Page 3838 - Week 11 - Wednesday, 25 September 2019
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In 2016, given the significant changes that had taken place in the mental health sector in the wake of the NDIS rollout and also the Capital Health Network commissioning psychological services in a stepped care, best practice mental health service redesign, the ACT Health Directorate undertook a review of mental health services to see that what was currently being funded was achieving the best possible outcomes for the community. In 2016 a one-year contract renewal was agreed with the doctor, with the intention of reviewing the services provided. This contract review was necessary, and important, to understand how this service fitted into the broader mental health service delivery, met quality and safety standards and accountability and transparency requirements.
In August 2017 officials from the mental health policy unit visited the doctor to discuss her end of year report and, following this, her contract was extended until June 2018. In this meeting questions were asked in regard to where the doctor was receiving her referrals from, the model of care and episode of care used when assisting clients towards their recovery. Officials learned in this meeting that no referrals had been made to the specialist’s service by any of the ACT mental health or health services, nor from the Deaf Society, for many years. This meeting highlighted the need to set clearer parameters on how this service would engage with clients to ensure that it is working with them to facilitate their mental illness recovery and rehabilitation and to teach the skills and coping strategies needed to keep them well and improve their overall mental health and wellbeing.
This is a requirement for any government-funded mental health service. All services are required to have criteria for service eligibility; provide comprehensive details on the model of care used when working with clients and participants; and give an indication of the care plan, which will provide evidence that the psychological interventions used to treat a person’s mental illness will achieve an improved psychological state and see symptom reduction, particularly whilst engaging in the service.
As this doctor had not received any referrals from Canberra Health Services and had not provided any evidence-based methods for working with her client base, the Health Directorate had some concerns. Subsequently, the executive branch manager, who is a trained psychologist, and the principal psychologist of the mental health, justice health and alcohol and drug services met with the doctor in late November 2017 to discuss the service provision and amend the contractual agreement. This series of meetings came from a genuine place of inquiry to ensure that the deaf community were receiving the best possible mental health care and also to ensure the accountability of public spending. The directorate also wanted to learn more about the nature of the clients being seen, what their mental health concerns were, the interventions and methods used to address their psychological concern and measure the success and positive outcomes from visiting the service.
It was not actually clear to the directorate that all the clients being seen by this doctor had a diagnosable mental illness or mental health concern, nor that all clients were deaf or deafblind. In addition, the doctor was seeing clients from outside the ACT in the space provided to her by ACT Health. Unfortunately, the doctor decided to cease
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