|Title:||Community Mental Health Welfare Checks: Role of Mental Health Clinicians|
|Document ID:||Operational Directive OD 0556/14|
|Date of issue:||Wednesday, 3 September 2014|
|Status:||NO LONGER APPLICABLE|
|File number(s):||F AA-24961|
|Description:||This Operational Directive is to ensure individuals in the community requiring mental health status review are seen and assessed by appropriately trained clinicians.|
|Legal requirements:||Coronial recommendation
|Applicable to:||This Operational Directive is applicable to all WA Health services, agencies and entities.|
|Period of effect:||from 5 August 2014 to 5 August 2019|
|Review date:||5 August 2019|
|Authorised by:||Dr Shane Kelly, A/Director General, WA Health, 12-Aug-2014|
|Print version:||View print version|
Community Mental Health Welfare Checks: Role of Mental Health Clinicians
This Operational Directive is applicable to all WA Health services, agencies and entities.
This Operational Directive is to ensure individuals in the community requiring mental health status review are seen and assessed, wherever possible, by appropriately trained clinicians, rather than a reliance on Police to undertake this function.
The term “Welfare Check” has been used historically in the context of community members or clinicians requesting the WA Police attend persons in the community and ascertain wellbeing, in a variety of circumstances. Formal recommendations from the WA State Coroner to WA Health have highlighted the need to ensure that acute community assessment of a person with mental health issues is primarily the remit of clinicians with appropriate mental health experience and training. It is not routinely a responsibility for Police to undertake alone. A Police welfare check does not replace an assessment by an appropriately trained clinician.
Community Outreach by Mental Health Clinicians
There are many circumstances where a mental health service staff will have legitimate concerns about an individual who is in the community and where community outreach is appropriate. This may include, but is not limited to circumstances where:
As well as a potentially deteriorated mental state or risk (suicide/aggression), concern for welfare may also extend to physical illnesses for this cohort.
In all instances, it is good clinical practice for mental health staff to contact the patient and suitable family/next of kin. If initial contact cannot be made, or is inappropriate to be made via telephone or electronic means, Mental Health Services are to ensure that there is a process in place for the timely assessment of the patient by mental health clinicians in order to clarify the need for specific psychiatric or medical intervention.
In such circumstances Community Mental Health Services from the relevant region/catchment in WA will actively assist Inpatient Mental Health Services in the provision of timely community outreach, with mutually agreed prioritisation.
Requests by Mental Health Clinicians for Assistance from Police or Ambulance Services
In most circumstances, mental health clinicians will manage a person requiring assessment, examination or treatment through internal clinical guidelines and procedures.
However, when a mental health clinician has serious and significant concerns about the current welfare of a patient, but checking on the person poses a risk to the clinician or to any other person present it may be appropriate for them to request Police assistance where:
In instances where the matter is an emergency, i.e. the equivalent of a “000” emergency, and it is clear that Police can reach the person first;
In regional or remote settings where there may not be a mental health clinician permanently stationed in the area, or where there are no designated after-hours outreach mental health services such services require a clearly articulated local arrangement for persons requiring a welfare check, which is documented and understood by all relevant parties.
If mental health staff have concern regarding the mental state or physical welfare of a known patient with psychiatric illness in the community, assessment is to be undertaken by mental health clinicians.
In situations where Police or Ambulance are required to attend, mental health clinicians are to provide all appropriate assistance to WA Police, Ambulance, the patient and the associated family/carers.
The Office of the Chief Psychiatrist is available to provide advice in the delivery and implementation of the work of this Operational Circular. Telephone contact: 9222 4462 Dr Nathan Gibson is the Chief Psychiatrist.
Dr Shane Kelly
This circular last updated: Wednesday, 3 September 2014 at 2:29pm