Section 1: Key Considerations in Establishing Respectful Relationships

Submitted by sylvia.wong@up… on Fri, 12/09/2022 - 01:03

In this section you will learn to:

  • Work in a way that reflects and prioritises the person’s right to self-define and direct their own recovery
  • Communicate in a way that develops and maintains respect, hope, trust and self-direction
  • Recognise and respect the person’s social, cultural and spiritual differences
  • Support the person to understand and exercise their rights
  • Maintain confidentiality and privacy of the person within organisation policy and protocols.

Supplementary materials relevant to this section:

  • Reading A: National Standards for Mental Health Services 2010

It is important for counsellors to know how to work effectively with people with mental health issues. Even though, as a counsellor, you would not be the sole practitioner ‘treating’ clients with mental health issues, you may be working with them as part of their larger case management plan, or you may assist individuals with mental health needs to seek out appropriate services. As such, it is important for you to have a good understanding of the key principles and processes of the mental health sector. In this section of the module, you will learn more about the key values and principles of working in the mental health sector and how these can be applied in your work as a counsellor.

Sub Topics

Historical Context of The Mental Health Sector

The way we view and treat mental illness has undergone major changes over the last 50 years. In particular, there has been a trend towards increased respect for the human rights of clients, more client-centred decision-making, and a focus on the principles of recovery.

Historical Perspective of the Treatment of Mental Illness

This video provides a historical perspective on the treatment of mental illness from ancient times to most recent times. 

The following extract provides an overview of the history and evolution of mental health services. While it focuses on Queensland, the changes discussed are applicable to all of Australia.

From Institution to Community

In the early days of Queensland’s history, it was assumed that people with mental illness had no capacity to look after themselves and should be separated from the rest of society.

In the 1950s, new ideas about the organisation of psychiatric care shifted the emphasis from custodial care in large, closed institutions to supporting patients to live in the community. Increasing numbers of patients were discharged and fewer admitted, and allied health professionals became involved in preparing patients for life beyond the walls of the institution.

Today, it is recognised that many risk factors for mental illness lie beyond the health system, and relate to aspects of our everyday lives. These aspects include material well-being, housing, education, community inclusion and acceptance and employment. There is growing recognition that a whole-of-government, whole-of-community approach is necessary to reduce the prevalence and impact on the mental health of individuals, their families, carers and communities.

In response, Queensland Health, as part of the Queensland Plan for Mental Health 2007-2017, committed $4.77 million over the four years to 2011 to strengthen the capacity to coordinate care for consumers with complex needs living in the community.

What It Was Like to Be a Mental Patient In the 1900's

A short documentary about mental assylums in the 1900's

Changing Community Attitudes

Community attitudes towards mental illness in Queensland have been complex and contradictory over the past 150 years, with public discourse demonstrating a mixture of both fear and concern.

Widespread social attitudes and values of colonial Australians influenced how people suffering from mental health issues were perceived by the community. Hard work, individual effort and virtuous living promised to bring success and security to individuals able to live up to these ideals. People who did not, particularly those considered ‘insane’, were seen to be responsible for their illness due to moral weakness and personal deficiency.

Mentally ill people were popularly considered ‘dangerous’ and were confined and separated from the broader society. The location of asylums away from large population centres reflected this principle. Mental illness was out of sight, and mostly out of mind.

Psychiatrists and other health professionals tried to influence the public perception of mental illness so it was regarded as an illness like any other. Recommendations for changes including those relating to opening mental health units in general hospitals and introducing the concept of voluntary admissions were specifically directed at reducing the stigma attached to individuals with mental illness. When the first ward of this type was opened at the Brisbane General Hospital in Queensland in 1918, Dr Henry Byam Ellerton commented:

This ward was built to meet a long-felt need – namely, to supply suitable accommodation where patients with impending mental breakdown, or even acute mental cases in their initial stages, might receive all the advantages of medical treatment and skilled nursing without the stigma of certification as insane.

