Week 11 & 12: NSW Mental Health Act (PDF)

Week 11 & 12 Week 11: The Mental Health Act , Health Practitioner Regulation National Law Act , Privacy Act Week 12: Burnout Week 11 The NSW Mental Health Act, 2007 (must follow this law) gove...

Week 11 & 12 Week 11: The Mental Health Act , Health Practitioner Regulation National Law Act , Privacy Act Week 12: Burnout Week 11 The NSW Mental Health Act, 2007 (must follow this law) governs the care and treatment of people with a mental illness. Principles: People are entitled to the best care and treatment the least restriction of their freedom the least interference with their rights and dignity proper protection of patients as well as the public Minimizing the adverse effects of mental illness on family life  Mental Health Act applies to patients: voluntary patients involuntary patients Patients required to receive treatment in the community Informal (voluntary) Admission Formal (involuntary) admission Involves informed consent A person is admitted to or detained in hospital, or forced to accept treatment provides permission for a specific treatment against their wishes The person must also be deemed ONLY if criteria is met well enough to be able to give informed consent. Mentally ill person Mentally Disordered Person  A Mentally ill person seriously impairs, either temporarily or permanently, the mental functioning of a person and is characterized by the presence of any 1 or more ❖ Delusions ❖ Hallucinations ❖ Serious disorder of thought form ❖ Severe disturbance of mood ❖ Sustained or repeated irrational behaviour indicating that the person is having delusions or hallucinations. Criteria: Has a mental illness; AND Is at risk of serious harm to self and others. physical harm emotional/ psychological harm financial harm neglect of self self-harm and suicide neglect of others (including children) violence and aggression including sexual assault or abuse Has a continuing condition, including any likely deterioration is taken into account AND No other care of a less restrictive kind is available  A Mentally Disordered Person Criteria: Displaying irrational behaviour; AND Significant physical risk to self or others; AND No other care of a less restrictive kind is available  Formal (involuntary) admission categories Involuntary patient. admitted to or detained in hospital against their wishes Forensic patient: has committed an offence unfit to be tried or found not guilty due to mental illness ordered to be detained in a facility, or released into the community Community Treatment Order (CTO): A CTO is a legal order made by the Mental Health Review Tribunal, a magistrate or a suitably qualified person in a hospital or community based service. A CTO is valid for 12 months. It sets out the terms which a person must accept medication, therapy, rehabilitation or other services ordered when (a) the person is currently mentally ill (b) the person is not currently mentally ill, but is judged by a suitably qualified practitioner to be likely to become mentally ill within 3 months, (c) a CTO is judged to be the least restrictive alternative for treatment.  5 Ways a person is Formally Admitted ‘Scheduling’ by Medical Practitioner(s). The practitioner fills out Schedule 1 of the Mental Health Act (2007). Valid for 5 days if Mentally ill valid for 1 day if Mentally Disordered Admission by Police or by Ambulance Officers. Especially for Forensic Patients or where the person is at risk of self-harm or other-harm. Admission at the request of a designated carer, relative or friend. Occurs ONLY in remote areas Only by written request to the medical superintendent of the hospital; Admission by Order of the Court when a person appears before a magistrate and is judged mentally ill Admission following an order by a magistrate for a medical examination.  Mentally disordered person Mentally ill person Examined within 12 hours of admission; Examined within 12 hours of admission; 2nd examination 2nd Examination Mental Health Inquiry by Tribunal ASAP Mental Health Inquiry by Tribunal ASAP after 2nd after 2nd examination; examination Can be detained for up to 3 days Tribunal can recommend Involuntary Admission for up to 3 months Must be examined every 24 hours by an OR a authorised person; Community Treatment Order for up to 12 months; Must be discharged if no longer mentally disordered. If still considered mentally ill after this period, must be reviewed by Tribunal, who can make further orders for 3 and 12 months  Mandatory reporting child safety in NSW mandatory to report child 0 to 15 years who is at risk of significant harm Report to NSW Child Protection Helpline and Child Wellbeing Units (CWU). CWU can help where harm not ‘significant’ Not mandatory for unborn children or children 16 or 17 — these under Dept Communities & Justice jurisdiction AHPRA PBA Mandatory reporting Health Practitioner Regulation National Law Act 2009 (National Law) requirements for registered health practitioners, employers of practitioners and education providers practitioners notify the Australian Health Practitioner Regulation Agency (AHPRA) if they believe that another practitioner presents a serious risk to the public Notifications made to the Australian Health Practitioner Regulation Agency (AHPRA) AHPRA then refer it to the appropriate Board (e.g. Psychologists Board of Australia) A notifiable conduct where a practitioner has practiced while intoxicated by alcohol or drugs; or engaged in sexual misconduct with clients placed the public at risk of substantial harm because the practitioner has an impairment; or placed the public at risk of harm because the practitioner departs from accepted professional standards.”  