was pleased to welcome psychiatrists from across the public health system to our offices in Perth and online for the Chief Psychiatrist’s Forum last month.

The forum is a regular initiative of my office to share our priorities and recent work with psychiatrists and to provide a forum for open dialogue about how we can better support the clinical workforce.

Highlights included discussions around peer groups for younger psychiatrists; the role of tertiary institutions and research partnership in service development and oversight; the implications of the Independent Governance Review and its recommendations on clinical governance and clinical leadership roles; and the development of improved resources around clinical practice and the Mental Health Act 2014.

Events like the Chief Psychiatrist’s Forum are essential for shaping my office’s priorities and ensuring our work can generate meaningful impact to improve mental health outcomes across WA.

I’m grateful for the clinicians who joined us and look forward to finding more ways to connect with our clinical workforce.

Dr. Nathan Gibson
Chief Psychiatrist of Western Australia

Voice to Parliament Referendum

As Chief Psychiatrist I acknowledge the democratic process that has occurred, and the importance of the right we all have to make a decision and vote as we see fit. However I am also aware of the sorrow that many Aboriginal and Torres Strait Islander colleagues and community members are feeling following the outcome of the referendum, and of the impact that the last weeks have had on many across the community. I urge us all to reflect on the need now for respect, healing and truth telling as we move forward.

The Office of the Chief Psychiatrist remains steadfast in its commitment to listening and collaborating in our work with Aboriginal people, and understands the importance of self-determination in improving mental health outcomes for Aboriginal people across Western Australia.

We will continue to work with Elders and community to ensure Aboriginal people are empowered to shape the policy that informs their lives and their healthcare.

Dr. Nathan Gibson
Chief Psychiatrist of Western Australia

World Mental Health Day and WA Mental Health Week

Today, Tuesday 10 October, marks World Mental Health Day, an international observance of the importance of mental health to wellbeing. It also falls in the middle of WA Mental Health Week, an eight-day period of celebration, reflection and connection centred on the importance of individual and shared mental wellbeing across Western Australia.

With its theme of Body, Mind and Environment, highlights from this year’s WA Mental Health Week include a screening and Q&A of the film PIECES on Wednesday, the opening of South West Aboriginal Medical Service’s Djin Djin Mart Building in Bunbury on Thursday and a community art event at Midland Head to Health on Friday.

I encourage everyone to use this opportunity to take part in the wide range of events on offer around the state and engage in meaningful conversations about improving mental health and reducing stigma associated with mental illness.

Dr. Emma Crampin
A/Chief Psychiatrist

Outcomes of the Independent Governance Review

Last month, the State Government announced the final outcome of the Independent Review of WA Health System Governance.

The Chief Psychiatrist sat on the Minister’s Working Party to advise on recommendations relating to the governance mental health and AOD sectors. The Office of the Chief Psychiatrist’s (OCP) leadership team also took part in stakeholder workshops to investigate how governance issues within the sector can be streamlined and addressed.

The State Government has now committed to developing a new mental health and alcohol and other drug (AOD) strategy, embedding greater lived experience leadership into health governance and the appointing senior mental health executives in each Health Service Provider (HSP), among other reforms.

The role of the Chief Psychiatrist the OCP remain fundamentally unchanged by the outcomes of this Independent Governance Review. However, as the authority tasked with maintaining standards of mental health treatment and care, the Chief Psychiatrist and the OCP will significant role in how these mechanisms of reform are developed and progressed.

The Chief Psychiatrist looks forward to working with the Minister, HSPs, consumers and lived experience advisors in bringing about these reforms to the mental health system.

Change to Accreditation Requirements for Mental Health Services

The Chief Psychiatrist has a responsibility under the Mental Health Act 2014 (MHA 2014) for overseeing the treatment and care of mental health patients throughout the State of Western Australia (s. 515 (1a-e) of the MHA 2014). The Chief Psychiatrist must discharge that responsibility by publishing standards and monitoring compliance with standards.

In 2015 I accepted the National Standards for Mental Health Services 2010 (NSMHS 2010) as the overarching standards relevant for the MHA 2014 and published an additional set of standards, the Chief Psychiatrist’s Standards for Clinical Care (CP Standards). Compliance with the CP Standards is assessed through the Chief Psychiatrist’s Clinical Monitoring Program, while compliance with the NSMHS 2010 has been assessed through accreditation programs, conducted by external accrediting agencies.

The Australian Commission on Safety and Quality in Health Care has released the National Safety and Quality Health Service Standards (second edition) User Guide for Acute and Community Mental Health Services (NSQHS User Guide for MH). My Office has reviewed both the National Safety and Quality Health Service Standards (second edition) 2021 (NSQHS Standards) and the NSQHS User Guide for MH and is satisfied that these standards provide appropriate guidance for clinical mental health services in Western Australia, along with the CP standards.

Clinical Services

From 1 November 2023, clinical services in Western Australia which are accredited against the NSQHS Standards will no longer be required to undergo accreditation against the NSMHS 2010.

Psychosocial Services

The Office of the Chief Psychiatrist is working on a transition plan with the Mental Health Commission and other stakeholders.  The NSMHS remain statutory and psychosocial services must maintain accreditation against the NSMHS until the transition plan has been finalised.

Please refer to the attached fact sheet which further explains this change.

Compliance with the CP Standards is still required and will continue to be monitored through the Chief Psychiatrist’s Clinical Monitoring Program.

Dr. Nathan Gibson
Chief Psychiatrist