People who live with mental illness still experience stigma and discrimination. The results of stigma can often be worse than the illness itself, particularly when people face discrimination finding employment, a place to live, satisfactory health care and connections to other people. This stigma has tragic consequences. Many people with mental health problems fail to seek treatment because of the shame associated with their illness.

Advocacy and Consumer Participation

While there have always been critics of asylums and institutions, advocacy for patients with mental health issues was formalised in Queensland in the 1940s with the formation of the Relatives of the Mentally Ill Association. The Association made frequent approaches to government over conditions at the Goodna Mental Hospital and raised issues such as increasing the quality of meals and clothing for patients, improving recreation facilities and establishing an ‘after-care home’ for patients who resided in the institution because they had nowhere else to go.

The civil rights movement of the 1960s and 1970s raised awareness of the rights of minority groups, including people with mental illness. In 1977, the Queensland Department of Health established the Office of the Patients’ Friend to advocate for individual rights including the right to be consulted about treatment, the right to be protected from abuse, and the right to be free from unnecessary controls.

Various non-government organisations have also been established to advocate and support people with mental illness and their families and carers.

As the human rights movement gained momentum, the voices of patients themselves emerged as a force for change. One objective was to shift the balance of power to place mental health service users on an equal footing with professionals. In recognition of the expertise that mental health consumers have in their knowledge of mental illness, current health policy in Queensland supports the active participation of consumers, families and carers in all aspects of policy, planning and services.

In the shadow of Fairview

A documentary about Oregon’s primary institution for people with developmental disabilities.

Recovery

The concept of ‘recovery’ is an emerging paradigm in mental health services that focuses not on a patient being ‘cured’, but of individuals living meaningful lives with mental illness. Recovery acknowledges that having a mental illness does not necessarily mean life long deterioration, but focuses on an individual’s journey toward a sense of identity, role and purpose beyond the boundaries of mental illness. The recovery approach focuses on the person experiencing improved quality of life and higher levels of functioning despite their illness, rather than solely on reduced symptoms or the need for treatment.

Patient Rights

The Queensland mental health system is based on a framework which encompasses fundamental rights and responsibilities for all people who have a mental illness, including the following:

People with a mental illness are entitled to respect for their basic human rights, confidentiality, and must be able to participate in decisions made about them.

The specific cultural, religious and language needs of individuals must be respected.

Treatment should only be provided where it promotes or maintains the person’s mental health, and should impose the least restriction on their rights possible with due regard for the safety of the person and others.

(Queensland Health, 2009)

Round the Bend: A History of Psychiatric Nursing in Victoria, Australia

This documentary film explores the development of psychiatric nursing from the early colonial beginnings in 1848, through to the post-institutional 1990s. 

Principles of Recovery and Empowerment

The extract from Queensland Health, 2009 highlights the importance of the concept of ‘recovery’ to modern mental health services. The concept of recovery-oriented practice is central to working effectively with clients with mental health issues. This is explained in the following extract from the Department of Health, 2010.

Principles of Recovery Oriented Mental Health Practice

From the perspective of the individual with mental illness, recovery means gaining and retaining hope, understanding of one's abilities and disabilities, engagement in an active life, personal autonomy, social identity, meaning and purpose in life, and a positive sense of self.

It is important to remember that recovery is not synonymous with cure. Recovery refers to both internal conditions experienced by persons who describe themselves as being in recovery— hope, healing, empowerment and connection—and external conditions that facilitate recovery—implementation of human rights, a positive culture of healing, and recovery-oriented services.
Jacobson and Greenley, 2001 p. 482

The purpose of principles of recovery oriented mental health practice is to ensure that mental health services are being delivered in a way that supports the recovery of mental health consumers.

1. Uniqueness of the individual

Recovery oriented mental health practice:

  • recognises that recovery is not necessarily about cure but is about having opportunities for choices and living a meaningful, satisfying and purposeful life, and being a valued member of the community
  • accepts that recovery outcomes are personal and unique for each individual and go beyond an exclusive health focus to include an emphasis on social inclusion and quality of life
  • empowers individuals so they recognise that they are at the centre of the care they receive.

