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Act for an inclusive mental health and wellbeing system

Thank you for agreeing to complete this survey. 

Please answer as many questions as you feel comfortable to answer. 

If you would like to provide any further feedback, please email us at info@tandemcarers.org.au.  

Tandem 'Act for an inclusive mental health and wellbeing system'

*This survey has been adapted to the family/carer perspective from VMIAC's 'Act on the Act' Survey (2021).*  
 
1.Name or Initial 
2.Age
3.Gender
4.Do you identify as...?
5.Where do you reside?
6.How would you define yourself with respect to your caring role?
7.Seclusion and Restraint

The Royal Commission has recommended that seclusion and restraint be eliminated in 10 years. The recommended maximum rate of seclusion has been halved immediately for adult services, and reduced by two-thirds for child, adolescent and aged services. These rates will reduce again every two years until eliminated.

Which of the following changes to the Act do you believe are important in making this happen?
8.Please provide any other suggestions you have:
9.Currently the Mental Health Act does not have a definition of "chemical restraint". The Royal Commission has recommended that "chemical restraint" be defined, reduced and eventually eliminated.  

What factors should be considered when defining chemical restraint in the new Act?

Should considerations such as consumer, family and service staff safety be included?
10.Please indicate if you agree or disagree (or are unsure) with the following in regards to the definition of ‘chemical restraint’:
Agree
Disagree
I don't know
The intention of the medication is to control a person's behaviour
The effect of the medication is restraint on a person's body, thinking and/or emotions 
The medication impairs a person's ability to make decisions  
The circumstances in which the medication is given? e.g. if bodily restraint is used to administer the medication 
How the medication is given, e.g. intramuscular injections 
Any medication given without informed consent
11.Please provide other suggestions: 
12.Compulsory Treatment

The Royal Commission recommends that compulsory treatment be reduced. It recommends a range of measures for its reduction overtime.

What does the reduction of compulsory treatment mean to you? Do you have hopes and fears around this?
13.The Mental Health Act doesn’t define the criteria for compulsory treatment in a lot of detail.

In the current act the term "serious" is used in the compulsory treatment criteria like this:  "the person needs immediate treatment to prevent (a) serious deterioration in the person’s mental or physical health, and (b) serious harm to the person or to another person”.

What, if any, of the following factors should be included or specifically excluded from a definition of "serious deterioration" or "serious harm":
Include in definition 
Exclude in definition 
I don't know 
Non-conforming behaviour or beliefs 
Taking financial risks 
Doing things that might damage the reputation of the person you love
The concern or fears of the person’s  family/friends/supporters
Ability to self-care; e.g.: not eating, showering or sleeping
Physical injury to self 
Physical injury to others 
Imminent death 
14.Is there anything else you would like to tell us about the use of the word "serious"?
15.The Royal Commission has recommended that compulsory treatment be used as a "last resort". 

"Last resort" commonly means that all other options have been offered and/or tried.

Which of the following should the Act say must be offered and/or tried before compulsory treatment is used as a "last resort"?
Agree
Disagree
Not sure 
Family psychoeducation, Multiple family group or similar program / family therapy/ participation in an open dialogue
Peer support 
Providing the opportunity to voluntarily try multiple medications
Specialist trauma services  
Respite services 
16.Do you have any other thoughts you would like to share from a family/carer/supporter/nominated person perspective?
17.Should the Act ensure family/friends/supporters/nominated persons have been identified/recorded and engaged in the recovery journey of the consumer before compulsory treatment is considered?
18.Do you have any further suggestions from a family/carer/supporter/ nominated person perspective?
19.The Royal Commission’s final report says about Community Treatment Orders (CTOs): 
“the sum of evidence does not support their effectiveness in preventing relapse and readmission”

Should CTOs be removed from the new Act?
20.Which of the following changes to the Act do you think would help to reduce compulsory treatment orders (including in the community, hospital and forensic settings)? Please select all that apply
21.Do you have any further suggestions from a family/carer/supporter/ nominated person perspective? 
22.Independent Advocacy

The Royal Commission has recommended that Independent Mental Health Advocacy (IMHA) will become an ‘opt out’ service. This means every person subjected to compulsory treatment will be offered an advocate, rather than having to ask to get one.

