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

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34 Chief Psychiatrist’s annual report 2008–09 7 Working with the department and other stakeholders The Chief Psychiatrist and staff from the office work closely with colleagues in the Departments of Health and Human Services, particularly the Mental Health, Drugs and Regions (MHDR) Division. The Chief Psychiatrist is involved in various policy, process and operational matters relating to mental health service delivery, where the office’s interface with service providers and service users can bring a first hand perspective to the issues being considered. The Chief Psychiatrist and staff are also involved in a number of departmental and interdepartmental committees. Liaison also occurs with a range of government, non-government and advocacy bodies including the Public Advocate, Health Services Commissioner, the Coroner, Mental Health Review Board, the Ombudsman and the Department of Justice on matters of common interest and in response to specific issues as they arise. Some key areas of involvement during the reporting period have also been with the Office of the Senior Practitioner in jointly seeking to improve outcomes for dual disability consumers 16 who come to the attention of either office, and with the Multiple and Complex Needs Panel on care plans for complex clients. 7.1 Mental Health Triage Project In 2007 the Chief Psychiatrist led the development of a draft mental health triage scale and guidelines in consultation with the MHDR Division’s Mental Health Triage Scale Advisory Committee, which comprised consumer and carer representatives, senior clinical experts from the mental health sector and divisional staff. The scale is a rating system that guides clinicians in classifying triage contacts according to level of urgency and the response required by mental health and other services. The purpose of the scale is to promote a more consistent and clinically appropriate response to consumers, carers and referrers seeking access to mental health services, and aid data collection about service access, utilisation and demand. Throughout 2008 the scale was piloted at 13 mental health services across the state, supported by a training program including an e-learning component. The scale and the training program have been formally evaluated and the findings used to inform further refinement of the scale and guidelines. It is anticipated that the triage scale will be introduced in all Victorian area mental health services in 2010. The draft scale and guidelines, and further information about the project, can be found at www.health.vic.gov.au/mentalhealth/triage. 7.2 Review of secure extended care services There has been a growing demand for secure extended care unit (SECU) beds over recent years, particularly for younger men with a dual diagnosis whose associated drug and alcohol issues places them or the community at risk. Victoria has an acknowledged shortage of secure extended care beds in both the general and forensic sectors. The Chief Psychiatrist regularly receives requests from mental health services to facilitate access to such beds. The frequency of these requests is increasing and metropolitan and rural units all report long waiting lists. 16 People with an intellectual disability and mental illness.
Chief Psychiatrist’s annual report 2008–09 35 In 2007–08 the division commenced a project to review the operation of SECU services. This project has examined issues of access, throughput, and alternative models for meeting the needs of this client group in the short, medium and longer term. The Chief Psychiatrist has chaired the divisional working group overseeing the project and addressing related clinical practice issues. The report of the working party is expected to be finalised in 2009–10. In the meantime, the Chief Psychiatrist will continue to respond to requests for a SECU bed on a case-by-case basis. Providing a wider range of bed-based and community options that are well connected with both clinical and psychosocial rehabilitation services is also one of the goals of the Mental Health Reform Strategy 17 . 7.3 Response to the Victorian bushfires The summer of 2008–2009 was accompanied by heartache and tragedy following the most destructive and severe bushfires experienced for well over a decade. The then Department of Human Services led the psychosocial response during the acute phase and in the aftermath of the fires. The Office of the Chief Psychiatrist, and especially the Deputy Chief Psychiatrist, Child and Youth Mental Health, contributed advice to those developing the psychosocial response and made a number of site visits to support and advise those providing direct support in the affected communities. 7.4 Gender safety In 2007 the Mental Health, Drugs and Regions Division established the Improving Gender Sensitivity and Safety in Acute Mental Health Inpatient Units project to examine practices relating to the safety and privacy needs of women admitted to these units. The Chief Psychiatrist was a member of the advisory committee overseeing the project. In 2008–09 staff from the office worked with the Senior Nurse Adviser and the Service Improvement Unit on the development of a Chief Psychiatrist guideline on promoting sexual safety, responding to sexual activity, and managing allegations of sexual assault in adult acute inpatient units. 7.5 Cross-border and interstate apprehension orders Victoria has agreements with New South Wales and South Australia covering the interstate treatment, transfer and apprehension of involuntary patients 18 . In 2008–09 the cross-border agreement with NSW had to be reviewed as a result of changes to mental health legislation in NSW. This review was undertaken by the division’s Legal and Forensic Policy Unit in collaboration with the Chief Psychiatrist. The Chief Psychiatrist and a senior clinical adviser from the office participated on the steering committee, took part in cross-border consultations with the sector and provided advice on the implications of the proposed changes for clinical practice. It is expected that the division will issue an updated program management circular in 2009–10. 17 See Because Mental Health Matters. Victorian Mental Health Reform Strategy 2009-2019, pp. 96-97. 18 These cross-border agreements can be found at: www.health.vic.gov.au/mentalhealth/crossborder
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