2. Real choices

Recovery oriented mental health practice:

  • supports and empowers individuals to make their own choices about how they want to lead their lives and acknowledges choices need to be meaningful and creatively explored
  • supports individuals to build on their strengths and take as much responsibility for their lives as they can at any given time
  • ensures that there is a balance between duty of care and support for individuals to take positive risks and make the most of new opportunities.

3. Attitudes and rights

Recovery oriented mental health practice:

  • involves listening to, learning from and acting upon communications from the individual and their carers about what is important to each individual
  • promotes and protects individual’s legal, citizenship and human rights
  • supports individuals to maintain and develop social, recreational, occupational and vocational activities which are meaningful to the individual
  • instils hope in an individual’s future and ability to live a meaningful life.

4. Dignity and respect

Recovery oriented mental health practice:

  • consists of being courteous, respectful and honest in all interactions
  • involves sensitivity and respect for each individual, particularly for their values, beliefs and culture
  • challenges discrimination and stigma wherever it exists within our own services or the broader community.

5. Partnership and communication

Recovery oriented mental health practice:

  • acknowledges each individual is an expert on their own life and that recovery involves working in partnership with individuals and their carers to provide support in a way that makes sense to them
  • values the importance of sharing relevant information and the need to communicate clearly to enable effective engagement
  • involves working in positive and realistic ways with individuals and their carers to help them realise their own hopes, goals and aspirations.

6. Evaluating recovery

Recovery oriented mental health practice:

  • ensures and enables continuous evaluation of recovery based practice at several levels
  • individuals and their carers can track their own progress
  • services demonstrate that they use the individual’s experiences of care to inform quality improvement activities
  • the mental health system reports on key outcomes that indicate recovery including (but not limited to) housing, employment, education and social and family relationships as well as health and well being measures.

(Department of Health, 2010)

As you can see, there is now an increasing focus on assisting individuals with mental health issues to understand their abilities, have a positive sense of self, develop their autonomy, and engage with the community. In fact, this focus is highlighted in the National Standards for Mental Health Services. The full Standards are provided in Reading A; however, the following extract provides a good outline of the key principles of these Standards.

Read

Reading A - National Standards for Mental Health Services 2010 provides a copy of the National Standards for Mental Health Services 2010 which outlines the key principles and standards underpinning mental health service provision.

Key principles that have informed the development of the Standards include:

  • Mental health services should promote an optimal quality of life for people with mental health problems and/or mental illness.
  • Services are delivered with the aim of facilitating sustained recovery.
  • Consumers should be involved in all decisions regarding their treatment and care, and as far as possible, the opportunity to choose their treatment and setting.
  • Consumers have the right to have their nominated carer(s) involved in all aspects of their care.
  • The role played by carers, as well as their capacity, needs and requirements as separate from those of consumers is recognised.
  • Participation by consumers and carers is integral to the development, planning, delivery and evaluation of mental health services.
  • Mental health treatment, care and support should be tailored to meet the specific needs of the individual consumer.
  • Mental health treatment and support should impose the least personal restriction on the rights and choices of consumers taking account of their living situation, level of support within the community and the needs of their carer(s).

Finally, the Standards describe care that will be delivered in accordance with each of the nine (9) domains from the Key Performance Indicators for Australian Public Mental Health Services (2005) as follows:

(Australian Government, 2010)

  • Effectiveness: care, intervention or action achieves desired outcome in an appropriate timeframe.
  • Appropriateness: care, intervention or action provided is relevant to the client’s needs and based on established standards.
  • Efficiency: achieving desired results with the most cost-effective use of resources.
  • Accessibility: ability of people to obtain health care at the right place and right time irrespective of income, physical location and cultural background.
  • Continuity: ability to provide uninterrupted, coordinated care or service across programs, practitioners, organisations and levels over time.
  • Responsiveness: the service provides respect for all persons and is client orientated. It includes respect for dignity, cultural diversity, confidentiality, participation in choices, promptness, quality of amenities, access to social support networks, and choice of provider.
  • Capability: an individual’s or service’s capacity to provide a health service based on skills and knowledge.
  • Safety: the avoidance or reduction to acceptable limits of actual or potential harm from health care management or the environment in which health care is delivered.
  • Sustainability: system or organisation’s capacity to provide infrastructure such as workforce, facilities, and equipment, and be innovative and respond to emerging needs.
10 principles to live a life of recovery

The presenter in this video discusses ten principles to recovery. 

