Page 2850 - Week 09 - Wednesday, 17 September 2014
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As members would also know, we are currently in the process of designing the new 25-bed secure mental health unit and mental health inpatient rehabilitation and day services which will be provided at the University of Canberra public hospital. Other work also underway at the moment is a review of the child and adolescent mental health service model of care, which has been undertaken. The alcohol and drug service is also currently reviewing its inpatient model of care to inform planning and design of a specialised inpatient unit as part of the broader redevelopment of the Canberra Hospital.
In terms of the model of care—Mrs Jones touched on this—ACT Health is developing a comprehensive service model for adult mental health services that encompasses and integrates community-based, subacute, acute, inpatient and emergency department care. This work is ongoing. As one of the last components of our adult mental health service model, the community-based components of our service system need to be redesigned to meet demand and address service gaps. So there is a lot of work happening around models of care, and the model of care does influence some of the issues that have been raised by staff in the Adult Mental Health Unit.
I will go to the issues around what happens when someone comes into the acute mental health system. If a person presents to the Mental Health Assessment Unit experiencing a mental health crisis, an assessment of that person’s mental health is undertaken and a treatment plan is developed. That plan includes the option for discharge to community care or family home or for admission to the adult mental health unit. The adult mental health unit is a gazetted inpatient facility which provides acute mental health treatment and care for people, including those subject to the Mental Health (Treatment and Care) Act 1994. The adult mental health unit provides an environment for people who are in the most acute phase of their mental illness.
Staff working in this unit, in the inpatient unit, are often providing care to people who are complex and challenging both in terms of their illness and their behaviour. Episodes of aggression and violence are experienced in varying degrees and frequency in mental health units worldwide, and I think Mrs Jones confirmed that in some of the content of her speech. People admitted to these units are often experiencing acute psychological distress, which in some instances leads to severe behaviour disturbance requiring acute management and containment.
The assessment and management of aggression and violence is a dynamic process and it requires a high level of clinical skill in order to ensure that compassion for the person is balanced with sound clinical care and environmental safety. Unfortunately, as I have indicated before, from time to time there are incidents of violence and aggression within these units.
All people who are admitted to the adult mental health unit have formal risk assessments completed as part of their comprehensive mental health assessment process. Using a tool, the clinical risk assessment is undertaken to monitor the risk profile and it is reviewed by the treating team, and the observation schedule is determined based on the outcome of that clinical risk assessment.
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