Chief Psychiatrist's annual report 2008-09 - Department of Health

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28 Chief Psychiatrist’s annual report 2008–09 5.1.3 Statewide inpatient unit managers forums Unit managers have a key role in establishing and supporting quality practice in inpatient mental health services. The office continued to convene regular forums with inpatient unit managers from around the state to discuss common issues. Topics discussed at the Inpatient Unit Managers Clinical Practice Standards Forum included: • clinical guidelines under development • seclusion and restraint best practice presentations and updates on the Beacon and Creating Safety projects • sexual safety in inpatient units • managing consumers with a borderline personality disorder in inpatient care • smoking in inpatient units • the review of the Mental Health Act. Topics discussed at the Aged Persons Mental Health Residential Services Nurse Unit Managers Forum included: • comprehensive care assessments • nursing leadership • risk management • accreditation • regulatory frameworks. These forums facilitate information sharing, foster best practice and innovation and help unit managers to assume a leadership role within their local service. 5.1.4 Eating disorder services The Chief Psychiatrist regularly meets with the statewide Centre for Excellence in Eating Disorders (CEED) and the three specialist adult eating disorder inpatient units. The purpose of these meetings is to: • improve the quality of clinical care for people experiencing eating disorders across public mental health and specialist services • improve clinical pathways to specialist tertiary services for people with eating disorders • support specialist tertiary eating disorder services to provide expert clinical care for people with eating disorders • facilitate resolution around complex issues relating to eating disorder clinical service provision.
Chief Psychiatrist’s annual report 2008–09 29 These meetings also provide a venue to identify other concerns that impact on the clinical care for people with eating disorders that the Chief Psychiatrist may pursue through other avenues. Key issues discussed in 2008-09 included: • service access • models of care and models of service for consumers with eating disorders • dealing with co-morbidity (for example, a concurrent personality disorder, or substance abuse) • common referral pathways and the role of triage • care coordination (including medical care and linkages with paediatrics and child and adolescent mental health services) • the changing role of CEED • changes in the client profile: younger persons presenting with more acute problems and with an increase in the presentation of males. 5.1.5 Working with families and carers The office has frequent contact with families and carers through telephone calls and letters, as evidenced by the number of contacts made during the reporting period. The Chief Psychiatrist recognises the important role of carers and the difficulties they can face in supporting their relative and getting their concerns heard by services and clinicians. Through these contacts, the office endeavours to support and guide carers in their interactions with service providers, and also draw the attention of service directors and clinicians to the need for continuing effort in improving carer engagement in the treatment and care process wherever possible. The Chief Psychiatrist guideline on working together with families and carers can be found at www.health.vic.gov.au/mentalhealth/cpg/families 5.2 Consumers with complex needs An increasing number of consumers have particularly complex service needs that exceed the capacity of a single service and require the coordinated effort of a number of agencies. Such individuals generally suffer severe mental illness or personality disorder complicated by substance abuse and/or intellectual impairment. A common feature is a level of behavioural disturbance that presents significant risk to the person themselves, the community and staff working with them. The Chief Psychiatrist provides an important leadership and coordinating role in bringing together the various services and service elements to achieve an appropriate service system response and support services in managing the risks. In doing so, the Chief Psychiatrist’s office works closely with the Multiple and Complex Needs Initiative (MACNI) in the Department of Human Services, Disability Services, Forensicare and with Spectrum, the statewide personality disorder service, to ensure good communication across services and a coordinated effort in caring for shared high-needs clients.
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Chief Psychiatrist's annual report 2008-09 - Department of Health

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