 

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When working with clients with mental health issues, all helping professionals are required to apply an appropriate approach so that the client’s individual, legal, citizenship and human rights are upheld. This involves treating clients with dignity and respect and allowing them to direct their own recovery by seeking their input about each step of the treatment process. Involving a person with mental health issues to direct their own recovery can be a challenging process. Some of the mechanisms that are commonly adopted to facilitate this process include:

  • Encouraging the client to identify his or her own goals and objectives.
  • Working with the client to develop plans of action.
  • Identifying areas of interest and preferences and drawing on these in the development of plans.
  • Supporting the client to reflect on their past and review issues that require improvement.
  • Presenting the client with a number of different options that they can choose from when deciding upon a way forward.
  • Encouraging the client to undertake activities independently (such as becoming involved in community groups and functions).
  • Ensuring that the client feels that they have a say at all junctures of the recovery process.
  • Undertaking evaluations of the recovery process in collaboration with the client.

While each of these components of care is equally important, they all start with establishing a respectful relationship with the client. This is particularly important because people with mental health issues often face a number of barriers to recovery, many of these related to the way in which others, even helping professionals, behave towards them. They often face discrimination, prejudice and the effects of social stigma which can impact upon their feelings of self-worth and desire to seek assistance. For example, experiences of discrimination, prejudice, and stigma can:

  • Create social isolation
  • Discourage people from seeking treatment
  • Limit recreational, educational, and employment opportunities
  • Impact self-esteem and allow negative perceptions to be internalised
  • Result in individuals blaming themselves for their issues and not believing that they have the same rights as others.

Discrimination against people with mental health issues is often the result of a number of socially accepted myths about mental illness. These myths include that:

  • Mental illness is caused by personal weakness
  • People with a mental illness can “pull themselves out of it”
  • People with mental illness are violent
  • People with mental illness are unable to recover or self-direct their recovery.

These myths are all without foundation. The facts are that mental health issues are caused by genetic, biological, social and psychological factors, many of which are beyond the control of the individual. Furthermore, people with mental health issues are more likely to harm themselves or be harmed by others than they are to be violent towards others (Government of Western Australia Mental Health Commission, 2010).

As a counsellor, it is important for you to understand the realities surrounding mental health and the common experiences of individuals experiencing mental health issues. This will enable you to work effectively with people with mental health issues.

Reflect

Consider your own attitudes towards people with mental health issues. Do the myths outlined resonate with you?

Do you think that you need to learn more about the facts of mental illness in order to allow you to work effectively with individuals with mental health issues?

When working with people who have mental health issues, it is also very important to develop a respectful relationship that promotes trust, hope, and a sense of self-direction. While there are a number of steps that you will take to do this (which you will learn about throughout this module), it all begins with respectful communication.

Click here for an informative article with useful resources about recovery. 
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You have learned about respectful communication throughout your Diploma. You will need to utilise these skills when working with clients with mental health issues. At a basic level, when communicating with people with mental health issues, you will need to ensure that you:

  • Minimise distractions (for example, ensure that communication is occurring in a suitable environment with minimal background noise and distractions)
  • Demonstrate that you are paying attention (for example, demonstrate active listening skills)
  • Use effective questioning skills to develop an understanding of the client’s needs without making them feel interrogated
  • Pay attention to both what the person is saying and what is being revealed through body language
  • Maintain a culturally appropriate level of eye contact
  • Acknowledge the client’s feelings (for example, reflection of feelings)
  • Do not interrupt the client unnecessarily
  • Do not make assumptions
  • Mirror the client’s verbal and body language where appropriate.

