Mental Health Act 2014: Post Implementation Review
The Mental Health Commission (MHC) recently reviewed the Mental Health Act 2014 (the Act). To provide feedback to the MHC and to ensure a variety of people are represented, the Western Australian Association for Mental Health (WAAMH) sought feedback from people who had experience (whether voluntary or involuntary) with mental health services since December 2015. This included feedback from families and carers.
The review focused on the Object (Part 3) of the Act, particularly:
- Ensuring people who have a been placed under the Act are provided the best possible treatment and care
- Recognising and facilitating the involvement of people who have been placed under the Act (and their families and carers) in treatment, care and support
- Helping minimise the effect of mental illness on family life
- Ensuring the protection of people who have or may have a mental illness.
Consideration was given to:
- The extent to which objectives have been achieved
- Any unintended consequences
- Effectiveness of mechanisms linking intervention with outcome
- Scope for simplification, improvement or deregulation
- A cost or benefit in retrospect and going forward
- The regulation remains an appropriate, effective and efficient method of achieving objectives
WAAMH consulted with our members and stakeholders, including the 350 participants in the Increasing Member Participation: Advocacy and Co-Design training workshops.
WAAMH recognised the significant steps the MHC and the Department of Health have taken in moving from a substitution decision-making model of legislation to a supported decision-making model and recognising the power, value and right of including the voice of lived experience, while ensuring those who are receiving treatment are central to their care.
WAAMH identified two overarching themes - the lack of a cultural shift and the need for further education and training of clinical staff. The spirit of the Act and its objectives promote supported- decision making, rights, and consumer, carer and family member engagement, which can only occur with an understanding of what support decision making is, the mechanisms for change and the practicalities of implementing this framework on a ward.
Feedback and recommendations provided to the MHC included:
- There has been a lack of communication around necessary culture change for consumer-driven care. Rectifying this would ensure people who are placed under the Act are central to their treatment and care
- The need for training and education for clinical staff, separate to the online learning package, around a change from substitution decision making to supported decision making and the mechanisms for this change. Helping to recognise and facilitate the involvement of people who have been places under the Act, their families and carers in treatment, care and support
- Informing consumers, carers and family members about their rights as active citizens and ensuring their opinions and wishes are heard in matters that affect their lives is needed
- A clear communication and collaboration between clinical and community stakeholders around discharge plans for consumers is required. This would help to minimise the effect of mental illness on family life.
The recent review and anecdotal feedback provided contributes to a five-year statutory review of the Act. This process continues to identify potential legislative improvements and both WAAMH and the MHC are committed to continual improvement.