States and Territories in their policies support the position that 'Carers are partners in the provision of healthcare to those they care for. Identifying and supporting them is a sound investment in continuity of care.'
Some jurisdictions have developed practical Guidelines on how to work with carers. However, it is difficult for these guidelines to be implemented in the absence of mechanisms to identify carers and to seek permission from consumers for the involvement of their carers in ongoing care.
These documents support involvement of carers at both individual and organisational levels. Over this period there has been an increase in consumer specific activity at local and state levels. However, opportunities for carer participation in activities that impact on them at local and state levels have not continued to develop in the manner initially hoped.
At the individual care level the policies require carer participation in all aspects of care with the consumers consent or at the clinician's discretion in certain circumstances such as involuntary detention. These policies require that services assist carers to manage their caring role and the impacts of mental illness on them and their family.
The policies also recognise carers as key stakeholders in the planning, development, delivery and evaluation of mental health services at a system–wide and local service level. Some distinct policies and programs exist in some states and territories including the one–off training of variable length and content offered to mental health staff to assist them to engage with carers. These programs have positive impacts, but generally appear to lack the capacity to reinforce practice changes though follow–up training, in–service sessions or consultation.
Feedback from carers indicates that both public and private mental health systems have been slow to implement these policies.
Engagement of carers to enable the implementation of legislation, policies and programs continues to be dependent on:
- Identification of the carer by the consumer;
- Self identification as a carer; or
- Identification by a service provider.