In a nutshell, you need to remember that clients with mental health issues deserve the same levels of respect and individualised attention as all other clients. You should not make assumptions about them or infer disrespect on any level. Such clients have the same rights as all others and, as a counsellor, you have the same responsibilities. Of course, depending on the client’s previous experiences, you may find that you need to spend more time establishing a respectful helping relationship, particularly if the client has previously had negative experiences as a result of discrimination, prejudice, or stigma. In such cases, it can also be useful to work from a strengths-based perspective in order to help demonstrate respect for the client and help facilitate the development of hope, trust, and self-direction.

Throughout your interactions with clients with mental health issues, the process of communication should be empathetic, engaging, and hope-giving. It should involve listening and responding in a non-judgemental and sensitive manner based on valuing the uniqueness of each person. Respecting the person’s own understanding of their experience is also vital as this provides them with an opportunity to find their own voice in expressing their experiences.

The following case scenarios provide some examples of respectful communication.

Case Study - Cynthia
Old man retiree sit by desk in examination room complain on bad health

Cynthia visits her client, Martin, in his home every week as part of a mental health outreach program. Knowing that she is a guest in his home, Cynthia always asks Martin if the visit is convenient and does not let herself into his home unless he invites her to come in. Today Martin is angry because of a dispute he had with his neighbour about loud noise coming from his apartment next door. Martin gets so excited telling Cynthia about the fight he had with his neighbour that he waves his arms about in the air and begins to shout. Rather than telling Martin to lower his voice, Cynthia responds by nodding her head and making understanding facial expressions while reflecting his story in a lowered tone and asking some clarifying questions. Cynthia’s communication techniques help Martin calm down as he realises that she is listening to him intently. Throughout this interaction, Cynthia has demonstrated respectful communication.

Case Study - Marcia
Young Man Talking To Counsellor Using Digital Tablet

Marcia is a counsellor who is meeting her new client, Jack, for the first time. Jack recently had a psychotic episode and has been diagnosed with schizophrenia. He has been referred to Marcia for counselling as part of a wider case management plan. During their first meeting, Marcia observes that Jack appears nervous, that his arms are crossed over his chest, and that he is not making eye contact. After Marcia introduces herself, she begins trying to communicate with Jack by asking him a couple of questions about his diagnosis and what has brought him to counselling. Jack tells Marcia that he’s not crazy and that he no longer hears the voices that were telling him that everyone around him was judging him and criticising him. Marcia realises that Jack doesn’t like to call his illness experience a “psychotic episode” or “schizophrenia” but rather refers to the illness experience in terms such as “when the voices were bothering me”. To help better develop rapport, Marcia decides to drop the medical terminology and talk to Jack using the words he chooses to describe his experience. Slowly Jack starts to uncross his arms and engage more readily with Marcia.

Reflect on Case Studies

Can you think of any other ways in which the counsellor could demonstrate respectful communication in the Cynthia and Marcia scenarios?

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When working with people with mental health issues it is also important to respect their social, cultural, and spiritual differences. Such differences can impact not only the way in which individual clients wish to work with services but it can also impact what services are required.

It is important to take the time to understand your client’s values and core social, cultural, and spiritual practices and ensure that you demonstrate respect for them. While you can improve your understanding of other cultures through professional development and research, it is important to avoid stereotyping or making assumptions. There is often great diversity within cultural groups due to regional, class, family, and individual differences. Therefore, it is always important to take the time to explore your client’s individual values and practices and make appropriate amendments to your practice to respect these. For example, some individuals may celebrate specific religious holidays and it would be appropriate to facilitate the client’s celebration of these dates and not seek to schedule service appointments on these dates.

The following case study demonstrates another way in which diversity can be respected.

Case Study
Upset teenager girl with her parents at a psychologist's appointment.

