|Title:||Community Mental Health Welfare Checks: Role of Mental Health Clinicians|
|Document ID:||Operational Directive OD 0644/16|
|Date of issue:||Thursday, 7 January 2016|
|File number(s):||F AA-24961|
|Description:||This operational directive describes the circumstances and procedures to ensure that individuals in the community who require mental health status review are seen and assessed by appropriately trained clinicians, wherever possible, rather than relying on Police to undertake this function.|
|Legal requirements:||Mental Health Act 2014
|Applicable to:||Psychiatrists, Mental Health Staff, Nurses, Psychologists, Social Workers, Occupational Therapists, Care Co-ordinators, Approved Mental Health Practitioners|
|Framework:||Mental Health Policy Framework|
|Period of effect:||from 30 November 2015 to 30 November 2020|
|Review date:||30 November 2016|
|Authorised by:||Dr David Russell-Weiz, Director General, Department of Health, 22-Dec-2015|
|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 by appropriately trained clinicians, wherever possible rather than relying on Police to undertake this function.
The Department of Health (the Department) has historically used the term “Welfare Check” in the context of community members or clinicians requesting the WA Police to attend persons in the community and ascertain wellbeing, in a variety of circumstances. Formal recommendations from the WA State Coroner to the Department of 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 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. This includes circumstances in which:
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 concerns regarding the mental state or physical welfare of a known patient with psychiatric illness in the community, a mental health clinician is to undertake an assessment.
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.
For further guidance on the delivery and implementation of this Operational Circular within services, staff are to refer queries to their line manager or, if necessary, to their Clinical and/or Executive Director.
Dr David Russell-Weiz
This circular last updated: Thursday, 7 January 2016 at 2:30pm