Carers identified?

6.4.4 Discharge process

Page last updated: 2010

Decisions and discussions regarding discharge need to focus on practical issues regarding availability of ongoing care and support, accommodation, future appointments and linkages to other services. This discussion presents a further opportunity to identify carers and to emphasise to consumers the importance of continued support for their recovery.

When undertaking these discussions staff need to be aware that carers may not view themselves as carers, but as partners, parents, sons, daughters etc. It may even be that young children will be taking on the role of carer. If this is the case, special provisions may need to be made including the development of Ulysses Agreements. Ulysses Agreements are a type of Advance Directive developed specifically for use in situations where young children are either cared for, or carers of, a person with a mental illness.

It is important that carers feel fully involved at all stages of care, including the decision to discharge the consumer. This is a process of handing over care and carers are critical partners in this process. Time should be allowed for carers to make choices about:

  • Taking on, or continuing to fulfil the role of carer; and
  • How much and what type of care they are prepared to provide taking into consideration family and caring commitments, their health, work, education and social activities.
Some people feel they have no choice in this matter even when their personal and physical resources have been exhausted, where they are afraid of the consumer, or where the consumer continues to refuse to acknowledge the role they play. This is an untenable situation for carers who self identify, and the National Standards for Mental Health Services and Carer Recognition Legislation now require services to listen to concerns and refer for support to meet the needs identified.

As part of the discharge process/referral back to a GP, or community service it is also essential that carers have sufficient information to undertake their role following discharge. The Information pack developed as part of this project covers most situations they are likely to encounter. It is also important for them to have information regarding the specific diagnosis, if one has been made, and the medication prescribed, including possible side effects. The name and phone number for a person for them to contact if they are concerned is essential. Top of page Suggested national protocols for identification of carers during discharge processes

It is recommended that the following protocols to identify carers during formal discharge processes from specialist mental health services are distributed widely to public and private sector services for feedback regarding the feasibility of introduction on a progressive basis.
  • Generic information encouraging self identification by carers is provided in waiting areas on electronic and paper notice boards including posters and leaflets.
  • Colour coded forms requesting consumers to identify carers and the level of involvement they want them to have be checked for completion.
  • Ensure carers have personalised information packs including:
    • Diagnosis;
    • Medication – dosage, purpose and possible side effects;
    • This is what you can expect;
    • Who to contact to discuss concerns; and
    • What supports are available to you locally, eg your GP, Carers Australia, ARAFMI.
  • Encourage the routine identification of carers, including children, in the development of relapse prevention plans emphasising the benefits of information sharing and support.
  • A specific member of staff be allocated responsibility for maintaining the Service's procedure for identification of carers and support.
  • Ensure accreditation and reporting systems incorporate the National Standards for Mental Health Services and in particular Standard 7 relating to the identification and participation of carers at all areas in service delivery.
  • Discharge letters, with the permission of the consumer and the carer, to identify carers, their willingness to continue in this role and an outline of potential support required.
  • Services to undertake regular satisfaction surveys regarding their level of engagement with carers.