Fatima is a 22-year-old woman who was born in Lebanon and came to Australia with her family when she was six years old. She has been diagnosed with bipolar disorder and is undergoing treatment at the local mental health clinic. Fatima attends her appointments accompanied by her family, which includes her mother, father, and older brother. In her culture the value of family involvement in her treatment and other aspects of her life is high. She consults her parents before she makes any significant decision and does not wish to engage with community workers unless her family is present. The mental health workers accommodate Fatima’s wishes by ensuring that there are always enough seats for each of Fatima’s family members to attend any meetings. They also make eye contact with everyone in the room and demonstrate inclusive practice in relation to Fatima’s family.

Clients from diverse backgrounds can also have different perspectives on mental illness and differing needs.

  • Generally, immigrants, refugees and asylum seekers have lower rates of mental health service utilisation than the Australian-born population. Barriers to access include greater stigma about mental illness in some CALD communities, language barriers, cultural misunderstandings, and limited knowledge of mental health and available services when compared with the Australian-born population. These barriers make it harder for people from CALD backgrounds to access mental health services when needed, resulting in higher acute and involuntary admissions.
  • People from CALD backgrounds are overrepresented in involuntary admissions and acute inpatient units and are more likely to be exposed to quality and safety risks. These risks include misunderstandings and misdiagnosis and they are often a result of language and cultural barriers.

(Mental Health in Multicultural Australia 2014)

When considering the presence of mental health concerns, you also need to consider cultural and spiritual factors. Just because a client has a belief that seems unusual to you, this does not necessarily mean that they have a mental illness. If an individual’s beliefs and practices are common and accepted within their own community then there may be no issue.

As a counsellor, you may be required to assist clients to better understand their needs and the services that they may require, and help them to exercise their rights to effective service provision.

People with mental health issues are often marginalised in society and are seeking assistance from a position of lowered power. It is important to support these individuals to understand and exercise their rights. While you should be aware of the general rights of clients by this point in your studies, the following extract provides a good summary of client rights.

Respect

You have the right to:

  • Be treated with respect
  • Have your individual human dignity valued
  • Be free from unlawful discrimination
  • Ask to have a staff member of your own gender when receiving treatment
  • Have your individual needs respected in relation to your age, culture, language, disability, gender and sexuality.

Safety

You have the right to:

  • Be safe when receiving treatment and care
  • Receive high-quality treatment and care
  • Be treated in the least restrictive environment appropriate to your individual needs
  • Receive appropriate and comprehensive information about your treatment, including the side effects, in a timely manner
  • Obtain a second opinion about your treatment and care.

Communication

You have the right to:

  • Be heard
  • Have a safe environment created that supports information exchange between you and your healthcare providers
  • Be informed about services, treatments, options and costs throughout your care
  • Ask questions regarding your care and have them answered in a clear and understandable manner
  • Communicate your views and preferences about your treatment and care options by using an Advance Agreement.

Access

You have the right to:

  • Timely access to health and human services
  • Care that promotes independence and recovery
  • Choose if, and when, family, friends and other supports are included in your care
  • Access mental health care that is equivalent to care available in the community, if you are subject to the criminal justice system.

Participation

You have the right to:

  • Live, work and participate in your community with equitable access to human services
  • Participate in decisions and choices about your care throughout all stages of your care and recovery
  • Receive information in a form and language that you understand
  • Have your Advance Agreement inform your care
  • Participate in mental health legal proceedings
  • Access independent advocacy and legal advice regarding your treatment, care and social needs.

Privacy

You have the right to:

  • Protection of your personal privacy
  • Privacy and confidentiality of your personal information
  • Access your own health records in accordance with the law.

Comment

You have the right to:

  • Comment on your care and to have your concerns addressed
  • Receive information on mechanisms of complaint and redress.

(ACT Government Health 2016)

As a counsellor, you must not only uphold your client’s rights in your own interactions with them, but you should also empower your clients to understand and exercise their rights. In many cases, this might involve explaining rights to a client so that they understand where they stand on issues as they arise. The following case study provides an example of such a situation.

Case Study
Female doctor therapist wearing white uniform consulting young woman patient

Jennifer is a client of a mental health clinic. She is socially isolated and has very few support networks as her parents have both passed away and her older brother lives far away in another state.

