What is a designated mental health service?
A designated mental health service is a health service that may provide compulsory assessment and treatment to people in accordance with the Mental Health Act 2014 (Act).
Compulsory assessment and treatment may be provided in a range of settings including mental health inpatient units, emergency departments, medical and surgical units (whenever they are providing concurrent medical and mental health treatment) and the community.
Which services are designated mental health services?
A list of designated mental health services is provided in table 1
below. They are health services that have been prescribed in the Mental Health Regulations to be a designated mental health service, plus the Victorian Institute of Forensic Mental Health.
When is a person ‘received’ at a designated mental health service?
The Mental Health Act enables a person subject to an Inpatient Assessment Order to be taken to and detained in a designated mental health service. Detention commences when the person is ‘received’ at the designated mental health service.
In many cases a person subject to an Inpatient Assessment Order will be taken to the emergency department of a designated mental health service. The timing of when the person is received at the designated mental health service is important because the person must be assessed by an authorised psychiatrist within 24 hours after they are received at the service. Consistent with the principles of the Act, this time should start when the person is first received at the premises of the emergency department. The time of reception is not conditional on the person being seen by a mental health practitioner.
Where are restrictive interventions regulated?
Part 6 of the Act regulates the use of restrictive interventions (bodily restraint and seclusion) on a person receiving mental health services in a designated mental health service.
For the purpose of determining whether a person is receiving services ‘in’ a designated mental health service and whether Part 6 of the Act applies, it will be those places or premises where people with mental illness are taken and detained for compulsory assessment or treatment in accordance with the Act. This will include acute mental health inpatient units and secure extended care units operated by the designated mental health service. It will also include emergency departments where the person is subject to an Order under the Act (excluding people apprehended by police under section 351).
While people with mental illness may receive mental health services in prevention and recovery care (PARC) services, community care units (CCU) and other residential services operated by a designated mental health service, they are not detained for assessment or treatment in these places and as such they are not receiving services ‘in’ a designated mental health service for the purposes of the Act and the regulation of restrictive interventions.
What is the role of general clinical staff in the designated mental health service?
All clinicians working in the designated mental health service may have a role providing assessment and treatment for people with mental health needs, including clinicians working in emergency departments and general medical and surgical units.
For example, emergency departments have a significant role in providing treatment and care to people with mental health needs, including people presenting with mental illness, behavioural disturbances associated with substance use and people brought to the emergency department by police under section 351 of the Act. Registered medical practitioners working in emergency departments will assess people who appear to have mental illness and may make Assessment Orders under the Act where required.
General health clinicians working in the designated mental health service are supported in their role by mental health clinicians located in emergency departments, consultation-liaison services, off-site community mental health teams, on-call clinicians and mental health triage services.
A collaborative approach between general health clinicians and mental health clinicians is critical to ensure timely access to mental health assessment and care for people with mental health needs. It is expected that health service management will implement policies and protocols to clarify responsibilities where clinical staff may have overlapping responsibilities.