Do you believe you as a family/carer/supporter/nominated person also need access to mandatory advocacy where the person you love is receiving compulsory treatment?
23.Please give reasons why:
24.Which of the following options should be included in the new Act to support this: 
Please select all that apply
25.Are there other circumstances in which IMHA should be notified?
26.Information Sharing

Currently people need to make a Freedom of Information request to access health records. How important is it in your view for people to have access to their health records in ‘real time’?
27.Do you think that the workforce receives adequate education and support to understand their obligation to families? What do you think should be done to make sure that they do?
28.Depending on the service used you may or may not be able to add information from your point of view to your mental health record.

Should everyone be able to add information from their point of view, to their health record? Should you, as the family member/friend/supporter/nominated person, be able to add information to the health record of the person you love?
29.The Royal Commission has recommended that current requirements for the sharing of information with families and carers be simplified.

In the past you have told us that even with permission from the person you love information has not been shared with you. How important is it to your role as a carer/supporter/nominated person that you are provided with ongoing information about the treatment of the person you love?
30.Please provide any further comments you have:
31.Are there any circumstances in which you believe a health service must share medical information with you regardless of whether you have the consent of the consumer?
32.If you answered yes, under what circumstances do you think it would be ok?
33.Would it be useful the for the new ACT to provide clear definitions of what is meant by the following types of information:

Personal information; General Information; Diagnostic information; Service information
34.Additional comments
35.Would it be useful the for the new ACT to identify with whom personal information, general Information, diagnostic information or service information can be shared?
36.Additional comments
37.Are there circumstances where you believe having a definition of excluded persons would be beneficial to the person you love?
38.Please elaborate
39.New Mental Health and Wellbeing Commission

The Royal Commission has recommended that a new Mental Health and Wellbeing Commission is established.  This new commission will have a monitoring and regulation function.  The Royal Commission also recommended that the role and function of the Mental Health Complaints Commission are transferred to the new Commission.

How should the new Commission respond to services who don't comply with the Act?  Please tick all that apply
40.Other: please provide comment
41.What should be included when the new commission issues public reports about mental health services?
42.Should the new Commission be able to act on the concerns of family/carers/supporters/nominated persons?
43.Nominated persons

The Royal Commission has recommended that the role of nominated persons could be improved in the Act. The following questions ask about ways that nominated persons might be improved.

Should the new Act explain that a nominated person may also be a family member (by birth or choice) but not necessarily? 
44.What would the benefit of this be?
45.Should services be required to report on whether nominated persons have been involved in consumer care, according to consumer preferences?
46.The new Act might describe nominated persons in a different way.

Please tell us which of the following descriptions would improve nominated persons:
Yes, include
No, don't include
Not sure
Nominated persons sign a statement that they understand their obligations 
Nominated persons agree to express the views, preferences and values of consumers, not their own personal views and preferences
Nominated persons agree to promote consumer personal and social wellbeing and to have regard to the need to respect consumer individuality
Nominated persons agree to read and understand any advance statement consumers make 
Nominated persons agree to provide consumers with support to make their own decisions 
47.Other (please specify)
48.Second Psychiatric Opinion

The new Act might make changes to how the right to a second psychiatric opinion operates, to try and strengthen the rights of consumers.
Which of the following options do you think would improve second psychiatric opinions?
49.Other: please specify
50.If you get a second psychiatric opinion, and you give consent, should a copy be sent to:
(please select all that apply)
51.Are there other people you think this could be sent to?
52.The Royal Commission has recommended that the new Act be independently reviewed in 5 to 7 years. This review will look at ensuring the law is contemporary, effective and responsive to people’s needs. Some other recommendations to enhance human rights are suggested for this review.

When do you think this more thorough review should happen?
53.Is there anything else that you would like to tell us about what the new Act should say?
54.Final questions 
Do you consent for Tandem to use the information in this survey for advocacy purposes, including through published articles or through social media?
55.Would you like for us to do so anonymously or under your name?
56.Please provide your contact details below if you would like to be contacted for any follow up regarding this survey.
If you would like to provide any further feedback, please email us at info@tandemcarers.org.au.
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