Jennifer has made a friend at one of the recreational functions that was coordinated by the mental health clinic. Her new friend, Simone, has also been diagnosed with a mental illness. Simone has very protective parents who want to know everything about her social interactions. They have met Jennifer and want to know more about her, including her diagnosis and where she lives before they permit her to socialise any further with Simone. They have approached the mental health clinic for information about Jennifer. As they have been quite aggressive in their requests, the mental health worker, Mary, decides to meet with Jennifer to explain to her that she has rights that include confidentiality. Mary tells Jennifer that the mental health clinic will not divulge any information about her to anyone who asks without Jennifer’s permission. She explains to Jennifer that she is under no obligation to disclose information to Simone’s parents and that both Simone and Jennifer are permitted to socialise with whoever they want during their visits to the mental health clinic.

If a person with a mental health issue feels that a community services provider has treated them unfairly they have the right to have their complaint heard and acted upon. As a counsellor, you may provide assistance to clients to make complaints. Most organisational policies will have procedures where the client can complain directly to the individual staff members concerned or have the matter escalated if they are not satisfied with the outcome of the complaint process.

Outside the relevant service provider, there are two places that a person with a mental illness can complain to if they feel that they have been treated unfairly. These include the Human Rights Commission which investigates complaints related to discrimination according to sex, disability (this includes temporary and permanent disability), medical conditions (including mental health), race, and age. There are also state-based Mental Health Commissions that can provide information about the Health Care Complaints Commission in the relevant state or territory.

Organisations found in breach may face penalties, reputational damage, or corrective measures to ensure compliance with mental health laws and regulations.

The privacy of all clients is protected by the Privacy Act 1988 (Cth) and various other relevant State and Territory legislation – clients with mental health issues are not exempt from this. Mental health services will have privacy and confidentiality policies that set out procedures for managing personal health information held by the service. These policies explain how personal health information is collected and used within the service and the circumstances in which it may be disclosed to third parties. These procedures typically include that:

  • The collection of personal health information should be conducted in a setting that protects the information from being accessed by unauthorised people and provides privacy to the client.
  • Health information should be collected, where possible, directly from the individual concerned.
  • Security exists to prevent loss of data.
  • Personal information is protected from unauthorised access.
  • Care is taken to prevent unauthorised access during the transfer of information.
  • The individual’s consent is obtained to use personal health information for the purpose of research or quality assurance and improvement.

Regardless of whether the information is recorded in the client’s file or even stored in your head, it is considered protected information and cannot be shared with anyone unless the client gives permission to share this information. There are some exceptions to this rule in relation to people who are experiencing involuntary treatment where information that is considered to prevent harm to the client, harm to another, or harm from another, is considered sufficient to breach client confidentiality.

When working with clients with mental health issues you may be required to make a referral. In such cases, you should follow your organisation’s standard procedures and codes of practice.

Throughout your practice you must ensure that you maintain your client’s rights. This will help you to establish a respectful and appropriate relationship that will allow you to best work to meet their needs. You will learn more about how to do this in the following sections of this module.

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In this section of the module you were introduced to the key practice principles involved in working with people with mental health issues. You also learned about some of the key considerations involved in establishing a respectful relationship that demonstrates respect for the individual and their diversity, their needs, and their rights.

Australian Government. (2010). National Standards for Mental Health Services 2010. Barton, ACT: Commonwealth of Australia.

ACT Government Health. (2016). Charter of rights for people who experience mental health issues. Retrieved from http://www.health.act.gov.au/our-services/mental-health/charter-rights

Government of Western Australia Mental Health Commission. (2010). Common myths about mental illness. Retrieved from http://www.mentalhealth.wa.gov.au/mental_illness_and_health/Myths_mental_illness.aspx

Mental Health in Multicultural Australia (2014). Framework for mental health in multicultural Australia: Towards culturally inclusive service delivery. MHIMA.

Queensland Health. (2009). The road to recovery: A history of mental health services in Queensland 1859-2009. Queensland Government.

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