Carers identified?

4.1 Context

Page last updated: 2010

Australian policy and legislation support carers as partners in the delivery of services to improve outcomes for people with a mental illness.

The contribution that carers make to the support and care of people with mental illness was recognised by the Australian Government in the Mental Health Statement of Rights and Responsibilities (1991). This document, together with the National Mental Health Policy (1992, revised 2009), has been the cornerstone of the National Mental Health Strategy since its inception in 1992.

The Mental Health Statement of Rights and Responsibilities acknowledges that caring and advocacy roles are complex and the relationship between carers and consumers can change frequently and may also vary according to the age of the consumer. The following statement, taken directly from the document, talks of the rights of carers but can only be fully realised through a process of identification:

"With the consent of the consumer, carers and advocates are entitled to:

  • have access to the consumer;
  • be consulted by service providers about measures under consideration for treatment of the consumer or for his or her welfare;
  • arrange support services such as respite care, counselling and community nursing facilities;
  • exchange information with those providing treatment concerning the consumer's lifestyles and their relationships with others."
Page 17, Mental Health Rights and Responsibilities, 1991

The document also acknowledges that there may be circumstances where the consumer is unable to give consent or may refuse consent because of their disturbed mental state. In such cases it may be appropriate for service providers and carers to initiate contact and involve those who may be able to assist with the consumer's diagnosis and care. Top of page

"Carers and advocates have the right to put information concerning family relationships and any matters relating to the mental state of the consumer to health service providers.

Carers and advocates have a right to help with their own difficulties which may be generated by the process of caring for or acting as an advocate for a person with a mental health problem or mental disorder."

Page 17, Mental Health Rights and Responsibilities, 1991

This Statement has been flagged for review as part of the Fourth National Mental Health Plan – An agenda for collaborative government action in mental health – 2009 – 2014.

A number of activities at national, state and territory levels have occurred in recent years that mandate carer engagement in all levels of service delivery. These changes include:

  • Development in some states of state based Carers Recognition Legislation;
  • Development of the national Carer Recognition Act 2010;
  • Development of a specific Carer Standard in the revised National Standards for Mental Health Services, 2010;
  • Revision of mental health legislation in some States and Territories to mandate identification in a variety of forms;
  • Revision of the National Mental Health Policy (2009) and funding of the Fourth National Mental Health Plan, (2009–2014); and
  • Publication of the RANZCP Guidance Notes, Involving Families, 2000.
In addition, the 2007 National Mental Health Survey brought to government attention the significant size of the population caring for people with mental health problems and mental illness. This survey found 40% of the adult population have at least one relative with a mental illness and 15% of the Australian adult population (approximately 2.4 million individuals) provide care for one or more people with a mental illness.

These carers provide a range of emotional and practical support to people who may be unlikely to access support elsewhere. This support makes a crucial difference to the wellbeing, ability to cope and likelihood of recovery of the person with the mental health problem or mental illness. Top of page

The size of the carer population and the impact that the caring role has on people was reinforced by data contained within the 2009 Report on the Inquiry into better support for carers, Who Cares...? undertaken by the House of Representatives Standing Committee on Family, Community, Housing and Youth.

The revision of the National Standards for Mental Health Services, 2010, has resulted in the development of a specific carer standard. Standard 7 states:

'The Mental Health Service recognizes, respects, values and supports the importance of the role of carers to the wellbeing, treatment, rehabilitation and recovery of people with a mental illness.

In the context of this Standard 'carer' refers to family members or friends of people with a mental illness whose life is affected by the mental illness and includes the partner, parent, friend or child of the consumer.'

The needs and rights of carers of people with a mental illness have been very comprehensively described. Following such comprehensive description one would expect a plethora of information and activities designed to meet these needs. This does not appear to be the case and while some States and Territories have developed guidelines for consumers, family carers and mental health professionals to work together in collaboration and partnership few changes have occurred at a practical level. Many would argue this relates to lack of processes to identify who carers actually are.