All active consumers of clinical mental health services must have a clinical review at least once every three months.
With the complex needs of many consumers, and strong variations in inpatient processes, incorporating consumer outcomes into a clinical review can provide an important platform for dialogue about a consumer’s symptoms and the clinical interventions available to them.
Self-assessed consumer measures also provide an important component of clinical reviews – highlighting issues related to consumers’ engagement in treatment and acceptance of their illness, as well as different perspectives and priorities around their treatment goals.
Requirements for clinical reviews
In addition to the mandated requirements of mental health review boards/tribunals and routine 91-day reviews, clinical reviews may be undertaken when a consumer transfers to another team or program in your service, or when they are requested by the consumer themselves.
Reviewing multiple consumer outcomes from the National Outcomes and Casemix Collection (NOCC) can be a helpful way of tracking changes for consumers who find it difficult to prioritise areas to focus on.
It is also helpful way of tracking changes for consumers who find it difficult to identify change and improvement, using the consumer outcomes to explore:
- what has changed or not changed, and why
- what interventions have been tried for clinically significant issues
- what alternative interventions might be tried
- what other circumstances in the consumer’s life are contributing to the measures increasing, decreasing or staying the same.
Clinical reviews are usually based on the clinician-rated consumer outcomes from the latest assessment of the consumer. Like the assessment, they should be informed by all available information, including clinical observations, information from key informants and historical documentation – as well as the consumer’s own assessment.
Types of reviews using consumer outcomes
Consumer outcomes may be used in any of the following types of review:
- multidisciplinary (91-day review, transfer or discharge)
- statutory body (mental health review board/tribunal, Office of Chief Psychiatrist)
- external agencies
- group programs
- clinical supervision
- requested by the consumer