Privacy Act 1988 13 Australian Privacy Principles (APPs) APP 1 — Open and transparent management of personal information APP 2 — Anonymity and pseudonymity give individuals the option of not identifying themselves APP 3 — Collection of solicited personal information Outlines when an APP entity can collect personal information that is solicited. APP 4 — Dealing with unsolicited personal information APP 5 — Notification of the collection of personal information Outlines when and in what circumstances an APP entity that collects personal information must notify an individual of certain matters. APP 6 — Use or disclosure of personal information Outlines the circumstances where personal information can be used or disclosed APP 7 — Direct marketing APP 8 — Cross-border (overseas) disclosure of personal information APP 9 — Adoption, use or disclosure of government related identifiers APP 10 — Quality of personal information ensure information is accurate and up to date APP 11 — Security of personal information protect personal information from unauthorised access, modification or disclosure. APP 12 — Access to personal information requirement to provide access APP 13: Correction of personal information  Week 12 Ongoing Professional Development As a registered psychologist 30 hours Continual Professional Development (CPD) required each year Must include 10 hours of peer consultation (i.e. supervision) each year Documented in a log book Providing peer consultation to another person counts as CPD hours but CANNOT be counted towards one’s own 10 hrs of peer consultation Supervising interns does not count towards CPD CPD portfolio: A learning plan (including desired outcomes) How the CPD relates to the psychologist’s professional development All CPD activities undertaken (including proof: receipts, invoices, certificates etc.)  Types of Continual Professional Development (CPD) Conducting or attending psychology lectures Writing, assessing, or reading articles, books Producing or viewing videos or audios Providing peer consultation to another psychologist Active CPD Recommended to have 10 hours Not mandatory Active training through written and oral activities that enhance or test learning Seminars with a written test Role playing Providing peer consultation to others  Approved areas of practice To maintain endorsement in an approved area of practice: 15+ of the 30 hours must be within the endorsed area If endorsed in 2 areas, 15 hours for each area are required. Punishments for non-compliance can include: Refusal of registration Registration will be renewed once completion of specified CPD activities Must undergo performance assessment Must undergo an examination  Self care For psychologists and counsellors, our tools of trade come from the self: knowledge experience empathy, communication Poor self-care can affect: Motivation judgement; regard for others Self-awareness Our capacity to think clearly and to solve problems Our capacity to deal effectively with our feelings  Maslach and colleagues 3 dimensions of burnout Exhaustion Cynicism Ineffectiveness Stress, anxiety, worry Increasing Feeling ineffective callousness/cynicism Impacts Being ineffective cognitive capacity and Depersonalisation causes withdrawal of the client Self-protective mechanism. Emotional/cognitive distancing  Gabriela Tavella (2023) 6 Dimensions of Burnout 5 factors; also measures unsettled mood Exhaustion Loss of empathy Maslach’s 3 dimensions Impaired work performance Cognitive impairment Withdrawal and insularity Unsettled mood  Sydney Burnout Measure Exhaustion I lack energy across the day I am not refreshed by my sleep Loss of empathy I struggle to understand the feelings of others I care less about people with whom I work Impaired work performance I cannot get pleasure out of my work I no longer feel as driven to meet my responsibilities I am less productive at work Cognitive impairment symptoms I cannot concentrate because of foggy thinking I take longer to finish tasks at work I feel slowed down mentally (e.g., hard to find words, slowed thoughts)  Withdrawal and insularity I keep to myself I do not look forward to spending time with family and friends anymore Unsettled mood I feel emotionally drained I spend much of my day worrying I feel self-critical and am hard on myself I feel sad, empty and hopeless Can experience symptoms without having burnout pattern of symptoms is important  Factors that influence burn out Situational factors Type of occupation Working conditions Overload Insufficient resources (physical, social, supervisory) Nature of employer Not fair, just, or equitable Mismatch between your values and employer’s values  Mismatch theory Maslach (2000) burnout is far more likely when there is a mismatch between the employees needs/capacity and working conditions in the following 6 areas 1. Workload amount, type (does it match your skills, abilities, interests, personality, morals?) 2. Control – over resources, decisions. Are responsibilities possible given resources? 3. Rewards – financial, social, intrinsic 4. Community – cooperative; respectful; enjoyable vs isolating, conflict prone? 5. Fairness – how management handle ‘cheaters” 6. Values – asked to be unethical? Poor organisational values  Factors within the person that influence burnout Demographics Age: young are more at risk ( greater burnout Personality Likelihood of burnout is greater for those who have: Low hardiness External locus of control (Fate controlled by outside forces) Poor coping styles Low self-esteem 'stress prone individual' high in trait anxiety, hostility, depression, self- consciousness, vulnerability Those prone to emotional instability and psychological distress Type A personality types 'Feeling' rather than 'thinking’ types in the Jungian typology Attitudes higher expectations are possibly more at risk of burnout  Combating Burnout Change organisation Promote job engagement Job engagement is characterized by: Energy feelings of effectiveness involvement, enthusiasm, inspiration Actively promote well-being for staff Reduce mismatches between employee and job  Change individual Self-care strategies generally related to the exhaustion component of burnout. Stress inoculation training Interpersonal and social skills training Relaxation training Time management training Meditation Personal strategies ❖ Peer support and other social support vital ❖ Prioritize recreation and recovery rather than ‘fit it in to a busy schedule’ ❖ Ongoing education and training maximizes feelings of (and actual) effectiveness ❖ At work – exercise, time alone, regular short breaks, debriefing with peers ❖ Personal counselling and therapy